Texas As An Example?

When ranking states, Texas is next to last in children's access to health care, yet U.S. Sen. John Cornyn (R-Texas) presents it as a shining example for the rest of the nation.

Here's a clipping from the Commonwealth Fund report (emphasis mine):

[...] the 13 states at the bottom quartile of the overall performance ranking—Illinois, New Mexico, New Jersey, Alaska, Oregon, Arkansas, Nevada, Texas, Arizona, Louisiana, Mississippi, Florida, and Oklahoma—lag well behind their peers on multiple indicators across dimensions[...]

Now for a bit of perspective on his health care stance: Cornyn voted against SCHIP, which now covers about half a million Texas children. He also opposed the reinstatement of adequate Medicare reimbursements to providers. Cornyn initially opposed reinstating adequate Medicare reimbursements to doctors, causing the Texas Medical Association to rescind their endorsement of him during a recent re-election bid.

Now according to The Houston Chronicle he has been speaking out about Texas as a shining example. Here's a quote form the Chronicle story:

"So, you have to understand what I mean when I say I want to make Washington, D.C., and the rest of our country more like Texas (because), frankly, we know the policies that actually work." [-U.S. Sen. John Cornyn]

As the debate continues and we see more instances like this, it would behoove us all to beware of political spin from either side and focus on the facts. The Commonwealth Fund has been doing a magnificent job of providing hard data at a time when it is so desperately needed. Thanks, guys!

SOURCE: "Out of touch Senator's depiction of Texas' health care system as a national role model departs from reality" 08/14/08
SOURCE: "U.S. Variations in Child Health System Performance: A State Scorecard" 05/25/08
photo courtesy of little black spot on the sun today, used under its Creative Commons license

Suffer The Children, Even if They Have Insurance

A staggering new report was released this morning that puts a whole new spin on the subject of children's health care. Nine million children across the country lack health insurance. We have seen those numbers repeatedly in recent news, but are the children with coverage truly taken care of? This report's shocking findings say no, and go on to state that less than half of them are.

The Seattle Times spoke with the study's prime mover:

"I was very surprised - and very distressed - about our results," said Dr. Rita Mangione-Smith, the study's lead author and a researcher at Seattle Children's Hospital Research Institute and associate professor of pediatrics at the University of Washington School of Medicine.

"There are a lot of failures there. And on very basic things that people agree we should be doing."

The nonprofit RAND Corp. contributed to the research, which is published in the New England Journal of Medicine. It was funded by the Centers for Medicare & Medicaid Services, the Robert Wood Johnson Foundation and the California HealthCare Foundation.

The records showed that children got the proper care only 46.5 percent of the time. It relied on records collected between 1998 and 2000 of 1,536 children in urban areas who had actually seen doctors, and for whom researchers were able to obtain one or more medical records.

Experts said it is unlikely that care has improved significantly since then, except for some improvements in immunization rates and asthma care. And almost all the children in this study were insured.

While debate continues over the uninsured youth of America, this study shakes some of the perceived axioms of that discussion. It is tacitly assumed that getting all of our country's children coverage is the answer, but what then? If only half of them get proper care once insured then there seems an even longer path ahead than previously thought.

ABC News zeroed in on the demographic slant:

"We had primarily white children with insurance from middle- to upper-middle income families," said Mangione-Smith. "This is probably a best-case scenario; this is as good as it's going to get."

More than half of children studied failed to receive the care they needed. More than half in a study that had few uninsured, minority, or rural children. So basically of those children who have the best health care protection, the batting average is less than 50%. Dr. Paul Wise, a Stanford University pediatrician and health policy researcher who was not directly involved with the study, finds the results disturbing. "The quality indicators are just so awful that even if they're off by a considerable extent, they still hold up," Wise told the San Jose Mercury News. "The findings suggest that the quality of health care for children is pretty pathetic."

BusinessWeek gives us some more statistics from the report:

Some of the more startling discoveries:

• Sixty-nine percent of 3- to 6-year-olds did not have their height and weight measured at annual checkups, and only 15% of adolescents were weighed and measured, even though one-third of American children are overweight or obese.


• Fifty-four percent of children diagnosed with asthma did not get recommended treatment.


• Sixty-two percent of children were not screened for anemia in the first two years of life, although the test is recommended for all babies.


• Only 38% of children received the proper care for acute diarrhea, one of the main causes of hospitalizations in children under age 5.

As additional information is revealed, the dialogue on children's health care and insurance reform gains more and more urgency.

SOURCE: "Health Care For Kids Falling Short" 10/11/07
SOURCE: "'Stunning' Deficiencies in Kids' Health Care" 10/11/07
SOURCE: "Health Care for US Kids Falls Short" 10/11/07
photo courtesy of ninjapoodles on Flickr under the Creative Commons license