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Health Insurance for Infants, Children, and Youth

Policy Date: 1/1/1974
Policy Number: 7408

Whereas, so-called comprehensive health insurance rarely insures payment for preventive and early disease detection services,
Whereas, health insurance policies, usually exclude coverage of infants in the most vulnerable period—the first six days of life.
Whereas, health insurance programs usually fail to insure payment for the costs of ambulatory office or clinic visits, which are the characteristic location of diagnosis and treatment for more than 90 percent of diseases occurring in childhood, and usually fail to insure payment for the costs of health services rendered by personnel other than physicians,
Whereas, health insurance rarely reimburses for the costs of diagnosis and treatment of problems in child development,
Whereas, dental care is an important part of comprehensive health care of children,
Whereas, adequate primary preventive care for children will reduce the need for subsequent restorative dentistry,
Whereas, many health insurance policies exclude or limit coverage for dental conditions, and
Whereas, in 1970 the American Public Health Association adopted a statement on a national program for personal health services, and there is further need to specify the conditions for coverage with respect to the health care of infants, children, and youth, therefore be it,
Resolved, that the American Public Health Association recommends that any acceptable plan for national health insurance must have the following characteristics to cover the health needs of infants and children:
1. Infants must be covered for all health services from the time of birth, and for all health conditions whether or not they existed at the time of birth, and including developmental disabilities.
2. Infants, children, and youth under 18 years of age must be covered for comprehensive services, whether rendered in a hospital, office, or clinic, including:
a. Preventive health services including maternity care and fertility regulation
b. Casefinding
c. Diagnosis
d. Treatment and health counseling
e. Correction of defects.
f. Aftercare and rehabilitation
g. Restorative and prophylactic dental services including at least semi-annual cleaning, fluoride application, and health counseling on dental hygiene.
3. Infants, children, and youth under 18 years of age must be covered for appropriate health services rendered by physicians, dentists, nurses, dental hygienists, nutritionists, social workers, psychologists, speech pathologists, audiologists, and all other qualified health workers.
4. Preventive and casefinding services should be excluded from any deductible and coinsurance provision.
And, be it further Resolved, that the American Public Health Association:
1. Incorporate the foregoing in its public utterances on the subject of national health insurance.
2. Communicate this resolution in its entirety to:
a. Congressional committees concerned with health insurance
b. State insurance regulatory agencies
c. The American Academy of Pediatrics and the American College of Obstetrics and Gynecology
d. Consumer groups
e. The National Council of Organizations for Children and Youth
f. Other organizations as may be appropriate.
3. Inform the public that no health insurance is comprehensive unless it covers the care of the individual starting at birth; preventive visits including maternity care and fertility regulation; ambulatory visits; diagnosis and treatment of medical, dental, and other health conditions; and basic assessment and treatment of child development problems.
4. Promote truth-in-advertising laws which title all other health insurance as "limited"
5. Encourage health education programs for consumers to acquaint them with the costs and benefits of health supervision, immunization casefinding, early treatment, and recognition of developmental problems and their multi-discipline treatment.