In my editorial in the last issue of MCN (March/April 2009) I wrote about the possibility of universal healthcare coverage-at last-for U.S. citizens because of our recent election and a new president. I don't want MCN readers to think that my words are political, for they are not. I would be praising any president from any political party who was moving healthcare to the top of the agenda. In my estimation, healthcare coverage for U.S. citizens is the most important method of improving maternal and child health. I'm so happy to be able to report that, as I write this editorial in February 2009 (publication processes take a few months!!), the first step of this new U.S. focus on availability of healthcare has already occurred. Healthcare for most citizens in the United States comes through private insurance, administered through one's employer, if the employer chooses to offer it. If your job is lost, so is your healthcare insurance. For the poorest in our country, the government provides health insurance called Medicaid. There are many who also fall somewhere in the middle, having a job which does not provide health insurance, and making just enough money to prevent them from qualifying for Medicaid. These people have no health insurance at all. I'm happy to tell you that our new president has signed a bill which will cover 11 million children. This is huge. I think it's important enough to cease writing my own words here, and to show you the words used by our new president when he signed it:

"Today, with one of the first bills I sign-reauthorizing the Children's Health Insurance Program-we fulfill one of the highest responsibilities we have: to ensure the health and well-being of our nation's children. It is a responsibility that has only grown more urgent as our economic crisis has deepened, healthcare costs have exploded, and millions of working families are unable to afford health insurance. Today in America, eight million children are still uninsured-more than 45 million Americans altogether.

"It's hard to overstate the toll this takes on our families: the sleepless nights worrying that someone's going to get hurt, or praying that a sick child gets better on her own. The decisions that no parent should ever have to make-how long to put off that doctor's appointment, whether to fill that prescription, whether to let a child play outside, knowing that all it takes is one accident, one injury, to send your family into financial ruin[horizontal ellipsis]

"This is not who we are. We are not a nation that leaves struggling families to fend for themselves. No child in America should be receiving her primary care in the emergency room in the middle of the night. No child should be falling behind at school because he can't hear the teacher or see the blackboard. I refuse to accept that millions of our kids fail to reach their full potential because we fail to meet their basic needs. In a decent society, there are certain obligations that are not subject to tradeoffs or negotiation-healthcare for our children is one of those obligations."

This is why elections matter. This is why our right to vote is precious. We're on our way to healthcare coverage for all children, and all citizens, as a right of citizenship. Next stop, universal healthcare for all.

Margaret Comerford Freda, EdD, RN, CHES, FAAN

EDITOR

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