Bill Considine: Adding children to the national health care reform debate

The president and chief executive of Akron Children’s Hospital, sees himself with a cloth in hand, polishing his jewel of a children’s hospital. Despite his longtime advocacy for children, however, Considine said he can’t give himself a passing grade for focusing the national health care reform debate on children’s issues.

AKRON, Ohio — Bill Considine, president and chief executive of Akron Children’s Hospital, sees  himself with a cloth in hand, polishing his jewel of a children’s hospital. “The work that goes on here is magical,” said Considine, who this week will celebrate 30 years as head of the Akron hospital that employs more than 4,000 people in 78 locations.

Considine has filled many national and state leadership roles among children’s hospital groups: He’s past chairman (and current board member) of the National Association of Children’s Hospitals and Related Institutions, where he’s a member of its Council on Child Advocacy and Resource Development Advisory Group. He serves on the American Hospital Association’s Maternal Child Health Governing Council. He’s past chairman (and a current member) of the Child Health Corporation of America. He’s also past chairman of the Children’s Miracle Network board and chairman-elect of the Ohio Children’s Hospital Association.

Despite his longtime advocacy for children, however, Considine said he can’t give himself a passing grade for focusing the national health care reform debate on children’s issues. He sat down with MedCity News to talk about some of his ideas for achieving this focus.

Q. Is the nation including children in its debate about health care reform?

A. Children need our voices. Advocacy for children has never been more important than it is today. Yet, are we talking about children in this reform? Not the way we should be. Why? Children are not a lobby group. Children do not vote. There’s consensus on both sides of the political aisle that children are our future. Yet, translating that into sound public-policy initiatives that are going to cultivate, nurture and develop children to their full, God-given potential is just not happening.

Q. Why should we focus on children in this debate?

A. If I had a magic wand, the group I would start with, relative to health care, is our kids. Why? I believe you can get public-policy consensus around that. Two, children are a definable population and most children are healthy. So the investment we would have to make in health care innovations for our children would not even come close to the billions of dollars we talk about to reform the overall health care system.

Q. How would you start this focus?

A. I would set up a pilot study. Ohio is a great place for pilots because of our demographics. I would bring insurers, employers and the public sector to the table to design a program. The largest payer of children’s health care in this country is Medicaid. But the public sees Medicaid as “welfare” and “nursing homes.” Let’s spin the children’s portion of Medicaid into a separate program.

Q. What would this program look like?

A. We would measure things like obesity and diabetes in kids. We would track immunization rates, low birth-weight babies, neonatal mortality. We can measure these things and see whether a health care program improves outcomes. The program would be focused just on kids and have prevention as a major component. The program would pay doctors fairly. If I’m a doctor and I lose money from giving a kid an immunization, that’s wrong.

Q. So what you’re talking about is a “public option” for kids?

A. That term, “public option,” is polarizing, so I would never use it. Would I use the term, “children’s option?” Absolutely. But it would include private insurance companies, employers and the government. And the thing I would strive for is that it would be the same plan, no matter where it is. So if my children are insured through private insurance and my neighbor’s children are insured through the government children’s program, the benefits would look the same. The government would have to pay more up front for this program, but the return would be enormous.

Q. Could you describe the potential return on such a program?

A. More kids being kept out of the hospital. Healthier lifestyles among our children. I’d also bring our schools to the table, looking at nutrition and physical education in schools. As a kid, I can remember doing the long jumps and sprinting in the alley behind St. Mary’s to get our President’s Award medals for physical fitness. We should do that again.

[Feature photos by Ted Stevens, Akron Children’s Hospital]