Free Health Insurance Makes Kids Resilient

Research shows that health insurance improves children’s psychosocial outcomes.

Posted May 23, 2017

I recently heard it said that while Americans were putting a man on the moon, Canadians were giving everyone free health care. Now, I admit, free health care isn’t as sexy as a walk on the moon, but a truly civilized society usually takes care of it’s obligations to its most vulnerable citizens before it reaches for the stars.

I was reminded of this while reading the US-based Child Trends May research brief that connects health insurance coverage and improved child well-being. As someone keenly interested in resilience, I am constantly reminded that resilience is something we facilitate in others. The more we have a social safety net, child protection laws, street signs, speed limits, food inspectors, and culturally sensitive cops, the more people who are the most in disadvantaged are likely to succeed. And the more people that succeed, the safer, richer, and happier we all are.

Somewhere in the debate over Obamacare vs. Trumpcare, we seem to have forgotten that there are solid social, moral and economic arguments for providing equitable, free access to health care for all citizens. How did the for-profit insurance companies ever con the people who have the most to gain from single payer health care to vote for politicians who profit from a system that works only for the wealthy? Even worse, how did the states that have the largest populations of people who would gain from publicly funded health insurance get convinced to elect politicians who were hell-bent on taking away their health care?

In a recent address to the graduating class at Virginia Tech, Sheryl Sandberg, Chief Operating Officer of Facebook, reminded her audience that resilience is something built. “We build it into ourselves. We build it into the people we love. And we build it together as a community.” Sandberg’s interest in resilience followed the sudden early death of her husband and the realization that we get through a crisis of that magnitude by relying on others. Resilience is seldom an individual trait alone.

Which brings me back to health insurance. In the United States, 95 percent of children are covered either by private insurance (52 percent) or Medicaid, CHIP, and other programs (43 percent). Those numbers are astounding, first for the fact that one in twenty children still can’t see a doctor for free any time he or she wants, and the second for the fact that the private insurance business has been an abysmal failure at ensuring the health and well-being of children in the most industrialized nation on earth. Slightly less than half of all children do not benefit from the for-profit health care system as it was designed, requiring a state-supported alternative.

This is a tragedy, especially since we know that when children have easy access to high quality health care their mental, physical, emotional and educational outcomes are all vastly improved. Earlier access to care (usually a privilege reserved only for those with private insurance) means fewer hospitalizations. Even more astounding, in studies of mothers and their children who were provided with access to an expanded program of Medicaid (much like what other countries such as Canada, Germany and the UK call regular everyday run-of-the-mill health care), the children grew into adults with a lower body mass index, lower rates of obesity, and fewer preventable hospitalizations for a range of disorders, all serious problems affecting Americans today. Of particular relevance to those of us concerned with mental health, kids with access to good health care also had fewer mental health problems, eating disorders, were at lower likelihood of risky sexual activity, smoked less and used drugs and alcohol less frequently as well. Even better, unmarried, low-income adolescent girls were less likely to become teen parents when enrolled in a health insurance plan.

The evidence is irrefutable. When it comes to health care, there are no alternative facts. In the annals of science, these relationships between access to health care and positive outcomes is about as certain as we ever get to truth.

If that isn’t enough to sway voters to stand up and demand publicly funded universal access health care, then consider that children who receive health care are also better learners with higher reading scores and better academic achievements. No wonder that healthy children also report higher rates of economic security and contribute more to their communities as adults.

Those are powerful stats. Of course, we can’t idealize any system of health care. The Canadian system, for example, has been accused of having longer wait times for elective surgeries. And many Canadians have a problem finding a family physician. There are the shortages of specialists in rural areas and the remote north. And of course there is the cost. Health care is a significant tax burden for sure, though I wonder if anyone has added up the cost of private premiums in the US, as well as all the money put into Medicaid and other programs.

Every well-considered study that I’ve read, however, has shown that the US health care system costs much more to deliver than that of other countries and produces far worse outcomes. Again, thinking about resilience, let me echo Sandberg’s words. Resilience is something we build together as a community.

Now dream for a moment. Imagine you can change jobs anytime you like and not have to worry about your children seeing a doctor or getting pregnant and incurring a massive medical bill. Imagine you don’t have to save in case you break a leg or hurt your back. Imagine your child, no matter what your economic status, can get the same world-class health care as the wealthiest child in your community. Imagine you never have to worry about a pre-existing condition or having higher premiums because you lost your job and couldn’t pay for health care for a year. And imagine that your nation was still wealthy, productive and safe. That would be a lovely world to raise resilient kids in.

Next time you go on vacation, visit Canada, Germany or the Netherlands. Poke around their hospitals and ask people about their health care. Before you criticize their high taxes, ask yourself whether their educational and health outcomes are a good return on investment. Ask if the social contract is intact. Governments are there to help their citizens live healthy happy lives. Especially their children. If Child Trends teaches us anything it’s that something has to change. If Obamacare failed, maybe that’s because it didn't go far enough. Its proponents didn't understand that for a society as a whole to be capable of withstanding significant challenges (think gun crime and racism), it needs to make those who are the most disenfranchised feel cared for first.