Children big winners in health proposals Clinton plan focuses on preventive care

September 18, 1993|By Karen Hosler | Karen Hosler,Washington Bureau

WASHINGTON -- Well-baby visits, lead paint screenings, checkups at the dentist. For many parents, these are luxuries they can't afford for their children, and their health insurance won't pay for it.

All that would change under President Clinton's health care reform plan, which would provide some of its most generous benefits to children, children's advocates say. Under the plan, children would gain access to a wide range of preventive services that most parents now have to pay for themselves or do without.

From conception through adolescence, all children would be guaranteed a basic program of medical care designed to prevent illness -- a change that would encourage parents to take their children to the doctor before a crisis develops. Visits to the doctor for routine exams, immunizations and preventive screenings would be covered for the first time, even for many families with health insurance.

"Much of this proposal is just like what we would have written ourselves," said Dr. Howard Pearson, president of the American Academy of Pediatrics. "I think it reflects the keen interest both the president and Mrs. Clinton have in children."

First lady Hillary Rodham Clinton is a former chairwoman of the Children's Defense Fund advocacy group.

The standard benefits package included in the plan provides for:

* Prenatal care and pregnancy-related services.

* A medically recommended regime of immunizations against infectious diseases.

* Testing for lead paint poisoning for children under the age of 2 who are deemed at risk.

* Seven well-baby visits from infancy to age 2; two checkups from ages 3 to 5, and five visits from the ages of 6 to 19.

* Low-cost dental care through age 18, including orthodontics.

* Low-cost routine eye and ear exams and eyeglasses for children.

* A prescription drug plan.

* Treatment for mental health problems and substance abuse.

Dr. Pearson said his organization "might argue with some of the numbers" on office visits. For example, he said, young people from 12 through 21 probably have more need of routine care than children from 6 to 12.

Most would see benefit

But overall the program would represent a vast improvement for many children, including those whose parents have health insurance coverage, because they would have access to care on a preventive basis, children's advocates say.

More than 7 million children in the U.S. have no access to routine medical care at all, according to a study performed in 1989 by the National Association of Children's Hospitals and Related Institutions.

"Children are the most affected by the lack of universal medical care in this country," said Ron Pollack, executive director of Families USA, an advocacy group that focuses on the concerns of children. "But we'll all be better off if they grow up healthy because we're going to need them to run the country and take care of us."

Work remains, some say

Some lawmakers and child advocacy groups say there is work to be done on Mr. Clinton's plan to make sure that the most vulnerable children -- the poor, the disabled, those from dysfunctional families -- don't continue to fall through the cracks.

These advocates say low-income families would have less choice about their doctors than the more affluent because they would be forced into cheaper health maintenance organizations. People who could afford to pay more for their health care coverage could choose a traditional plan allowing them to pick a doctor or hospital.

Through the HMOs, most services are fully covered or require a small co-payment. The higher-cost plan requires a $400 deductible, and 20 percent co-payment with a maximum of $3,000 in out-of-pocket spending.

Others complained that the Clinton plan makes no provision for standardizing support services -- such as transportation and day care -- that some states provide through their Medicaid program to help low-income families get to doctors and medical facilities.

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