Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Need For Universal Child Health Care in the United States

Category: Access To Children's Health Care


At the recent American Academy of Pediatrics national meeting in New Orleans, Dr. John Lewey was the keynote speaker at the Tulane Pediatric Alumni supper. He shared his past year's experience working in Washington with congressmen and the American Academy of Pediatrics to develop a plan to provide medical care for all children in our society. He summarized the major bills which are coming down the line from both sides of Congress and the reality of passing them and listed several of the feelings of professionals as to how we will ultimately resolve this challenge.

We still have a tremendous amount of under served children in our society which will obviously impact our future. If these children are to be healthy, well educated, productive citizens, we will end up paying much more in the long run. Also, ethically, it is shameful that a country as wealthy as the United States doesn't take care of 12 to 15 million children in even the most basic ways.

One of the major areas that needs to be changed is the tremendous number of insurance carriers, over 1,400 at the present time. This makes it very difficult to get payment for routine well child visits and immunizations. A simplified system which would perhaps be universally used by all the insurance companies would be much better. Another needed change is medicaid eligibility. The medicaid system is now paying a much better price for child care but is still not reaching all of the kids who need it. Many risk being dropped if the parents get married, even though they may be out of work or destitute financially. Also, children are dropped when they reach 18 when they may need ongoing coverage even more. We would like to see coverage extend to age 21. Finally, we need to find a way to get more doctors to accept medicaid and work with the system so that these poor children can have easy access to care, get all their immunizations on time and get good well child check-ups. We must strive for preventive medicine in an ongoing manner.

Another area which Dr. Lewey discussed was the possible need for a co-pay system to discourage overuse. This might involve a dollar per visit and would, in my opinion, significantly cut down on abusive overuse. Dr. Lewey felt, after spending a year working with the Louisiana senators and congressmen in Washington, that pediatricians and parents and all citizens do have a significant voice on this issue. It is up to us all to be heard by writing to our congressman and letting them know we care about the laws which are being proposed to promote a universal child health plan. Senator Bentsen from Texas, who is the chairman of the Finance Committee, does not feel that any of the present bills which include over 14 bills in this area will be passed because of the upcoming election. Despite that negative attitude, it is still vital that we all address this issue now. Every day that goes by another child is maimed or hurt, possibly for life and another family is devastated because of the crazy system of medical access, medical insurance availability and high cost of medicine which we have in the United States today. I, for one, would like to see a system which guaranteed that every child in our society would get good regular medical care, easily available, with simple forms to fill out. Please join Dr. Lewey and the thousands of concerned pediatricians and other child advocates to push for a sensible national child health bill soon.