Residents of the nation's capital woke up one morning not long ago to the sort of bad news that we like to think doesn't happen in America: A child died from lack of dental care.
Deamonte Driver, a seventh grader in suburban Prince George's County, Maryland, died on Feb. 25. Bacteria from an abscessed tooth had spread to his brain, doctors said. Two operations and eight weeks of care and therapy failed to save him. Total cost: more than $250,000.
His mother, Alyce Driver, worked at low-wage jobs. She did not have employer health insurance. Between her struggles to navigate between private coverage and the state's public health care coverage, her child never received the $60 tooth extraction that would have saved his life.
Now Deamonte's story is one in a disturbing stack of horror stories that Marian Wright Edelman, founding head of the Children's Defense Fund, carries over to Capitol Hill to persuade Congress to close gaps in health coverage for children.
The horror stories are horribly sad. They include children like Devante Johnson, 14, who died in Houston in March. His kidney cancer went untreated for four months because of a paperwork snafu. His family's state representative intervened, but it was too late.
There are stories of children whose families lost health coverage when they moved from one state to another, including kids in families fleeing disasters like Hurricane Katrina.
Some children get caught without coverage because their parents must constantly re-apply for it, even when they stay in the same state. Others are caught in the gap when state Medicaid eligibility levels or federal Children's Health Insurance Program levels are too low and private insurance too expensive.
That $40 billion program, commonly known as S-CHIP, is up for reauthorization after 10 years and 6 million additional children covered. States are free to design their programs, helped by federal grants and subsidies.
There's a good chance that the program will be reauthorized at current funding levels, insiders say. But with health costs skyrocketing, that would be, in effect, a cut.
Bills to double S-CHIP spending over the next five years are being pushed by Sen. Hillary Clinton, who is famously associated with a failed attempt at universal coverage in her husband's presidential administration, and Rep. John Dingell (D., Michigan). Depending on their economic conditions, states could offer coverage to families making up to 400 percent of the poverty line, or about $68,000 for a family of three.
Who could oppose this noble effort on behalf of children's health? The usual suspects. There are ideologues who have never found a government-funded health program that they didn't dislike. There also are budget hawks who quite reasonably worry about what revenue needs to be raised or what other program needs to be cut in order to pay for it.
What's needed is leadership to persuade Congress that children shouldn't be allowed to slip through growing cracks in coverage.
"Covering all children is an achievable goal in 2007 with political leadership," Edelman told me. "It won't happen without large-scale mobilization and public awareness."
Edelman's organization, which trademarked the slogan "Leave No Child Behind" years before the Bush administration came along to embrace it, endorses a similar bill by Rep. Bobby Scott (D., Virginia) that would add prenatal, mental, dental and vision care. It would also equalize access to prevent children in poorer states from being shortchanged.
It's not the first time that Edelman, a veteran of voter registration missions in the South in the early 1960s, has pushed farther than Clinton to help children and families. They've known each other since Clinton worked at the fund as a law student. Marian's husband, Peter Edelman, was an assistant secretary at the Department of Health and Human Services in President Bill Clinton's administration. But the Edelmans parted company with the Clintons over the 1996 welfare reform law.
The good news is that child poverty has declined sharply since then, helped by a healthy economy. But too many families are having a tougher time making ends meet, especially for health coverage.
As health costs and insurance costs skyrocket, the issue is taking on new political life. Americans are growing impatient with the bean-counting rhetoric. We have the best health care system in the world, we are constantly told, and that's true. But the best in the world doesn't do much good to those who can't gain access to it.
Everyone should have coverage. Our children are the best place to start.
