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Having Insurance Is No Guarantee Your Kid Will Get Basic Health Care

Photograph by Twenty20

Here’s the basic assumption about health insurance coverage: If you have a plan, you will get to see a doctor. Well, apparently, that's far from reality for millions of insured Americans.

The New York Times recently bought this issue to light in a poignant profile of a Bronx family of five. Margo Solomon has health insurance for herself and her four children. However, getting in to a see a doctor has been a near-impossible feat at times. Solomon has had trouble finding a general practitioner who will take her insurance.

And when it comes to finding a specialist to treat her children’s asthma, she has a better chance for finding a four-leaf clover sprouting through a crack in the sidewalk. Then, when she does find a health provider who will take her insurance, the deductibles and medications are too costly for her to afford.

Her case isn’t an anomaly. According to a new study by the Children’s Health Fund, one in four children in the U.S. do not have access to regular, essential health care even if they have insurance. Stats show that more children than ever have health insurance, yet 20.3 million people under the age of 18 aren’t getting basic pediatric or dental care. Shocking and shameful, isn’t it?

Experts warn this should be addressed immediately but the problems with the system are manifold: Employer-based health insurance premiums increased by 73 percent from 2003 to 2013, and employee contributions went up by 93 percent.

The average deductible climbed, too. On top of that, many clinics and providers will no longer accept Medicaid (the plan that Solomon has). During her last pregnancy, she made 20 calls before she found a doctor who accepted her insurance to give her prenatal care.

To combat the issue, telemedicine has become a growing trend. It allows patients to be evaluated over the internet or by phone. And some parents rely on treating their kids with the free sample meds that are given at doctor’s offices. Although some drug manufacturers also offer deeply discounted prescription medications when the cost is too prohibitive to get them from a pharmacy, it's not nearly enough—and parents can't rely solely on samples from their pediatrician's office, either.

Sadly, things are not likely to get better if President-Elect Donald Trump follows through on his promise to repeal the Affordable Care Act (aka Obamacare), which has extended healthcare to 20 million people.

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