Inequitable financing mechanisms contribute to the current level of preventable mortality and morbidity today among American infants, children, and adolescents. Current financing systems must be improved to maximize access to and ensure the quality of comprehensive pediatric care.

The American Academy of Pediatrics (AAP) advocates universal and insured financial access to quality health care for all pregnant women and infants, children, and adolescents through age 21 years, here-inafter referred to as pregnant women and children. Such insurance should be a comprehensive benefit package which contains preventive care, including immunizations, and acute and chronic care services.

As the public and private sectors and the AAP continue to explore the structure of health care financing, the following principles will be used to evaluate proposed changes.

1. Children's Right to Access to the Health Care System.

• All pregnant women and children have a right to comprehensive health care.

• Financial barriers should not prevent pregnant women and children from receiving comprehensive health care.

• When families are not covered by insurance provided by an employer, purchase of a private plan, or personal means, pregnant women and children should be insured by public funding.

• Health care financing mechanisms should permit the patient and his/her family to choose a health care professional who provides quality pediatric care, particularly pediatricians whose offices will serve as the medical home and from which referrals would be made only as appropriate.

• Managed care plans should not restrict access to qualified pediatric primary care or appropriate referral to pediatric subspecialty and inpatient care.

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