Health Care for All Kids

April 18, 2006

Editor’s note: From time to time, we will place a diary on the front page in hopes of sparking debate and discussion. Thanks, Shenanigans, for such a well-written diary.-Erika

There are a lot of ideas floating around about healthcare. Mostly we know that the system we have is not working. It makes us insecure, vulnerable to small twists of fate. It is the most expensive in the world. And even the economics of it are just plain nutty, ironic given that we consider our great nation as the cradle of All Sensible Economic Theory.

Linking employment to health care has historical legacy, but it goes with the old days when your employer practically owned you and your family. (In which case, the corporations were just caring for their assets, like a farmer calls a vet.) And it was more equitable when pretty much all your workers had a similar number of dependents. But in today’s world, where people stay with a company for much shorter stays, and where many workers don’t have any dependents, having employers buy health insurance is a drag on our economy, thwarts innovation, and leaves kids in a unique situation.

After all, kids aren’t allowed to work, and when they are, they’re not even eligible for employer plans.

So, why don’t we just accept this and start with a Medicare program for kids? There are many advantages. Unlike old people, kids are less likely to need expensive care, and when they do, the payoff (in terms of years of productive life ahead) is the largest. I understand Kerry is working on it – and I signed his petition – but I’ve been disappointed at the visibility of the idea.

Meanwhile, we hear people talking about getting more needy kids into the programs that exist. But why should kids get coverage based on the income of their parents, which they don’t and can’t control? Do we really want Johnny to not get vaccinated or not get tested for a bladder infection because his mommy makes a few thousand dollars too much? Choosing children to enroll by income costs money in administering the forms, and while it works well for steady wage earners with W-2 forms, it is very hard on the self-employed. There are many people in the construction trades who work for themselves, and their income varies up and down constantly. They won’t know how much they made in a year until December, and even if the whole year turns out OK, that misses the fact that the big payment in December was for work completed in August, when the family had trouble buying food or paying the rent.

And what happens when ordinary working people get sick kids? Not just the typical colds/flu/chicken pox, which are bad enough, but kids that get cancer, or diabetes, or are in accidents, or get into other chronic, expensive situations? In my town, last year there was a collection jar for a county employee with 3 boys. The youngest had a nasty cancer. She’d used up all her sick leave and was going to have to give up her job, which also provided insurance for her whole family. The collection was to cover her COBRA payments for the next 18 months. I’m not sure what she’ll do then if he hasn’t died. Is that horrible or what? That the best financial outcome for this family is that their youngest son will die before insurance runs out for the whole family, so that Mom can go back to work?

Hunter, on DailyKOS, wrote a diary in June 2005 (I can’t find the link, but I had saved the text) that moved me to tears, about his childhood asthma attacks that ended up in the ER.

Treatment fluctuated depending on family finances; for most of my childhood, medication was there; for brief, intermittent spurts of time, it was not, and aside from whatever number of sample packs could be shoved in a bag by our unrelentingly supportive doctor, that was that. Insurance for our family was simply non-existent, making an emergency room visit a costly escalation only dared when it was unambiguous that there was simply no alternative. And so, even for a ten or twelve year old, there was a financial responsibility to each attack. When the maximum dose of every medication was reached in careful sequence, and even those doses pushed slightly upward in a last-ditch effort, and the question was asked, in all earnestness, spoken in a very adult way but with the unmistakable inflections of a parent who will decide against you with no hesitation if they think you are lying to them, do we need to go to the emergency room now, all parties understood, myself included, that it was a family failure of potentially epic proportions.

The idea that a child has to know that when he asks to go to the ER that it means that his siblings won’t get Christmas presents is appalling.

How can we get this first step? How can we get visibility, get action, get motion, on a plan that covers our kids at least as well as our Congressmen are covered? (Adopt-a-constituent day?) How can we change the conventional wisdom so that our politicians know that all Americans want and need this, and that it is the right thing to do?

Mind you: in the end I want healthcare for all Americans, working or nonworking. As moms, many of us have temporarily left the workforce or started our own businesses so that we can raise our kids with more flexibility – and we’ve hit this dead on, finding that the companies will do whatever they can to avoid serving us. I know plenty of moms who would prefer to stay home for a few years if it didn’t mean the loss of their insurance benefits – and it’s not just the cost, but also the availabilty of them. In a world where “pro-life” is surprisingly silent about people who want to preserve life, what can we do to transfer that sentiment into something useful?