Cutting Health Care Costs: Children's Care

8 Tips From a Pediatrician on Managing the Costs of Children's Medical Care

From the WebMD Archives

(Editor's Note: This is the third in a three-part series on trimming your personal health care spending. The first two articles offer tips on cutting prescription drug costs and reducing the costs of doctor visits and medical tests.)

Dec. 11, 2008 -- Vaccinations, checkups, sniffles, fevers -- children need lots of medical care.

If those medical bills are piling up, pediatrician Andrew Racine, MD, PhD, has suggestions about ways to lighten your tab without compromising your child's health.

Racine directs the general pediatrics division at Albert Einstein College of Medicine and Children's Hospital at Montefiore in New York. Here are his dos and dont's:

1. Do look into local and state resources.

If you meet certain income standards, check with your state or local health department about insurance for your children.

"The first thing that I would advise people to do is to investigate what they may be eligible for, in terms of coverage, that they may not know about," Racine tells WebMD. "There are many, many families eligible to be on that program who are not enrolled."

2. Don't skip children's vaccines.

"I think of all of the things that we do, in terms of preventive health for children, that's probably the most important," Racine says. "It may even be more important than regular checkups ... prioritizing vaccines is an important thing."

Of course, vaccines aren't just for kids. Teens and adults also need to stay up to date with their immunizations.

And don't forget the yearly flu vaccine -- it's flu season now, and the CDC recommends annual vaccination for children who are at least 6 months old.

3. Don't water down infant formula.

Follow the instructions on the product's label. In extreme cases, watered-down formula can cause life-threatening disruptions in the baby's electrolyte levels; such a case recently happened in Florida, Racine notes.

Even if you don't add enough water to create an emergency, Racine says adding extra water to formula may still be a problem because the baby won't get as many calories as it would if the formula were prepared correctly, and that could hinder the baby's weight gain.

It's not clear how common that is. "It's only in extreme circumstances that they would come to medical attention," Racine says.


4. Do consider breastfeeding.

"Breastfeeding is a great way to save money," and it's healthy, too, Racine says.

Racine is sympathetic to the challenges that breastfeeding poses for mothers who work outside the home. He says there are "very, very few places in the United States that actually have adequate facilities for moms to nurse their children or to pump for breast milk when they're on the job. These are basic things in most parts of the industrialized world that we just neglect."

Racine also suggests making your own baby food. "Baby food is more expensive than the ingredients that are in it, and it's an easy enough thing to do," Racine says.

For instance, he says do-it-yourself applesauce is "simply a matter of peeling apples and cutting them up and boiling them in a little water until they're soft, cooling them down, and pureeing them. That's applesauce, nothing much to it."

5. Don't delay buying a car seat or crib for a baby.

"Everyone needs to have a car seat when they're transporting their child," Racine says. "That's a major safety issue for all children."

Cribs are also a must, he says, noting the risks of parents sharing beds with babies. "We know for sure that babies are much safer when they're sleeping on their backs in a crib than they are sleeping with parents in their own bed," Racine says.

A bassinet may be OK for a newborn, but "a lot of bassinets are not designed with the same safety features as most cribs are, so that there may be more areas where babies can get their faces next to parts of the bassinet that don't allow them to breathe well,' Racine says.

"Really, they should be in cribs as soon as you can get them there, because it's just a safer environment for them," he says.

6. Do try phone or email for questions for your pediatrician's office.

Checking in by phone or email with basic questions may head off the cost of a trip to the pediatrician's office, Racine says.

"Most pediatricians' offices offer telephone counseling for lots of routine kinds of problems that some people either end up going to an emergency room about ... or end up going to their doctor's office, when really a lot of it could be handled on the telephone," Racine tells WebMD.

"More and more pediatrician's offices are doing similar things with regard to the Internet, so you can email your doctor with a question and they can get back to you by email -- a way to answer some of these basic issues without you having to incur the costs of a visit," he says.


7. Don't spread out children's vaccination appointments.

The American Academy of Pediatrics and the CDC are "very careful about how they make the recommendations with regard to the childhood immunization schedule," Racine says.

"There is no danger in having a child get all the vaccines that they are normally scheduled to get in a given visit," he says. "If you're trying to spread them out, you're just going to incur the increased costs of additional visits and additional transportation costs."

8. Don't share medications or medical equipment among siblings.

Don't assume that the prescription that works for one child is OK for their brother or sister, or that leftover pills are still OK to use. Always check with a doctor first.

Also, if one child has a medical device -- such as a nebulizer to deliver asthma medicine -- don't let their siblings use it. Sharing those devices could help spread infections.

WebMD Health News Reviewed by Louise Chang, MD on December 11, 2008



Andrew Racine, MD, director, division of general pediatrics, Albert Einstein College of Medicine and Children's Hospital at Montefiore, New York.

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