The American Academy of Pediatrics

Section on Developmental and Behavioral Pediatrics

Developmental and Behavioral News Volume 7, Number 1

Fall 1998

Fall 1998

Printable Version (pdf)
Section Home
Fall 98 Section Meeting
From the Editor
From the Chair

Articles

Board Certification Update
ADHD and the Military

Reviews

DC: 0-3 Casebook
Running on Ritalin

1998 Award Recipients

Robert Coles, M.D.
Stanford B. Friedman, M.D.

1997 Award Recipients

William Harris, Ph.D.
Morris Wessel, M.D. FAAP

Special Presentation

Marshall Klaus, M.D. FAAP:
Perinatal Care in the 21st Century

Lobbying for Children
by William Harris, Ph.D., Boston, MA

Editor's note: William Harris, Ph.D. was the 1997 recipient of the Dale Richmond Award. Dr. Harris is the founder of KidsPac, a political action committee that focuses on children's issues. KidsPac was founded nearly 20 years ago. Dr. Peter Gorski and Dr. Barry Zuckerman introduced him at the 1997 Section meeting. The Dale Richmond award is given to individuals, typically non-physicians, who have had a major impact in improving the lives of children. Here are excerpts from his inspiring acceptance speech.

KidsPac is a political action committee that accepts contributions from individuals and makes contributions to people running for Federal office—the House and Senate—whom we believe will support good policies for very young children and their families. Occasionally we have supported some Party activities.

The first person I sought advice from in 1981—the very first—was Julie Richmond. He was then, as he remains today, a giant in the field, one who graciously shares his wisdom, advice and caring. So thanks to you as well, Dr. Richmond.

Incrementalism

From the beginning KidsPac has sought Federal programs and resources that would provide incremental advances for poor children and women—modest increases in feeding programs, Head Start, immunizations and other such programs—all proven to be good investments in children—all backed by credible, scientific research.

But these early incremental advances were only bits and pieces. And I tried to stay under the radar screen. I tried not to be visible to the broad public. This was a conscious strategy that I believed fit the times: a Democratic congress and the Reagan and Bush administrations all complaining about the Federal budget deficit. This strategy also seemed to fit the general lack of interest the public and elected officials seemed to show for making larger and better investments in children's programs. I think of this as a more, better, sooner strategy. We wanted more money to do a better job for kids and families as soon as possible. Incrementalism.

Then came 1992—the promise of a Democratic administration and a Democratic congress. Better yet, a President and a First Lady who really understood children's needs and policies.

Before we could truly mobilize this New World, however, 1994 was upon us with the Gingrich/Lott Congress. Echoes of the 80’s, of overreaching government, Proposition 13 in California, Proposition 2 ½ in Massachusetts, Waco, welfare queens, Rush Limbaugh and talk radio. Clinton called for ending welfare as we know it, and Gore had reinvented—read "downsized"—government. All of these voices merged into a crescendo of anti-government feeling by 1995. Government didn’t work, was bad, couldn’t adequately address the real needs of children and families, was too intrusive. These were the prevailing sentiments.

A Bridge to the 21st Century?

Unfortunately, I’m afraid that much of this pessimism and anti-government feeling still prevails today and, as a result, I think the bridge to the 21st century will remain a bit wobbly for children. Why?

As you may recall, President Bush’s number one education goal—pushed principally by then-Governor Clinton—was that by the year 2000 all children should arrive in school ready to learn. I don’t believe that we will achieve this goal. Nobody I know does. Here are some reasons why:

The recent budget agreement signed by the President includes large increases for Head Start. But still, less than 50% of eligible children will be served by 2002. Furthermore, although the President recently mentioned Early Head Start—a new 0–3 program he helped to create—the President said it only serves 25,000 families or so. He implied that the program should be bigger, but said, "choices must be made." Assuming the numbers included in the budget agreement, fewer than one in 20 eligible children will be served by Early Head Start by 2002.

