The Ultimate Back-to-School Health Checklist

NEW YORK -- The first day of school always requires preparations -- notebooks, pens and a new set of clothes. But don't forget to prepare for your child's health, says Dr. Luz Adriana-Matiz, pediatrician and medical director of Win For Asthma at NewYork-Presbyterian Morgan Stanley Children's Hospital and assistant professor of clinical pediatrics at Columbia University College of Physicians and Surgeons. "Children spend the majority of their days in the classroom and the first step to achieving a healthy school environment is to have healthy students."

Dr. Romina Wancier, assistant attending pediatrician in the Division of General Academic Pediatrics at the NewYork-Presbyterian Phyllis and David Komansky Center for Children's Health and instructor of pediatrics at Weill Cornell Medical College, adds, "Your child should be physically and mentally prepared to go back to school. By ensuring a healthy start, parents can lay the groundwork for children to achieve their highest academic and extracurricular potential."

Dr. Adriana-Matiz and Dr. Wancier provide parents and caregivers with tips to help their kids get a smart start to the academic year.

* Are your child's immunizations up-to-date? The last thing you want is for your child to be turned away from school on the first day because he or she is not properly immunized. If you have recently moved from one state to another, check to see if your child meets the new state's regulations. In addition, new immunizations, such as hepatitis B, are now required. Check with your child's pediatrician.

* Has your child been vaccinated against influenza? More than 36,000 people die every year from influenza (flu). Children, the elderly and people with chronic medical conditions such as asthma and chronic lung disease are at greater risk for contracting influenza and experiencing its complications. The influenza virus changes every season so your child needs to be immunized every year against this illness. As you prepare to send your child back to school, make an appointment to have your child immunized.

* Have you noticed your child scratching his or her scalp since camp ended? It may be a sign that a case of lice was contracted during the summer. It is important that you check your child's head yourself, and, if you are unsure, contact the school nurse or your child's pediatrician. Head lice will not go away by itself, but can be treated with over-the-counter remedies.

* Does your child receive medication on a regular basis for diabetes, asthma or another chronic problem? School nurses and teachers must be made aware of your child's needs, especially if they are the ones who administer the medicine. Be sure to speak with them about these procedures before school begins, and work out an emergency course of action in case of a problem. Make sure emergency medications are close at hand -- that your child, their teacher and the nurse know where they are.

* Have your child's vision screened. It is important for children to have an annual vision screening because young children, especially, often don't know if they can't see adequately. If your child wears glasses, be sure that the prescription is current. If your child cannot see, they cannot learn properly.

* Have your child's hearing tested. Most states now mandate hearing tests for babies. But many school-age children have not been tested. If your child is listening to the television or music at a very high volume, or tends to favor one ear over the other when listening to you speak, it may be a sign of hearing loss.

* Does your child eat breakfast? Studies show that children who eat breakfast are more alert in class. Also, be sure that your child has a balanced, nutritious lunch, whether it is one you send or one provided by the school cafeteria. If your child is allowed to bring a snack, try to avoid junk food and focus more on fruits and other healthful food.

* Be equipped for sports. For children who wear glasses, the American Academy of Ophthalmology recommends one-piece wraparound polycarbonate sports frames for all contact sports, including soccer, field hockey and basketball. All children wearing spectacles need sports frames for gym. All children are being urged to use sports frames for contact sports.

* Is your child anxious and apprehensive? Most children are naturally anxious about the new school year. It normally takes about a month for children to adjust to new situations. A new school, fear of a class bully, or taking a school bus for the first time may cause anxieties. If after a few weeks your child continues to be anxious and apprehensive, bring this to the attention of his or her teacher so that you can identify the source of his or her anxiety and work out a solution.

* Do you suspect a learning disability or dyslexia? If you suspect that your child is not processing information as he or she should, speak to the teacher or learning center in your child's school as soon as possible. A professional diagnosis usually requires two days of testing.

* Are your emergency phone numbers up-to-date? Make sure that the school and your child know how to reach you or another caregiver at all times. The school administration and teachers should always know how to reach you if there is an issue that needs to be discussed.

Looking Beyond The Public Option

The Obama administration claims its motivation for a public plan option--government insurance for all--rests on the more fundamental goal of increasing competition among health insurance providers. But we now hear rumblings that the "public option" is not necessarily a required part of the administration's reform package.

The public backlash against the public option seems to have yielded reconsideration--and no wonder. We already know a "public option" actually reduces access and choice of health insurance coverage to Americans. Public insurance expansions erode private insurance coverage, rather than provide coverage to the uninsured. They also increase the likelihood that small-business employers limit their coverage, cutting back on employees' choices to funnel them into subsidized government plans. Choice of insurance is reduced, not increased, by a public option.

