Children s health care falls short Claudia Martinez came into the Family Resource Center to pay her medical co payment with her children, nba jerseys 3 year old Leonardo Espinoza and 2 year old Tanya Espinoza. (Judith Calson Mercury News Archives)Now, researchers are reporting that the same holds true for America s children, leading them toward an unhealthy adulthood. In some cases, they fare even worse than adults. On average, children get less than half of the recommended treatment and preventive care for conditions such as asthma or fever, according to a study published in today s New England Journal of Medicine. Babies aren t getting regular height and weight checks to make sure they re growing properly. Toddlers don t receive all their recommended immunizations. Schoolchildren don t have all the medication they need to control chronic asthma. Rita Mangione Smith moncler cheval vest of the University of Washington Seattle. "This study shows that health care quality for kids is an issue in itself." Health care experts, reacting to the study, say the reasons for the problems include inadequate insurance payments for pediatric treatment and the health system s failure to focus on children. The study comes at a politically fraught time for children s health, as congressional Democratic leaders work to overturn President Bush s recent veto of a major expansion of a popular national children s health insurance program. Nearly all the children had some form of health insurance, and 82 percent of the insured children had private health coverage. In reviewing the records, researchers looked for evidence that the right kind of medical care was provided to children in a timely fashion. For example, did children with major depression begin counseling, medication or both within two weeks of diagnosis Did children whose asthma medication was changed get a follow up visit with a doctor within three weeks Did doctors test children s blood pressure before starting them on medication for attention deficit disorder In these situations moncler alpin jacket and others, the quality of care children received varied widely. In the best case, children with colds and flu received, on average, 92 percent of the recommended care. But adolescents received only about 35 percent of the recommended preventive care, such as chlamydia screenings and weight checks. The study has limitations, including a relatively small number of medical files reviewed and a lack of minority children. The medical care examined by the researchers was moncler urville delivered from 1996 to 2000, and trends in care may have changed since then. Finally, medical records were incomplete for some children. Still, Mangione Smith contended, "What you re looking at is the best case scenario. For people without insurance, the numbers would be worse." Dr. Paul Wise, a Stanford University pediatrician and health policy researcher who was not involved with the study, agreed. "The quality indicators are just so awful that even if they re off by a considerable moncler jacket for kids extent, they still hold up," Wise said. "The findings suggest that the quality of health care for children is pretty pathetic." Mangione Smith, who practices at Children s Hospital and Regional Medical Center in Seattle, collaborated with researchers from the University of California Los Angeles and the Rand Corp. The study was funded by the Oakland based California HealthCare Foundation, the Robert Wood Johnson Foundation and the federal Centers for Medicare and Medicaid Services. Spending moncler kids jackets on seniors Pediatricians and health policy experts say there are myriad reasons for why children don t always get the health care they need, even if they have good insurance and their parents are diligent about taking them to the doctor. Most of America s health care dollars are spent on adults and particularly seniors, Wise said, so programs to improve health care quality focus on them rather than on children, who tend to be healthier and less expensive to treat. "Children are cheap," Wise moncler outlet italia said. "If you add up all the health care that children get, it s basically a rounding error for Medicare." Wise and other experts also noted that pediatric care is poorly reimbursed by the government and private insurers, giving doctors an incentive to shorten visits with young patients. Some insurers also won t cover some vaccines, routine physicals or certain preventive medications for children, requiring more costly care down the line, said Dr. Lydia Tinajero Deck, a pediatrician at Children s Hospital Oakland. Care also can be fragmented among emergency rooms, urgent care clinics and a child s Moncler Down Jacket Red BRANSON regular doctor, particularly in asthma care, she said. As children progress through school, they are less likely to see a doctor for preventive care, unless they need a physical to be cleared for sports activities. There s the belief that "they re kids, they re healthy enough, they ll be fine," Tinajero Deck said. Stanford s Wise said he hopes the landmark study will sensitize lawmakers and the medical establishment to the importance of improving health care quality for children, not Moncler himalaya Down Men Jackets Blue just adults

