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U.S. Child Health System a Failure?
In February of 2007, a U.N. survey named the Netherlands, Sweden and Denmark as the world's leading countries when it comes to child health and well−being. As in previous studies, the U.S. finished at or near the bottom among developed nations.
So, what are we doing to change things? Not nearly enough, according to three UCLA professors who are calling for a complete overhaul of the U.S. child health care system, which they describe as a "patchwork of disconnected programs, policies and funding" that lacks "clear accountability or performance goals."
In their report, which appears in the March 2007 issue of the journal Health Affairs, Dr. Neal Halfon of UCLA's School of Public Health and his co−authors argue that even as Congress, the nation's governors and the Bush administration debate the State Children's Health Insurance Program, which covers low−income children whose families earn too much to qualify for Medicaid, our leaders are ignoring the fundamental problems of the nation's child health system.
According to the authors, the current system is failing because it is hindered by outdated thinking, outmoded organization and unwieldy finance strategies that were designed to respond to the health issues of the last century.
"An increasing body of science now tells us that the scaffolding for our adult physical, cognitive and socioeconomic health is built in the early years of life," said Halfon. "We know now that many health problems have their origins during childhood and simply compound over time."
For example, child obesity rates have doubled in the last 20 years, Halfon said, and more than 20% of all young people have been diagnosed with mental health or behavioral problems, creating the prospect that the current generation could be significantly less healthy than their parents.
"The most common diseases of the past were acute illnesses or infections, but today's children and youth face chronic conditions that will impact them for the rest of their lives − diseases like asthma and diabetes; and mental health problems like ADHD and depression," Halfon said. "These emerging health needs are simply not being addressed."
The authors call for reforms that include:
"The outmoded operating system and obsolete logic employed by the U.S. child health system is analogous to a modern business ignoring the Internet, Windows and new Pentium processors and running their operations using MS−DOS on separate and unconnected 286 machines," Halfon said. "It worked in the past, but it is not very effective and efficient for a competitive business, nor is it appropriate for a health system that needs to produce health outcomes that will help our children compete in the future."
March 9, 2007
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