Strollerderby : medicaid

Kids are Suffering in Emergency Rooms Nationwide

JeanneSager — Wed, 20 May 2009 14:00:00 GMT

No one wants to spend a night with their child in the emergency room. But the numbers of kids spending hours in the nation's ERs waiting to be seen by doctors is on the rise.

The problem? It's the economy (duh).

Without health insurance to cover an expensive doctor's visit, parents are turning to the emergency room for their primary care. And they're bringing their kids.

Forty-four percent of children's hospitals in the U.S. have reported a spike in emergency room visits. That's just child-specific hospitals, but numbers are up at other hospitals too (where patients are both adults and kids). This comes on the heels of already growing numbers - even when the economy was steady, the CDC reported a decade-long hike in emergency room visits from 1996 to 2006. Of them, kids made up the largest number, followed by adults over the age of seventy-five.

The chief problem is health insurance, and one in nine kids is estimated to be without it (and of those kids, nine in ten has at least one working parent and is a U.S. citizen). Even folks who qualify for Medicaid often end up carting their kids to the ER because private doctors won't accept it.

But kids are waiting longer and longer periods of time before getting treatment. That's both in the ER (where more visits combined with fewer emergency rooms means longer waits) and out - where parents who worry about the hospital bill are delaying the trip to the hospital. A recent Kaiser survey found at least twenty-seven percent of Americans have actually delayed care because of the cost, And that's what has medical practitioners worried.

Kids' bodies are changing quickly and their immune systems are less developed. They're at greater risk than the average adult, and they need healthcare more desperately than the average adult. Which means parents have to make tough choices - as hard as it may be, and as many sacrifices as it might take, that emergency room visit might be the best option.

Have you suddenly found yourself in an emergency room when you'd never visited one before?

Image: CBS News

The New State of Children's Health Care

Hannah Tennant-Moore — Fri, 30 Jan 2009 16:30:00 GMT

Soon after President Obama signed the Lilly Ledbetter Fair Pay Act into law, the newly empowered Democratic Congress has once again signaled their commitment to what they’re calling “women and children first.” The Senate voted 66-to-32 to expand the State Children's Health Insurance Program to cover four million currently uninsured children by 2013. A tobacco tax will be used to pay for the increase in the federal program.

This legislation, which former President Bush vetoed twice, couldn’t come at a more important time, as job losses mean that tens of thousands of children are losing their health insurance.

One of the most controversial aspects of the bill is that it allows states to decided whether or not recent legal immigrants can benefit from federal programs like Medicaid and the State Children’s Health Insurance Program. Currently, federal law bars legal immigrants from participating in these programs for five years after they move to the U.S.

According to The Times, “Many Republicans, including Senator John McCain of Arizona, said they worried that it was part of a long-term effort to replace private health insurance with government programs.” Since it's clear from President Obama's health care proposals that no one will be taking away McCain’s (or any rich, powerful man’s) private insurance, I think that the real concern is the possibility of having to pay an eensy bit more in taxes in order to help impoverished children and families get covered.

Some critics of the bill are also up in arms because the expanded program would offer federal assistance to families that do not qualify for Medicaid, but who can't afford private insurance--such as a family of four, living in New York, with a combined income of approximately $66,000. Although this is technically three times above the poverty level, it's easy to see how many families in this income range would find it impossible to spend upwards of $12,000 a year on health care.

Hmmm, let's see--would we rather help smokers keep their tobacco costs down or give four million children health insurance?

Photo: faithfulamerica.org

Michigan to Parents: Get Married, Or Pay Up

Miriam Axel-Lute — Tue, 20 Jan 2009 15:00:00 GMT

The state of Michigan says Gary Johnson owes them $3,800 for the birth of his daughter. Unless, of course, he wants to actually marry her mother already.

How exactly do they rationalize this? Gary Johnson is not a deadbeat dad. He lives with Rebecca Witt, his daughter's mother, and they plan to marry someday, but they were hoping to wait until they were in a better financial position to do so. Right now, though, they're pretty poor, as evidenced by the fact that Witt was on Medicaid at the time of the birth. That's the payment that the state is trying to recoup from Johnson.

Now, I could understand if they thought the couple wasn't getting married in order to hide Johnson's income and qualify for Medicaid if they wouldn't otherwise. (I might argue, still, that that's the state's own fault for defining families the way they do, but I'd understand it from a self-interest perspective.) However, if they're willing to let him off the hook entirely if he just gets hitched, then clearly it's not just a matter of needing the money. Besides, the report I read made no mention of anything less than honest on the part of the couple.

It appears that this is one of those instances where the state has just decided it will help society to force people into legal marriage. For more examples, along with an explanation of why this is a dumb way to go about things, check out the splendidly named report Let them Eat Wedding Rings.

As for me, I might disagree with Witt about what constitutes a "really nice" wedding or how important it is, but I also understand wanting to make it special and not just exchange Cracker Jack rings in front of a judge. In fact, I think it comes down to this: Witt and Johnson appear to be (1) caring for their kid together (2) taking marriage seriously and (3) being prudent and trying to plan ahead rather than putting an expensive wedding on a credit card or something. Isn't that the sort of behavior Michigan ought to be supporting?

Image from Liam's Pictures from Old Books.

