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Arch Pediatr Adolesc Med. 2004;158:1091.

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In reply

I appreciate the comments of Dr Berman on my editorial, "Sustaining Optimism."¹ I agree that Medicaid has many problems. However, it does provide insurance coverage for 17 million children in the United States, in contrast to the 9 million children without insurance. Universal coverage, even with Medicaid, is still far off and an improved system of coverage even farther. Right now, it is what we have to work with.

Dr Austein also underscores the bureaucratic problems we all encounter dealing with Medicaid as an insurer. Whether we would be better off with a European-style system of universal coverage I have no idea, but I do think that Medicaid is better than no insurance for children in the United States. The quality of patient care in institutions serving a sizeable proportion of Medicaid patients must be high; I agree we cannot set a standard that is suboptimal.

We all . . . [Full Text of this Article]

AUTHOR INFORMATION

Frederick P. Rivara, MD, MPH

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Arch Pediatr Adolesc Med. 2004;158(11):1090-1091.
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