Read Health Insurance and Children with Disabilities. (click the link for PDF Full text, please; do not read only the Abstract). Evaluate this article in terms of the proposed benefits to children with disabilities and challenges in providing universal healthcare to them.
What do you think? Policies like managed care are an example of the outermost layer in Bronfenbrenner’s model (see Module 3 e-book chapter titled: Human Exceptionality in Context) – and serve to remind us that social policies can have a direct effect on an individual child.
Please post a response, and remember to respond to two other people’s postings. You must cite all resources using APA format.
Your main post should be substantive – at least 200 words, not including the Discussion questions or references. Each discussion response/reply to me or others must have a minimum of 125 words, spell checked, well written and citing references in support of arguments. Active participation is required.
In your reply to others: You could include additional research info (don’t just share a website link, explain what you found, summarize the info, and then share the website link), or, provide a few suggestions based on the class reading/additional reading, or explain why you agree or disagree with your classmate. Always provide at least ONE citation from the reading to ‘support’ your discussion.
1ST DISCUSSION POST
I think that managed care is very important for an individual child because not every disability is the same. For example, a child with autism might need physical therapy, but another child might not. Large shares of children with special health care needs also had insurance coverage that their parents considered inadequate because it did not meet the child’s needs (13 percent), did not cover costs adequately (28 percent), or did not permit the child to see needed providers (9 percent) (Szilagyi, 2012, p. 126). If children don’t receive managed care based on their needs, they won’t be able to show improvement. For many people with exceptionalities, schools and the health care system play a large role-both as microsystems, which include interactions with the people (teachers, school administrators, doctors, nurses), and as mesosystems, ecosystems, and macrosystems (Staff, n.d.). All kids need to have some type of insurance, whether or not it’s through the state or private insurance companies. If children don’t have insurance, they won’t receive the services or care they need. If a child doesn’t have insurance coverage, there is a possibility their health and behavior by decrease tremendously. Many programs are run off of insurance, and if the child is not insured, they won’t be able to participate.
The two main health insurance programs are Medicaid and SCHIP (known since 2009 as the Children’s Health Insurance Program, or CHIP). Nearly half of children with special health care needs who have insurance are covered by one of these two programs; 90 percent are enrolled in Medicaid, and the other 10 percent in CHIP (Szilagyi, 2012). I have seen where some companies accept one insurance but not the other. This issue causes a delay in receiving services for the child.
Staff. (n.d.). Book: Human Exceptionality in Context. Retrieved from Suny Empire State College: https://mylearning.suny.edu/d2l/le/content/292048/viewContent/8160903/View
Szilagyi, P. G. (2012). Health Insurance and Children. Futur of Children, 27.
SECOND DISCUSSION POST
For children born with special needs, access to adequate and affordable health insurance is essential. By examining Bronfenbrenner’s model of social ecology, we can understand the importance of a strong and supportive health care system for someone with special needs. Microsystems, such as schools and health care systems, have the most impact on those with special needs. Access to medical procedures, prescriiption drugs, regular doctor check-ups, specialists and therapists, and assistive technologies, are just some of the services that health insurance covers. But for uninsured or underinsured children, these options are unreachable and can place a financial burden on the families that pay out-of-pocket. Szilagyi (2012) states, “nearly 2 of every 5 special needs children are either uninsured or inadequately insured” (p.123). Medicaid and CHIP are government programs that provide the bulk of health insurance coverage for children that have special health needs. By providing such coverage, families can properly provide for their children’s medical needs. The long-term effects of having adequate health insurance on children with special needs has not been evaluated. But it is commonly assumed that “by increasing the level of care children with disabilities receive and the degree of functioning they achieve, health insurance could have later effects on outcomes in adulthood” (Szilagyi, 2012, p.132).
Microsystems, like proper health care, have the most impact on an individual’s life. Making health insurance affordable and accessible for children with special needs should be a top priority. The medical care one receives in early life can predict and dictate the quality of life they have in adulthood. If we want to prepare our youth to be contributing members of society, then we need to take care of their health needs when they are young. Enrolling all eligible children into public health insurance programs, like Medicaid, CHIP and others, will increase the positive outcomes for children and families with special health needs. While universal healthcare is not available in the US, the assistance programs such as Medicaid provide some relief to families that cannot afford private insurance. Taking advantage of the programs available would alleviate some of the financial burden that children with special health needs face. Knowing how Microsystems impact an individual’s life only solidifies the importance of social programs such as Medicaid.
PLEASE REPLY TO BOTH DISCUSSION ABOVE
Szilagyi, P. G. (2012). Health insurance and children with disabilities. Future of Children, 22(1), 123–148. https://doi-org.library.esc.edu/10.1353/foc.2012.0000