Quantity and quality in children's healthcare

It is unclear what will happen after the president’s veto of the bill reauthorizing the State Children’s Health Insurance Program (SCHIP) and the inability of Congress to override his veto. John Iglehart, the highly-respected national correspondent for the New England Journal of Medicine, reviews the episode here. It is brief, understandable, and to the point. Whatever you think of the issue, it is clear opponents of the program misrepresented what it was.

But there is a deeper issue — quality, as well as quantity, matters. In a way, the SCHIP debate is about quantityof healthcare because it concerns access to care; children and adolescents are disproportionately more likely than adults to be poor, something SCHIP was designed to address. Another recent New England Journal article shows how qualityof healthcare for children is also a major problem.

This observation goes against the common wisdom, which has been that problems in quality of healthcare are not such a problem for children as they are for adults. The unspoken assumption has been that children’s conditions are somehow easier to diagnose and less complicated to treat than those adults get. So if the child could get to the doctor, then we presumed the child usually got the correct care. This is not true; deficiency rates in the quality of care for children were similar to those noted in adults.

What is the solution? We need to assume children are just as complicated as adults in their healthcare needs.


Comments

2 responses to “Quantity and quality in children's healthcare”

  1. My mom, a retired school speech pathologist, spent over 95% of her career working in schools populated by poor children who had virtually no health care. The disappointment she feels with our government at the moment is such that I cannot adequately convey it in this space. This issue is one she believes in mightily and her sadness over this program’s abandonment is palpable.

    If we do not care for our children, what hope is there for the future of this country? It is illogical and ignorant to believe otherwise.

    Thanks for posting about this.

  2. Thanks for your comments. I sometimes despair about it myself. I think things will eventually get made better, but first they will need to become so chaotic that all will agree something needs to be done. I think money invested in children’s health is just that–an investment that will easily repay the investment, with interest, later. More importantly, it will yield benefits to our society that cannot be measured on dollars.

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