Welfare rules, health needs often conflict, doctors say

Families dealing with chronic illnesses need more help than was provided under welfare reform, which Congress is due to reauthorize this year.

By Amy Snow Landa, AMNews staff. June 24, 2002.

Washington -- When Congress debated welfare reform in 1996, there was little discussion of how the legislation might impact families affected by chronic illness. Instead, the goal was "to end welfare as we know it," which meant moving adults from welfare to work as quickly as possible.

By that standard, the reform effort has largely succeeded. The U.S. Census Bureau reported this month that the number of mothers who receive welfare benefits has been cut in half over the past five years.

But the push to get adults into the work force largely ignored the health concerns of poor families, particularly those affected by chronic illness, said Paul Wise, MD, MPH, director of social and health policy research at Boston Medical Center's Dept. of Pediatrics and a professor at Boston University School of Medicine.

During the 1996 debate, lawmakers paid scant attention to how chronic illness might make it more difficult for parents to get and retain employment, which they are now required to do as a result of welfare reform.

On the flip side, parents who must work have less time for doctor appointments, which has major implications for families with special health care needs.

Some physicians, including Dr. Wise, are hoping to draw lawmakers' attention to these issues this year. The timing is critical because Congress is gearing up to reauthorize the welfare reform law, and many families are about to reach their five-year limit for welfare benefits.

The physicians have launched "Doctors Speak Out on Welfare Reform," an initiative led by Dr. Wise and Wendy Chavkin, MD, MPH, a professor of obstetrics and gynecology, and population and family health at Columbia University, New York City. [...]