A Pediatrician’s Take on the Health Care Debate

Congress goes back into session next week with health care high on the agenda.

So much is at stake that I feel compelled to jump in with my point of view–from my 35+ years on the frontlines of primary care as a pediatrician.

Children are literally our future.  They should be center stage in this health care debate.  I believe the Federal government should approve a national plan for delivering the best pediatric health care to every child in this country.  Federally-mandated pediatric care delivered through Medicaid would give every single child (who does not have private insurance) access to quality health care without discrimination.

I would also like to see healthcare focus on PREVENTION.  By consistently checking in with kids as they grow, you can catch and treat any problems early and give every child a chance to grow into a healthy adult. This is good for each individual kid, family and our society at large.

1.  Focus on delivering primary preventive care: Check in with moms before and after birth for optimal pregnancies and well babies.  Further, all infants, children, and adolescents should be guaranteed regular physical exams to monitor physical and emotional growth and well being.  These exams must include screening tests for development and autism, lead exposure, depression and anxiety.  (Insurance should reimburse for these!)

2.  If a child is obese and the doctor determines that dietary guidance is needed, nutritional counseling by a nutritionist should be available (and reimbursable).

3.  Free immunizations for all children through 21 years of age (and even older): This is already working with Massachusetts’ Immunization Program—promoting the health of its citizens through preventing diseases via a widespread free immunization program. I am consistently frustrated by the confusion and chaos of price and reimbursement from insurance companies versus the costs of vaccines to individual states by the pharmaceutical companies.  Don’t get me started on this topic!

4.  All children should have hearing and vision screenings performed and reimbursed by insurance companies.

5.  Train primary care pediatricians to treat depression, ADD/ADHD, anxiety and other mental health issues: there is a lack of child psychiatrists (especially ones that accept insurance). Many parents cannot afford the out of pocket fees.  Hence, the burden falls to the primary care pediatrician. Training in this area should be made available to greater numbers of primary care pediatricians.  Insurance companies should reimburse for mental health services for kids to help grow stable and healthy adults.

6.  Behavioral health: As a corollary to the above mental health issues, let’s work on finding ways to handle kids’ behavior without the prescription pad.  Teaching children (and parents and teachers) behavior techniques (and combining with medication(s), if necessary) has a direct correlation on adult mental health and productivity.

7.  Parenting skills: It should be a natural skill yet it can’t be taken for granted.  The primary care pediatrician’s office is primed to see and help here.

By focusing on primary care, particularly in pediatrics where we are investing in our nation’s future, we can effect a “win-win” for all.

What a legacy it would be for President Trump and all elected officials if we could create a comprehensive health plan that really addresses the needs of children and families.