Time ran out earlier this month before Dr. David Alexander could tell a state House committee hearing what he thought of state Rep. John Coghill's proposal to cut state medical coverage for pregnant women and children who don't have health insurance.
Rep. Coghill, R-North Pole, thinks the state program, known as Denali Kid Care, covers families who make too much money. Dr. Alexander, an Anchorage pediatrician with 40 years of experience, disagrees.
He notes the families Rep. Coghill wants to toss aside are those who fall between the cracks of today's patchwork system of medical coverage. They have jobs, so they aren't poor enough to qualify for free care from Medicaid. Those jobs don't have health insurance, or if they do, the plans don't cover children. Buying their own health insurance is out of the question for these not quite impoverished people because it is so costly.
The state estimates that the families Rep. Coghill wants excluded from the program would have to spend more than $5,000 a year on insurance and deductibles to cover two children. And that assumes the necessary insurance is available at any price. Some people who most need Denali Kid Care have pre-existing conditions that insurance will not cover.
If the state leaves more families to fend for themselves, Dr. Alexander says, ''sick kids still need care. Where are they going go? They go to the emergency room.'' And that, he says, is a very expensive medical option.
Minor illnesses left untreated can erupt into costly medical crises. Emergency rooms are required by law to treat all comers, regardless of ability to pay. When hospitals can't collect, they make up the difference by charging paying customers more. We all pay, whether it is through the state budget or through higher health care costs and insurance premiums.
Congress decided to encourage states to launch children's health insurance programs in 1997, when Republicans controlled both the House and the Senate. The feds supply most of the money but give states lots of flexibility to design and operate their own programs. Republican backers of the program include Utah Sen. Orrin Hatch and Indiana Sen. Richard Lugar.
Denali Kid Care's coverage for pregnant women is an even more compelling case for spending money today to save money later on. ''The most expensive item in pediatrics is newborn intensive care for premies,'' Dr. Alexander says. ''There is no question that good health care while a woman is pregnant does prevent a significant number of premature deliveries.''
Denali Kid Care also is a critical part of the state's effort to move parents from welfare to work. Leaving welfare means giving up free health care; people re-entering the work force are lucky if they find a job that offers affordable health insurance for children. ''Parents are more likely to go to work if they are confident they can get health care for their kids,'' says Dr. Alexander.
Financially, scaling back Denali Kid Care is just plain foolish. To save $6 million or so a year, the state would give up more than twice that much in federal money. That's because the feds pay more than 70 percent of the bill. Those federal dollars feed one of the fastest-growing high-wage industries in the state, medical care.
''Denali Kid Care is a great program,'' says Dr. Alexander. He's right. There's no point in trying to squeeze a few million dollars from a multibillion-dollar budget by squeezing Alaskans who need health care.
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