Intended for healthcare professionals


Paediatricians propose plan to insure every US child

BMJ 1999; 319 doi: (Published 23 October 1999) Cite this as: BMJ 1999;319:1087
  1. Scott Gottlieb
  1. New York

    The American Academy of Pediatrics announced a new health insurance proposal that would create a national programme in the United States in which all children and young people up to the age of 21 are automatically eligible for full, government funded healthcare coverage. At present, 11 million children are not covered by insurance.

    The new programme would have uniform eligibility and benefits, and if enacted, would replace a patchwork of existing programmes that provide partial but not complete health insurance coverage, mostly to children born into poor families.

    The announcement was made at the academy's annual meeting held at the Washington Convention Center in Washington, DC—an event which President Clinton attended and at which he offered his own version of health insurance for children.

    Under the president's proposal, federal agencies would be directed to visit schools and proactively enrol children into existing federal health insurance programmes that the president said are largely underused.

    Congress created a new programme that expanded health insurance to children in 1997. It provided $24bn (£15bn) over five years and a total of $39bn over 10 years, but states have used less than 25% of the money made available so far.

    “It's simply inexcusable that we've been sitting here with the money for two years to provide health insurance to five million kids, and 80% of them are still uninsured,” President Clinton said.

    The academy's proposal, however, goes further than the president's, and would seek to insure greater numbers of children.

    Under the academy's proposal, either families could choose to enrol their children in a private insurance plan or they would automatically be enrolled in a national programme. The academy said that it was still looking at a variety of ways to fund the proposal.

    Census Bureau data show that the number of US children without health insurance has increased by 15.6% since President Clinton took office, to 11.1 million last year from 9.6 million in 1993.

    The number of uninsured children rose by 330000 in 1998 alone, despite an exceptionally robust economy.

    “The world's most powerful democracy has 11 million uninsured children,” said the academy's president, Dr Joel Alpert, in an address he delivered at the annual meeting. “There is no excuse for it,” he said.

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    More than 11 million children in the United States are not covered by health insurance


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