A Lot of Kids Left Behind

Kids are at risk.

I know this topic is not nearly as appetizing as Shrub missing Senator Kerry's poorly delivered joke, or the Republican leadership ignoring a congressman's harassment of an underage intern, or a meth-crazed Evangelical pastor playing hide the salami with a male prostitute. And of course in our popular press every topic is framed around the obligatory question “How will this affect Republican voters on Tuesday?”**

The larger issue is how much damage GW will do before he gets his ass continuously subpoenaed over the next two years (as we can only hope.)

Kids are at risk. Make no mistake.

I know this topic will get lost among all the juicy news of yet another Republican hypocrite getting male tail on the sly, but it's just too emblematic of the cognitive dissonance within the White House, even with all this red meat out there to be devoured.

Reuters is reporting that the administration has revised the Medicaid policy to withhold coverage for children born to illegal aliens unless their parents make formal application.

New federal rules deem babies born in the United States to poor illegal immigrant parents no longer automatically qualify for Medicaid health coverage, a policy some doctors worry might deprive these newborns of vital preventive care.

As with most Bush policies, I have no idea the purpose of this mandate. Like the Medicare drug plan, Social Security privatization, reducing dividend taxes, and many many other ideas, this one is just plain inexplicable.

The babies are American citizens by virtue of being born in the United States, even if their parents are in the country illegally.

Medicaid is a joint state-federal government health insurance program for low-income people. Previously, a child born in the United States was deemed automatically eligible for Medicaid for a year after the mother got emergency care under Medicaid for the birth.

"Since the mothers are illegal immigrants, they are not very likely to go to the Medicaid office to enroll their children because they're worried that they're going to get caught and deported," said Dr. John Lewy, a senior official with the American Academy of Pediatrics and retired pediatrician.

"The children are getting trapped by this," Lewy added.

So, Bush is instituting a draconian policy that puts the most vulnerable citizens at risk. Instead of defending our borders to keep illegals out; instead of enforcing laws to catch employers who hire illegals, Bush puts obstacles to care for babies who are eligible for necessary and cost-effective preventive care.

Dr. Rick Kellerman, a family doctor in Wichita, Kansas and president of the American Academy of Family Physicians, said as a result of the policy, parents of these babies might not get them preventive care and early intervention for illness.

Because such care reduces the likelihood of major medical problems that are costly to treat, the policy might become hugely expensive for federal and state governments, Kellerman said.

The leaders of the two physician groups who care for children understand the challenges associated with care of poor and defenseless kids. Preventive care has been shown to reduce chronic illness and suffering on a human level, and reduce cost of care on an economic level. Bush's policy is not only inhumane but financially foolish. Surprised? Don't be. Just look at almost any other mandate or project that has come out of the White House-- from the Iraq war to the fight against embryonic stem cell funding: inhumane and costly.

Kids are at risk.

The administration lackeys at the Centers for Medicare and Medicaid have tried to defend this lame policy by stating that they know of no child who has been refused care because of this mandate. Of course, they are missing the chilling nuance which is provided by Dr. Lewy:

"I don't think there will be evidence that they're denied care. What I think is that they're not seeking care."

Duh! As a taxpayer as well as a physician, I have some appreciation that our nation faces the daunting enterprise of providing increasingly expensive health care to an ever more populous underclass. That's a tough nut, no doubt, but this is not the answer. Public Health 101 clearly states the the most cost-effective measures any community can institute are 1) clean water, 2) sewage management and 3) vaccinations. Even the poorest Third World countries make every attempt to provide these basic aspects of health care to their citizens, but our government is going to withhold one of the most treasured parts of our child care: vaccinations, among other preventive care and anticipatory guidance.

Kids are at risk. And I'm not even getting into the more nuanced topics of “herd immunity” which protects all of us, nutrition, proper use of car seats, prevention of accidents, emergency notification procedures and all the other benefits that these small citizens would have by being plugged into the medical care system from the start.

Why would GWB sign on to such a dangerously negligent policy? Does he think he will coerce the illegals to take their kids-- US citizens-- back to Mexico or Honduras? Does he believe that the few dollars saved by delaying these vaccinations and other services is cost-effective? Does he think that the illegal parents will somehow find the cash to enroll in private insurance to avoid this bureaucratic snafu? Or is Bush just stupid?

For the life of me I cannot see the purpose of this policy. A more sane policy would be to do the opposite: provide the very best medical care for these young citizens. Lavish them with Cadillac care in order to ensure that they grow up healthy and able. Provide parents with needed transportation to bring these tiny American citizens to the doctor. Make every attempt to increase the interaction these poor and often uneducated parents have with health professionals.

Am I a bleeding heart liberal? Hardly. I'm just being plain selfish. These kids are US citizens, so they aren't going anywhere. It's in our best interest they make it to adulthood in one piece, and don't infect our families with rubella or pertussis on the way...

After all, these diapered little citizens are the ones who will be caring for us when we are diapered senior citizens.

[**How the hell should I know?!! I have no idea how anyone could possibly even consider voting Republican on Tuesday, or any other day for that matter. If the Democrats don't win at least the House, then I know in my heart that Diebold delivered this election to save Chicken George and Darth Cheney from impeachment.]