What you would say to Obama

A few weeks ago, Contemporary Pediatrics asked its readers what they would say to president Obama regarding health care and pediatrics. No two responders hit the same points. The letters in full are all available for reading, and have been forwarded to the White House.

Everyone was, of course, in favor of quality health c are for children. But the variety of the specifics perhaps illustrates the gridlock and confusion over the health care agenda. With so many avenues just in pediatric health care – SCHIP, Medicare, subspecialties, mental health care – no two people agree fully on what should and shouldn’t be focused on.

Shaija George, MBA, MA, CPNP, APN, told Obama about everything from child mental health to increasing safety in communities and health maintenance programs at school. George in unequivocal about mandates: “There should be mandatory child health insurance based on parental income. Negligent parents should be…held accountable through the child welfare services.”

Les Trubow, MD, focused on the financial side: Medicare’s meager payments alone aren’t enough to keep most docs in practice. He also sees the problem of retail-based clinics, which similar to the “death spiral” of insurance companies only treat the relatively healthy, leading the primary care physicians more and more with the problem cases, to “leave us with all the difficult patients that insurance doesn’t pay fairly on.”

For Rashmi Arora, MD, it all boiled down to a few actionable points. Reimbursement for phone calls, better communication, more doctors talking to students in schools. Arora sees no difference between mental and physical health: “Psychiatry health should be covered the same way, by health insurance companies, as any other health issues>”

And for Thomas Maloney, MD, he’s willing to do his part. “I am willing to pay for the cost of reform, ‘he said, point-blank. "I already pay for the health care of the poor, but I am willing to share the cost of health care for everyone. (In truth, we all already do this, but not efficiently or effectively.)"