Many in the Keystone state wonder why health care is so expensive, even though more people become uninsured every year. According to Michael Moore’s new movie, Sicko, it’s because the government doesn’t command enough of the spending. Take the money away from private insurers, he says, and everything will be fine. But Michael Moore’s got it wrong.

Government already controls most health care spending in the United States; it’s just found a way to keep it "off the books." And Pennsylvania is now witnessing runaway government at its worst, eager to impose costs on individual citizens in order to appease a highly committed interest group.

Governor Rendell has urged the House to pass quickly a bill levying a "hidden tax" on Pennsylvanians, by compelling those with private insurance to pay for autism treatment costing $36,000 per year, and increasing annually.  The Senate has already passed the bill unanimously. By the way, in Canada’s government monopoly health care, praised by Michael Moore as "universal," autism treatment is not covered.

Until recently, only 10 states mandated that costs of autism treatment be covered by the privately insured, but committed autism advocates have ramped up the pressure nationwide. Recently, the South Carolina legislature unanimously passed a bill similar to Pennsylvania’s.

Relatives of people diagnosed with autism comprise a highly effective lobby for their loved ones’ interests. Autism is not diagnosed by lab tests but through physicians observing patients’ speech, responses to touch, and other behaviors. Even more challenging, autism is now defined as a "spectrum disorder," whose boundaries have blurred beyond initial definition. Scholars have suggested that the autism "epidemic" is, at least partly, a re-classification of behaviors previously labeled differently, such as "learning disabled." But it is the other end of the spectrum that shocks.

A federal court recently began a trial concerning the scientifically unfounded idea that a certain vaccine additive causes autism. According to a reporter covering the trial, a twelve-year-old girl "was rolled into the courtroom in a wheelchair at the start of the hearing. She wore hearing protection similar to that worn by heavy-machinery operators. She hit herself repeatedly and made loud grunting noises. Her parents soon rolled her out."

This mystery and tragedy of autism caused Pennsylvania’s state government to launch an autism task force in 2003 that resulted in a new agency, the Bureau of Autism Services, with a broad mandate to address the issue.  Mix this new and energetic government bureaucracy with a well-organized lobby of patient advocates and the predictable result is a "perfect storm" of calls for more money for autism.

Amazingly, Pennsylvania’s politicians are eager to levy this hidden tax on you without even knowing how much it will cost. According to Nina Wall-Cote, Director of the Bureau of Autism Services, her first objective is to "resolve the basic question: How many people in Pennsylvania have Autism Spectrum Disorders?" The answer will doubtless be: "Many more than we thought."

According to the Centers for Disease Control & Prevention, one in 150 children has autism. These children grow into adults, so let’s assume that ratio for the entire population. That means around 83,000 Pennsylvanians would fit the diagnosis. With mandated treatment of $36,000 per patient, the state is about to impose a hidden tax of $3 billion on privately insured Pennsylvanians.

Forcing privately insured Pennsylvanians to bear the cost of autism treatments that politicians decide are appropriate is an abuse of health insurance. Every year, private insurers add coverage of often expensive and controversial new treatments, such as the Human Papilloma Virus (HPV) vaccine for cervical cancer, because they believe their beneficiaries demand and value them. But treatment mandates imposed by state power increase the cost of health insurance beyond that, and are an important reason why more Americans go without health insurance. 

There is a better solution, but it causes pain for politicians rather than the privately insured. If they really believe that these autism treatments should be subsidized, legislators should do so explicitly, and put the costs in the state budget so that Pennsylvanians can inspect them in daylight.