Do no harm!All of us have heard of the Hippocratic Oath new physicians take. We also know another Hippocratic phrase, “First, do no harm“, found in the ancient Greek physician Hippocrates’ work titled, Of the Epidemics. In response to large health care crises, Hippocrates instructed physicians: “First, do no harm“.

Only a few politicians are also physicians, but when it comes to the current U.S. Senate healthcare debate, we in Louisiana have every reason to expect Senator Cassidy and Senator Kennedy to act on our behalf in the spirit of Hippocrates: First, do not harm.

We have every reason to expect Louisiana’s Senators will act to ensure health care services are available to our most vulnerable children. To act otherwise, would be to do harm … and I fear harm is on its way.

If the U.S. Senate’s health bill passes, Louisiana will suffer harm making it impossible to effect the significant changes our children require. I believe the Senate Health Bill will do permanent harm by cutting Medicaid, the insurance that covers nearly half a million Louisiana children.

According to the Congressional Budget Office, the Senate health bill designed to repeal the Affordable Care Act would cause 22 million Americans to lose health insurance by 2026 and cut federal Medicaid by $772 billion. In the United States, four million children would lose health coverage under the Senate health bill.

Those are big numbers – 22 million, 772 billion, 4 million – but that’s national. I am most concerned about how the Senate health bill would play out for Louisiana’s children.

First, let us consider the current status of Louisiana’s children and their health. Today, Louisiana ranks 49th in the nation for children’s health. Louisiana’s children are also ranked 49th on economic well-being with 28% of our children living in poverty.

We often think only of medical care when we think of Medicaid, but dental care is important, too. According to a recent federal Office of the Inspector General report, 26% of Louisiana’s poorest children received NO dental services during the year of the OIG’s review. 55% received only some required dental care.

Louisiana’s child poverty and a dearth of healthcare resources impact children very early in their lives. Louisiana’s infant mortality rate in 2016 was 8.1 infant deaths per 1,000 births. 8.1 means one out of every 123 babies born in Louisiana did not live long enough to celebrate her or his first birthday.

Today, if Louisiana were ranked as a nation for infant mortality, we would lag 81 other countries. Louisiana’s infant mortality rate lags behind the current rates of the “second world”, former communist-socialist and Soviet Bloc countries such as Ukraine, Serbia, Bosnia and Herzegovina, Poland, Slovakia, and Latvia.

The opioid epidemic we read about and hear about every day hurts infants and children. The number of babies born exposed to prenatal alcohol and drug use in Louisiana has almost tripled since 2008. Babies are born addicted. According to Louisiana’s Department of Children and Family Services, this increase is driven in part by a rise in heroin and prescription painkiller use among pregnant women.

While the Department of Children and Family Services is working to protect the babies, Louisiana’s Department of Health is concentrating on the opioid epidemic for good reason: 80% of children who enter Louisiana’s foster care system do so for reasons of neglect rather than physical abuse. (80% for neglect, 15% for physical abuse, and 5% for sexual abuse.) Much of the parental neglect which requires foster care for children is a consequence of substance use by parents whose addiction prevents proper attention to their children.

This is Louisiana and these conditions are not new. There is no way to touch paint to the condition of Louisiana’s children and create a pretty picture. This is why it is so critical that when it concerns health care for children, Senators Cassidy and Kennedy must, “First, do no harm!

The Senate health bill will decimate Louisiana’s weak child healthcare system. The impact on our limited perinatal healthcare services will further increase infant mortality rates. Louisiana, we are already behind second world countries! Is it not reasonable to consider that with fewer resources Louisiana may one day have the infant mortality rate of a third world country?

If healthcare funds for substance abuse treatment are cut by passage of the Senate health bill, the number of foster children in Louisiana will increase – and this, in a state that significantly underfunds its child welfare system. Foster parents in Louisiana have not had an increase in support for the foster children in their care since 2007.

Today, Medicaid provides health insurance to 466,000 children in Louisiana, paying for everything from routine immunizations, check-ups and dental care, to life-saving chemotherapy. Knowing how important healthcare is for children, I find it particularly disturbing that the U.S. Senate’s plan to “repeal and replace” Obamacare also includes massive cuts to Medicaid. These cuts would directly and severely impact the health of Louisiana’s children.

You have never heard of a Louisiana politician trying to CUT health care for poor children. However, the U.S. Senate’s health bill is a bizarre effort to do just that.

If passed, it will weaken Louisiana’s healthcare system for children. With its accumulating series of reductions in coverage for the poorest children, the nonpartisan Urban Institute estimates 58,000 Louisiana children would be uninsured five years from now because of the Senate bill. That is simply unconscionable.

Our kids only grow up once. They deserve access to health care. When children receive the right health care, we all benefit. Healthy children do better in school, are less likely to engage in negative behavior, are more likely to graduate, can work more hours and will earn more as adults. If you want a picture of Louisiana in 20 years, simply look at how we care for our children today.

If Louisiana ever wants a vibrant, strong economy, taking health care away from children is one of the worst things we can do. On behalf of Louisiana’s children and families, I urge Sen. Cassidy and Sen. Kennedy to say “no!” to cuts to Medicaid and to step back from this Senate health bill. Work on something that makes health care more available and affordable for families with children, not less.

And, first, do no harm.

Rick Wheat, President and CEO
Louisiana United Methodist Children and Family Services

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