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Statewide child health care an issue at Anchorage summit

Posted: Tuesday, October 19, 2010

Even though Gov. Sean Parnell vetoed a bill that would have made health care available for every child in the state last year, several groups are interested in finding ways to get more children insured and in pushing the bill forward again.

The bill, SB 13, was passed by both chambers of the Legislature and addresses eligibility requirements for medical assistance for certain children and pregnant women.

A child health summit will take place among medical professionals, insurers and advocacy groups today in Anchorage. Tricia Brooks, a senior fellow with the Georgetown University Health Policy Institute's Center for Children and Families, will speak about how the state and others can streamline functions like the application process to better serve families. Prior to working with Georgetown, she spent 15 years as the State Children's Health Insurance Program director in New Hampshire and other groups.

Alaska also has a SCHIP program, which is administered through Denali Kid Care.

Brooks said the Center for Children and Families also works as communication support for advocacy groups. In the spring, they sponsored a series of regional meetings inviting advocacy groups from all states to attend. Now, dialogue branching from that will take place.

"We're going to take stock of where Alaska is in terms of covering kids," she said.

Brooks anticipates a focus on getting children in the programs, potentially in an effort to expand eligibility. She said there are 22,000 uninsured Alaska children. She estimates half of those are eligible for insurance through Medicaid or Denali. Brooks said there are three main reasons why the eligible children are uninsured: Families are confused as to who is eligible, some families have difficulty filling out all the paperwork, and there is a newer group of folks who have been hit hard by the economic downturn and focus on putting food on the table, paying the bills and finding work over health care for their children.

"One of the things we'll talk a little bit about (today) are some of the ways that the state could streamline the programs and requirements to make it easier and also the way community-based organizations can get involved," she said.

Brooks said Alaska children are 25 percent more likely to be uninsured over children in the Lower 48. She said in areas like Alaska where there is a high cost of living and high health care costs, there also is usually higher eligibility levels. This is not currently the case in Alaska, she said.

Some ways the state and other organizations can streamline the process is through the Internet. She said currently, those applying for Denali have to fill out an application online, then print it out, sign it and mail it in. Time could be saved and errors eliminated if people could simply submit the application online. Brooks said there are other options, some simple and relatively low-cost, others more costly.

Brooks also will speak about health care reform. She said the reform will give 30-34 million Americans insurance coverage - half through an extension of Medicaid. The other half will be through subsidies to purchase private insurance. Brooks believes an open marketplace for private insurance will be good because some people and small businesses will be eligible for a federal tax credit, there will be information assistance and people will be able to compare rates and packages.

Local private pediatrician George Brown, who has practiced in Alaska since 1965, said he is passionate about getting all children covered by insurance. He also believes the reform has benefits. He said many people feared the federal government taking health care over, but he said currently it's already socialized medicine through insurance companies. Brown believes health care will improve with a single-payer system and that the reform does away with a fee for service. He said doctors have the capability to charge by what they think they should get paid by using a standard of codes. Brown said this can lead to greed on either the insurance companies part or doctors.

"Many of (the doctors) are making a lot of money that they don't really need to make," he said. "My colleagues don't really like to hear me say this. Uniform payments is really what's going to happen."

Others who will speak include Vikki Wachino, director of Family and Children's Health Programs Group, about options available to families and health reform legislation.

Barbara Hale, child health liaison with Alaska's SCHIP will talk about efforts being made in Denali Kid Care. There also will be a presentation by the Southcentral Foundation, which has an outreach grant and programs for Natives.

Brown spoke to Brooks about a program he favors that the American Academy of Pediatrics promotes - a medical home.

"What this means is if children have a place their parents can always take them," he said. "If they come in for regular well-child care visits, that's prevention. We're teaching healthy nutrition, guidance for child development and child behavior problems and prevention of infectious diseases."

Brown cited an Alaska State Legislature document on SCHIP and Denali Kid Care that said in 2006 the cost of Denali was $25.9 million, but $18.2 million was paid for by the federal government. In that same year, two hospitals in Anchorage provided $89 million in uncompensated care for families and children who did not have health insurance.

"The cost of this uncompensated care is passed on to other people and ultimately increases the insurance premiums for everybody else," he said. "So we pay for it one way or another. It is much less expensive to have children seen in a medical home than an emergency room."

Brooks believes programs such as medical homes are essential for the future of health care.

• Contact reporter Sarah Day at 523-2279 or at sarah.day@juneauempire.com.



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