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Health Care Reform for Children: Views From the Academic Pediatric Association

  • Nicolas M. Oreskovic
    Correspondence
    Address correspondence to Nicolas M. Oreskovic, MD, MPH, Massachusetts General Hospital Center for Child and Adolescent Health Policy, 50 Staniford Street, Suite 901, Boston, Massachusetts 02114.
    Affiliations
    From the Departments of Internal Medicine (Dr Oreskovic) and Pediatrics (Dr Oreskovic and Dr Kuhlthau), Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass (Drs Oreskovic, Kuhlthau, and Schuster); Division of General Pediatrics, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY (Dr Laraque); Department of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Serwint); and Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Boston, Mass (Dr Schuster)
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  • Karen A. Kuhlthau
    Affiliations
    From the Departments of Internal Medicine (Dr Oreskovic) and Pediatrics (Dr Oreskovic and Dr Kuhlthau), Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass (Drs Oreskovic, Kuhlthau, and Schuster); Division of General Pediatrics, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY (Dr Laraque); Department of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Serwint); and Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Boston, Mass (Dr Schuster)
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  • Danielle Laraque
    Affiliations
    From the Departments of Internal Medicine (Dr Oreskovic) and Pediatrics (Dr Oreskovic and Dr Kuhlthau), Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass (Drs Oreskovic, Kuhlthau, and Schuster); Division of General Pediatrics, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY (Dr Laraque); Department of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Serwint); and Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Boston, Mass (Dr Schuster)
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  • Janet R. Serwint
    Affiliations
    From the Departments of Internal Medicine (Dr Oreskovic) and Pediatrics (Dr Oreskovic and Dr Kuhlthau), Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass (Drs Oreskovic, Kuhlthau, and Schuster); Division of General Pediatrics, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY (Dr Laraque); Department of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Serwint); and Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Boston, Mass (Dr Schuster)
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  • Mark A. Schuster
    Affiliations
    From the Departments of Internal Medicine (Dr Oreskovic) and Pediatrics (Dr Oreskovic and Dr Kuhlthau), Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass (Drs Oreskovic, Kuhlthau, and Schuster); Division of General Pediatrics, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY (Dr Laraque); Department of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Serwint); and Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Boston, Mass (Dr Schuster)
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      National public opinion polls indicate that a majority of Americans favor expanding the federal government's role in regulating health care to ensure coverage for all Americans.
      • Blendon R.J.
      • Benson J.M.
      Understanding how Americans view health care reform.
      Polls conducted prior to the recently enacted Patient Protection and Affordable Care Act indicate that an increasing number of Americans were not satisfied with the proposed health care reforms.

      Jones JM. Americans still leaning against healthcare legislation. Available at: http://www.gallup.com/poll/124496/Americans-Leaning-Against-Healthcare-Legislation.aspx. Accessed December 1, 2009.

      National physician surveys indicate that most physicians also believe that a larger portion of the population should have health insurance coverage and favor expanding the government's involvement to achieve this.
      • Keyhani S.
      • Federman A.
      Doctors on coverage–physicians' views on a new public insurance option and Medicare expansion.
      A majority of physicians, across a spectrum of specialties, believe they have a fiduciary obligation to address health policy issues as part of their professional responsibility and report that they would be willing to accept limits on reimbursement for expensive drugs and procedures to achieve expanded access to basic health care.
      • Antiel R.M.
      • Curlin F.A.
      • James K.M.
      • Tilburt J.C.
      Physicians' beliefs and US health care reform–a national survey.
      Although state-administered programs such as the Children's Health Insurance Program Reauthorization Act currently ensure partial coverage for children through 2013, proposed health care reforms could alter pediatric coverage through alternative coverage options, such as exchange plans, or by increasing dependent coverage through reforms aimed at increasing parental coverage.
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      References

        • Blendon R.J.
        • Benson J.M.
        Understanding how Americans view health care reform.
        N Engl J Med. 2009; 361: e13
      1. Jones JM. Americans still leaning against healthcare legislation. Available at: http://www.gallup.com/poll/124496/Americans-Leaning-Against-Healthcare-Legislation.aspx. Accessed December 1, 2009.

      2. Rasmussen Reports. Health Care Reform. Available at: http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/september_2009/health_care_reform. Accessed December 1, 2009.

        • Keyhani S.
        • Federman A.
        Doctors on coverage–physicians' views on a new public insurance option and Medicare expansion.
        N Engl J Med. 2009; 361: e24
        • Antiel R.M.
        • Curlin F.A.
        • James K.M.
        • Tilburt J.C.
        Physicians' beliefs and US health care reform–a national survey.
        N Engl J Med. 2009; 361: e23
      3. American Academy of Pediatrics. Periodic Survey of Fellows number #72, 2008. Available at: http://www.aap.org/. Accessed November 1, 2009.

        • Steelfisher G.K.
        • Blendon R.J.
        • Sussman T.
        • Connolly J.M.
        • Benson J.M.
        • Herrmann M.J.
        Physicians' views of the Massachusetts health care reform law–a poll.
        N Engl J Med. 2009; 361: e39
        • Palfrey J.S.
        How health care reform can benefit children and adolescents.
        N Engl J Med. 2009; 361: e34