Wednesday, March 14, 2007
But the children of the kingdom shall be cast out into outer darkness: there shall be weeping and gnashing of teeth.
— The Holy Bible, Matthew
If you didn’t like the results of the most recent UNICEF report on children you’ll like the future ones even less.
In a report entitled “An overview of child well-being in rich countries” or the “Innocenti Report Card” the report says the United States and Britain are at the bottom of 24 rich nations when it comes to caring for their young in a variety of categories. The report concludes that the fact that the United States is one of the wealthiest countries in the world does not mean its young are the best cared for. It is not referring to the fact that we have 8 million youngsters who have no health insurance, a fact that would be upsetting were it not for the fact that they mostly belong to people who are irresponsible else the children would be insured. The report’s conclusions have nothing to do with that.
The report ranked the welfare of children in six categories one of which pertained to “Infant survival and health.” Within that category it measured the infant mortality rate (IMR), i.e. the number of deaths before the age of one per thousand live births. The report says that the IMR “is a standard indicator of child health and reflects a basic provision of the Convention on the Rights of the Child which call on all countries ‘to ensure the child’s enjoyment of the highest attainable standard of health, including by diminishing infant and child mortality.’” In IMR the United States comes out 24th with 6 deaths per thousand.
The second indicator in this category that UNICEF measured is the prevalence of low birth weight. Low birth weight refers to babies born weighing less than 2500 grams. In that category the United States came out better. It ranked 21st in the world with only 8% of live births being below 2500g.There is little hope for improvement in those statistics in the foreseeable future. That is not because the United States is poor. It has to do with fiscal responsibility, a concept favored by George Bush. The targets of George Bush’s newest attack on fiscal irresponsibility were children.
Pursuant to a 1984 law, a child born to a pregnant woman on Medicaid was eligible for Medicaid for one year without producing his or her birth certificate or passport. Under a federal policy that took effect on July 1, 2006, as part of the budget legislation approved in February 2006, children born in the United States whose parents are not citizens will no longer automatically be entitled to health insurance through Medicaid. They will have to prove they are citizens of the United States before they become entitled to treatment. When a child is born the first thing the parents should do is complete an application form to prove that the child is a citizen. In many states that process takes weeks. During the wait the child will not be entitled to Medicaid benefits except for emergency care.
Dr. Jay Berkelhamer, president of the American Academy of Pediatrics said the new policy “punishes babies who, according to the Constitution, are citizens because they were born here.” He observed that the result of the policy is that children of illegal immigrants will go without immunizations, preventive care and treatments needed during their first year of life.
The law is not, as might first be thought, a mindless exercise by the Bush administration. It was needed because too many immigrants were fraudulently claiming United States citizenship to get Medicaid. The number of new-borns engaging in this activity is probably fairly small, but fiscally responsible people can’t be too careful.
One of the persons commenting on the new policy is Marilyn E. Wilson who was speaking for the Tennessee Medicaid Program. She explained that, “The federal government told us we have no latitude. All states must change their policies and practices. We will not be able to cover any services for the newborn until a Medicaid application is filed. That could be days, weeks or months after the child is born.” Health experts have estimated that tens of thousands of new-borns will be affected by the new rules.
Leslie Norwalk is acting administrator of the Centers for Medicare and Medicaid Services. She explained: “When emergency Medicaid pays for a birth the child is not automatically deemed eligible. But the child could apply and could qualify for Medicaid because of the family’s poverty status. If anyone knows about a child being denied care, we want to know about it. Please step up and tell us.” No need. We’ll read about it in future reports describing the status of care for new-borns in the United States.