FacebookTwitterGoogle+RedditEmail

Child Health Care and the Class Divide

The U.S. split between a wealthy elite and the majority poor is old news. Yet as revelations surface as to who siphons off money for themselves and what happens to the impoverished many, the story continues. It gets into how governments deal with health care. In that regard, health care for children may serve as a marker for when government programs leave off serving the common good. The state of children’s health is like the proverbial “yellow canary” in a mine shaft whose death warned of toxic gas accumulation.

Children are vulnerable, and when problems emerge, they are readily apparent. That’s the case in Florida now. On December 31, 2014 U.S. Circuit Judge Adalberto Jordan announced a decision involving Florida’s Medicaid program and its role in serving child health. Jordan was responding to a 2005 legal action brought by pediatricians, dentists, and nine children on behalf of children enrolled in Florida’s Medicaid program. The lawyer arguing their case insisted that $200 million was needed to fix the program.

As reported by the Miami Herald, Jordan stated that “lawmakers had for years set the state’s Medicaid budget at an artificially low level, causing pediatricians and other specialists for children to opt out of the insurance program for the needy.” Jordan’s ruling declared that to force physicians caring for poor children to accept payments “far below what private insurers would spend — and well below what doctors were paid in the Medicare program for a more powerful group, elders — amounted to rationing of care.”

Judge Jordan cited adverse effects: physicians refusing to care for children served by Medicaid, children going without preventative care, dental care, and screening for lead intoxication. To secure specialty care, children had to travel to other states or to distant cities in Florida. Every year Florida’s Medicaid program removes thousands of recipient children from its roles.

Jordon’s ruling applies to large numbers of children. In 2013, 24 percent of Florida children were classified as poor, presumably making them Medicaid-eligible. More specifically, 40 percent of black children and 15 percent of white children were poor. The year before, 11.4 percent of Florida Children had no health insurance at all.

Child death figures for Florida’s children suggest health services for low-income children and families are fundamentally flawed. For example, mortality for African American children, whose families are much more likely to be poor than those of white children, is high. In 2011, out of 1000 babies born, 11.5 African American babies died in their first year of life; the comparable figure for white babies was 4.8. Similarly, out of 100,000 children from one to 14 years of age, 35 black children and 27 white children died in 2011.

Yet well-to-do Floridians, and their children, are far removed from grim realities like these. It appears that, “Florida ranked third (in the nation) in 2011 in a study measuring the gap between the income of the top 1 percent of Floridians and the bottom 99 percent. In Florida, the top 1 percent earned on average 32.2 times as much as the bottom 99 percent.”

Governor Rick Scott and colleagues drawn from Florida’s wealthy minority have operated Florida’s Medicaid program since 2011. A basic assumption would be that as a program serving the public’s health, Florida Medicaid should prioritize thriving and survival for all children. Judge Jordan’s findings suggest that goals for the program are otherwise, or that its administration is incompetent. Governor Scott is an experienced health care administrator, but what about his priorities?

During Scott’s tenure as CEO of the massive Columbia/HCA health care corporation, the U.S. government convicted 14 of his underlings on charges of fraud. His corporation paid a $1.7 billion fine. The Tampa Bay Times reported that, to avoid incriminating himself, Scott pled the Fifth Amendment 75 times during the course of depositions related to the case. He resigned in 1997, spent a few years as a “venture capitalist,” and then turned to politics.

In a financial disclosure statement released at the end of his successful 2014 gubernatorial campaign – his second – Scott reported a 2013 net worth of $132.7 million. Additionally, “three members of the state cabinet (…) reported a net worth of $10.95 million.” With Scott and his team attending to their personal wealth, the suspicion is that children’s health was never their foremost concern.

Pondering on who is in charge of public health programs for children and how such programs operate has its limitations, however. A larger, more basic, question remains: why are some population groups of children in trouble and others not? A recent United Nations statement epitomizes worldwide epidemiologic analyses over many years. “Children born into poverty,” it said, “are almost twice as likely to die before the age of five as those from wealthier families.”

In this sense, Judge Jordon’s epoch ruling on the Florida Medicaid program evokes an oil and water difference between the interests of two social classes. If that is so, then remediation of problems with Florida Medicaid – the cure – rests ultimately on achieving big changes within U.S. society such that all children survive and live in dignity. The health care part of that agenda would entail a universalized health-care endeavor or a national health service.

