Pediatricians believe that the life success of every child should be our highest national priority. In order to do that, we must provide coverage for all children in the U.S., age-appropriate benefits in a medical home, and appropriate payment rates and workforce improvements to allow access to covered services.
Quality, affordable health insurance should be a right, regardless of income, for every infant, child, adolescent and young adult. The House bill will ultimately cover more individuals—36 million in the House package versus 31 million in the Senate—and therefore the House language should remain in the final compromise legislation.
In addition, all children should have age-appropriate benefits in a medical home. Pediatrics is about prevention and health promotion. Pediatricians do a host of things during well-baby and well-child visits that are totally different than what is done in an adult well-visit. We provide protection against life-threatening diseases through the timely provision of immunizations, the most effective public health intervention ever launched. Through our injury prevention efforts, we work to keep children and youth safe and protected against the number one killer of children over the age of one – injuries. Child health providers are also on the front lines in the battle against the obesity epidemic. Pediatric efforts will prevent many long-term illnesses, such as diabetes, heart disease, hypertension and some cancers.
The recommendations for well-child visits are contained in a document called Bright Futures. It is the appropriate preventive benefits package for all children in the United States, and it is wonderful that the Health Resources and Services Administration (HRSA)-approved consensus guidelines (embodied in Bright Futures) are being recommended by the Senate as a first dollar item for both private and public payers. Prevention works, and Bright Futures gives us the tools to make prevention available to all children.
Pediatricians and other health care providers also need to be focused on treating and caring for our children, not worried about how to pay their bills. The Academy strongly believes that appropriate payment rates are needed to provide real access to care.
Medicaid, which is the program that covers most children, pays around two-thirds of Medicare rates for the exact same service. Appropriate payment rates lead to appropriate access. There is good evidence that appropriate payment of providers results in children having better access to comprehensive health services in a medical home, because if physicians don’t get paid, they unfortunately cannot care for the most vulnerable patients. The most recent survey from the Center for Studying Health System Change shows that only 53 percent of physicians are willing to take on new Medicaid patients.
Over the next few weeks, our nation’s lawmakers need to continue to prioritize coverage, benefits in a medical home and access through appropriate payment rates for child health services. It is time to do right by our children and pass health reform that works for all of us. Children cannot become a casualty of compromise. We must continue to make children’s health needs our nation’s highest priority.