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U.S. Birth Centers in Danger of Closing

Miriam Axel-Lute — Thu, 18 Dec 2008 21:00:00 GMT

Everyone likes a best of both worlds solution, right? For many pregnant women, birth centers provide just that. For low-risk pregnancies, they are a comfortable, calm, non-hospital atmosphere in which to give birth. They often have pools, and kitchens for family members to cook in. They don't separate mother and baby after birth, but check vitals right there. And yet, for those uncomfortable with birthing at home, there are also a staffed and equipped medical facility, usually quite near a hospital and with established transfer protocols in place. They are often crucial in rural areas where hospitals are few and far between.

And yet, after 20 years, the federal Medicaid agency has all of a sudden begun to refuse to pay for them. (Why? Do they prefer to pay tons more for a hospital birth?) The agency claims there is nothing specifically in any legislation saying that it's a covered cost. (Ah, I see. Bureaucracy strikes again.)

This is not merely a case of the poor getting screwed either notes the American Association of Birth Centers. Other payers follow Medicaid's example, they say. Basically, if the law isn't changed, pronto, freestanding birth centers will be fighting for their financial lives. Many are already suffering from refused payments.

There is a chance to clarify the law when the SCHIP bill passes, but it has to be done before the Christmass recess, so AABC is asking everyone to call their congresspeople and let them know that this is in fact important—a no-brainer even (but perhaps you oughtn't to use that phrase).

Photo from Alma Midwifery.

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They Say: Anesthesia Can Cause Trouble Down the Road

Amy Kuras — Thu, 23 Oct 2008 17:32:00 GMT

As if watching your kid get wheeled away for surgery isn’t bad enough, today comes news that anesthesia can cause developmental problems in children.

A preliminary study by Lena S. Sun, professor of anesthesiology and pediatrics at the Columbia University found that children who were exposed to anesthesia were about twice as likely to be diagnosed with a later behavioral or developmental disorder.

Sun looked at a database of Medicaid patients in New York. The Columbia team studied a group of children born between 1999 and 2000 who had received general anesthesia for hernia repair and a group of 5,000 children who never had the surgery.

After adjusting for other factors associated with such disorders, such as low birth weight and gender, 30 anesthesia-exposed children, or 4.8 percent, were found to have developmental and behavior disorders during follow up, compared with 75 unexposed children, or 1.5 percent.

Because all of the kids in the study would be considered to be economically disadvantaged, that may have led to the higher levels of developmental or behavioral delays as well. Even the lead researcher is cautioning that these findings are preliminary and need to be looked at further.

Still, as someone whose baby just had surgery, which was thankfully minor but still required general anesthesia, UGH. It was hard enough to watch my little guy get carried away for surgery knowing they would put him under, but to know I may have put him at higher risk for more problems down the road is just upsetting.

What Keeps us from Being a Great Society?

Rachael Brownell (Redsy) — Fri, 23 May 2008 18:35:00 GMT

44 years ago, President Lynden B. Johnson delivered a speech describing a Great Society where equality, civil rights, elimination of poverty and quality education for all children as a way of life. Great Society programs include Medicare, Medicaid, and federal funded education.

This vision of a caring helping society has long since been replaced by a culture of blame and a determination to look the other way when faced with the suffering of others.

Part of this ignoring is a failure to acknowledge the lives of soldiers and Iraqi citizens that have been lost since the Iraq War began 5 years ago. On the cusp of Memorial Day Day weekend, what will you tell your children about the war?

This is the first year I face Memorial Day with children old enough (6) to understand something about war and peace and the price we pay for our prosperity. I've talked to them about our duty as a family to help out others, but this weekend, I'm going to talk to them about why people go to war, what happens there, and what we can do to thank them. If we fail to care for each other, we'll continue to create a world nearly impossible to inhabit.

President Johnson was hated as the architect of the continued failure in Vietnam yet his legacy of social programs and a vision for the future of our country is quite beautiful:

The Great Society is a place where every child can find knowledge to enrich his mind and to enlarge his talents. It is a place where leisure is a welcome chance to build and reflect, not a feared cause of boredom and restlessness. It is a place where the city of man serves not only the needs of the body and the demands of commerce but the desire for beauty and the hunger for community.

Is it possible to aspire this greatness again? Somehow I think it is linked to honoring those who've given their lives fighting for our country, regardless of our views of the rightness of those wars.

Keep Your Laws Off My Kid: When is Government Too Intrusive?

Rachael Brownell (Redsy) — Tue, 03 Apr 2007 14:31:00 GMT

Government programs designed to help children frequently succeed at providing early education (Head Start), nutrition (Free Lunch Program), and health insurance (Medicaid), but when does help become unwanted intervention? According to a Chicago Tribune op-ed, that line has already been crossed.

In the debate over required vaccination against cervical cancer, which is being hotly contested in several states, opponents feel the rights of the parents are being overrun by government interests and that ultimately parents should be able to decide what is best for their children.

The problem always rests in legislating childrearing practices for everyone. The laws that are meant to protect children in those cases where the parents are unfit or unwilling to do so provide protections that we as a society cannot live without. But at what point are these helps a hindrance to personal liberty? Personally, I prefer to err on the side of over-helping than neglecting an issue, especially where children are concerned.