List of Ailments and a Remedy on Caring for Children

Responding to Mayor Richard Riordan’s call for aggressive efforts to protect and help children, his handpicked Commission for Healthy Kids on Tuesday joined a growing statewide debate over how to provide medical insurance to 1.6 million uninsured young people in California.

The commission--a group of health care providers, politicians, educators and others--moved quickly to complete its proposal, which, first, recommends replacing the state’s sliding eligibility scale for a new program with a fixed level that is just above the federal poverty line and, second, compromises between plans to provide coverage through the government-backed Medi-Cal system and others that would turn that business over to the private sector.

Commission members said they believed their approach could take a new source of federal money, combine it with determined outreach efforts and eventually add hundreds of thousands of California children to the insurance rolls.

“This is one of the most extreme problems that our state and city face,” said Dr. Arthur Southman, president and chief executive officer of the HealthNet health maintenance organization and a member of Riordan’s commission. The commission’s approach, Southman added, “is not utopian. This is within our grasp.”

The Riordan-supported proposal was completed in Los Angeles a day before Gov. Pete Wilson was slated to release his package of recommendations, which are expected to lean more heavily on the private sector. Several Democratic legislators, meanwhile, have urged heavier reliance on the existing Medi-Cal system, which they want expanded to cover more children. At present, Medi-Cal provides insurance coverage to most of the state’s uninsured children, but many fail to qualify for that program, leaving them without any coverage at all.

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According to the Riordan commission, approximately 750,000 uninsured children live in Los Angeles County, more than 45% of the state total.

All of the proposals are being drafted in part because new federal money is being offered to help California wrestle with one of its saddest tragedies--children whose lack of health insurance leads to serious illnesses because their parents cannot afford to get them routine medical care.

The consequences of children not having insurance can be acute or long-term. For parents who hesitate to take a feverish youngster to the doctor, only to have the fever turn into meningitis, the result can be a child afflicted with a long and potentially devastating illness. For children who go for years with undetected vision or hearing deficiencies, the consequence can be poor academic performance.

Riordan, who has little direct oversight in issues involving children but who is determined to play a policy role on a topic near his heart, convened his group last month, the day after he proclaimed in his second inaugural address that the benchmark for government programs should be “what is in the best interests of the children.”

His commission focused initially on competing suggestions for how best to extend medical insurance to young people and to capitalize on new federal money that will become available to states this fall.

States that want a share of that money must submit plans next month or risk delays in receiving the funds. In California’s case, acting quickly could allow the government to begin extending coverage as early as October; dawdling could mean a long wait to get as much as $800 million and would leave uninsured children at risk.

Gary Mendoza, who chairs the Riordan commission, said the proposal completed Tuesday would be forwarded immediately to the state Legislature. He expects to testify before a special legislative committee on the topic later this week.

Times staff writer Josh Meyer contributed to this article.