Politics, Society, and Law Scholars Second Year Advocacy Project

It is no secret that healthcare in the United States is expensive. Every year, millions of children are hospitalized, and the average cost of pediatric stays is over $6,000. A significant portion of these stays are expected to be paid by Medicaid, which covers many low-income families and qualified pregnant women and children. While there may be no easy solution to curb the rising costs of healthcare, there are means of supporting individual families through organizations like the Ronald McDonald House Charities. The Ronald McDonald House, which has numerous volunteer opportunities, offers invaluable resources for families with seriously ill children, including a place to stay close to local hospitals at little to no cost, home-cooked meals, and a sense of comfort while away from home.

Unfortunately, every year large numbers of children must spend time in the hospital. In 2012 alone, hospital stays for children totaled just shy of 5.9 million. The mean length of stays was 3.9 days, and the average hospital costs were $6,415. These numbers are all the more striking in comparison to adults aged 18-44 for the same year. For the latter group, hospital stays averaged 3.6 days and had an average cost of $7,612.[1] Stays for children were on average slightly longer than for adults, and the average stay cost only a little over a thousand dollars less. As suggested by the data, hospital stays for children are not insignificant and can impose high costs on families. Furthermore, pediatric hospital costs have been increasing in recent years. From 2008-2012, the average yearly increase in mean hospital costs was 6.7% per stay for infants and 6.4% for children 1-17 years of age per stay. That rate of growth was over three times greater than the growth in cost for any other age group. Part of the reason behind this growth is related to changes in the conditions for which children are being treated. A recent study found that the number of hospital days, aggregate hospital charges, and the number of patients grew faster in children with chronic conditions than those who did not have chronic conditions from 2004-2009.[2]

Given the high costs, paying hospital bills can be daunting. Families typically utilize private insurance or Medicaid, a government program that requires states to cover certain groups such as qualified pregnant women and children, low-income families, and individuals receiving Supplemental Security Income.[3] In 2016, a study found that private insurers or Medicaid were expected to pay for more than 90% of all hospital stays for individuals 0-20 years old. The expected payer of 49.1% of pediatric stays was Medicaid, while private insurers were expected to pay for 43.0% of all stays.[4] The rate of Medicaid payment is greater than it has been in recent years; over time, the percentage of kids’ stays covered by Medicaid has increased. As of 2012, Medicaid paid for almost half of all child hospitalizations, and that proportion had jumped significantly from 36.5% of children covered by Medicaid in 2000 to 48.6% just twelve years later. During that same period, the proportion of stays covered by private insurance fell from 55.1% to 43.6%.[5] Taken together, the results of the study reveal the severe and rising burdens that can be imposed on low-income families whose children require hospital stays, especially those of longer duration.

When considering the significant costs required in pediatric hospitalizations, one factor that is often overlooked is the matter of costs of living, particularly if a family or parts of a family must travel significant distances to receive care from distant hospitals. For example, the highly respected Cleveland Clinic has consistently been named the number one hospital for heart care in the nation, extending its streak to twenty-four years in 2018.[6] A family whose child has a serious heart condition may travel across the nation or even the world in order to receive treatment from Clinic specialists. In that case, not only does the family need to worry about immense medical bills, but they must also try to find somewhere to stay in Cleveland. Options like hotels can be expensive and are not always feasible in the long term.

While the issue of rising medical costs offers no easy solution for individuals looking to make a difference, there are ways to support individual families and remove at least some of the burden by offering them a place to stay that is affordable or even free of charge. One organization that does so is the Ronald McDonald House Charities. With the stated mission to “create, find and support programs that directly improve the health and well-being of children and their families,” the Ronald McDonald House envisions “[a] world where all children have access to medical care, and their families are supported and actively involved in their children’s care.”[7] There are over 365 local Ronald McDonald Houses throughout both the United States and the world, with chapters in 64 countries.[8] Each one offers invaluable resources to families with children who are seriously ill, such as private bedrooms, home-cooked meals, and playrooms for kids. Some houses also offer accredited education programs, special suites for children with suppressed immune systems, recreational activities, sibling support services, and non-clinical support services.[9]

