America's Children Health Insurance and Access to Care (1998) / Chapter Skim
Currently Skimming:
1 Introduction and Overview
1 Introduction and Overview
Pages 9-22
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part Does nsur~lnce Clue Access to ~ ore .
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Among employers who c30 offer some form of health insurance coverage for full- time employees, a larger share of the costs of clepenclent coverage is being shifted to employees (GAO, 1996; Weigers et al., 19981. Traditionally, uninsured children have received "charity care" from hospital emergency rooms, outpatient departments in public anc3 teaching hospitals, state anc3 local health departments, community health centers, anc3 incliviclual practitioners, all of which are known as "safety net providers." The availability of safety net services varies from community to community.
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. The SCHIP program was ciesignec3 to help states cover uninsured children with family incomes that are too high for Meclicaic3 but too low to afford private coverage.
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If, however, states actively support the inclusion of safety net providers in SCHIP anc3 enhance their efforts to coordinate enrollment anc3 services across different programs anc3 sources of financing, a seamless system of chilciren's coverage could begin to emerge. PURPOSE OF THIS STUDY In the summer of 1996, the Robert Wood Johnson Foundation asked the National Academy of Sciences to conduct a study of the relationship between health insurance anc3 access to care for children.
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The Committee on Children, Health Insurance, anc3 Access to Care incluclec3 14 inclivicluals with expertise in health care financing anc3 delivery. Collectively, these inclivicluals hac3 expertise in private insurance, managed care, Meclicaic3, anc3 other public programs; health care delivery, including primary anc3 specialty care in pediatrics anc3 adult populations; health care policy, including legislative policy, regulation, health law, anc3 health economics; epidemiology; anc3 health services research.
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The budget question is not one of whether we have enough money being spent in total, but rather to what extent can we reallocate that money to buy what we really think is best. Eugene Steuerle Urban Institute, Washington, DC Public Workshop June 2, ~ 997 In response to the charge from the Robert Wood Johnson Foundation, the committee's intention was to conduct a thorough review of the existing scientific evidence on insurance and access and to present and summarize the best available information as clearly and objectively as possible.
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Kim Monk Washington Business Group on Health, Washington, DC Public Workshop June 2, ~ 997 It's very important to worry about safety net providers because they are doing very critical work in our communities. But I would hope that we come to some lessons about the value of insuring individuals and creating financial resources which follow the individual, as opposed to trying to set those resources into the institutions.
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When compared with insured children, uninsured children are more likely to be sick as newborns, less likely to be immunized at appropriate ages, less likely to receive medical treatment when they are injured, and less likely to receive treatment for illnesses such as acute or recurrent earaches and asthma. Having analyzed the available evidence on financial and nonfinancial barriers to care, the committee concludes that children's health insurance status is the single most important influence in determining whether health care is accessible to children when they need it.
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With the new chilciren's health insurance programs anc3 other initiatives, more efforts are being macie to help parents learn about the different programs anc3 make enrollment easier, including having common application forms anc3 streamlining the application anc3 enrollment process. States also will need to improve their efforts to coordinate administration anc3 data collection among Meclicaic3, SCHIP, Title V maternal anc3 child health agencies, anc3 other state anc3 private programs involving children and families, especially low-income working families.
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The second section of the report describes a variety of means for financing health care for children. Chapter 4, Safety Net Proviclers, describes the current safety net providers and the ways in which they are meeting the demands for expansion of health insurance coverage for children during a period of rapid change in the health care delivery system.
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From page 22... ...
1995. Ability to Obtain Health Care: Recent Estimates from the Robert Wood Johnson Foundation National Access to Care Survey.
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