Occam’s razor health care costs and insurance coverage

Every year, about 759,000 children with asthma are at risk for an attack while they have no insurance, according to an analysis of data from the National Survey of Children’s Health.

About 30 percent of those families earn more than 200 percent of the federal poverty level, putting them above the threshold for the State Children’s Health Insurance Program (SCHIP) in most states. Studies have shown that providing insurance to children with asthma through SCHIP reduces their unmet needs and reduces racial disparities in access to care.

“These children need to have ongoing treatment from a primary care provider to avoid serious health complications. Without that, they are at increased risk for ongoing symptoms and even hospitalization,” says Jill Halterman, MD, MPH, lead author of the paper, which appeared in the journal Ambulatory Pediatrics.

In addition, about 13 percent of children with asthma were without insurance at some point during the year. That includes 2 percent of children who were uninsured for the entire year. This amounts to 114,000 children who were 14 times as likely to have had an unmet need for medication than were children with private insurance. Even those who were covered by the time of the survey were six times as likely to have missed out on needed medication.

No differences were found between children with private and public insurance when it came to unmet needs, discontinuity of care, or poor access. This suggests that consistency of coverage for children with asthma is more important than the source of insurance.

The researchers also found that many children with asthma were not seeing a primary care physician often enough. Almost one-third of parents of uninsured children said they had no personal primary care doctor for their child.