Point of View

A giant step for children's health care

April 22, 2010 

— Much criticism is being aimed at the Obama administration and Congress for passing major health care reform legislation. For me, a busy rural pediatrician and a leader in the American Academy of Pediatrics, it is a new day in America. We Americans can finally hold up our heads in the company of other developed nations that afford all their citizens the right to health care. It is an especially good day for our children and youth.

As a result of the votes taken in the House and Senate last month, we have significant reforms that will benefit our children in the following ways:

The reform covers 31 million Americans and ensures health care coverage for children in the United States, including young people up to age 26. No child or youth will be denied services because of a pre-existing condition.

Recognizing that children are not just little adults, this health reform will provide age-appropriate benefits in a "medical home," where partnerships are established between individual patients, their physicians and their families.

This model of care works for families. North Carolina has actually proven this to the rest of the country through its very excellent Community Care portion of the Medicaid program. Child health advocates are thrilled to see new funding in Medicaid for more state medical home pilot programs as part of health reform.

In addition to the medical home, all Bright Futures services - the definitive standard of pediatric well-child and preventive care - will be covered for children as an immediate benefit for no co-pay, no matter what type of insurance the children have.

Health care reform greatly improves children's access to care based on workforce support and appropriate payment rates. The new law offers improvements to the pediatric primary and subspecialty workforce through loan forgiveness for medical students who choose often lower-paying pediatric specialties instead of more lucrative adult subspecialty careers.

Also, for the first time there will be a federal commitment to bring Medicaid payment in line with Medicare. This is a great step forward and will translate to more children being able to get the care they need from their pediatricians.

Currently, across the country, Medicaid pays about two-thirds of the Medicare rates to physicians. Thankfully, our governor and legislature have tried to keep Medicaid payment rates up over 90 percent of Medicare to assure that Medicaid-eligible patients actually have access to physicians.

The reauthorization of Emergency Medical Services for Children is included in the health reform measures. This federal program ensures that all children and adolescents, no matter where they live, attend school, or travel, receive appropriate care in case they experience a health emergency.

As a nation, we have not come to this day easily. Throughout the country, we have had open dialogue about some of the deepest questions that face a democracy. We have worried about how to balance the rights and needs of all different demographic groups. We have realized that nothing good and meaningful comes without compromise and even sacrifice. But we have acknowledged that the path we were on was leading us the wrong way - down an economic spiral that was bankrupting our families and businesses and breaking our national spirit.

We acknowledged that despite having the most advanced health technologies and services that man has ever known, we have been operating with an overly expensive, highly dysfunctional health care system. We were spending pounds on cure and not even pennies on prevention.

But now we are setting a new course. President Barack Obama, Sen. Harry Reid, Rep. Nancy Pelosi and countless other courageous members of Congress, along with child health advocates and physicians, have worked around the clock over the past year to speak up for the children who could not speak for themselves.

I am especially proud of the North Carolina members of Congress who had the guts to support health care reform in spite of polls that show dissatisfaction among many of their constituents. They all deserve profound thanks. I honestly believe that the majority of us, when we fully understand the implications of reform, will conclude that this legislation is good for us, for our families and for America.

As a parent, grandparent, pediatrician and lifelong child health advocate I am incredibly grateful for the commitment and dedication to making this day happen. The American Academy of Pediatrics has been working toward access to health care for all children since its founding in the 1930s. Last month's historic votes are testament to the persistence, wisdom and caring of so many people over a very long haul.

This passage of health reform is a significant investment in the health and future of all our children. Thanks so much for a new day for America's children.

David T. Tayloe Jr., M.D., is immediate past president of the American Academy of Pediatrics.

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