December 1, 1999

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December 1, 1999

TALKING IT OVER

HILLARY RODHAM CLINTON

December 1, 1999

Ask any young parent whom they turn to first with questions and concerns about their children, and they're likely to answer, "The pediatrician." When our children are young, many of us call the pediatrician at the first sign of a sniffle. We rely on them to calm our anxieties about the full range of complaints -- from colic to chicken pox, bronchitis to boyfriends.

Last month, with overwhelming bipartisan support, Congress passed the Children's Hospitals Education and Research Act. Introduced by Congresswoman Nancy Johnson of Connecticut, and Senator Bob Kerrey of Nebraska, the bill will provide long overdue financial support to the very institutions -- the children's medical centers and teaching hospitals -- that are the most important training facilities for our children's doctors.

In an increasingly competitive health-care market, dominated by managed care, teaching hospitals struggle to cover the significant costs associated with training and research. While other teaching hospitals receive support for these costs through Medicare, children's hospitals receive virtually no federal funds, even though they train 30 percent of the nation's pediatricians and nearly 50 percent of all pediatric specialists. In many cases, they provide the regional safety net for children, regardless of medical or economic need, and they are the major centers of research on children's health problems.

Millions of American children each year are treated by physicians affiliated with or trained in one of 60 independent children's hospitals across the country. As I have traveled around the country over the past 25 years, I have had the opportunity to become acquainted with the valuable services many of them provide.

When Bill and I lived in Arkansas, one of Chelsea's pediatricians was Dr. Betty Lowe, the medical director of the Arkansas Children's Hospital, a facility dedicated exclusively to the care of children and the training of children's doctors. I was proud to have played a part in the development and expansion of this important regional facility, serving as a member of its board of directors for many years. I saw firsthand the miracles that happened there every day -- miracles that would have been impossible without the commitment of both its dedicated senior staff and its roster of talented medical residents.

Here in Washington, one of my favorite Christmas traditions is a visit to the Children's National Medical Center, widely considered one of the best pediatric hospitals in the nation, and the largest private provider of pediatric primary care in the Washington, D.C., region. The annual trip to Children's is also a favorite outing for Socks, who typically sits in my lap as I read holiday stories and answer questions from the young patients -- many of whom will spend their holidays in the hospital.

In recent years, I have made several trips to Children's Hospital in Boston, the nation's oldest children's hospital. In addition to treating young patients suffering from complex medical conditions, Children's runs the largest pediatric training program in the country, and the largest pediatric research program in the world.

I have also spent time visiting the patients at Children's Mercy Hospital in Kansas City, Mo. There, I read to the youngsters as part of the hospital's Reach Out and Read program, which provides books for hospitalized children. Like Children's Mercy, pediatric hospitals around the country are dedicated to treating not only the immediate condition that brings sick or disabled children to the hospital, but also to improving their overall health and well-being.

Earlier this year, I invited a group of senior children's hospital administrators to the White House to discuss the burdensome costs of graduate medical education. A typical independent children's teaching hospital receives less than 1/200th, or .005 percent, of the Medicare graduate medical education support that other teaching hospitals receive. This inequity is only exacerbated by the fact that these centers face the additional costs of serving the poorest, sickest and most vulnerable children, as well as conducting research that benefits all children.

That day, I was pleased to announce that, in order to address this issue, the President would earmark $40 million in his FY2000 budget plan to provide federal financing of graduate medical education for freestanding children's hospitals. On average, hospitals could receive nearly $10,000 per resident, or almost $700,000 for each facility. We worked tirelessly to win these funds, and were extremely pleased that Congress authorized them in the budget agreement.

When the President signs the Children's Hospitals Education and Research Act, we will have taken an important first step toward putting children's teaching hospitals on an even footing with other medical education centers -- a critical investment in a healthy future for all our children.

To find out more about Hillary Rodham Clinton and read her past columns, visit the Creators Syndicate web page at www.creators.com.

Talking It Over: 1999

December 1, 1999