The Ronald McDonald House is an amazing resource for many families. The organization serves families with children aged 0 to 18 or 21, depending on the location, being treated at local hospitals. This allows families to stay close to their children while they receive treatments, promoting a much greater degree of comfort for the child and the families as well. The lengths of stays varies and can last from just a night to a year or more. To ease the burden on families financially, the Ronald McDonald House asks families to pay only what they can while staying at the House. They are able to stay at no cost or to make a donation up to $25 per day, but for those who cannot afford it, payment is never required. The cost for the House to operate a room per night ranges from $50-$100, and these costs are fulfilled through donations. Indeed, the vast majority of the Houses’ operating budgets are funded from the donations of organizations, businesses, and individuals.[10]

There are numerous opportunities to help the Ronald McDonald House in its mission. I have been volunteering at the House in Cleveland since I was young, and have done a variety of tasks in and around the House, including cooking meals, putting together Christmas packages around the holidays, bringing meals to House Family Rooms in local hospitals, checking that rooms are ready for guests, working the front desk, storing donated pop-tabs, and helping with landscaping. At Ohio State, there are also a number of ways to get involved with the House in Columbus. Interested students can volunteer individually or in groups, and there is also a club, Buckeyes for Ronald McDonald House Charities, on campus focused specifically on helping the families at the House. Projects that BRMHC have worked on include making blankets and cards for families, as well as traveling to the House and making breakfasts, lunches, and desserts. Some residence halls, including Smith-Steeb, also participate in pop-tab collections, which provide a valuable source of income for the House.

Rising medical costs can be daunting for American families. Children’s hospitalizations are often expensive, and ever more families are relying on Medicaid in order to cover those costs. While it is not entirely feasible for the average person to be able to help curb rising hospital costs, there are other means of supporting families with seriously ill children. The Ronald McDonald House Charities offer an incredible opportunity for families to stay close by their children as they receive treatment at little to no cost while also offering some of the comforts of home like home-cooked meals. There are abundant opportunities for people of all ages to volunteer, and help is always welcome at the House.

 

References

“Cleveland Clinic Again Ranked No. 2 Hospital in Nation by U.S. News; No. 1 in Heart Care for 24th Consecutive Year; No. 1 in Urology.” Cleveland Clinic Newsroom. Cleveland Clinic, August 14, 2018. https://newsroom.clevelandclinic.org/2018/08/14/cleveland-clinic-again-ranked-no-2-hospital-in-nation-by-u-s-news-no-1-in-heart-care-for-24th-consecutive-year-no-1-in-urology/.

“Eligibility.” Medicaid.gov. Centers for Medicare and Medicaid Services, accessed April 15, 2020. https://www.medicaid.gov/medicaid/eligibility/index.html.

“Frequently Asked Questions.” RMHC. Ronald McDonald House Charities, accessed April 15, 2020. https://www.rmhc.org/frequently-asked-questions.

“How Many Ronald McDonald Houses Are There?” Ronald McDonald House Charities Intermountain Area. RMHC, accessed April 15, 2020. https://www.rmhcslc.org/faqs/how-many-ronald-mcdonald-houses-are-there/.

“Mission and Vision.” RMHC. Ronald McDonald House Charities, accessed April 15, 2020. https://www.rmhc.org/mission-and-vision.

Moore, Brian J. (IBM Watson Health), William J. Freeman (AHRQ), and H. Joanna Jiang (AHRQ). “Costs of Pediatric Hospital Stays, 2016.” HCUP Statistical Brief #250. Rockville: Agency for Healthcare Research and Quality, August 2019. www.hcup-us.ahrq.gov/reports/statbriefs/sb250-Pediatric-Stays-Costs-2016.pdf.

