More than a dozen states are considering requiring a test for newborns that would help identify congenital heart disease, a birth defect that affects about one of every 100 babies and can cause physical and mental disabilities, or even death.
The test, painless and costing as little as $1 per child, measures the percent of oxygen in the blood, allowing doctors to determine whether to do further testing. More than 40,000 babies born in the USA each year have congenital heart defects, says Gerard Martin, professor of cardiology at Children's National Medical Center in Washington, D.C. Early testing could spot problems in an additional 4,000 children and save as many as 200 lives, Martin says.
One of those children saved by early detection is Eve Saarinen, now 2.
Her mother, Annamarie Saarinen, says Eve was diagnosed with congenital heart disease two days after she was born. Other parents and their children haven't been as fortunate.
"I have been to more funerals than I care to count with babies in coffins the size of shoe boxes," says Saarinen, 42, of Shoreview, Minn., founder of 1in100, a congenital heart disease advocacy group. "You can pinpoint up to half of those deaths that could have been impacted in a positive way by earlier detection."
The tests aren't always accurate, however, and some doctors say they will prompt follow-up tests that could prove expensive perhaps as much as $1,500.
"No question about it raising health care costs, it definitely will," says Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, N.H.
"Why is this being mandated by a legislature?" wonders physician Stuart Kaufman of Morristown, N.J. "There are some benefits, but they are passing a law that is going to increase the cost of health care at a time when health care costs are rising and we are trying to contain the cost. They are mandating a test that may have very little effect on the outcomes."
New Jersey this month became the first state to make testing mandatory.
Maryland passed a law that will require testing after further studies and Minnesota has a pilot program to expand the screenings.
Other states considering mandatory testing include Arkansas, Georgia, Indiana, Michigan, Mississippi, Missouri, Nebraska, New York, Pennsylvania, Tennessee and Wisconsin, Saarinen says.
New Jersey Assemblyman Jason O'Donnell, a Democrat who crafted the mandatory testing law, says the cost is justified if even one baby is saved.
"What is a newborn's life worth?" O'Donnell asks.
"I challenge anyone to bring up the cost. It is not a Republican or Democratic issue. It's a human issue."
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