NYT - May 19, 2007
Op-Ed Columnist

Young, Ill and Uninsured

By BOB HERBERT
Fourteen-year-old Devante Johnson deserved better. He was a sweet kid, an honor student and athlete who should be enjoying music and sports and skylarking with his friends at school. Instead he’s buried in Houston’s Paradise North Cemetery.

Devante died of kidney cancer in March. His mother, Tamika Scott, believes he would still be alive if bureaucrats in Texas hadn’t fouled up so badly that his health coverage was allowed to lapse and his cancer treatment had to be interrupted.

Ms. Scott, who has multiple sclerosis, understood the grave danger her son would be in if he were somehow to be left without the Medicaid coverage that paid for his chemotherapy, radiation and other treatment. She submitted the required paperwork to renew the coverage two months before the deadline.

“I was so anxious to get it processed,” she said, “so we wouldn’t have a lapse of coverage.”

In Texas, as in many other states, there is a concerted effort to undermine programs that bring government-sponsored health care to poor and working-class children. It is not an environment in which bureaucrats are encouraged to be helpful, not even when lives are at stake.

“They kept losing the paperwork,” Ms. Scott told me, her voice quivering with grief. She submitted new applications, made dozens of phone calls and sent off a blizzard of faxes. Despite her frantic efforts, the coverage was dropped.

When the coverage lapsed, the treatment Devante had been receiving ceased. “They put us on clinical trials,” Ms. Scott said. “They changed his medicine, and he started getting sicker and sicker. After awhile it was like his body was so frail and he was so weak he could barely walk on his own.”

Four months after the Medicaid coverage lapsed, the mistakes were finally corrected and the coverage was reinstated. By then, there was no chance to save Devante.

“I believe he would be with me now if they hadn’t let his insurance lapse,” said Ms. Scott.

Across America children by the millions are being denied the health care they need and deserve — and some are dying — because the U.S. has no coherent system of health coverage for children.

Stories like Devante Johnson’s are not unusual. Three months ago a homeless seventh grader in Prince George’s County, Maryland, died because his mother could not find a dentist who would do an $80 tooth extraction. Deamonte Driver, 12, eventually was given medicine at a hospital emergency room for headaches, sinusitis and a dental abscess.

The child was sent home, but his distress only grew. It turned out that bacteria from the abscessed tooth had spread to his brain. A pair of operations and eight subsequent weeks of treatment, which cost more than a quarter of a million dollars, could not save him. He died on Feb. 25.

There’s a presidential election under way and one of the key issues should be how to provide comprehensive health coverage for all of the nation’s children, which would be the logical next step on the road to coverage for everyone.

That an American child could die because his mother couldn’t afford to have a diseased tooth extracted sounds like a horror story from some rural outpost in the Great Depression. It’s the kind of gruesomely tragic absurdity you’d expect from Faulkner. But these things are happening now.

“People don’t understand the amount of time and stress parents are going through as they try to get their children the coverage they need, in many cases just to stay alive,” said Marian Wright Edelman, president of the Children’s Defense Fund and a tireless advocate of expanding health coverage to the millions of American children who are uninsured or underinsured.

Medicaid and the State Children’s Health Insurance Program provide crucially important coverage, but the eligibility requirements can be daunting, budget constraints in many jurisdictions have led to tragic reductions in coverage, and millions of youngsters simply fall through the cracks in the system, receiving no coverage at all.

It is time for all that to end. American children should be guaranteed nothing less than comprehensive health coverage from birth through age 18. This can be achieved if an effort is mounted that is comparable to that which led to the first moon shot, or the Marshall Plan, or the postwar G.I. bill.

Keeping American children alive and healthy should be at least as important as any of those worthy projects.