Richard Roehm
(Address Snipped)

May 15, 1998

The Honorable Loretta Sanchez
United States House of Representatives
Washington, D.C.  20510

Dear Representative Sanchez:

I am writing to urge you to cosponsor legislation introduced by Senator Jack 
Reed (D-RI) and Representative Constance Morella (R-MD) -- the "Children's 
Health Insurance Accountability Act of 1998" -- that will provide important 
health care protections for children as well as enable providers, professionals,
systems, and workers to assure improved quality of health care for our
nation's children.

That legislation is supported by us because it recognizes that, as the 
President's Advisory Commission on Consumer Protection and Quality in the 
Health Care Industry writes, "Children have health and developmental needs 
that are markedly different from adults and require age-appropriate care.
Developmental changes, dependency on others, and different patterns of
illness and injury require that attention be paid to the unique needs of 
children in the health system."

Access to Care

By any measure, children are particularly vulnerable to health care quality 
problems or differential experiences in the health care system.  Children are 
the poorest demographic group in the nation and therefore have enormous 
financial barriers, particularly in the case of children with special
health care needs.  Children are also dependent on others for their care, understanding and communication of health problems.  Moreover, they have 
unique patterns of illness and injury that creates special challenges to the 
health system.

It is precisely these sources of vulnerability for children that make the 
assurance of their access to appropriate pediatric care and emergency care, as
provided for in the Reed/Morella legislation, so very important.  They also 
ensure that children receive health care in the most appropriate setting and 
condition possible.

Appeals and Grievances

I also support the provisions in the Reed/Morella bill that recognize the 
importance of having appeals and grievance procedures that require review by appropriate pediatric providers.  Moreover, the legislation takes the important 
steps of ensuring that plans have an expedited process for children whose life, 
health and development is threatened and that appeals mechanisms and panels have appropriate pediatric representation and expertise.

Accountability and Information

When making health care decisions, families need information that is specific 
to their family's and child's needs.  Information and materials that are 
provided about health plans and providers is often focused and targeted only 
on the adult care system.  For families trying to negotiate through the health 
care marketplace, this is not only unhelpful but detrimental to children. 
Without focus, there is less attention to quality.

As a result, I am strongly supportive of the provisions in the Reed/Morella 
bill requiring plans to include measures and indicators of care that are 
specific to children in the information they provide to families, businesses, 
and other purchasers.

Once again, I urge you to cosponsor the Reed/Morella bill in recognition of 
the need to improve the protection and quality of care to children in the 
health care system.

Sincerely,
Richard Roehm