"THE HEART OF THE MATTER"
a special program of the National Emergency Medicine Association (NEMA)


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Week: 583.6 pt. 1 

Guests: Stan Dorn, Children's Defense Fund and Josh Cooper, American Lung Association 

Topic: Health on the Hill / Kids health insurance 

Reporter: Aaron Cohen 

Host/Producer: Steve Girard 

NEMA: Thanks for joining us. Today, a couple of stories for you...we'll have some advice from the Centers for Disease Control on how to deal with problems associated with the extreme heat of summer. But first...Health on the Hill.

The House and the Senate have agreed to plug one of the more gaping holes in the nation's health care system. Lawmakers in both sides of the legislature have passed competing bills aimed at providing health insurance for the roughly one in seven children whose parents are stuck with huge doctor bills if the kids get sick. Aaron Cohen reports on the two approaches for insuring uninsured children....  

COHEN: The state of Florida doesn't claim to have all the answers, but they've devised a program Congress hopes to emulate. it's called "Healthy Kids", and it enables the state to help parents buy insurance for their children....and instead of allowing minor ailments, like ear infections of strep throat to fester, kids are treated by family doctors. Florida says the results have been promising - 70% fewer E.R. visits and 13 million dollars the state saved on expensive medical treatments. Stan Dorn with the Children's Defense Fund says Florida's experience belies the myth that children don't need health insurance...  

DORN: According to one major national survey, the majority of uninsured children with asthma never saw the doctor during the year of the survey, and more than one third of uninsured children with reoccurring ear infections never saw the doctor. Many of those children wind up in the hospital with acute attacks of asthma that could have been prevented, or wind up with permanent hearing loss.  

COHEN: Enter the odd couple of the United States Senate...conservative Republican Orrin Hatch of Utah and liberal Democrat Ted Kennedy of Massachusetts... the two joined forces to pass a bill insuring about half of the nation's 10 million uninsured children. it's a five year, 24 billion dollars allocation of block grants to the states, partially paid for by a 20 cent increase on a pack of cigarettes. The idea of insuring poor, uninsured children caught fire at the White House and in the House... President Clinton's budget would expand access to Medicaid and the House passed a less expensive, less restrictive bill that does not include the cigarette tax increase and allows the states to spend the grant money anyway they choose. New York, for example, really likes the House bill. The Empire state, if it uses its own benefits package, which runs the gamut from primary care to substance abuse, says it would spend 20% less per child than if the Kennedy - Hatch bill becomes law. But Josh Cooper of the American Lung Association says his and other like-minded groups prefer the Senate bill....  

COOPER: Little kids lungs would definitely be helped by the Hatch - Kennedy bill. Not only would there be a reduction in youth smoking, because of the tax...as everybody knows youth are much more price sensitive to products than adults....but the child health care portion would also help. There are many of those children, the 10 million uninsured, who have asthma, and they need health care as well...and this would definitely help them.  

COHEN: Children began slowly slipping through the cracks in the health care system as some businesses gradually began eliminating benefits to employees as they became too expensive. And what frustrates Advocates for Children is that three million of the ten million uninsured are eligible for Medicaid. Many parents either don't know they're eligible or shun the health plan because of the negative image of it being medical care for the poor. Despite all the sound and fury about insuring half of the nation's uninsured children, the non-partisan Congressional Budget Office says either bill would fall well short of its billing. CBO says at best, only about a million and a half kids would have medical coverage, while the Senate says it could protect 5 million, and the Children's Defense Fund says the Senate bill insures over six million. Regardless, Stan Dorn with the CDF says it's worth the effort...  

DORN: Let's be honest, the Senate bill...as positive as it is overall, doesn't get us all the way there. It represents a significant down payment on solving this problem. So, we have to make sure we keep an eye open for additional resources to help us solve the problem. At some point, we may see a big settlement with the tobacco companies. Senator Hatch ....  

COHEN: That could mean many billions of dollars...which could go a long way to adding a few bells and whistles to what is now just a basic benefits package for kids who have no health insurance at all. For Health on the Hill, I'm Aaron Cohen.

NEMA: Thanks Aaron...we'll be right back to talk about how to know heatstroke.....  

SPOT: 15 years in the prevention of heart disease, stroke and trauma - The National Emergency Medicine Association. This show is just part of what NEMA does. We send out millions of pieces of prevention information to people around the country, give grants to organizations in research, public information and emergency services, and have been instrumental in the creation and expansion of the Chest Pain Emergency Room movement. To play a role, call 800-332-6362.  

CONTINUES WITH 583.6 pt. 2 Heatstroke/CDC