Over nine million children lack health insurance, a trend that shows no sign of slowing down. The consequences can be grievous. Twelve-year-old Deamonte Diver died when an infection from his abscessed tooth spread to his brain; he had no insurance and his mother could not afford $80 to have the tooth pulled. Devante Johnson, age 14, died when his health insurance lapsed -- due to a bureaucratic snafu -- right in the middle of his treatment for kidney disease.
Children should not be falling through the cracks like this. In 1997 Sen. Ted Kennedy (D), Sen. Orrin Hatch (R), and First Lady Hillary Rodham Clinton spearheaded S-CHIP, a joint federal-state effort to subsidize health coverage for over six million children whose parents earn too much to qualify for Medicaid but not enough to afford private coverage.
Why, then, are so many children still without health care? In 2007 Congress voted to expand S-CHIP to include another 3.5 million children, but the bill was vetoed by President Bush, who sneaked behind closed doors to cast his veto without media coverage. Sen. Harry Reed (D) called this decision "heartless."
The candidates are divided on the issue of how to expand health care for children. For example, Barack Obama supported expansion of S-CHIP; John McCain opposed it. S-CHIP will come up again for reauthorization in early 2009.
To learn more about what's at stake in this arena, OffTheBus spoke with Marian Wright Edelman, founder of the Children's Defense Fund, the nation's strongest voice for children and families. In 2000 she received the Presidential Medal of Freedom, the nation's highest civilian honor, and the Robert F. Kennedy Lifetime Achievement Award. She is a board member of the Robin Hood Foundation, and is a member of the Institute of Medicine of the National Academy of Sciences.
Is the U.S. experiencing a children's healthcare crisis?
Marian Wright Edelman: I call it a crisis. One out of every nine children have no health care at all. The effect is devastating. Too many infants are born at low birth weight and die in their first year of life. Uninsured children often go two years without seeing a doctor, even for basic health screenings. And when they go to an emergency room, uninsured children are twice as likely as insured children to die in the hospital.
Is the number of uninsured children increasing?
Actually it decreased last year -- from 9.4 million to 8.9 million -- but it was not because more children were covered by private health insurance. Far from it. Private coverage for children continues to erode, and I expect the number to drop again next year as more parents lose their jobs and health insurance due to the economic downturn. The only reason the number of uninsured children wasn't higher last year was because more children enrolled in two critical safety net programs -- Medicaid and S-CHIP.
What is your perspective on the S-CHIP program?
I'm president of the Children's Defense Fund, an original proponent of S-CHIP. Sadly, today nearly nine million children remain uninsured. We must seize this opportunity -- this election -- to make sure all of the candidates understand that coverage for all children is something the American people want. Children can't wait.
What are the long-term implications for children without health care?
All children need health coverage now. Their growing bodies, developing brains, and emotional health are the building blocks of their adult capabilities and our nation's future. Children with unmet health care needs have immeasurably lower educational outcomes, and as adults their earning power is lower on average. A child without health care is starting life at a serious disadvantage.
What does it mean to be under-insured?
Underinsured children have health coverage but not full benefits. For example, mental health, vision and dental services are often excluded, with heartbreaking consequences. That's what happened to Deamonte Diver, who died because he couldn't afford to have his infected tooth removed.
What is your perspective on coverage for the children of immigrants?
A child is a child is a child. I believe all children, regardless of immigration status, should receive health care. Immigration status is not a factor when it comes to public education, why should it be a factor in access to health care? The way it stands now, the Federal government allows S-CHIP dollars to cover legal immigrants that have been in the U.S. for five or more years.
President Bush says expansion of S-CHIP would entice parents to move from private to government coverage at taxpayer expense. Is there any evidence to support this concern?
That didn't happen when Congress voted to add a prescription drug benefit to Medicare for seniors. Seventy percent of those people already had private coverage for prescription drugs, and they kept it.
What do you think of John McCain's plan to expand children's health care?
Senator McCain has no specific health care plan for children. In 2007 he voted against legislation that would have improved and expanded S-CHIP to cover an additional 3.5 million children. At the Children's Defense Fund, we keep a Congressional scorecard. Senator McCain received the lowest score of anyone in the Senate in 2007.
What do you think of Barack Obama's plan to expand children's health care?
Senator Obama's health care reform plan calls for a "mandate" to cover all children and young adults under age 25. Recognizing that children are a special population with specific and immediate health care needs is the right way to go. Preventive care costs a fraction of emergency room care: $100 to treat an asthma attack at a doctor's office; $7,300 when emergency room care is the only option.
Realistically, is there any money left for children, after the Iraq War and the Wall Street bailout?
As we prepare to spend billions of taxpayer dollars to rescue Wall Street from its own excesses, it is unthinkable to me that we would quibble about the cost to care for children -- a mere fraction of the cost of the bailout. To insure nine million children would cost taxpayers less than $1 per week. We can't put the Wall Street bailout on our children's backs. This November, we must hold our elected officials accountable for the policy choices that led us to this place.
Polls show that health care coverage for all children is something nearly everyone wants. Almost universally considered the decent thing to do, it is also a smart investment. In Florida when parents were helped to buy coverage, emergency room visits dropped by 70 percent, saving the taxpayers $13 million. Few policies are more clearly aligned with American values. Still, Republicans have managed to turn this issue into a political football.
John McCain believes more vigorous competition among private insurers will go a long way toward solving many of the problems plaguing health care today. He says freeing the market from regulation will drive down costs. For an overview of the McCain-Palin health care plan, click here.
Barack Obama believes enlightened regulation and government intervention will help make affordable health insurance available to all Americans. He would begin by mandating coverage for children. For an overview of the Obama-Biden plan, click here.
The Kaiser Public Opinion Spotlight on health care and elections examined public opinion data and historical trends to give some insight into the potential role health care will play in this election. To download the Spotlight, click here.
CBS News reports that one in four children have no full time coverage, a gap twice as big as anyone thought. Eight in 10 Americans favor expanding S-CHIP, which also has the support of private insurance companies, organized labor, the pharmaceutical industry, and hundreds of leading health and children's advocacy groups. This popular children's health insurance program is designed to give low-income working families access to regular check-ups, hospitalization, and vision/hearing screenings. To find out if your children are eligible call toll free 1 (877) KIDS-NOW.
Candidates' Voting Record On Issues Related To Children's Health Care
-- State Children's Health Insurance Program (S-CHIP) Reauth. (8/2007): McCain - No; Obama - Yes
-- Teen Pregnancy Education Amendment (2006): McCain - No; Obama - Yes
-- Hurricane Health Care Amendment, to provide emergency health care for survivors of Katrina (2005): McCain - No; Obama - Yes