Health Care Has A Relapse

• Share

For most children, a hug is all it takes to treat the bruise from a playground fall. But when Dalton Dawes collided with a classmate on his first day of preschool three years ago, the bleeding inside his shoulder would not stop. Dalton, an 8-year-old with fine blond hair and intelligent blue eyes who lives in North Carolina's Blue Ridge Mountains, is a hemophiliac. What prevents the mishaps of childhood from killing him is $2,000-a-week injections of a medication called Mononine. But no private insurer will cover Dalton, so his parents, Leonard Poe and Heather Dawes, held their income to $22,900--33% over the poverty line--to qualify for Medicaid.

That worked until March 2001, when Dalton turned 7 and his Medicaid eligibility ran out. (For him to stay in the program, his parents would have had to earn no more than $15,492 a year.) Heather, a paralegal, tried to enroll him in the Children's Health Insurance Program (CHIP), a state-federal initiative that provides coverage to children of working families. But North Carolina had burned through all the money allocated to CHIP that year, so Dalton joined 23,000 other kids on a waiting list. By the time legislators found the $8 million needed to resume enrollment last September, Dalton was down to his last three weeks' supply of Mononine. After months of seeing her son's survival in the hands of politicians and bureaucrats, Heather could not stop thinking about "how flimsy it all is." She notes, "They could decide to set it aside tomorrow again if they wanted."

In 13 other states, from West Virginia to Hawaii, lawmakers are talking about cutting funding, narrowing eligibility or placing restrictions on CHIP. And that's just one small part of what the new health-care crisis looks like across America. In California nurses are leaving hospitals to take jobs at Starbucks and Macy's because the benefits and working conditions are better, and hospitals are so understaffed that patients' families are answering phones on the wards. In Arkansas lawmakers cut a deal last week to preserve Medicaid benefits, after protesting parents wheeled their disabled children into the statehouse. In Idaho parents angry over proposed cuts in the state's already skimpy health program sent their children to the Governor's office with valentines pleading DON'T BREAK OUR HEARTS. Tennessee's health plan, hailed only a few years ago as a national model for covering the working poor, is falling apart as its cost approaches $6 billion a year. As many as 500,000 people may be dropped. In Florida a 1999 state Chamber of Commerce survey found that 91% of businesses provided health insurance for their employees; by last fall, the figure had dropped to 77%.

One measure of popular passion on the subject is that the movie John Q.--in which Denzel Washington plays an underinsured father holding a hospital at gunpoint to get his son a heart transplant--was No. 1 at the box office during its opening weekend in late February. When the movie came out, the HMO industry's lobbying group bought full-page newspaper ads blaming Washington politicians for failing to address the problems of the uninsured. There's not much evidence, however, that anyone in Washington is paying attention. "While there's conversation going on," says John Engler, Michigan's Republican Governor, "it doesn't appear to us to be a very focused conversation or a very clear strategy to get something done."