We also know that the costs of a public plan would represent a massive burden to taxpayers. Look at Hawaii, our most recent failed experiment with universal government insurance. Just seven months after offering the only state-wide universal child health care insurance program in the country, Hawaii terminated the program because public funds had essentially replaced private coverage that children already had. More than 80% of those taking up the state's insurance for children were already covered by private insurance. Massive costs were shifted onto taxpayers from those who were already buying their own insurance. When this happens, costs to the American taxpayer end up dramatically increasing.

Here are five straightforward steps the government could take, right now, that would increase the competitiveness in the health insurance markets.

First, allow a national market for health insurance so people can shop for insurance they actually want to buy at competitive prices. It is ill-conceived, unnecessary and self-defeating to force Americans to restrict their purchases to in-state goods or services. Government can rapidly lower the price of health insurance by breaking down these anti-competitive barriers that result in shocking price variations--on the order of several multiples--among states for equivalent health coverage.

One specific and immediate action would be to allow small businesses to band together through trade associations to purchase coverage for their employees. If regulated by the Employee Retirement Income Security Act of 1974, they would be exempt from state health insurance mandates and regulations. Just like large businesses, small businesses need this capacity now, so their employees could get coverage they actually want while saving money compared with bloated plans they don't desire. Since small-business employees make up the biggest proportion of uninsured workers, this one change would have a high impact.

Second, government can force a more transparent system, ensuring that Americans have a clear understanding of the price and quality of their doctors and hospitals. They would also have enough information about health and diseases to make informed, value-conscious decisions.

Let's leave the experts--medical scientists in their peer-reviewed literature--to determine efficacy and clinical utility. A far more important governmental role needs to be explored: to make transparent the pricing of medical procedures. Public knowledge of price will provide an impetus toward competitive pricing by both physicians and hospitals. In our current system, few patients are aware of the charges about to be incurred for their medical care, generally because patients have no reason to ask--the current third-party-payer structure makes patients believe that "someone else is paying." This has allowed hospitals and doctors to cloak their pricing methods in a shroud of mystery. The government should require posting of prices for medical procedures and services, as well as qualifications of doctors. Information is power, and price visibility is essential to coaxing competition.

Third, it is time to reduce the mandate-created distortions of health insurance markets. State-based mandates alone now number over 2,000 and are an abuse of government dictates. They increase insurance costs by anywhere from 20% to 50% and force Americans to buy policies covering massage therapy, acupuncture, chiropractors, in vitro fertilization, wigs and other services used by only a small minority of American families.

Governments can put a halt to the unending stream of mandates advocated by these special interest groups and start stripping away some of these costly and ill-advised regulations. How about letting patients themselves decide what sort of coverage and benefits they want for their families by watching what they actually purchase, rather than declaring appropriate coverage as if they are naive children or simply incompetent?

Fourth, expand the availability and simplify the rules and regulations of lower-cost health plans with health savings accounts, like high deductible plans for catastrophic coverage. This will make insurance an attractive purchase for the millions of Americans who can afford insurance but choose (arguably wisely) to forgo buying something they consider a poor value with their money.

Health savings accounts increase choice for consumers, expand individual ownership and control over health spending, promote price visibility to allow value-based purchasing, and provide incentives for savings to prepare for future health care needs. Congress should allow more flexibility in employer contributions to "disease management accounts" in lieu of traditional third-party benefits. It should also support tax reform proposals to allow HSA balances to transfer to their children's HSA tax-free and permit holders of HSA plans who relocate because of a job change to purchase health insurance across state lines without being subject to state mandates.

Fifth, government can empower the consumer by revamping the tax treatment of health care expenses, so that all Americans will truly shop for--and ultimately own--their health insurance. A national system of refundable health care tax credits--actual cash even for those who pay no income tax--would foster personal ownership and control of health plans and increase the competition for a newly engaged and expanded market of consumers.

The essential portability of insurance truly owned and designed by American consumers eliminates the fear of job loss and exposure to financial disaster and creates a new group of value-seeking shoppers for insurance. Empowerment means having control of the health care dollar. This single policy change would reduce health expenditures on the order of hundreds of billions of dollars, simultaneously eliminating the crippling burden of health costs on American businesses created by historical accident rather than intention.

We know the disastrous consequences of opening government insurance to everyone under the guise of spurring competition. And we must be wary of any administration plan that forces guaranteed issue and community rating on private insurers as a "compromise" to dropping the public plan option. According to the Council for Affordable Health Insurance, the cost of health insurance will increase 75% to 95% for most Americans who buy their own coverage in that scenario.

