As the battle in Washington continues on how best to reform the nation's healthcare system, some children's advocates are working to ensure that kids aren't left out of the discussion.

 

A grassroots effort called Speak Now for Kids was created earlier this year by the National Association of Children's Hospitals (NACH) to do just that. It includes five partners; the American Academy of Pediatrics, the Children's Defense Fund, the Children's Health Fund, First Focus, and the March of Dimes.

 

According to Sharon Ladin, NACH's director of legislative action programs, the effort has a very broad aim: keeping children's health care in the mix as the nation grapples with health care reform.

 

In addition to its partners, Speak Now for Kids has 130 major supporters. In Arkansas, the only one of these is the state's lone children's hospital, Arkansas Children's Hospital in Little Rock. David Berry, senior vice president and chief operating officer, said children are often ignored during discussions about healthcare "because they spend less money on healthcare, and because they don't vote. When you get right down to it, it's adults that vote. It's the other organizations that represent adults that have so much of the voice, and while there are strong advocates for kids, and I certainly don't mean to take away from them, the reality is most of our healthcare dollars in America are spent on adults, and they vote."

 

Children 18 and under represent 25 percent of the population, but only 9 percent of the nation's healthcare costs. Nine million are uninsured, a number that is distributed unevenly across the states, with Arkansas faring better than many. Providing figures that it asserts should be used with caution because they result from a small sample size, the NACH estimates that 6.6 percent of Arkansas' children are uninsured, compared to a national rate of 11.2 percent. Among the state's neighbors, Louisiana has the lowest uninsured rate in the nation at 1.3 percent, while Texas has the highest at 21.7 percent.

 

According to Berry, the hospital has a good relationship with Arkansas Medicaid and hasn't run into problems here, but the future is uncertain in Washington, D.C. "We are in good shape at the moment in terms of caring and covering for Arkansas' kids," he said. "That said, our real concern is not about what happens at the state level. Our real concern is about changes to Medicaid funding or whatever that comes from the national level that comes about as part of healthcare reform."

 

Ladin said Speak Now for Kids was conceived this year by NACH's chief executive officer, Lawrence McAndrews, who noticed during White House events and public meetings across the country that other health issues overwhelmed children's needs. "Once those conversations were happening, children's issues were not actually being discussed," she said. "We were in the room but not at the table."

 

McAndrews approached the CEOs of the other organizations about creating the joint effort, and it quickly took flight. The time between conceiving the idea and launching it May 1 was "a week or two," Ladin said half-jokingly.

 

It was the first time the NACH has taken a grassroots campaign outside of its own association. A Web site (www.speaknowforkids.org) was created that helps supporters stay connected and features personal stories across America, including one from "Donna S" of Rogers. Working without an advertising budget, the effort is also communicating with supporters using social media such as Facebook and Twitter.

 

Berry said Arkansas Children's is encouraging staff and board members to sign up on the effort's website so they can be linked into the effort. "We're sort of taking a watchful approach," he said in June.

 

Meanwhile, NACH is communicating with its members and continuing its own lobbying efforts, including its recent annual Family Advocacy Day in which 39 hospitals descended on Capitol Hill. While Speak Now for Kids' message is simply to ensure children aren't left out of the healthcare debate, NACH has more specific goals. These include ensuring that all children are covered comprehensively and affordably, and that a default coverage system is created so that children of newly unemployed parents who lose their insurance still will be covered.

 

It's also working to educate congressional representatives and others about workforce needs as they relate to children. According to Aimee Ossman, NACH director of Medicaid and state policy analysis, many in Congress are surprised to learn that while adult healthcare providers are moving to the specialties and leaving a shortage of primary care physicians, in children's health it's just the opposite; adequate primary care pediatricians, but a shortage of specialists.