Yet Another Reason Not to Be Too Enamored of SCHIP

The U.S. health care sector is fundamentally broken. Yet most reform proposals, including Congress’ plan to expand the State Children’s Health Insurance Program, would just throw more money at the dysfunction without doing anything to fix it. (Mind you, that suits the health care and insurance industries just fine.) 


Another example of what such reforms won’t fix emerged in this week’s New England Journal of Medicine. Researchers examined the medical records of 1,500 children and found that the kids received (what the evidence suggests is) high‐​quality care only 47 percent of the time. 


Similar studies have found that adults receive recommended care only 55 percent of the time. One of those studies even found that having insurance doesn’t much improve the quality of care that adults receive:

Although having insurance increases the ease of access to the health care system, it is not sufficient to ensure appropriate use of services or content of care. Indeed, within systems where access to care is more equitable … substantial gaps between observed and optimal quality remain. In the United Kingdom, with universal coverage, a study using our methods found that the overall proportion of recommended health care that was received was similar to what we have reported.

This week’s study on the quality of pediatric care did not compare the quality of care received by insured children to that received by uninsured children. Nonetheless, the researchers closed with an illuminating comment on the current debate over SCHIP:

Expansion of access to care through insurance coverage, which is the focus of national health care policy related to children, will not, by itself, eliminate the deficits in the quality of care.

Yeah … but … oh, what the hell. Who’s up for throwing more money at the problem?