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Editorial - Insuring the working poor

August 07, 1997

It's been described mostly in terms of taxes and the economy, but the Balanced Budget Act of 1997, signed by President Clinton Tuesday, also has a health-care component - $24 billion to provide insurance for the children of the working poor. We recommend that other states follow Pennsylvania's lead and start soon on plans to phase in this new system.

Legislators in Harrisburg heard testimony this week from doctors and parents whose children are served by a clinic in the state capital, children who might otherwise lose coverage when new laws force their parents off the welfare rolls.

Lawmakers heard that for some working parents, insurance is now too expensive. That shouldn't be a problem under the new law, unless the state sets up a new bureaucracy to administer it.

We'd rather see that job done by Pennsylvania's insurance companies, under state regulation, with some incentives for employers who agree to take on some of the costs, perhaps by handling the paperwork involved in filing claims.

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We recommend an emphasis on preventive care, with immunizations and regular check-ups covered as part of a basic plan. We also recommend some incentives for insured people whose children avoid dangerous or risky behavior, like that described this week by Dr. Frank Boehm, director of obstetrics at Vanderbilt Medical Center in Nashville.

Writing in the Boca Raton (Fla.) News, Boehm said that too many Americans expect medical science to save them from the consequences of their poor diets, lack of exercise and alcohol/drug abuse. At the same time, Boehm said, because many Americans frequently switch health plans, insurers don't get a return on the money they spend on prevention education.

That would argue for some form of bonus - enhanced coverage, perhaps - for those people who stay with one company for an extended time and provide evidence through physicals that their children are eating right and avoiding substance abuse. Some will see the hand of Big Brother in this scrutiny, but if taxpayers provide the cash, shouldn't they be able to reward those who don't waste it?

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