All children, even the healthiest, have preventive and acute health care needs. Moreover, a
growing number of children are chronically ill, with preventive, acute, and ongoing care needs
that may be much more demanding than those for healthy children.
Because children are unable to care for themselves, their parents are expected to provide a
range of health care services without which the current health care system for children would
not function. Under this “shadow health care system,” parents or parent surrogates often need
to be with the child, a requirement that can create difficulties for working parents, particularly
for those whose children are chronically ill. How federal, state, and employer policies and
practices mesh with the child health care needs of families is therefore a central issue in any
discussion about work and family balanc