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This article appeared in the April 8, 2010 edition of the St. Louis Post-Dispatch.

            With the ongoing national discussion about health care reform, many parents are understandably confused about what will happen with their children’s medical care.

            We have more options for getting health care and paying for it than ever before. There is a movement toward “consumer-directed health care,” health insurance that is designed to get those who use health care — like parents — to play a bigger part in keeping costs in check.

            Many different types of consumer-directed health care plans are available, each with their own benefits and limitations. Many of these plans feature high deductibles (the amount of money parents must spend before health care is covered by insurance) as well as health care savings accounts, which make it easier for parents to save money to pay for the services that insurance doesn't cover.

            Some plans cover preventive care, routine checkups, vaccines, tests, and regular disease screenings, but others do not. When you're choosing health insurance, it is important to look for a plan that meets your family's needs.

 Navigating the Health Care System

            Rising costs and increased variety among health care plans can make it challenging to find your way in the health care system. Making decisions while everyone is healthy can help reduce the stress and financial strain when someone in your family does need medical care.

Choose your coverage carefully. Carefully consider your family's health care needs. While it's impossible to predict sudden illnesses and accidents, you can anticipate some things. For example, if your child has a chronic disease such as diabetes, asthma or allergies that requires frequent checkups and tests, make sure to pick a plan that covers them. A representative from the insurer — or your employer — should be able to answer any questions about those kinds of issues.

Make a medical home. Try to establish a long-term relationship with a pediatrician or family doctor who can:

  • get to know your family
  • provide well care and most of the sick care your child might need
  • keep complete medical records of things like immunizations and growth
  • become familiar with your family's medical history

A doctor who has all this information, and gets to know your family over time, can better determine when your child is healthy and developing well and when something is off track.

Don't skip checkups. It's important to keep regular checkups even when kids aren't sick — this way, doctors can make sure they're developing as expected and can catch any health concerns early so that they don't become expensive and hard-to-treat medical problems later.

Letting regular checkups lapse may save time and money in the short-term, but ultimately might translate into bigger bills and longer waits at the doctor's office. If parents wait until kids are really sick to see the doctor, they're likely to require more intensive — and expensive — medical care.

Keep vaccines up to date. Checkups are especially important so that kids can stay current on their immunizations. In recent years, vaccines have been developed to stem illnesses like the flu, infantile diarrhea (rotavirus), hepatitis, meningitis, and human papillomavirus (HPV). Parents have more opportunities than ever to keep kids healthy and safe from contagious illnesses.

Don't delay care. When children are sick or injured, it can be difficult to decide how much medical care they need. Ultimately, if you're unsure about what medical care your child needs, your doctor — or a nurse who works in the office — can help you determine what to do. The important thing is to ask questions before something turns into an emergency.

            Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Medical Center and is a Professor of Pediatric Medicine at Saint Louis University School of Medicine. 

4/8/2010 
 
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