Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Hawaii and Vermont in Forefront of Pediatric Care

Category: Access To Children's Health Care


In June of 1992, Vermont decided to provide health care for all of its children. This is in line with the American Academy of Pediatrics goal for all children in the United States. Vermont is taking the lead in providing for these children on a state level instead of waiting for the federal government. Hawaii also has an innovative program which provides for all of the children in the Hawaiian Islands and prevents the low vaccine rates and disasters which we see in most of the other states throughout the United States. Both these states have taken on some of the specific plans as well as the overall goal of the Matsui Bill, House Bill 3933 in which Congressman Matsui of California has sponsored the children first agenda of the American Academy of Pediatrics. This bill would provide adequate health care for all children up to age 21 in the United States and would bring us into line with all other modern societies. As months and years pass, the cost of providing basic health care for youth will become exceedingly more expensive and more difficult to find the money in the budget. At present, it would cost about 4 1/2 billion dollars which is infinitely less than the 30+ other health care bills being pushed in Congress. Obviously, we need to care for all people in our society but until we work out how we are going to do that, the children in our society are probably the most needy group and deserve to be at the start of such changes. This also makes sense money wise in that every dollar spent on preventive health care in children saves at least ten dollars in the long run, through lessening of disease and disability.

Louisiana, believe it or not, is one of the better states in the United States in providing medicaid funding for its' poor children.

Despite that, about 80% of pediatricians and primary care health workers are not willing to get involved with medicaid and care for these children. Because of that, areas of the state which cannot find physicians to care for sick children must travel to regional charity hospitals and clinics. This system is certainly better than not having access to care at all but it is not a good system in my opinion. The main drawback is that big hospitals such as Charity Hospital in Lafayette or in Independence, Louisiana are designed for tertiary care, which means high risk care, rare things, things which cannot be handled in a local community such as day to day fevers that children get, ear infections, asthma attacks, etc. Nevertheless we have many fine health care workers in these charity hospitals and they do their best to fill in the gaps for these indigent children.

The other group in Louisiana worse off are those who have no insurance and who have no medicaid card. This is one- third of the population and is increasing yearly. These patients must pay cash for any health care they need and, if it is at all serious, they obviously cannot afford it and must travel to the nearest charity hospital. In the case of a child, this may mean a two hour drive and six hour wait to treat an ear ache or a broken bone. This is shameful in my opinion. Louisiana as well as the federal government and all health care workers must come up with a better plan, such as Hawaii and Vermont have, to take care of these needs.

In summary, we Americans are creeping into the 21st century in providing health care availability to all children and individuals in our society.

We have a very long way to go and the problem seems to get worse each year. Please join with me and the American Academy of Pediatrics in supporting the Matsui Bill which is a wise, initial step to rectifying this major flaw in our wealthy society.

Discuss and work with your local and state legislators to come up with creative answers to provide better availability in health care for all people in our society particularly our children.

Ultimately, we are all interdependent and how we treat each other will benefit everyone, in the long run.