child care - Digital Library Collections

CHAPTER
CHILD HEALTH
dequate health care is essential for every
child. Without it, children may suffer enormously,
losing the chance for a healthy start
in life and a productive future. Untreated
medical conditions often worsen over time
and can lead to permanent disabilities. In some
cases, lack of medical care may cost children their
very lives. Poor health can also jeopardize children's
ability to succeed in school and in later jobs.
Yet more than II million American children
lack health insurance today, and the percentage of
children without health coverage has risen in recent
years to the highest levels ever recorded by the
u.s. Census Bureau. The vast majority of uninsured
children, more than 90 percent, have parents
who work. However, as more and more employers
have made dependent health coverage more costly
for employees or dropped it altogether, fewer families
can afford private insurance. In the past year,
extraordinary strides were made in expanding children's
health insurance coverage through landmark
legislation that may help up to 5 million
uninsured children. Intensive efforts are required
in all 50 states for children to benefit fully from this
new law. States now have an unprecedented opportunity
to make high-quality, affordable health care
more widely available to uninsured children and to
dramatically improve the health of millions.
Child Health: 1973 to 1998
Child health has improved in important ways
over the past 25 years. For example, infant
mortality and preventable childhood illnesses
have declined substantially. Change has also swept
the country's health care system, profoundly affecting
access to health care for children. Notably, a
nationwide shift to managed care delivery systems
has altered the way many children receive health
services. In addition, two dramatic and contradictory
trends have emerged: a steep decline in employment-based
coverage for children and significant
increases in the number of children covered
by Medicaid (health insurance coverage for lowincome
children and families, for elderly individuals,
and for people with disabilities).
According to two different federal surveys, private
coverage ofAmerican children (most ofwhich
is employment-related) dropped more than 7 percent
between 1977 and 1987 and another 7 percent
from 1987 to 1996. Meanwhile, the number of
children covered by Medicaid rose from between 9
CHI L D R EN'S D E FEN S E FUN D 21