Congress Must Fulfill Our Promises to America’s Children

This week, Maddox Hatch, a 3-year-old boy from Hermon, Maine, who loves to dance and fold laundry, will visit our nation’s capital to meet with members of Congress. At birth, Maddox was diagnosed with Down syndrome, several holes in his heart and just one heart valve.

Because Maine lacks pediatric cardiac surgeons, Maddox was airlifted to Boston Children’s Hospital. He is doing fine these days and is very grateful that, in his short lifetime, he has been treated by no fewer than eight highly skilled pediatric specialists who have provided him a quality of life that would be otherwise unimaginable.

Maddox is one of 3 million children nationwide with complex medical needs who benefit from the care provided by top-notch pediatric specialists trained in children’s hospitals. The cost to train pediatricians and pediatric specialists, while significant, is partially offset by federal funding allocated annually thanks to the bipartisan support of House and Senate members who believe, like most Americans, that children should be able to see a doctor when they need one.

This week, children from children’s hospitals across the country, along with their families, will join Maddox in urging Congress to increase funding for the crucial program that enables nearly 60 children’s hospitals to train 7,000 physicians annually. For 20 years, funding through the Children’s Hospitals Graduate Medical Education Payment Program has made a positive impact. But despite its success and bipartisan backing, the program still falls short of keeping up with the urgent needs of our children — in the communities they live in and in the hospitals caring for them.

Representing a small percent of all U.S. hospitals, children’s hospitals bear a large share of the financial burden associated with training half of all pediatricians — the doctors who will care for our future generations. While adult teaching hospitals receive reliable funding to train physicians through Medicare, children’s hospitals must advocate every year for CHGME funding.

And the disparity is growing between the funding to train adult physicians versus training support for pediatricians. At current levels, the average CHGME payment per pediatrician-in-training represents just 40 percent of what Medicare provides to support physician training in other teaching hospitals.

The fact is, children’s hospitals cannot keep covering the ever-increasing costs of training a disproportionate number of America’s pediatricians without curtailing other services. As our ability to care for and, in many cases, heal very ill children increases, the demand for pediatric specialists continues to rise.

Every day, about 1 of every 10 babies is born prematurely and goes on to develop health conditions requiring life-long therapies. Other babies are born with conditions such as congenital heart defects or cystic fibrosis, and many otherwise healthy babies will go on to develop different varieties of childhood cancers as they grow older. Developing and deepening training programs in highly specialized disciplines helps us meet the diverse and complex needs of these children.

Training highly skilled pediatricians is also one of the smartest, most cost-effective strategies for our future. Every dollar invested not only helps children lead the healthiest lives possible but also provides incalculable benefits by helping so many children realize their full potential — without becoming a burden to taxpayers.

Sustaining high-quality teaching programs at children’s hospitals requires bolstering our national commitment. We cannot risk falling further behind in advancing children’s health. Ongoing physician shortages need to be addressed, most acutely among specialties such as developmental pediatrics, child and adolescent psychiatry, and pediatric genetics and genomics.

Reaching parity for training children’s doctors could be achieved by funding CHGME at $635 million annually. Current funding is about half of that — $325 million.

We realize that we cannot eliminate this gap as fast as we need to. But we are asking Congress to take an important first step toward this goal by approving $400 million to train the next generation of pediatricians and help usher in a healthier generation of Americans. Maddox’s mission this week will be conveying to Congress the importance of CHGME with a simple message: Please don’t forget me.


Sandra L. Fenwick is CEO of Boston Children’s Hospital in Boston and serves on the board of directors for the Children’s Hospital Association.

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