Hospital CEO has Rx for kids’ care

By William k. Alcorn

Akron Children’s Hospital’s president advocates creating a health care system aimed solely at children.

BOARDMAN — Start with the children.

That is the advice given to President Barack Obama as a starting place to fix health care in the United States by another president, William Considine, president and chief executive officer of Akron Children’s Hospital.

Considine, who describes himself as a “privatization kind of guy,” nonetheless advocates some type of combined private/nationalized health care system for children.

The reason, he said, is that: “The financing of health care, as we all know, is broken. I’d like to see nationalized health care for children, birth through 21. It could serve as a pilot program and perhaps eventually be expanded to other age groups.”

“I consider myself a champion for kids, and I really believe one of the things that government can do is advocate for our children and give them a good start in life by leveling the health care field,” he said.

A lot of things have been tried, said Considine, who has been CEO at Akron Children’s for 30 years. Akron Children’s Beeghly Campus in Boardman has been open for a month.

“But, what we have done is not working relative to the financing of child health care in this country. I still think I’m in the minority on this issue in terms of my colleagues. But, I believe if something is not working you have to have the courage to try a new approach,” he said.

Even with programs in play, such as Medicaid, the State Children’s Health Insurance Program (SCHIP) and private insurance, there are still large numbers of children who don’t have adequate health care. The challenge is to figure out how to cover them. Maybe that’s where a national program can fit in, he said.

Medicaid is the national health program for low-income people that is jointly funded by the states and federal government and is managed by the states. SCHIP is a federal program that gives matching funds to states with which to provide health insurance to children in families with incomes too high for them to qualify for Medicaid.

Considine thinks private insurers need to be involved in any type of nationalized scheme, but they cannot be permitted to deny coverage because of preconditions.

“A key to medical care is accessibility,” he explained.

Considine said children are the largest underinsured and uninsured group in the nation.

To combat that, he believes, health care needs to be segmented by age groups, with children by themselves, as the elderly are now with Medicare, to level the field for all kids.

One child in five is living in poverty, and the number of uninsured children is growing, said Considine, past chairman of the National Association of Children’s Hospitals and chairman of the Ohio Association of Children’s Hospitals.

Since 2004, about 40 states have seen the number of uninsured kids grow, despite programs aimed specifically at helping children, he said.

The reasons are several, he said.

A lot of the private insurance in this country is tied to employers. Dependents are covered, but as an add-on in many plans. In a lot of cases, add-ons to cover children cost more than the wages of the working adults and are not affordable, Considine said.

Even tax-subsidized programs for children are faulty because eligibility is tied to income, unlike the federally funded Medicare program that provides health care for the elderly, regardless of income. Also, he said, Medicare rules and levels of care are the same nationwide.

Eligibility for Medicaid, of which SCHIP is a component, is tied to income. To get health coverage, a family must qualify for welfare. For many working families, they earn too much money to qualify for Medicaid, and not enough to afford private coverage.

Another disadvantage of Medicaid is that eligibility requirements and benefits can vary from state to state.

The U.S. has 10 million children underinsured or uninsured. Sixty percent of all children have some kind of private coverage; 28 percent have some kind of public coverage; and 12 percent of kids are underinsured or uninsured.

“This is a great country. For us to have that kind of statistic is embarrassing,” he said.

Considine said his “simplistic approach” to the problem is to dedicate some Medicaid funds and other revenues to health care for children.

At present, he said, 72 percent of Medicaid goes to the elderly and 28 percent to children and mothers, who make up 70 percent of number of people on Medicaid.

In Ohio, the Medicaid annual expenditure per capita is $1,200, but for the elderly it is close to $12,000, primarily driven by the cost of pharmaceuticals and long-term care, he said.

“Two diverse populations in one program is hard to manage. We need ‘Kidcaid,’ or whatever you want to call it, and blend it with the private side so we have one standard of care across the country for children,” Considine said.

Let’s separate health care for children from welfare and have one standard of care for which every child is eligible, he said.

“If we can spend $700 billion to bailout financial institutions, we can surely spend a fraction of that amount to put a health care plan in place in this country for our children,” Considine said.

alcorn@vindy.com