FOR YOUR BACK-TO-SCHOOL SHOPPING LIST:
MEDICAL INSURANCE

Aug. 5, 2002
By Mary Koch

LEAD-IN: The number of Americans who have no health care insurance is growing annually. Yet the number of children without medical insurance is declining, thanks to a five-year-old federal program. Here with more information about the "CHIP" program and Your Health Care Dollar is Mary Koch.

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It's back-to-school shopping time. Let's see, now. Check your list: crayons, pencils, colored markers, spiral notebooks, Peechees, backpacks, medical insurance . . .

Hey, what? Insurance on the back-to-school shopping list? You bet. There's a national campaign underway to sign up uninsured children for low-cost and free health care. The sponsors say nearly five million children in the United States lack health insurance even though they're eligible for Medicaid or the State Health Insurance Program, called CHIP.

In a few minutes, I'm going to give you a toll-free phone number for more information. So if your child or grandchild doesn't have insurance, get your paper and pencil ready.

CHIP was initiated five years ago by Congress, which for once didn't get bogged down in partisan politics. It was the biggest expansion of government health care coverage since Medicare and Medicaid. Leaders in creating the CHIP program were an unlikely duo — conservative Republican Senator Orin Hatch of Utah and liberal Democrat "Ted" Kennedy from Massachusetts.

Hatch calls CHIP a "legislative success story." In his words, "we saw the need to provide health insurance for the poorest of the poor working families who weren't eligible for Medicaid."

Senator Hatch says parents whose kids are enrolled in CHIP no longer have to decide whether to pay the electric bill or take their child to the doctor.

Not only did Kennedy and Hatch work together effectively in 1997, this year they're partners again, sponsoring legislation that will keep the CHIP program viable. Their bill will maintain funding levels through fiscal year 2004.

The senators also want states that don't spend all their CHIP money to keep it instead of following the usual requirement of returning the money to the federal treasury. Kennedy says it would be "intolerable" not to spend money on the program at a time when many children remain uninsured.

The reason all the money hasn't been spent is that four-point-seven million children who could be covered are not enrolled. It's very likely that many working parents who are struggling with a tight budget don't realize their kids are eligible for low-cost or even free insurance.

The U.S. Census indicates eight out of 10 uninsured children come from working families. Three-quarters of these families do not have access to an employer-provided health plan that covers children.

And that's what medical insurance is all about. It's access. It opens the door to treatment, especially to preventative care. Pediatrician and parenting expert, Dr. Berry Brazelton says health care coverage "from day one is critical to a child's long-term health."

Unfortunately, the largest group of uninsured children is found among the fastest growing segment of our Okanogan County population. The Census Bureau says 25 percent of Latino children are uninsured. Most would be eligible for CHIP and Medicaid. So this fall's national enrollment campaign is intensively targeting minorities, who face cultural and language barriers to health care access.

Got your pencil ready? Here's that toll-free number for more information about health care insurance for kids: 1-877-KIDS-NOW, or if you prefer the numerals, 1-877-543-7669. Don't be afraid to call. I called myself just to see if the person at the other end was user-friendly. She was, and she had specific information for Okanogan County residents right at her fingertips. So that number again is 1-877-KIDS-NOW, or 1-877-543-7669.

Click here for more information about the national campaign to insure children.

HEALTH CARE IN JAIL
No. 7 - Aug. 19, 2002
By Mary Koch

LEAD-IN: The state of Washington spends more than 60 million dollars a year on medical care for the 15 thousand inmates in state prisons. If you have health care problems, would you be better off in jail? Here's Mary Koch with "Your Health Care Dollar:"

KOCH: A Seattle newspaper recently carried an editorial cartoon showing a state official advising the poor, the elderly and the ill to stage a riot over their lack of health care. Then, the official says, they'll be arrested, go to jail and finally get their medical care.

The cartoon exaggerated the point, but there may be some truth to it. Okanogan County jail administrator Mary Apodaca says plenty of her prisoners do require medical attention.

APODACA: (154) Part of that issue is when people come to jail things that they have never taken care of before now they want taken care of because they have a means to pay which is basically us. And the same is true of the dental. We also provide a dental service and people that have gone an extended period of time without even seeing a dentist now say, you know, I'm in need of some dental attention because I don't have any teeth on this side, or my teeth are decaying, and we have to provide for them.

KOCH: Despite that, annual costs for medical care at the jail are relatively low — well under 40,000 thousand dollars. That includes doctor visits, dental care, hospitalizations and prescription drugs.

Apodaca says this county's been lucky because it hasn't had to deal with extraordinary illnesses among its jail population. King County spends 22.5 million dollars a year on jail medical services. Of course, King County not only has thousands of prisoners, but they're much sicker. Officials there say infectious diseases and drug withdrawal are common.

Okanogan County has an average of 113 prisoners in its jail each day. There were about 26 hundred bookings in all last year.

When a prisoner is booked, he or she is asked about possible health problems. The county determines if prisoners have insurance and a regular medical provider. The booking officer also observes the prisoner for injuries or infestations that may need treatment.

State regulations require that a medical provider visit the jail three times a week. The county contracts with Okanogan Valley Clinic for that service, which includes having a doctor on-call 24 hours a day. All in all, Apodaca says the quality of health care is excellent.

