J eff, a 19-year-old who dropped out of school after tenth grade, has lived "emancipated" for the past 3 years on his own in New York, and survived for a time as a male prostitute. At a community health center he was recently discovered to have AIDS. When his disease progressed far enough to require hospitalization, it was found that he was ineligible for Medicaid without a prior assessment of whether his parents' health insurance covered him. But he did not want his parents to know that he had AIDS. While this may be seen as a problem with Jeff's pride, the fact that there is not presumptive eligibility for Medicaid, as there is for pregnancy, is a failure of our health system. This catch-22 situation is extreme, to be sure, but Jeff is one example of a group of poor and underserved children often forgotten by pediatricians and, indeed,
Haggerty RJ. Care of the Poor and Underserved in America: Older Adolescents: A Group at Special Risk. Am J Dis Child. 1991;145(5):569–571. doi:10.1001/archpedi.1991.02160050095025
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