Our Health Care System Puts Our Children in Jeopardy

Congress and the President are at Logger Heads over the issue of financing health care to children. However, a recent study looks at the type of care we are currently giving to children, and the results are shocking.

  • 46% of the children received indicated care
  • 67.6% of the indicated care was given in acute medical situations
  • 53.4% of the indicated care was given for chronic conditions
  • 40% of the indicated care was given for preventive services
  • 34.5% of the indicated care was given for preventive services to teen-agers

An example of how these statistics play out in practice will help to enlighten the reader.

Asthma is a chronic disease that causes the airways - the tubes that carry air in and out of your lungs - to become sore and swollen. In the United States, about 20 million people have asthma. Nearly 9 million of them are children. Children have smaller airways than adults, which makes asthma especially serious for them. Children with asthma may experience wheezing, coughing, chest tightness and trouble breathing, especially early in the morning or at night.

Asthma attacks are always an emergency and may lead to death. The first line treatment for chronic asthma is to administer an inhaled anti-inflammatory medication. This decreases the inflammation in the airway, and prevents asthma attacks.

Yet, in the above situation, only 40% of the children had an anti-inflammatory medication prescribed. Quality of life, frequent hospitalizations, and possibly death are the outcomes of such negligent care.

The deficiencies in the quality of care were about the same as seen in adults. Insurance was not a factor in the type or quantity of care that was given. This points out the importance of not singling out insurance as the sole assurance of the type of care that is provided. Entreaties to hard-working and compassionate health care workers to do more and care more are also not effective strategies. System wide changes are needed in a health care system that is broken for all of us. It's time to wake up and smell the coffee. We deserve better.


Mangione-Smith,R. et al: "The Quality of Ambulatory Care Delivered to Children in the United States", NEJM, Volume 357:1515-1523 October 11, 2007
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