IMPROVING CHILDRENS ACCESS TO HEALTH-CARE - THE ROLE OF DECATEGORIZATION

Far too many children in this country are unable to obtain the health care they need because of barriers that prohibit easy access. Among th e most significant obstacles are financial barriers, including lack of adequate health insurance and inadequate funding of programs for low- income children and those with special health-care needs. Another set of ''non-financial'' barriers are related to the categorical nature of addressing children's health-care needs, which impedes access by incr easing the complexity and burden of seeking care and discourages provi ding care. Decategorization represents an appealing partial remedy to these problems because it can lead to fundamental and lasting changes in financing and delivering health services. The greatest appeal of de categorization is its potential to improve access to care with the exp enditure of little or no new funds. Decategorization represents an app ealing partial remedy to these problems because it can lead to fundame ntal and lasting changes in financing and delivering health services. The greatest appeal of decategorization is its potential to improve ac cess to care with the expenditure of little or no new funds. Decategor ization also hods considerable risk. Depending on how it is designed a nd implemented, decategorization may lead to diminished access to care by serving as a foil for budget cuts of by undermining essential stan dards of care. However, these risks do not negate the value of explori ng decategorization as an approach that can be taken today to better o rganize services and ensure that existing resources adequately meet ch ildren's needs. In this report we examine the role of decategorization as a mechanism for removing the barriers to care that are created by categorical funding of health programs.