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Children s Health Insurance Program Reauthorization Act of 2009 SEC. 2111. PHASE OUT OF COVERAGE FOR NONPREGNANT CHILDLESS ADULTS; CONDITIONS FOR COVERAGE OF PARENTS. (2) Moncler down jackets Women with hooded zip green TERMINATION OF CHIP COVERAGE UNDER APPLICABLE EXISTING WAIVERS AT THE END OF FISCAL YEAR 2010. (A) IN GENERAL. No funds shall be available under this title for child health assistance or other health benefits coverage that is provided to a nonpregnant childless adult under an applicable existing waiver after September 30, nhl jerseys 2010. (B) EXTENSION UPON STATE REQUEST. If an applicable existing waiver described in subparagraph (A) would otherwise expire before October 1, 2010, and the State requests Moncler Down Jacket Men with Rabbit Hooded coffee an extension of such waiver, the Secretary shall grant such an extension, but only through September 30, 2011. (C) APPLICATION OF ENHANCED FMAP. The enhanced FMAP determined under section 2105(b) shall apply to expenditures under an applicable existing waiver for the provision of child health assistance or other health benefits coverage to a nonpregnant childless adult during fiscal year 2010. The Secretary may adjust the amount set aside under the preceding sentence, as necessary, on the basis of the expenditure moncler jacket for sale data for fiscal year 2010 reported by States on CMS Form 64 or CMS Form 21 not later than November 30, 2010, but in no case shall the Secretary adjust such amount after December 31, 2010. (B) NO COVERAGE FOR NONPREGNANT CHILDLESS ADULTS WHO WERE NOT COVERED moncler gamme bleu DURING FISCAL YEAR 2010. (i) FMAP APPLIED TO EXPENDITURES. The Secretary shall pay the State for each quarter of fiscal year 2011, from the amount set aside under subparagraph (A), an amount equal to the Federal medical assistance percentage (as determined under section 1905(b) without regard to clause (4) of such section) of expenditures in the quarter for providing child health assistance or other health benefits coverage to a nonpregnant childless adult but only if such adult was enrolled in the State program Moncler bastille Men Down Short no Hat zip Black Jakcets under this title during fiscal year 2010 (without regard to whether the individual lost coverage during fiscal year 2010 and was reenrolled in that fiscal year or in fiscal year 2011). (ii) FEDERAL PAYMENTS LIMITED TO AMOUNT OF BLOCK GRANT SET ASIDE. No payments shall be made to a State for expenditures described in this subparagraph after the total amount set aside under subparagraph (A) for fiscal year 2011 has been paid to the State. (4) STATE OPTION TO APPLY FOR MEDICAID WAIVER TO CONTINUE MONCLER Fur collar and long sections Black coats COVERAGE FOR NONPREGNANT CHILDLESS ADULTS. (A) IN GENERAL. Each State for which coverage under an applicable existing waiver is terminated under paragraph (2)(A) may submit, not later than June 30, 2011, an application to the Secretary for a waiver under section 1115 of the State plan under title XIX to provide medical assistance to a nonpregnant childless adult whose coverage is so terminated (in this subsection referred to as a Medicaid nonpregnant childless adults waiver ). (B) DEADLINE FOR APPROVAL. The moncler outlet reviews Secretary shall make a decision to approve or deny an application for a Medicaid nonpregnant childless adults waiver submitted under subparagraph (A) within 90 days of the date of the submission of the application. If no decision has been made by the Secretary as of September 30, 2011, on the application of a State for a Medicaid nonpregnant childless adults waiver that was submitted to the Secretary by June 30, 2011, the application shall be deemed approved. (C) STANDARD FOR BUDGET NEUTRALITY. The budget neutrality requirement applicable with respect to expenditures for medical assistance under a Medicaid nonpregnant childless adults waiver shall (i) in the case of fiscal year 2012, allow expenditures for medical assistance under title XIX for all such adults to not exceed the total amount of payments made to the State under paragraph (3)(B) for fiscal year 2011, increased by the percentage increase (if any) in the projected nominal per capita amount of National Health Expenditures for calendar year 2012 over 2011, as most recently published by the Secretary; and (ii) in the case of any succeeding fiscal year, allow such expenditures to not exceed the amount in effect under this subparagraph for the preceding fiscal year, increased by the percentage increase (if any) in the projected nominal per capita amount of National Health Expenditures for the calendar year that begins during the fiscal year involved over the preceding calendar year, as most recently published by the Secretary. (B) EXTENSION UPON STATE REQUEST. If an applicable existing waiver described in subparagraph (A) would otherwise expire before October 1, 2011, and the State requests an extension of such waiver, the Secretary shall grant such an extension, but only, subject to paragraph (2)(A), through September 30, 2011. (C) APPLICATION OF ENHANCED FMAP. The enhanced FMAP determined under section 2105(b) shall apply to expenditures under an applicable existing waiver for the provision of child health assistance or other health benefits coverage to a parent of a targeted low income child during the third and fourth quarters of fiscal year 2009 and during fiscal years 2010 and 2011. (2) RULES FOR FISCAL YEARS 2012 THROUGH 2013. (A) PAYMENTS FOR COVERAGE LIMITED TO BLOCK GRANT FUNDED FROM STATE moncler clothing sale ALLOTMENT. Any State that provides child health assistance or health benefits coverage under an applicable existing waiver for a parent of a targeted low income child may elect to continue to provide such assistance or coverage through fiscal year 2012 or 2013, subject to the same terms and conditions that applied under the applicable existing waiver, unless otherwise modified in subparagraph (B)

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