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The Male Room

with Sheldon Marks, MD

Men's health is a growing field. Dr. Sheldon Marks shares advice and information on men's health issues, from prostate problems to hair loss, as well as fitness and nutrition.

Wednesday, March 11, 2009

Health Care for Children – Who Can Argue with That?

Last month President Obama signed a bill that adds nearly $33 billion to the State Children’s Health Insurance Program (SCHIP). The program will insure 11 million children in lower-income families. Health care for children – who can argue with that? It makes sense, and is obviously the right thing to do. But as with so many good ideas out of Washington that turn sour, the devil will be in the details. My worry, based on past experience, is just how this may actually back-fire and end up hurting children. “But how can that happen?’ you ask. Let’s look at past government attempts at caring for children.

In Hawaii they came up with what sounded like a good idea – provide health care to all children in the state. Seems like a no-brainer. But it failed and failed miserably.

As happens so often with government ideas, no one bothered to think through natural and unintended consequences. What went wrong in Hawaii was simple – families who were paying for their child’s insurance dropped their own health care coverage to allow their children to qualify for the free state-sponsored insurance. Why should they pay for something that the government will give them for free? Makes sense. Suddenly the number of children qualifying for the free health care skyrocketed. Within just 7 months the system went bankrupt, leaving all the kids – those in need and those whose families dropped their insurance – without any health insurance.

The idea was good – let’s be sure that all children get a basic level of health care, from birth to age 18. But the fun comes in as the government decides who low income is and who is not. So who defines low income? In Hawaii, if you made less than $73,000, your children could qualify. That’s more than 36 dollars an hour. That doesn’t sound like low income to me.

Unintended consequence #2 – some families sign up for insurance just for their children to get health care. If our government will pay for children’s care, then many parents will drop their own insurance and suddenly find themselves in the land of the uninsured.

I will be the first to admit that I do not know the details of the new plan President Obama signed. I hope and pray it works as intended. But the very fact that it comes out of Washington makes me worry. Who will qualify? What necessary treatments or medications will not be covered? What ridiculously unneeded aspects of care will be included? Were any real life “in the trenches” pediatricians included in the development of this or was this a government/big business developed program? And what incentives will be in place to encourage families who can afford it to pay for their own insurance? Seems that our government should offer an incentive for you to take responsibility for your own children’s health. I am sure we will soon discover the answers to these and more questions as the plan begins.

I only hope that there are no unintended consequences that will in the long run actually hurt our children and society.

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Posted by: Sheldon Marks, MD at 1:06 pm

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