SANTA CRUZ -- Before Healthy Kids was created six years ago, veteran pediatrician Dr. Christine Griger could only see patients whose families had private insurance, Medi-Cal or enough money to pay out-of-pocket.
If a family slipped through the cracks because they lost insurance and didn't qualify for public health insurance, there was little she could do for them.
Griger, who this May will mark 30 years of practicing in Santa Cruz, said the groundbreaking health care program that now covers about 2,000 children in the county dramatically bolstered her ability to reach families tumbling toward safety net clinics and emergency room care. And it accomplished something equally important, she believes.
"The biggest thing Healthy Kids gave families, besides care, is dignity," said Griger, 57.
But like other local pediatricians, Griger worries about the number of uninsured children increasing just as funding cuts have halted new enrollments in Healthy Kids.
And with the state facing a $19.9 billion shortfall and federal health care reform in limbo, doctors fear that Healthy Families or Medi-Cal, the two programs that might be other options for uninsured families, also could get cut. About 7 percent of the 11,000 patients seen by the nine doctors in Griger's Sutter Health practice are Healthy Kids patients.
When parents lose coverage, they tend to avoid child wellness checkups and immunizations, or generally delay care, pediatricians say.
Parents skip medication and ask doctors for phone appointments to avoid the cost of an office visit.
"That's scary -- if that starts happening again, it will make it more difficult for everyone in terms of continuity of care," she said.
Last month, Griger was tending to a newborn whose family lost their insurance at year's end. She wanted to see the newborn again to resolve a lingering problem, but his parents were reluctant to come in. For a reason they didn't disclose to Griger, they family didn't qualify for Healthy Kids.
She is monitoring the case by phone for now, but can't handle every situation, especially chronic conditions like asthma, without regular visits. For uninsured or underinsured patients she needs to see, she works to connect them with a charity program tied to Sutter's umbrella organization, the Palo Alto Medical Foundation.
As a member of the foundation's Community Board of Trustees, Griger helped raise $600,000 for Santa Clara County's Healthy Kids last year, and the foundation is a major contributor to the Santa Cruz program. Griger said she also donates personally because she's seen firsthand the difference Healthy Kids makes.
"People were having to make a choice about whether I'm going to buy food or pay rent or pay the doctor," she said of uninsured families. But with Healthy Kids, she said, "They feel like they have real insurance because they do. They're not embarrassed about it."