Politicians are faced with a serious dilemma in the near future: reauthorize the State Children’s Health Insurance Program (SCHIP) and spend billions of dollars on a single-payer government health program or fail to renew the program and leave many children uninsured and many constituents angry. The Kaiser Family Foundation reports (“Several Lawmakers…“) that the SCHIP will expire on September 30th, 2007, and that currently several Democratic Congressmen are working on competing SCHIP renewal bills. The New York Times reports (“…Helath Care Battle“) that renewing SCHIP for the next five years will cost $50-$60 billion.
While SCHIP enjoys widespread support (its is politically difficult to oppose providing health insurance to uninsured kids), opposition to the program comes from a curious source: the House Black Caucus. The Health Care Policy and Marketplace Review blog says that Caucus members such as Charles Rangel oppose SCHIP because they believe
“all of that money going to cover healthy children should be used for the people who really need it – the ’55-year-old like me’ who has diabetes or heart failure of mental illness. Medicaid funds are being used to send hundreds of thousands of healthy children of the chronically ill, near-poor diabetics to a doctor — while the actual sick person in the family sits on park bench and can’t afford to go anywhere except the ER or a public hospital, if they can afford the copay.”
Another view comes from the Health Affairs blog. In a recent post, Sarah Dine argues that providing health insurance for children isn’t enough; enabling children to easily access high quality care can be just as or more important. Ms. Dine cites a paper by Julia Lear which posits that health care professionals can often best treat children right in their own schools. The abstract from the paper is quoted below.
“A vast array of child health professionals—99,000 counselors; 56,000 nurses; 30,000 school psychologists; 15,000 social workers; and smaller numbers of dental hygienists, dentists, physicians, and substance abuse counselors—provide care to children and adolescents at school. However, most thought leaders in child health know little about this “hidden” system of care or are skeptical about its capacity to contribute to children’s well-being. Increased interest in prevention and chronic disease management, powered by escalating concern about childhood overweight, might end the isolation of school health programs and link them more effectively to community-based prevention programs and health care services.”