The ethics of price gauging special needs families

[Anonymous]

I'm not sure if this is the right title. I understand professionals deserve to make a lot for their work and special needs children are more work. I know "price gauging" is strong language, but I also have many years of experience with this. I just can't help but comment on what we have been through sometimes even with talented professionals. The cost gets high enough I am unimpressed with what we get. Yes, I know their costs go up too, but I almost wonder how can some sleep at night if they do not follow through with the promised service as the prices skyrocket. Over the years...

-Had an amazing developmental pediatrician who took our insurance. We accepted that he could never get reports done and if we really needed it, we would be calling over and over and emailing and sometimes ignored, but he was fantastic in every other way. Then he went off our insurance. We paid top dollar, and he still could not get the report done, yet his prices kept going up.

-Had a top-notch PT-same thing. We overlooked a lot because she took insurance until she didn't. Prices kept going up, but still ran late, ended early (not just early to meet with parent-sometimes extra early because she had her own appointment), canceled last minute, could not get paperwork we needed done, etc.

-Had an ST who came to our home and was OOP-charged a fortune. Very impressed the first year and saw some decent progress the second, but each year price went up and service went down-no show for appointments or late, frazzled, canceling last minute, etc. Finally had to end services.

-The school system has done decent to lousy educational assessments, but at least they are free! When the reports were decent, I let the people in power know and did everything I could to reinforce. The times we have paid we are talking thousands of dollars I am stunned when I see the wrong name inserted or scores in the summary that do not match the discussion of the same scores. I know it's a business and that money pays for lots of things, but when you take that much money- please proofread.

-Paid out of pocket once for a report with blatant errors where they refused to make corrections! These were factual errors not a parent's subjective opinion.

Have other people experienced this and at what point is there really a lapse in ethics? I'm all for talented people who work for our kids making a good living, but it saddens me when even seemingly good people will take a large sum of money and not give the appropriate quality of service without any remorse.

[Anonymous]

I definitely see a "special needs" premium for services like tutoring. It is unconscionable how little is covered by insurance/how difficult it is to find in network providers, but the OON providers we've used (dev ped, therapist, OT, speech) have been excellent.

[Anonymous]

I see the flip side. I see a bunch of mostly women in these therapy and similar roles (dev pediatricians being the exception) making shockingly low rates for the services they are providing, the care they put into things, the "free time" they give with texts and panicked calls outside of the time they are on the books.

My rate is $1800 an hour. My friends who are doctors are around $700-1500 per hour. And OT and even MD psychs make $100-$250 per hour. My electrician makes the same or more as our therapists and didn't go to college, while every therapist has a masters or more. I think that's scandalous. I make a point of always paying extra the minute we go overtime and making sure they don't undercut their rates for me. I have the money, so of course that helps. Not everyone can. But no one expects a cancer MD to work for cheap just because the govt isn't covering the bill. Not sure why these docs and other providers should?

And to take it further, i guess we shouldn't be surprised that there are delays and errors in their work product when they're being paid insultingly low wages.

I know it sucks for a lot of parents who can't afford a lot of this stuff, but it's not your providers' fault that the US doesn't provide robust social services.

[Anonymous]

One of my children had significant therapy needs and spent years in PT, OT, and speech. We did several medical explorations for which he needed general anesthesia, saw a developmental pediatrician, and did did two neuropsychological evaluations. We also paid for expensive tutoring. He saw a psychiatrist and we paid for medication for his mental health for many years.

Even though our income is not high by DCUM standards, no one gouged us (despite the high cost of some of these services), everyone was professional, reports were accurate (and took a long time to produce, but we knew that in advance). The IEP teams we worked with at his public school were all helpful within the limits of what they could offer.

Are you perhaps unhappy at the price of medical care, medications and medical-adjacent services in general? Because that is a particularly American problem. In our home country, none of this stuff would cost as much. They have a socialized system of care over there. On the other hand, we wouldn't have the economic opportunities we have in the USA... which is why a lot of people like it here.

It would be nice if we could reform American healthcare to make it more affordable. I am convinced this is possible to do without reducing the quality of care or the number of care options.

[Anonymous]

Anonymous wrote:I see the flip side. I see a bunch of mostly women in these therapy and similar roles (dev pediatricians being the exception) making shockingly low rates for the services they are providing, the care they put into things, the "free time" they give with texts and panicked calls outside of the time they are on the books.

My rate is $1800 an hour. My friends who are doctors are around $700-1500 per hour. And OT and even MD psychs make $100-$250 per hour. My electrician makes the same or more as our therapists and didn't go to college, while every therapist has a masters or more. I think that's scandalous. I make a point of always paying extra the minute we go overtime and making sure they don't undercut their rates for me. I have the money, so of course that helps. Not everyone can. But no one expects a cancer MD to work for cheap just because the govt isn't covering the bill. Not sure why these docs and other providers should?

