Op-Ed

N.C. children and Medicaid reform

As a pediatrician and mother, I know that North Carolina’s prosperity depends on the healthy development of our children. Timely, quality medical care is essential for growing children.

Children who live in low-income families too often have additional medical needs because of other factors going on in their lives – toxic stress, not enough access to healthy foods, unsafe communities. These factors are called social determinants of health, and they play a big part in a person’s health.

Medicaid was designed to be a safety net for low-income children to get the medical care they need to be healthy and thrive. Furthermore, Medicaid in N.C. works well for children. They make up 75 percent of the Medicaid population, but only account for 25 percent of Medicaid costs.

Medicaid reform is under discussion in the General Assembly. As a pediatrician in a small town practice for almost 25 years, I see daily the health benefits for children who have Medicaid. For these reforms to work, they must work for children.

Many legislators seek changes to control costs. This is an understandable and responsible concern. But it is critical to recognize that the major cost savings in treating children is to help them grow into the healthiest possible adults. They need vaccines, healthy weights and early medical attention so that small problems don’t develop into bigger, costlier, more life-altering problems. These are savings that take more than a single fiscal year to earn. Children are, thankfully, mostly healthy – and thus relatively inexpensive.

To be successful for our state’s population, any Medicaid reforms should:

▪  Build on the success of medical homes, provider-led initiatives and local case-management infrastructure that is the envy of my colleagues across the nation.

▪ Improve and promote the health and well-being of children and youth with special needs.

▪  Include metrics and outcomes that accurately reflect the conditions of the populations and success of pediatric medical homes.

▪ Make the system easier for patients, families and doctors to use without increasing bureaucracy and paperwork.

▪  Be North Carolina-focused and North Carolina-based.

▪ Be designed to work for infants, toddlers, children and youth.

In our rush to reform, we must remember that Medicaid is about making sure people – most of whom are children – get the quality care they need when they need it wherever they live in our state.

Quality medical care improves the quality of people’s lives. As a mother, that’s what I want for my sons. As a pediatrician, that’s what I want for all my patients. And as president of the N.C. Pediatric Society, that is what I want for all children in North Carolina – regardless of their health insurance.

Deborah Ainsworth, M.D., is president of the North Carolina Pediatric Society.

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