Autism Treatment: Buying Hope
Over at Marginal Revolution, Tyler Cowen has an interesting post up about the economics of autism treatment.
Yesterday, we talked a bit about the cognitive roots of the vaccines-cause-autism myth. Well, seeking treatment for autism is another area where reason takes a backseat to emotion. I can’t claim to be any sort of expert on the treatment options or their effectiveness. But a rule of thumb is that when there are a hundred treatments for something, it’s because none of them work. There are hundreds of treatments for autism.
So, Cowen treats autism as a case study in what happens to a health-care market when third-party payers are taken out of the picture. The usual claim, of course, is that third-party payment inflates health-care costs by insulating the consumer from the true price of the services he or she is consuming.
Insurance — private and government — doesn’t tend to cover autism treatment (because it doesn’t work). So, does this lead to a well-functioning market? Cowen paints this picture of the autism-treatment market:
1. Services are not especially cheap nor do they seem to be falling in price.
2. Market participants are not well informed about what works. Many parents of autistic children pursue hopeless treatments or unvalidated or even refuted theories. Some of the treatments, such as chelation, are harmful in many cases and yield no benefits.
3. There is lots of innovation — in terms of advertised methods of treatment — but it is unclear, to say the least, what percentage of these innovations succeeds. Very often it is parents “buying hope.”
This is an important point. As Cowen puts it, “the more emotional the issue, the less effective any health care system will be.”
I do believe that third-party payment is a big problem. But even as a libertarian I have serious doubts about how well health-care consumers can make these sorts of decisions. The more untreatable something is, the more people will be willing to throw good money after bad at quack cures.
I don’t have any answers, but Cowen has another good question: Would a Democrat’s ideal government health-care system cover any of these treatments? Is making this a political decision much better than making it an emotional personal decision?
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So yesterday’s thread you had us rally for science, and now you’re asking us if we will pay for non-science based treatments. The answer is no. Govts should only shell out the bucks for that which can be supported by science. If not, how or where do you draw the line?
I’d be pretty horrified to see government (or really even private insurance) shelling out for most of the quackery involved here.
But have a rally of parents of autistic children at the Capitol, and suddenly it might just be covered. Politics is an emotional thing.
In response to another comment. See in context »Mix parental emotions with a disorder that is broadly defined, misunderstood, and (at this time) uncurable, add the Internet, and the result is a golden age for snake-oil salesmen. Easy access to anecdotes presented as clinical proof lead the scientifically naive down the road to ruin, sometimes even death (e.g., the 5-year old who died from chelation therapy that would supposedly cure him).
We need a skepticism pill or, barring that, more websites like quackwatch.com
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