>>I guess it might depend on what one considers "junk food". That's the way it was with the old-fashioned food stamps, anyway... you couldn't buy potato chips, candy, etc.<< I consider Twinkies, SnoBalls, and Pinwheel cookies to be junk food... all can be purchased with the debit cards. Not to mention cereal that is 60% sugar, chocolate syrup, etc, etc, etc,.... >>health insurance would encouage people to get more preventive care.<< Insurance requires a co-pay for the parents that is larger than the $3 or $5 they may need to pay at a clinic.... most preventive health care clinics and immunization clinics are free.... Medicaid has no co-payment... >>And I would think these are quite limited in what they offer. << Since most of the clinic systems work in conjunction with medical schools, they have access to the finest doctors, facilities, and treatment protocols. Children are referred to special clinics when indicated. >>HMOs give VERY LITTLE choice in what doctors a person can see. Sure, you can pick a primary doctor. but once you choose that person, he or she is the gatekeeper and decides when and if you can get a referral, see a specialist, etc. (unless you want to pay out of you own pocket).<< Treatment protocols in HMO's are determined by what treatment is cheapest and most effective for the largest percentage of patients. Treatment protocols in clinic systems are determined by what treatment is safest, easiest to follow, and most effective for the largest percentage of patients. >>Better care than a private doc? Not even close, not where I Iive anyway.<< Clinic systems tend to have a lower morbidity and mortality rate than private systems even though they deal with a higher risk population. There are wonderful private doctors.... but the private system as a whole, especially when dealing with low income families, has higher morbidity and mortality rates. When health care is determined by how much you can afford to spend... risks are increased and safety suffers... The prescription that is not filled because the family cannot afford to fill it, will do nothing for the illness being treated.... >>some overcrowded clinics with overworked staff.<< They are sometimes very crowded and the lines can be long. Appointments are usually given within a block of time, not at a specific time. But I have spent many hours waiting in the "waiting" room at a private physicians office also.... The staff are no more over worked in the clinic system than they are in the private sector... and they are frequently better paid... >>I'm not an expert on child health care or S-CHIP, but the fact that so many members of Congress--from BOTH parties--have studied the issue extensively and feel the bill is worthy says a lot.<< I am not an expert on SCHIP but I am an expert on children's health care issues.... And from what I have heard politicians say about this new bill.... I believe that health care and health insurance are being muddled together.... Every one wants good health care for our children... but there is a difference between health care and health insurance.... Lots of people have health insurance... but cant afford to use it. Just giving people access to insurance is not the answer. They have to have the resources to utilize the insurance. Half of the families who qualify for the current SCHIP insurance program have not signed up for it... why is that? If it was such a wonderful program, wouldn't everyone who was eligible for it, want it? I just dont think that making the program bigger is going to make it better.... I would be more interested in seeing a comprehensive analysis of what is wrong with the program now than a campaign to make a bad program bigger.... Angel

In addition to emergency room care, there are preventive health care clinics and sick child clinics provided by the Health Departments of all states.... But they are time consuming, and many parents choose to go to the emergency room so they do not have to enter into an evaluation by social services for an income evaluation. That evaluation places them on a sliding scale for payment. They are then issued a clinic id to obtain services for their children. Medicaid is another option for low income families. This is not an issue of providing health care for the children in this country... this is an issue of providing insurance. Insurance gives parents more choices as to what doctor they see and so forth. I believe that is a luxury. If my tax dollars are paying for the care of these children, I prefer that it be done in the least expensive, safest manner. That will provide the best standard of care for the children. I have worked in the field as a medical liason finding services for indigent children and I have looked carefully at the services provided by these clinics. When a parent takes a child to a preventive health care clinic the child receives the appropriate immunizations and evaluation of development. The parent receives valuable information about the developmental milestones to expect of the child and nutritional counseling to help them provide proper nutrition for the child. They are given referrals to other services if those services are needed. Services like WIC which provides coupons for selected free nutritious foods that are necessary for proper growth and development of children and for subsidized child care for low income families...working families... They get more comprehensive care than they will at some private pediatricians who are being paid a discounted insurance rate by the insurance provider and who are not used to dealing with low income clients. Those physicians do not have the same social service resources that clinics have and few of them provide social workers in their office to help with community referrals... As I discussed in the article http://www.xomba.com/schip_veto I would not like to see the current health care clinics suffer the same fate the commodities food programs suffered. The commodities food programs gave poor people surplus government food... nutritious food ...meat, butter, cheese,peanut butter, soy enriched pasta, fruits, vegetables, rice, oil and staple items. Now we give people a debit card to buy junk food with at the grocery store and burn the surplus food when it goes out of date. Angel