Editorial distorted truth on health plan for children

March 07, 1998|By Dr. Timothy F. Doran

YOUR Feb. 25 editorial "Sensible health plan for children" makes no sense. The piece contains misinformation and distortion, and suggests that you have not carefully researched this important subject.

The reason health care for uninsured children is a major focus of this year's legislative session is that the federal government has made available to Maryland $60 million a year for five years to provide health coverage for uninsured children, a fact you neglected to mention.

This money comes in a 2-to-1 federal grant, so Maryland would pay only $30 million (not the $76 million stated in your editorial) in order to capture the $60 million from the State Child Health Insurance Plan (SCHIP).

The Maryland figure in the governor's plan is $21 million, because not all the uninsured children would be reached the first year.

The money comes with clear stipulations.

The federal SCHIP dollars cannot be used to cover children with access to employer coverage (nor does the governor's plan allow families to immediately drop private insurance for free government benefits, as you state).

The insurance plans need to meet specific benefit levels and many employer plans, therefore, would not qualify for federal funds.

Tax credits, in and of themselves, would most likely not qualify for the federal matching dollars.

It is important to note that the current Health Choice program for Medicaid children is a private insurance plan. These children receive care through a small group of commercial carriers, such as Prudential, in a private system.

The tax-credit plan would create a separate system of agents and brokers selling plans to employers individually, instead of the state contracting for large groups of children with attendant cost savings. The broker fees would include a profit, which would come directly out of services to the children, as opposed to the state, which has no financial self-interest.

Tax credits would be unworkable. The comptroller of the treasury of Maryland has already pointed out some obvious problems, the need for revised tax forms, the need for a special work sheet, the need for some low-earning taxpayers to file only for the credit, the need for employers to fill out more forms, and the fact that family income is not currently calculated on Maryland tax forms.

It would be a bureaucratic nightmare whose only beneficiaries would be insurance agents and brokers. The state would lose, employers would lose and, most important, the children would lose.

Finally, why have we provided (appropriately) universal health insurance, regardless of income, for our elderly, yet there is still some resistance to covering our poor or near-poor children?

Surveys across the country have shown broad support for this entitlement, in contrast with The Sun's opposition to such a program.

Most Americans believe that all children should receive adequate health care. It is our duty as a civilized society to nurture and protect them. Let's not miss a golden opportunity to approach this goal by passing a Byzantine tax-credit scheme.

The governor's proposal makes the most sense: a simple, scamless system building on the hard work of the last two years.

The writer is president of the Maryland chapter of the American Academy of Pediatrics.

Pub Date: 3/07/98

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