PEDIATRICS Vol. 119 No. 5 May 2007, pp. 1034-1035 (doi:10.1542/peds.2007-0344)
LETTER TO THE EDITOR |
Uninsured Latino Children: A Call to Action: In Reply
Glenn Flores, MDSandra C. Tomany-Korman, MS
Center for the Advancement of Underserved Children
Department of Pediatrics
Medical College of Wisconsin and Children's Hospital of Wisconsin
Milwaukee, WI 53226
Milagros Abreu, MD, MPH
Department of Epidemiology
Boston University School of Public Health
Boston, MA 02118
We thank Ms Garvin for her letter regarding our article1 and commend her early interest as a medical student in advocating for immigrant children and their families.
We agree wholeheartedly that pediatricians can and should play an important role in shaping immigration policy. We take issue, however, with the statement that pediatricians have not traditionally engaged in shaping immigration policy. Indeed, there is clear and abundant evidence to the contrary. For example, several pediatricians recently testified on behalf of the American Academy of Pediatrics about the impact of policies on immigrant children's health care before several committees of the US House of Representatives, including the House Committee on Government Reform, the House Judiciary Committee, and the House Committee on Energy and Commerce.2 Pediatricians have published narrative accounts about immigrant patients that cogently articulate the need for immigrant health care policy reform.3,4 A recent article by pediatricians described the case of an undocumented immigrant child in acute renal failure who was refused dialysis by a hospital, and these authors also analyzed the key policy issues for health care providers and policy-makers when faced with caring for undocumented children who need expensive life-saving care.5 This case and the article were key components of a subsequent challenge by the Mexican American Legal Defense and Educational Fund and a broad coalition of other organizations of the constitutionality of Proposition 200 in Arizona, which cut off all state services, including education, medical care, and police and fire services, to all individuals who are unable to immediately provide adequate proof of their US citizenship or residence.6
We also agree, however, that much more policy work is needed on behalf of immigrant children's health care in the United States. Perhaps most importantly, every child in our nation, regardless of immigration status, should have health insurance. Several states, including California,7 Oregon,8 and Washington,9 currently are considering bills that would provide universal health insurance coverage for children, including all immigrant children and the children of all immigrant parents. We believe that such universal coverage makes sense, will enhance children's health care access and outcomes, and should be instituted throughout our nation.
We invite Ms Garvin and all pediatricians to join us in advocating on behalf of immigrant children and their families so that no child in America ever suffers, is sick, or dies because of discrimination or lack of access to health care because of immigration status, national origin, race/ethnicity, primary language, or English proficiency.
REFERENCES
1. Flores G, Abreu M, Tomany-Korman SC. Why are Latinos the most uninsured racial/ethnic group of US children? A community-based study of risk factors for and consequences of being an uninsured Latino child [published correction appears in Pediatrics. 2006;118:2270]. Pediatrics. 2006;118 (3). Available at: www.pediatrics.org/cgi/content/full/118/3/e730
2. Ring P. Pediatricians urge end to restrictive documentation requirements.
AAP News. 2006;27
:4
. Available at: http://aapnews.aappublications.org/cgi/content/full/27/10/4-a. Accessed February 1, 2007
3. Mullan F. Immigration pediatrics.
Health Aff (Millwood). 2005;24
:1619
–1623
4. Flores G. She walked from El Salvador: caring for an immigrant nation.
Health Aff (Millwood). 2005;24
:506
–510
5. Young J, Flores G, Berman S. Providing life-saving health care to undocumented children: controversies and ethical issues.
Pediatrics. 2004;114
:1316
–1320
6. Mexican American Legal Defense and Educational Fund. MALDEF files suit against Proposition 200 "Pan" initiative: wins temporary restraining order against measure. Available at: www.maldef.org/news/press.cfm?ID=244. February 2, 2007
7. Governor's health care proposal. Available at: http://gov.ca.gov/pdf/press/Governors_HC_Proposal.pdf. Accessed February 2, 2007
8. 74th Oregon Legislative Assembly: 2007 Regular Session—House Bill 2201. Available at: www.leg.state.or.us/07reg/measpdf/hb2200.dir/hb2201.intro.pdf. Accessed February 2, 2007
9. Washington State Legislature. HB 1071-2007-08: Concerning access to health care services for children. Available at: http://apps.leg.wa.gov/billinfo/summary.aspx?bill=1071&year=2007.Accessed February 2, 2007
PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics
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