“Ronald McDonald House.” RMHC. Ronald McDonald House Charities, accessed April 15, 2020. https://www.rmhc.org/ronald-mcdonald-house.

Witt, Whitney P. (Truven Health Analytics), Audrey J. Weiss (Truven Health Analytics), and Anne Elixhauser (AHRQ). “Overview of Hospital Stays for Children in the United States, 2012.” HCUP Statistical Brief #187. Rockville: Agency for Healthcare Research and Quality, December 2014). http://www.hcupus.ahrq.gov/reports/statbriefs/sb187-Hospital-Stays-Children-2012.pdf.

 

[1] Whitney P. Witt (Truven Health Analytics), Audrey J. Weiss (Truven Health Analytics), Anne Elixhauser (AHRQ). “Overview of Hospital Stays for Children in the United States, 2012,” HCUP Statistical Brief #187 (Rockville: Agency for Healthcare Research and Quality, December 2014). http://www.hcupus.ahrq.gov/reports/statbriefs/sb187-Hospital-Stays-Children-2012.pdf, 2.

[2] Ibid., 1.

[3] “Eligibility,” Medicaid.gov, Centers for Medicare and Medicaid Services, accessed April 15, 2020, https://www.medicaid.gov/medicaid/eligibility/index.html.

[4] Brian J. Moore (IBM Watson Health), William J. Freeman (AHRQ), and H. Joanna Jiang (AHRQ), “Costs of Pediatric Hospital Stays, 2016,” HCUP Statistical Brief #250. (Rockville: Agency for Healthcare Research and Quality, August 2019), www.hcup-us.ahrq.gov/reports/statbriefs/sb250-Pediatric-Stays-Costs-2016.pdf, 3.

[5] Ibid., 6.

[6] “Cleveland Clinic Again Ranked No. 2 Hospital in Nation by U.S. News; No. 1 in Heart Care for 24th Consecutive Year; No. 1 in Urology,” Cleveland Clinic Newsroom, Cleveland Clinic, August 14, 2018, https://newsroom.clevelandclinic.org/2018/08/14/cleveland-clinic-again-ranked-no-2-hospital-in-nation-by-u-s-news-no-1-in-heart-care-for-24th-consecutive-year-no-1-in-urology/.

[7] “Mission and Vision,” RMHC, Ronald McDonald House Charities, accessed April 15, 2020, https://www.rmhc.org/mission-and-vision.

[8] “How Many Ronald McDonald Houses Are There?” Ronald McDonald House Charities Intermountain Area, RMHC, accessed April 15, 2020, https://www.rmhcslc.org/faqs/how-many-ronald-mcdonald-houses-are-there/.

[9] “Ronald McDonald House,” RMHC, Ronald McDonald House Charities, accessed April 15, 2020, https://www.rmhc.org/ronald-mcdonald-house.

[10] “Frequently Asked Questions,” RMHC, Ronald McDonald House Charities, accessed April 15, 2020, https://www.rmhc.org/frequently-asked-questions.

Congressional Seat Apportionment

There is no way to change the Congressional apportionment system to make it truly “fair.” No matter what changes are made, it is highly unlikely that a method can be found in which the citizens of all states have exactly the same representative power. There is no way to get the numbers to work out neatly as whole numbers when comparing state populations, and there is no way to let states have a fraction of a representative. In terms of the people serving as representatives, it’s the whole individual or nothing; they can’t be cut in half. Because of this, whole number ranges are used to allocate seats, which is the best solution given the circumstances. The numbers will not work out nicely on their own, especially as state populations change over time.

However, there are ways in which the system could be made fairer than it currently is. The ranges used to determine the number of seats each state is allowed could be made smaller so that states at the high and low ends of those ranges are closer in terms of per capita representation. Discrepancies would remain, but at least the gaps would be smaller. Another change that should be made is to give seats to Washington D.C. and the U.S. territories (a better change would be to give the territories their statehoods, but at the very least they should have seats). The decisions made in the House have an influence on the people living in these areas, and they should be given the ability to have a say in such decisions.

