Homespun Safety Net for the Young

March 08, 1992

Marooned in the spirited debate over health care reform are hundreds of thousands of children whose working parents don't qualify for Medicaid but cannot afford private doctors. The problem -- now affecting upwards of 180,000 Maryland youngsters -- continues to escalate as local government health services disappear in the face of budget cuts just as demand soars.

One workable, if temporary, response to this gaping hole in the health care system is the grass roots alliances springing up between communities and providers across the region. Next month, Montgomery County and Kaiser Permanente embark on a program to split the cost of pediatric care for 35 children. In Allegany County, doctors and churches have teamed up to provide free doctor's visits, dental care, prescriptions and hospital stays for children and families without health insurance. Blue Cross and Blue Shield's Caring Program taps corporations to pay for immunizations, vision checks and other preventive care for youngsters in Howard and Anne Arundel counties. The list goes on.

Granted, these efforts only paper over the problem. But they represent a welcome patchwork on a quilt that's far from finished. State lawmakers, to their credit, are pushing hard to hammer out some kind of workable health care reform. But even under the most optimistic scenario, no real progress is likely until next year. In the interim, thousands of Maryland youngsters will go without the kind of preventive and primary health care every child deserves.

The need to provide basic care for the young transcends sympathy for parents forced by circumstances to choose between groceries and immunization shots. Some of these youngsters, not treated for routine ailments, will end up in the expensive emergency rooms of area hospitals, adding to the state's uncompensated care burden. Others will suffer debilitating illnesses that will prove extremely costly to the state -- which will pick up the tab -- in the years ahead.

Providing health care to the young is a pressing concern that demands immediate attention and action. In the wake of budget cuts and pared services, communities and health providers have stepped into the breach. But local jurisdictions still have an important role to play. That most can't pay for the services they once offered is painfully obvious. But financial extremity needn't necessarily dictate retreat. As the Montgomery experiment suggests, the time has come to explore new approaches to old problems.

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