Fixing A System Where Children Die For Lack of Health Coverage

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The Baltimore Sun

Fixing A System Where Children Die For Lack of Health Coverage


WASHINGTON -- Residents in and around the nation's capital woke up one recent morning to the sort of bad news that we like to think doesn't happen in America: A child died from lack of dental care. Deamonte Driver, a seventh-grader in Prince George's County, died Feb. 25. Bacteria from an abscessed tooth had spread to his brain, doctors said. Two operations and eight weeks of care and therapy failed to save him. Total cost: more than $250,000.

His mother, Alyce Driver, worked at low-wage jobs. She did not have health insurance. Between her struggles to get coverage and wide cracks in Maryland's public health-care system, her child never got the $60 tooth extraction that would have saved his life.

Now Deamonte's story is just one in a stack of horror stories that Marian Wright Edelman, head of the Children's Defense Fund, trucks over to Capitol Hill to urge Congress to close gaps in health coverage for children.

The stories are horribly sad. They include children like Devante Johnson, 14, who died in Houston in March. His kidney cancer went untreated for four months because of a paperwork snafu. A Texas state representative intervened, but by then it was too late.

There are stories of children whose families lost health coverage when the families moved from one state to another.

Some children get caught without coverage because their parents must constantly reapply for it, even when they stay in the same state. Others are trapped in the gap when state Medicaid eligibility levels or the federal Children's Health Insurance Program levels are too low and private insurance too expensive. That $40 billion, 10-year program, commonly known as SCHIP, is up for reauthorization. The program provided health-care coverage for an estimated 6 million children who otherwise would not have been covered. States are free to design their programs, helped by federal grants and subsidies.

There's a good chance the program will be reauthorized at current funding levels, insiders say. But with health costs skyrocketing, that would be, in effect, a cut.

Bills to double SCHIP spending over the next five years are being pushed by Rep. John D. Dingell, Democrat of Michigan, and Sen. Hillary Rodham Clinton, Democrat of New York.

Who could oppose this noble effort on behalf of children's health? The usual suspects. There are ideologues who have never found a government-funded health program they didn't dislike. There also are budget hawks who quite reasonably worry about what revenue needs to be raised or what program needs to be cut in order to pay for it.

What's needed is leadership to persuade Congress that children shouldn't be allowed to slip through the growing cracks in health-care coverage. "Covering all children is an achievable goal in 2007," Ms. Edelman told me. "It won't happen without large-scale mobilization and public awareness."

Ms. Edelman's organization endorses a similar bill by Rep. Robert C. Scott, Democrat of Virginia, that would add pregnant women, mental, dental and vision care. It would also equalize access to prevent children in poorer states from being shortchanged.

Ms. Edelman's husband, Peter, was an assistant secretary in the Department of Health and Human Services in President Clinton's administration. But the Edelmans parted company with the Clintons over the 1996 welfare-reform law.

The good news is that child poverty has declined sharply since then, helped by a largely healthy economy. But the working poor are having a tougher time making ends meet, especially amid rising health-care costs.

We have the best health-care system in the world, we are constantly told, and that's true. But the best in the world doesn't do much good to those who can't gain access to it. Everyone should have coverage. Our children are the best place to start.

Copyright © 2007, The Baltimore Sun

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