There is also a possibility of increasing the size of the House. This decision could potentially help to narrow down the ranges since more seats would mean more opportunities for representation. However, considering that the current size of the House is 435, any increase in size should not be very large. Major increases in size may have negative impacts on efficiency and increase the challenges in solving disagreements currently facing the House. An increase in the number of seats in the House should not expand the total number of representatives beyond four hundred and sixty or seventy-five to avoid huge losses in efficiencies while providing a decent number of new seats for D.C. and the territories and the current states as well. There should be a fairer allocation of seats in the House, but there will never be a way to give each American citizen the exact same representative power, regardless of what changes are made.

Career

[“Career” is where you can collect information about your experiences and skills that will apply to your future career.  Like your resume, this is information that will evolve over time and should be continually updated.  For more guidance on using your ePortfolio, including questions and prompts that will help you get started, please visit the Honors & Scholars ePortfolio course in Carmen. To get answers to specific questions, please email eportfolio@osu.edu. Delete these instructions and add your own post.]

Artifacts

Hanna Stolzer is a current sophomore in the College of Arts and Sciences. She is originally from Shaker Heights, Ohio, but moved to Pittsburgh and Lancaster due to her dad’s work as a lawyer. Currently undecided in her major, Hanna is pursuing her interests in both business and public policy and is hoping to attend either grad or law school, preferably in Pennsylvania, after earning her diploma from OSU. In her free time, Hanna enjoys theater, reading mysteries and traveling, and she was fortunate to have the chance to visit several cities in Greece this past summer.

About Me

Mary (Mattie) Conley is a history and political science double major from Shaker Heights, Ohio. She is a member of the Politics, Society, and Law Scholars program and hopes to attend law school after graduating from Ohio State. A passionate reader and writer, Mattie intends to pursue undergraduate research in the next few years and to expand her horizons by becoming involved in an education abroad program. She also hopes to be active in the campus community by working as a University Ambassador, PSL mentor, or FYE peer leader. In previous years, Mattie has spent time volunteering at the Ronald McDonald House in Cleveland, and she is excited to continue to help out at the House in Columbus as a member of Buckeyes for Ronald McDonald House Charities.

Year in Review

[ “Year in Review”  is where you should reflect on the past year and show how you have evolved as a person and as a student.  You may want to focus on your growth in a particular area (as a leader, scholar, researcher, etc.) or you may want to talk about your overall experience over the past year.  For more guidance on using your ePortfolio, including questions and prompts that will help you get started, please visit the Honors & Scholars ePortfolio course in Carmen. To get answers to specific questions, please email eportfolio@osu.edu. Delete these instructions and add your own post.]

G.O.A.L.S.

Over the course of my time at Ohio State, I hope to accomplish each of my Honors and Scholars G.O.A.L.S. To gain a greater global awareness, I would like to take advantage of the opportunity to meet and interact with many different people from various backgrounds. Additionally, by the time I graduate, I hope to be able to participate in an education abroad program in Europe or Australia. I also intend to become involved in original inquiry by taking part in undergraduate research, most likely in history or political science, and graduating with research distinction. In terms of academic enrichment, I aim to challenge myself by taking rigorous courses and graduating with a double major in history and political science, as well as a minor, perhaps in economics or English. In doing so, I hope to explore my various academic interests in greater depth and to prepare myself for the rigors of law school, which I plan to attend after graduating. By becoming active in various groups and clubs, as well as by becoming a University Ambassador, FYE peer leader, or PSL mentor, I hope to develop my leadership skills throughout my time here at Ohio State. I would also like to become involved in service. In the past, I have spent time volunteering at the Ronald McDonald House in Cleveland, and I am happy to be able to continue to support the organization here in Columbus as a part of Buckeyes for Ronald McDonald House Charities.