A step in the right direction

The victors celebrated. The critics kept critiquing. The general public wonders “what’s in it for (or against) me?”And those of us in the health care industry just keep on working.

The author at his desk in Cincinnati

I’m talking, of course, about the passage, on Saturday, of what some are calling the first major congressional overhaul of health care since the 1965 passage of Medicare and Medicaid. The bill includes individual and employer insurance mandates, and it also would expand Medicaid and create health insurance exchanges.

The passage is, in our opinion, a step in the right direction.

The spotlight has already shifted across the Capitol to the Senate, where a contentious debate is expected to surface. President Obama on Sunday raised the pressure on Senate Democratic leaders to finish the job.

As we’ve said all along, we need to make sure the needs of children and their families are met in whatever overhaul we have. Somehow we tend to overlook the little ones time and again. I know they’re just a small part of the overall picture — at least in terms of cost — but we have a great responsibility to them.

As we wrote in a letter to Sen. Sherrod Brown 10 days ago, the focus of many in the Senate has been strictly on adults. For instance, pediatrics has been excluded from most federally-funded quality and transformation work because it’s Medicare based. This despite the fact that Cincinnati Children’s and the other Ohio children’s hospitals have been working together on a number of quality projects.

A blog post in the New York Times suggests that it’s hard for hospitals to gripe too much about health reform when it does, in effect, expand the market by insuring tens of millions of people who heretofore didn’t access the system for lack of coverage. But, most kids are covered thanks to Medicaid and the CHIP program. Our market isn’t expanding. The problem is the massive under-reimbursement rate by Medicaid. This is another place “reform” is needed.

As the playing field shifts to the upper chamber, we’ll be there, speaking on behalf of children and the adults who take care of them.

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