Such ambitious thinking rests on unified struggle by the many, which is not presently in the cards. In the meantime, however, what is to keep healthcare activists buoyed up by Judge Jordan’s decision from taking incremental, consciousness –raising steps as they look toward healthcare for us all?

W.T. Whitney Jr. is a retired pediatrician and political journalist living in Maine.

More articles by:

W.T. Whitney Jr. is a retired pediatrician and political journalist living in Maine.

November 19, 2018
David Rosen
Amazon Deal: New York Taxpayers Fund World Biggest Sex-Toy Retailer
Sheldon Richman
Art of the Smear: the Israel Lobby Busted
Chad Hanson
Why Trump is Wrong About the California Wildfires
Dean Baker
Will Progressives Ever Think About How We Structure Markets, Instead of Accepting them as Given?
Robert Fisk
We Remember the Great War, While Palestinians Live It
Dave Lindorff
Pelosi’s Deceptive Plan: Blocking any Tax Rise Could Rule Out Medicare-for-All and Bolstering Social Security
Rick Baum
What Can We Expect From the Democrat “Alternative” Given Their Record in California?
Thomas Scott Tucker
Trump, World War I and the Lessons of Poetry
John W. Whitehead
Red Flag Gun Laws
Newton Finn
On Earth, as in Heaven: the Utopianism of Edward Bellamy
Robert Fantina
Shithole Countries: Made in the USA
René Voss
Have Your Say about Ranching in Our Point Reyes National Seashore
Weekend Edition
November 16, 2018
Friday - Sunday
Jonah Raskin
A California Jew in a Time of Anti-Semitism
Andrew Levine
Whither the Melting Pot?
Joshua Frank
Climate Change and Wildfires: The New Western Travesty
Nick Pemberton
The Revolution’s Here, Please Excuse Me While I Laugh
T.J. Coles
Israel Cannot Use Violent Self-Defense While Occupying Gaza
Rob Urie
Nuclear Weapons are a Nightmare Made in America
Paul Street
Barack von Obamenburg, Herr Donald, and Big Capitalist Hypocrisy: On How Fascism Happens
Jeffrey St. Clair
Roaming Charges: Fire is Sweeping Our Very Streets Today
Aidan O'Brien
Ireland’s New President, Other European Fools and the Abyss 
Pete Dolack
“Winners” in Amazon Sweepstakes Sure to be the Losers
Richard Eskow
Amazon, Go Home! Billions for Working People, But Not One Cent For Tribute
Ramzy Baroud
In Breach of Human Rights, Netanyahu Supports the Death Penalty against Palestinians
Brian Terrell
Ending the War in Yemen- Congressional Resolution is Not Enough!
John Laforge
Woolsey Fire Burns Toxic Santa Susana Reactor Site
Ralph Nader
The War Over Words: Republicans Easily Defeat the Democrats
M. G. Piety
Reading Plato in the Time of the Oligarchs
Rafael Correa
Ecuador’s Soft Coup and Political Persecution
Brian Cloughley
Aid Projects Can Work, But Not “Head-Smacking Stupid Ones”
David Swanson
A Tale of Two Marines
Robert Fantina
Democrats and the Mid-Term Elections
Joseph Flatley
The Fascist Creep: How Conspiracy Theories and an Unhinged President Created an Anti-Semitic Terrorist
Joseph Natoli
Twitter: Fast Track to the Id
William Hawes
Baselines for Activism: Brecht’s Stance, the New Science, and Planting Seeds
Bob Wing
Toward Racial Justice and a Third Reconstruction
Ron Jacobs
Hunter S. Thompson: Chronicling the Republic’s Fall
Oscar Gonzalez
Stan Lee and a Barrio Kid
Jack Rasmus
Election 2018 and the Unraveling of America
Sam Pizzigati
The Democrats Won Big, But Will They Go Bold?
Yves Engler
Canada and Saudi Arabia: Friends or Enemies?
Cesar Chelala
Can El Paso be a Model for Healing?
Mike Ferner
The Tragically Misnamed Paris Peace Conference
Barry Lando
Trump’s Enablers: Appalling Parallels
Ariel Dorfman
The Boy Who Taught Me About War and Peace
FacebookTwitterGoogle+RedditEmail