
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, June 16, 1994                   TAG: 9406270143
SECTION: EDITORIAL                    PAGE: A-12   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

AN UNHEALTHY STATUS QUO FOR KIDS

ALL THE lobbying and debate about competing versions of health-care reform have almost drowned out the bottom-line message supported by most people: that health-care reform is needed. And perhaps no one needs it more than do children, whom Americans purport to care most about, yet who often are overlooked in public policy making.

The lack of regular, basic health care for all children should be well-known to residents of the Roanoke Valley, birthplace of the Child Health Investment Partnership. Since 1987, CHIP has provided its admirable services to thousands of poor children. But thousands more could benefit.

This is in a locality blessed with leaders in the health-care professions and community services who recognize the problem, care about it and have taken initiatives to try to deal with it. Imagine the shortfall in preventive and primary care for children nationwide.

You don't have to imagine. The Children's Defense Fund issued a report the other day illustrating the extent to which children are being left without health-insurance coverage.

Among the nation's 66.8 million children under age 18 in 1992, 8.3 million - more than 12 percent - had no health insurance the entire year; no Medicaid, no anything. Many of these were children of two-parent households in which at least one parent was employed. Of the 8.3 million uninsured, 5.4 million were living with both their parents.

Another stereotype-busting statistic: 4.4 million of these children were in families with incomes 125 percent or more above the poverty line. In fact, far from being on the fringes of mainstream, working America, 13 percent of the uninsured children had at least one parent with employer-provided insurance. The companies either didn't extend coverage to dependents, or offered it at a price too high for families to afford.

The percentage of children covered by job-related insurance dropped at a rate of almost 1 percentage point a year from 1987 to 1992, going from 64.1 percent of children to 59.6 percent. If this trend continues, barely more than half of American children will be covered by job-related health-care insurance at the end of the century. Without reform, how many of their parents will be able to afford individual policies?

In Virginia, the estimated average over three years of children uninsured year-round was 14 percent. That's an annual average of 229,804 youngsters under 18 without coverage.

Of course, as the status-quo-ticians point out, lack of insurance doesn't mean lack of treatment. Hospitals don't turn away people needing care.

But it does mean many of these children will get medical attention only after they are sick. Which usually means (1) they'll be brought to a hospital only after they are very ill and the cost of treatment has risen, or (2) they'll be brought to a hospital for minor ailments to receive expensive emergency-room care when a visit to a doctor's office would have sufficed.

The higher immediate costs of this kind of care are but a fraction of the eventual cost. These are, after all, critical development years. Health-care reformers shouldn't lose sight of the fact that the bill for missed opportunities in early treatment and prevention will grow right along with the child.

by CNB