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Thomas K. McInerny, MD
Department of Pediatrics,
University of Rochester Medical Center,
Rochester, NY 14642
We appreciate the comments of Abston et al in response to the American Academy of Pediatrics (AAP) Medicaid policy statement.1 As lead authors of the statement, we offer the following reply.
We agree that all pediatricians are responsible to provide high-quality, equitable care. The AAP is opposed to discrimination in the care of any patient.2 Pediatricians should provide medical care for underserved children including those enrolled in Medicaid as well as the uninsured, immigrant, homeless, and migrant.3 Pediatricians also should address the needs of their patients and all children in the context of the community.4 Finally, we also should continue to transform our private and public pediatric health care systems to emphasize value.5
Pediatricians have made a strong commitment to children enrolled in Medicaid. Nationally, a majority of pediatricians accept all Medicaid patients.6 On average, 30% of a pediatrician's patients are covered by Medicaid.7 In general, pediatricians serve more Medicaid patients than do other primary care physicians.8
All physicians and society are also responsible for ensuring that all children are treated equitably. In particular, policy makers should address low payment and paperwork concerns to ensure sufficient primary care physician capacity to appropriately serve children who are enrolled in Medicaid.6
The AAP is committed to improving child health and reducing the gap in health disparities among populations of children in the United States and the world, in particular among children living in poverty and other groups of marginalized children. In partnership with the Royal College of Paediatrics and Child Health, the AAP has established the Equity Project to ensure that all pediatricians and providers of child health services understand the issues and experience of marginalized children and health implications of inequity and have the capacity for resolving health disparities among children; this project also seeks to advance the understanding of the genesis of health disparities and raise the national profile of the health implications of inequity through research and the development of relevant public policy.9
REFERENCES
Related articles in Pediatrics:
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