Friday, April 6, 2001 Volume 66, Issue 127



Children's health care addressed at discussion

Almost 1.5 million children in Texas are without health care

By Mauryzia Wong
Daily Cougar Staff

The UH Health Law and Policy Institute played host to a panel discussion on the current status of children's health care on Thursday. 

The panel, moderated by institute director and law professor Mary Anne Bobinski, featured economics professor John Antel, Graduate School of Social Work Dean Ira Colbey, optometry associate professor Karen Fern and psychology professor Kathleen Sheridan.

Colby addressed access to and eligibility for health care coverage of poor children. He said 1.4 million children in Texas, including 280,000 in Harris County, have no health insurance. He added that, of the state total, 1.2 million children have at least one parent working full time.

"So what is it that we expect when we have people who are working but still cannot afford or have access to health insurance?" he said.

Johnny Kow/The Daily Cougar

Mary Anne Bobinski, director of the UH Law Center Health Law and Policy Institute, economics professor John Antel, Ira Colby, dean of the Graduate School of Social Work, optometry professor Karen Fern and psychology professor Kathleen Sheridan addressed the problems of health care coverage for Texas children.

Fern addressed the access that preschool children have to vision care. She said that children are underserved in this area, a problem recognized by the U.S. Department of Health and Human Services.

Fern said it is estimated that only 10 percent of preschoolers undergo complete vision exams, and only one-third even have a vision screening. She said that the vision screenings that are performed are not effective at detecting vision anomalies. 

She added that there is little follow-up, with Texas Department of Health statistics showing that fewer than half of the children failing screenings have any type of follow-up at all.

Sheridan discussed the issue of chronic illnesses among children. She said that 10 to 15 percent of children under the age of 18 have been diagnosed with some type of chronic illness. She said the most prevalent chronic illnesses among children include asthma, diabetes, sickle cell disease, and HIV infection. 

She discussed problems in regards to understanding how the families of chronically ill children cope. She said that the majority of studies conducted have neglected fathers while focusing on mothers and their coping mechanisms.

She also said that with the exceptions of pediatric oncology and rehabilitation, few ongoing support programs are in place for the children and their families.

Antel addressed cost-benefit issues in children's access to health care. He said research economists have learned that early interventions are beneficial.

Colby, addressing access issues, said that the two programs in Texas geared toward uninsured children are the Children's Health Insurance Program, for families above the poverty line, and Medicaid, for families at or below the poverty line.

Colby said 600,000 children in Texas are Medicaid-eligible and 500,000 are CHIP-eligible.

He said children under five years old in families over the poverty line may still qualify for Medicaid, resulting in families with one child in one program and another child in the other program.

However, the cumbersome process of completing forms for the different programs and the time involved may ultimately affect access in families with one child who qualifies for one program and one who qualifies for the other, he said.

Medicaid requires the completion of 16 to 59 different eligibility and verification forms every six months. CHIP requires one to five forms to be filled out every 12 months.

"Medicaid creates barriers," he said. 

Additionally, Medicaid eligibility in Texas does not allow ownership of multiple vehicles, pension plans or savings accounts. Colby said that poor people are told that they have to save but if they do, they are no longer eligible for various government programs.

"They are blamed on the one hand for not doing something," he said, "but conversely, doing something makes them ineligible for healthcare."

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