I'm not advocating denying health care to children and pregnant women. Charity care has always been available, and much less charity will be necessary if we stop subsidizing these destructive behaviors. In thirty-nine years, our practice has not turned away a single sick child due to inability to pay. I myself came from a modest background. I worked my way through college and medical school, so I know what it's like to struggle.
Many parents work two and three jobs to make ends meet and make responsible decisions.
When they find their taxes going up to pay for others, they are justifiably angry. I don't have all the answers, but I would suggest that we re-examine the effects these programs have on children and families in the real world. Reforms should be based on an objective look at our experiences over the last thirty years. For example, Medicaid might be restructured to help children with chronic, severe medical problems or as temporary aid when breadwinners lose their jobs. In order to help parents provide health care for their children, we could pass insurance reforms such as portability, exclusion of pre-existing conditions, and expansion of well child care coverage.