Some of what the county spends is reimbursed. Okanogan County contracts with various cities such as Renton and Auburn to house prisoners. In those cases, Apodaca says the cities pay the doctor bills. Indian Health Service also reimburses the county for services provided to its clients, and sometimes, Apodaca says the prisoners themselves chip in. A five dollar co-pay is required for doctor's visits. Apodaca says prisoners pay it pretty regularly. The county also requires prisoners to pay for their own medications if they have the means to do it.

APODACA: (127) We try to make the inmate responsible because some of them, that's the reason that they're in here in the first place. You know, they haven't become accountable for their own actions and they're not taking responsibility, and we say, you know, this is not supposed to be a total burden to the state or to the citizens of Okanogan County. And so if we can recoup some of their costs, we certainly do. If we can save the taxpayers, we do and still take very good care of the inmate's health.

KOCH: Even though health care costs for the Okanogan County jail are low, Apodaca says the welfare of inmates, not the dollars, is her primary concern.

APODACA: (184) Yes, these people are inmates but the bottom line is they're somebody's brother, or sister, or mother or father or cousin. I mean, they're from our community. They are people we know. Some have made very bad choices. Some have made a one-time mistake but because they're in jail does not lessen how they should be treated.

KOCH: That was Mary Apodaca, Okanogan County jail administrator. And this has been Mary Koch with "Your Health Care Dollar" for this week.

The Perils of Second-hand Smoke
and Smoke-Free Dining in Okanogan County

Aug. 26, 2002

By Mary Koch

INTRO: You're in a good restaurant and the waiter has just placed your order in front of you. You take a moment to appreciate the aroma of the fresh-cooked food before you pick up your fork. And then . . . someone in the smoking section nearby lights a cigarette. Suddenly your food doesn't smell as good. That's happening less often as more restaurants ban smoking altogether. The Okanogan County Health Department even has a program to let you know where you can enjoy smoke-free dining. Here's more from Mary Koch with Your Health Care Dollar.

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KOCH: Enjoying a restaurant meal away from cigarette smoke is about more than esthetics. It's about protecting your health. It could even be about life and death.

The American Lung Association says secondhand smoke causes some three thousand nonsmokers to die of lung cancer and 35 thousand of heart disease each year.

Secondhand smoke is especially harmful to young children. The Environmental Protection Agency estimates that every year, secondhand smoke is responsible for as many as 300 thousand lower respiratory tract infections in children under 18 months of age.

In some areas of the country, smoking is illegal in public places like restaurants. Studies in southern California showed that restaurant business actually improved after smoking was banned.

In Washington state, restaurants are still free to choose whether to ban smoking. A growing number of Okanogan County restaurants are declaring themselves non-smoking zones, and the county health district is helping to promote those restaurants.

The health department publishes an attractive guide called "Smoke-Free Dining in Okanogan County." The guide is available free at clinics, medical offices, visitor information centers and other outlets.

Madge Vandervort is coordinator of the health department's Community Tobacco Prevention Program. This is the second year she's published the guide, and there's an increased number of restaurants included.

VANDERVORT: (77) I've gotten really good response. We do a survey, we send out a survey every year to update: "Do you still want to be in our dining guide, what's going on?" . . . We got more this year. We got more restaurants this year that were committed to having their restaurant smoke-free."

KOCH: Restaurants that have restricted smoking areas do not qualify for the guide. The entire building, including the cocktail lounge, must be smoke-free. Vandervort. would like to have the entire premises smoke-free, including the grounds outside. But it's too difficult for restaurant owners to manage patrons who insist on stepping outside for a smoke.

VANDERVORT: (118) They can't like tie up anybody's hands, you know, to not smoke. But if they don't, if the restaurant does not offer ashtrays, then, what can they do about their clients that go outside and smoke? You can't do anything.

KOCH: Two years into the program, Vandervort says she's received only one negative response.

VANDERVORT: (127) Last year I received one very hostile letter. He addressed — he, she, whoever it was, and they didn't leave their name or their restaurant name — they were incensed that public money was going for this guide.

KOCH: But the funny thing is, public money is NOT going for this guide. It's tobacco money. The county's Tobacco Prevention Program is funded through the state's big settlement with the tobacco industry in 1998. It pays not only for the dining guide but a number of smoking prevention programs in schools.

Washington state attorney general Christine Gregoire says programs like these are saving the state more money than it spends. Last year the state spent more than 285 million dollars treating Medicaid patients with smoking-caused illnesses.

A study by the American Legacy Foundation estimates that if smoking was reduced by just 25 percent, the state could save 13-and-a-half million dollars a year. Even so, our state legislature, facing one of its worst budget crises in recent memory, raided tobacco settlement money to pay other bills.

VANDERVORT: (27) They didn't raid the money that's guaranteed for seven years. They raided the money way out.

KOCH: So for seven years at least, Vandervort and other public health officials will continue their efforts to educate kids about smoking and to protect non-smokers from second-hand smoke. Especially children. For Vandervort, it's a simple issue.

VANDERVORT: (140) I think if you love your kids, you won't smoke — or not smoke around them.

KOCH: We've been talking with Madge Vandervort, coordinator of the Okanogan County Tobacco Prevention Program. I'm Mary Koch and that's Your Health Care Dollar for this week.

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Click here for links to the Okanogan County Health District tobacco information page

Click here forAmerican Legacy Foundation
campaign for a tobacco-free future