If Congress enacts reforms that remove artificial barriers and constructively open markets to competition, private sector creativity will generate innovative, low-cost insurance products for the tens of millions of newly empowered shoppers. In America's long history of innovation benefiting consumers with new products and services they value, that innovation has always come from the private sector, not government, and there is no reason the health insurance industry should be an exception.

Scott W. Atlas

Children's insurance helps generate funds

Life insurance plays an important role in an individual's financial planning exercise. Insurance can assist individuals in planning for their own life stages as well as provide for their children's future.

It also secures a child's future in case of any unfortunate event. Various kinds of child insurance products are available in the market.

Parents need to build a sufficient corpus for their children . They should start planning for their children at an early age.

One of the biggest financial commitments for parents is to meet the expenses incurred in bringing up and settling their children. Child insurance plans play an important role in securing a child's future. With a number of children's insurance plans available in the market, it becomes difficult for most parents to evaluate them objectively.

The factors to be kept in mind include the timeframe for building a corpus, age at which the funds would be required, approximate amount needed to build the corpus, investment avenues to be considered and the amount available to the child in case of death of parents.

As inflation rises, the first impact is on the education sector. Planning for a child's future is an important step. It is advisable that parents go for a term policy.

That will take care of the child's financial needs in case of untimely death of any of the working parents. For the child's future, one can create a specific financial plan through systematic investment planning (SIP) in mutual funds.

Health Officials Urge Immunizations

SAN ANTONIO -- As summer break comes to an end, the San Antonio Metropolitan Health District and its partners are making a final push for back-to-school immunizations.

Metro Health, the University Health System and the Northside Independent School District plan events in the coming weeks before school starts to maximize opportunities for families to have access to services. The goal is to prevent potentially life-threatening diseases like whooping cough, measles and meningitis.

There will be clinics throughout the city and a major immunization event on Aug. 18 from 1 p.m. to 7 p.m. at Freeman Coliseum. NISD officials said they plan to enforce a "no shots, no school" rule, which means that children without up-to-date shot records will not be allowed to attend class.

"It is one of the big jobs that our school nurses have," Shirley Schreiber, NISD director of health services, said of making sure that students are immunized. "So that it can be a safe and healthy environment."

New state-mandated immunizations will be required, especially for those children entering kindergarten or seventh grade.

Parents are also reminded to bring their child's most current shot record and insurance card when they their child immunized. No fees will be charged for children enrolled in Medicaid or the Children's Health Insurance Program. For children with private health insurance, fees will be based on level of benefits.

Health officials said the new school year will pose an even bigger challenge due to the H1N1 flu virus. They said the virus continues to affect the community and expect a significant number of cases when school begins.

Kids will also need to be vaccinated against the virus when it comes available, probably in late October.

Governor signs bill assuring kids health insurance

PORTLAND — Thousands of Oregon children without insurance can now get coverage for their medical care — and by January the same will be true for all youngsters in the state, following Gov. Ted Kulongoski’s Tuesday signing of “Healthy Kids” legislation.

The Democratic governor’s signing of House Bill 2116 into law, along with his earlier approval of a companion bill, clears the way for one of Kulongoski’s longest-sought goals: bringing all Oregon children into the ranks of the insured, especially those whose parents don’t have access to private coverage and have not met low-income standards to qualify for the state-run Oregon Health Plan.

“We will, at long last, bring health care to every Oregon child,” Kulongoski said at a gathering of lobbyists, health care bureaucrats, politicians and even a young patient at Doernbecher Children’s Hospital on the campus of Oregon Health & Science University in Portland.

Through a combination of increased “provider taxes” on most Oregon hospitals and a new 1 percent tax on health insurance premiums, Oregon is adding 200,000 uninsured children and poor adults to the ranks of the insured.

Combined, the two taxes will generate between $300 million and $400 million in the next two years, jumping to about $500 million in 2011-13. Hospitals eventually supported the tax, because it’s expected to be fully offset by new federal Medicaid dollars coming to Oregon by the jump in state health care spending. Insurance companies stopped short of supporting the plan, instead agreeing not to oppose it while warning that it would drive up health care costs for companies and individuals who pay for private insurance.

Kulongoski said Congress, in the midst of its own debate on overhauling health care coverage, could take a lesson from Oregon.

“Together we have set Oregon on the path to create a health care system that will be a model for the rest of the nation,” Kulongoski said.

The expansion of coverage will be phased in until it’s fully in place in January.

Dr. Bruce Goldberg, head of the state Department of Human Services, which oversees the program, encouraged all families without insurance for their children to register now, either online or by telephone. Those who aren’t immediately eligible under federal poverty level guidelines will be enrolled as soon as they are eligible, Goldberg said.