- The Washington Times - Thursday, January 22, 2004

There is good, even great, news for families whose daughters suffer from eating disorders. The complex illness — with psycho-social and genetic triggers — is better understood and more effectively treated with a combination of therapy and an expanding range of medications. Recovery is still a long and difficult process for those with the illness. But success is more certain, and with much of medical science, treatments are becoming increasingly individualized and based on a rapidly emerging body of evidence of what works at a personal and even genetic level.

I know, and my daughter Sara, who has struggled with bulimia for eight years, knows. Today, she is on the road to recovery, thanks to a mix of new medicines, caring therapists, savvy specialists, her own courage and my ability to set aside tax-free money that I used to pay for the best care possible. The insurance companies were rarely so generous. The first time Sara was hospitalized they stopped payment after a week and terminated outpatient coverage a week thereafter. As long as Sara wasn’t vomiting in the hospital, they wouldn’t pay. They didn’t care if she didn’t have the ability to recover. A year later, as she told me, she would rather die than eat again. A year later, paying for half of her care with money in my medical savings account, I was able to access the best care possible.

Sara was lucky. One of her friends in the Princeton hospital eating disorders program had a perforated stomach from so much vomiting. Against the medical advice of her doctor, her insurance company kicked her out after a week. Her doctor — one of the nation’s experts in treating bulimia — had not yet found the combination of medicines to control her disease (people with eating disorders often grapple with a combination of manic depression, anxiety and depression, as well as the illness itself).

Democrats will cry that insurance companies should be forced to cover the cost of such diseases. And believe me, I am the first to feel the tug of anger, having fought the insurers on behalf of my daughter. But I also realize that our current approach to paying for health insurance, forged in an industrial age when medicine could do very little and was designed to pay for the occasional trip to the hospital, is outdated. And so is the approach to controlling cost. In its present form — handing money over to insurers who look backward to determine what to cover, when we are moving forward in medicine faster than ever toward better and more personalized care — insurance is like having our employers buy typewriters and telegraphs in bulk to allow us to communicate and be creative in a digital age.

It is painfully apparent to me as well that the more we move toward greater government involvement in health care financing and cost containment, the more intense is the desire to both control and ultimately attack the very source of hope and better health that is at the heart of modern medicine. The insurance companies and government programs with their formularies, technology review committees and prior authorizations would have summarily delayed and denied my daughter access to the medicines that are making her well. They are drugs being used in a novel fashion, they are new and they are expensive. They are, therefore, hated and hunted by the bureaucrats, the politicians and the candidates. And they and their proposals for universal care that would control costs by limiting access or imposing price controls have nothing but dire news for Sara and others in the Princeton eating disorders program.

But President Bush has a better and more compassionate way. If his bill passes, low-income people will have the opportunity and choice to buy insurance, save for health care and deduct the full cost of insurance premiums. I will be able to invest directly in keeping my daughter alive, and millions of other families will be able to accumulate billions that will ultimately force insurers to deal directly with our doctors and us in providing more compassionate and cost-effective care for people with eating disorders.

There are too many great things happening on the medical front for me to wait around for a regulatory solution, and I know that any universal health solution will fail here. In Canada and Britain, bulimic women are given self-help pamphlets and sent away. Universal care is a death sentence, and that is what Democrats offer my daughter, as far as I am concerned.

By contrast, under the president’s proposal, millions of children like my daughter will have the chance to obtain the best care possible for devastating and life-ending illnesses like bulimia, bypassing insurance companies and government-run programs that ration access to cutting edge cures in the name of universal care. The forces that oppose the Bush plan wish to maintain a determined death grip on medical decisions that I, as a parent, should and must make to keep my daughter alive.

I now see a glimmer of hope that my daughter’s destiny can be controlled by her caring doctors, by me and by what the next generation of drugs can offer — not Ted Kennedy, not insurance bureaucrats and not some public housing equivalent of health insurance that liberal think tanks would shove down her throat. Under the Bush plan, I can finally hope that I fully can save and invest in what matters most to me, my daughter’s life. That’s a difference worth fighting for.

Robert Goldberg is director of the Manhattan Institute’s Center for Medical Progress.

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