And to take it further, i guess we shouldn't be surprised that there are delays and errors in their work product when they're being paid insultingly low wages.

I know it sucks for a lot of parents who can't afford a lot of this stuff, but it's not your providers' fault that the US doesn't provide robust social services.

I know several STs, tutors, and OTs to are out of pocket and they do very well. I think you are referring to people who take insurance.

[Anonymous]

Yep, OP, you are right. We have two SN kids and have experienced all of this. It is what it is.

[Anonymous]

It was a rude awakening when I realized that plenty of people in the sn world were just out for our money.

[Anonymous]

Anonymous wrote:I see the flip side. I see a bunch of mostly women in these therapy and similar roles (dev pediatricians being the exception) making shockingly low rates for the services they are providing, the care they put into things, the "free time" they give with texts and panicked calls outside of the time they are on the books.

My rate is $1800 an hour. My friends who are doctors are around $700-1500 per hour. And OT and even MD psychs make $100-$250 per hour. My electrician makes the same or more as our therapists and didn't go to college, while every therapist has a masters or more. I think that's scandalous. I make a point of always paying extra the minute we go overtime and making sure they don't undercut their rates for me. I have the money, so of course that helps. Not everyone can. But no one expects a cancer MD to work for cheap just because the govt isn't covering the bill. Not sure why these docs and other providers should?

And to take it further, i guess we shouldn't be surprised that there are delays and errors in their work product when they're being paid insultingly low wages.

I know it sucks for a lot of parents who can't afford a lot of this stuff, but it's not your providers' fault that the US doesn't provide robust social services.

DP. But OP is also talking about professionalism as well. Like leaving early or starting late is unacceptable whatever your income level is. And not really scandalous that electricians make more than SLPs because 1) they also have to be trained 2) union.

[Anonymous]

The word you want is “gouging,” OP. “Gauging” means something very different.

I don’t understand why you expect charity, though.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I see the flip side. I see a bunch of mostly women in these therapy and similar roles (dev pediatricians being the exception) making shockingly low rates for the services they are providing, the care they put into things, the "free time" they give with texts and panicked calls outside of the time they are on the books.

My rate is $1800 an hour. My friends who are doctors are around $700-1500 per hour. And OT and even MD psychs make $100-$250 per hour. My electrician makes the same or more as our therapists and didn't go to college, while every therapist has a masters or more. I think that's scandalous. I make a point of always paying extra the minute we go overtime and making sure they don't undercut their rates for me. I have the money, so of course that helps. Not everyone can. But no one expects a cancer MD to work for cheap just because the govt isn't covering the bill. Not sure why these docs and other providers should?

And to take it further, i guess we shouldn't be surprised that there are delays and errors in their work product when they're being paid insultingly low wages.

I know it sucks for a lot of parents who can't afford a lot of this stuff, but it's not your providers' fault that the US doesn't provide robust social services.

DP. But OP is also talking about professionalism as well. Like leaving early or starting late is unacceptable whatever your income level is. And not really scandalous that electricians make more than SLPs because 1) they also have to be trained 2) union.

My kid talked smack about becoming an electrician because he thinks school is boring. I showed him that in our state it's a 5 year process of classroom training and union apprenticeship. Electrical mistakes cause fires and can kill people.

[Anonymous]

What field earns $1800 an hour?

[Anonymous]

You just have to be a smart consumer and quit the minute it’s useless. Why should doctors and therapists have our trust?

[Anonymous]

You require a highly trained and educated professional to provide services for you. I agree these services should be covered by insurance, but that’s the real issue here, not how much they are charging. As a previous poster pointed out, these services are often provided by highly educated, underpaid, overburdened and burned out women.
Also, keep in mind when someone does an assessment for your child, it takes literally hours to write a report.

[Anonymous]

Anonymous wrote:You require a highly trained and educated professional to provide services for you. I agree these services should be covered by insurance, but that’s the real issue here, not how much they are charging. As a previous poster pointed out, these services are often provided by highly educated, underpaid, overburdened and burned out women.
Also, keep in mind when someone does an assessment for your child, it takes literally hours to write a report.

Well said.

[Anonymous]

Anonymous wrote:What field earns $1800 an hour?

It’s gotta be law with the ego distilled in the comment - and the s*it sure attitude of the poster.

Happy as hell AI is about to destroy that 1800 bucks an hour bs. To the PP: Save your gotten gains for your kids… IBW Local 1200 all the way!