Coverage for children

The Bush administration has made it pretty clear that it doesn't want to expand a federal/state health insurance program for children under which subsidies are paid to cover children of the working poor. And the administration, in fact, has instituted new guidelines that would prohibit states (which pay about 30 percent of the costs) from expanding the Children's Health Insurance Program on a scale that might reach some families in the middle class.

The maneuver the administration is using is to say that states can expand eligibility for the program only if they have covered 95 percent of children who already qualify. Reaching those children is a worthwhile goal, of course. But the White House knows that such a requirement would make it virtually impossible for the states to try to cover more kids, because some 30 percent of those who are eligible are not enrolled.

Given that these are children of lower-income families, many are transient and hard to find, and in other cases, parents just don't know about the opportunity. States have made an effort through schools and health fairs and the like, but there remain people who are uninformed and thus are still taking their sick children to emergency rooms, typically after the kids become very sick.

Democrats in Congress want to address the problem another way, namely by expanding the program's funding to find and cover more children who are eligible.

Why does the administration favor what amounts to a narrower approach to coverage? Because this Republican White House isn't about to do anything -- even when it involves the health of the nation's children -- that might raise the ire of insurance company executives who would complain about "national health care."

Actually, this program isn't national health care or a single-payer insurance system (something the public doesn't seem nearly as leery of as once it was). But the administration is determined to protect the "market-driven" health care system that leaves not only these children but 40-million-plus Americans uncovered by insurance.

The New York Times, in an article carried by The N&O, cited a woman in Greensboro who had been taking her children to emergency rooms for years, absent health insurance. The children were, it turned out, eligible for the federal program but she didn't know it.

There are hundreds of thousands of other kids in the same boat. It seems likely that this, along with all of the Americans who seek emergency room care for routine illnesses and the like, is driving up the cost of health care for those who pay for insurance. That's because providers must cover the cost of free care by charging those who can pay.

Support for significant reform in America's health care system, especially its financing, understandably is growing, and it's no surprise that presidential candidates have "discovered" the issue on the campaign trail. The American people are fed up with a system full of potholes and twists and turns in coverage along with control issues that make patients mere pawns in the game. The administration's narrow-minded view of the children's insurance issue is just one example of what ails the system as it stands.