Prescriptions for health care

Voters, patients can start small ÑÊwith kids

As a registered nurse, I witness firsthand the faults of what we Americans inaccurately call our health care 'system.'

Yes, we probably have the most up-to-date technology for dealing with a variety of serious health conditions, including severe prematurity and heart disease. Yes, we can keep a body technically alive for weeks or months. And yes, our research has produced miracles such as cures for some leukemias. We have a highly sophisticated, expensive set of systems, yet our overall health outcomes can't match those of some less wealthy countries. Why?

Of course, individuals should take responsibility for their own health, and many of our citizens and residents fail to do so, as evidenced by the growing problem of obesity in both children and adults. But there also is the responsibility of our society to recognize and fund health care as a right. I am not talking about any health care that is desired but a basic package of essential services that will provide the best care for the most people.

That is why the Oregon Nurses Association is proposing 'Health Care for All Kids.' It is a place to start. Our plan is based on using all programs that are available to children, including private health insurance, Medicaid, other federal health care programs and a new state-sponsored plan. We believe that a universal health care program for children up to 18 years old should be based on the following principles:

First, enrollment needs to be efficient and as simple as possible. It should take place where children are located, such as at hospital discharge after birth, Head Start or during a yearly checkup.

Second, primary care should be available where children are located, such as schools.

Third, the system should operate with a universal benefit card so that children can receive care at any clinic or, if needed, a hospital.

Fourth, the system needs to track usage and be able to identify gaps in care, especially in essential preventive care.

And last, the system should be developed in such a way that it could be expanded to other populations over time.

This is a difficult time to talk about new government programs. Yet we recently witnessed the birth of Medicare's drug program, which is expected to cost billions of dollars. Prescription drugs are primarily used to treat illnesses that already are present, and the number of prescriptions per person is generally higher in the elderly.

Since some of today's working teenagers already are paying for their grandparents' health care, isn't it time we invest in theirs?

Kelly Maggi is chairwoman of the Oregon Nurses Association Cabinet on Health Policy.