Seriously. The Senate Finance Committee’s nearly 50-page description of policy options for “Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs” literally has nothing to say about the steps that could be taken to improve the system we use to deliver health care to children in this country. It is almost exclusively devoted to changes to the Medicare program, which won’t help the 74 million children in America who need a transformation of the health care delivery system as much as anyone.  A 2007 study by RAND Corporation researchers found that children in the U.S. receive the care they should only about half of the time.

The omission of children from a document that serves as a guide as to how the Senate Finance Committee is likely to approach delivery system issues in the context of broad health reform is alarming.  It is a warning sign that policymakers may be forgetting that the recently-adopted legislation renewing and strengthening the Children’s Health Insurance Program was supposed to be a “down payment” toward health reform (see video below), and not the end of a conversation about how to ensure that all of America’s children have access to affordable, high quality health care.

There is much, much more that needs to be done to improve the care that children receive, as well as to make sure that they have coverage and are integrated into national health reform as my colleague Liz Arjun has begun to discuss elsewhere.  The federal government can and should play a critical role in transforming the delivery system for children.  Through Medicaid and CHIP, it pays for most of the cost of providing care to nearly one in three children in America.

Despite my disappointment over this opening salvo from the Finance Committee on delivery system reform, I’m optimistic that children will become a larger part of the health reform agenda in the weeks and months ahead.  Earlier this week, Senator Chris Dodd publicly made the case for ensuring that the unique needs of children are considered in health reform, and Congress has a relatively strong record when it comes to health care for kids.  So, I’m not despairing yet, but I’m also not assuming that children’s health issues will “naturally” be addressed in broader health reform.  It is going to take a lot of education and a lot of work.