... And access for all?

Whenever we talk about children, we are talking about the future of our nation. And when we focus on the health of minority children, we cannot help but focus on the major causes of racial inequity and deprivation in this country: discrimination, education and poverty.

When we address the subject of health care, we talk about availability, affordability and accessibility All three are denied, or significantly reduced, when one is poor. Poverty has everything to do with poor health care.

Think about our own middle-class children. Why are they healthy? The answer is quite simple--because we can afford for them to be. They do not have to languish in crowded emergency rooms for primary care. If they need hearing aids and glasses, we can afford them. They receive proper dental care. They have health insurance, not Medicaid, which would relegate them to some degree of reduced medical care. And before they were born their mothers had prenatal care.

Unfortunately, the same set of circumstances is not true for the 10 million children under the age of 18 in this country who have no health insurance. This fact angers me. I hope it angers every state legislator in every state. We should be outraged and ashamed for allowing such conditions to persist. Even if we are insensitive to the human suffering, we should be intelligent enough to understand the cost-effectiveness of providing the optimum level of health care for all children in this country.

What can states do to bring about some type of meaningful change?

First of all, it is past time that the president of the United States and Congress get together to enact a law, that guarantees that quality health care be provided to all citizens of this country, regardless of their ability to pay. I recommend that state legislators aggressively lobby the president and the Congress to enact a national system of health care.

Second, we need to coordinate a plan of attack on the issue of child health care, with quantifiable goals and objectives. We cannot continue to fund programs without measuring them, without asking "What kind of progress have we made?"

We talk about health care goals at the national level for the year 2000. But we also need health care goals in our respective states.

Ohio was the first state to establish a commission on minority health--a separate agency that has its own autonomy. We did not want it to be tied up in health, human services or some other state agency. It has a budget of $3.4 million, which was, at the time of the agency's creation, three times the size of the budget for the U.S. Office of Minority Health. The national office now has a budget of $20 million, which is a substantial improvement over the $1 million it had in the first year of its operation.

But it is a shame that here in America only $20 million is targeted to deal specifically with the health status of the minority population. We in Ohio have been working very hard to attract funds from every source we can find to address the serious health care needs of the minority population in our state.

We were also one of the first states in the nation to appropriate state funds for Head Start so children can start learning about their health at all early age. The first year we appropriated $19 million. In 1991 our governor recommended $49 million. What does Head Start have to do with health care for children? If we can get our young children to start thinking positively about their health in the early grades, then those positive habits will follow them throughout their lives.

In addition, Head Start has a good nutrition component built right into the program. That is why it is so important that we fund Head Start at the highest possible level. Furthermore, we have put $28 million in our public school preschool programs.

We have what we call a "children's cluster" in our state that provides a central point of access for children with serious health care needs so that they don't have to bounce around from agency to agency. We now have child and family health clinics in every county within our state. And adolescent pregnancy prevention programs are funded at $2 million for the biennium.

We even stole a program from Utah. Their "Baby Your Baby" program became Ohio's "Healthy Babies" program. It's primarily a health promotion and communication program. Too often such programs are soft sells; they're not hard-hitting enough. But the Utah program is a good solid program. It offers information to pregnant mothers about alcohol abuse and the possibilities of fetal alcohol syndrome, mental retardation, serious deformities or death.

Expanding child support to include health insurance is another way to help minority children. We amended our child support law to require parents who are obligated to pay child support and have jobs with health care benefits to include their children under their health care program.

Finally, we need to elect to public office more women--more minority women--who are intelligent, committed and strong. Women have a greater understanding and are more sensitive to children and child health care issues. And we need to appoint more intelligent, aggressive and committed women to various positions within all levels of government.

These are some of the initiatives that must be taken to ensure the good health of our children, and more needs top be done. Each state must develop a coordinated plan of action to address the crisis in health care for minority children. We cannot afford to sit idly by and debate the macro issues while children are dying, from treatable and preventable illnesses.