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Summary
Pages 1-8

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From page 1...
... The committee included 14 individuals with expertise in health care financing and delivery, private indemnity insurance, managed care, Medicaid, and other public programs; health care delivery, both primary and specialty care for children and adults; health care policy; legislative policy, regulation, health law, and health economics; health services research; and epidemiology. The committee convened a public workshop in dune 1997 in Washington, D.C.
From page 2...
... The committee began the study with a decision to take an evidence- based approach to its examination of the relationship between health insurance and access to care. With the rapid rate of ongoing change in the health care insurance and delivery picture for children, the committee later decided to supplement the review of scientific and empirical evidence with an analysis of health care trends that are likely to affect the implementation of new chiluren's insurance programs.
From page 3...
... Without a regular source of care, low- income children are more likely to use publicly funciec3 clinics for stanciarc3 preventive services such as immunizations anc3 are more likely to use emergency rooms for care for acute illnesses. Some aspects of the health care system also can create barriers to access, particularly the shortages of providers to serve low income groups, lack of cultural sensitivity, anc3 inconvenient scheduling.
From page 4...
... No managed care organization will compete to care for uninsurec3 inclivicluals, anc3 government subsidies to care for low- income anc3 uninsurec3 inclivicluals are generally being reclucec3. Not all safety net providers will be able to make a successful transition to the competitive health care marketplace.
From page 5...
... This group accounts for 70 to 80 percent of all medical expenditures for children. Some of these children require extensive health care services (e.g., surgical procedures)
From page 6...
... CONCLUSIONS From the beginning of their deliberations, the committee members took the position that several strategies potentially could increase the number of insured children anc3 that their task was not to recommend one particular policy option. The committee members agreed throughout their cleliberations that the ultimate goal of these strategies is to provide access to coorclinatec3, efficient, effective, anc3 cost effective health care for all American chilclren, including children who have preventable illnesses anc3 injuries, chronic conditions, or other special health care needs.
From page 7...
... 5. Information generated from children's health care and insurance programs should be designed to be useful in evaluating short term trends and making program adjustments, and should be made widely available.


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