The President and the First Lady recently held a one-day conference on child care to start a national conversation on this critical issue. The people who presented at the conference put forth compelling evidence of the importance of quality of child care, the importance of increasing its accessibility, and the requirement that it become more affordable for those who need it. The conference was linked by satellite to 110 different locations where people were reminded that as much as 40% of infant and toddler care was substandard or dangerous, that well-trained, consistent child care workers are required to give the kind of care each of us expects, and that turnover rates of these workers range from 40-90% and they receive poverty wages. Indeed, many of these workers cannot even afford quality care for their own children. As more and more fathers and mothers enter the work force, leaving more and more infants and toddlers who need care, how will we address these problems? The President has offered a $50 million per year package for childcare worker scholarships.

Good News for Children

If I sound a bit too glum, I apologize. I recognize that there has been some good news for children during the last year.

In April 1997, before the child care conference, the President and First Lady held the first day-long conference at the White House to explore new directions of brain research and neural development and their implications for child development. The conference brought together serious academics who communicated clearly with the First Couple, the audience, and the press about how important the first three years of life are to a child’s developmental trajectory. The Carnegie Corporation, Dr. Barry Zuckerman, Rob Reiner, the Families and Work Institute and others collaborated in a successful attempt to transfer this knowledge to policy makers at the local, state and federal levels. And to the media. I sincerely believe that this new knowledge has begun to sink in with policy makers and the public. I am hearing more and more elected officials proclaiming the importance of the first three years. Good news, I think. I’ve been told recently that another $100 million will be appropriated for 0-3 in FY98 if the Republicans and the Democrats can agree on voluntary school testing.

And, as many of you know, the recently signed budget deal contained $48 billion of new funds to provide health insurance for uninsured children. Many people in this room were very helpful with this effort. This money should cover up to half of the 10 million children whose families can’t afford this insurance themselves but are not poor enough to receive Medicaid. It remains to be seen how well the states will use this money in carrying out this vital task. Key issues such as the comprehensive nature of the benefit package and the amount of copays must still be decided by each of the 50 states. Unfortunately, we know that some important preventive services will not be provided to some children and it is still unclear how children with disabilities will fare in many of the states. But it is a solid victory for kids and thanks are due particularly to Senators Hatch and Kennedy, who were responsible for this huge initiative, paid for, I might add, with a tax on tobacco. A newsclip yesterday hinted at another potential run on tobacco money for children and research.

The Role of the Government

I mentioned the anti-government crescendo earlier. Let me return to this issue—the role of the government. The examples of the brain development conference and health care for uninsured children are instructive. The brain conference illustrates a fine use of the President’s bully pulpit. The child health care package contains government money illustrating, I believe, a use of public money being dedicated for a public good: healthier children.

I am reminded of that old story about the bank robber, Willy Sutton, who was asked why he robbed banks. His reply: "Because that’s where the money is." For poor children trying to make it across the bridge to the 21st century, the bank is still the government.

As we move into the next millennium, it should be perfectly clear to most of us that the free market is not going to provide sufficient resources to take care of all of our children’s most basic developmental needs. By basic needs, I mean at least nutritious food, basic health care, including prevention and early intervention services; high quality child care—developmentally appropriate and provided by well-trained, fairly-paid people—family support systems; and quality early education. Providing these basics to all of our children will cost billions of dollars. Billions.

It is high time for each of us to acknowledge these facts publicly—to move beyond our incrementalist mindset and begin to address the full, real, basic needs that all of our children have and, if we are to be successful in this endeavor, we are going to need our government’s bully pulpit, as well as a larger portion of its resources.

A Parable

My father tells a story about a man who went to a picnic next to a river. All of a sudden he looked in the river and saw a baby floating by. So he jumped in the river with all his clothes on a saved the baby. People cheered and he went back to the picnic. A few minutes later another baby floated by and he repeated his heroic actions. This went on for another ten babies and finally the man started to run up a path—not to the river. The people yelled, "Where are you going?" He said, "I’m going to see who keeps throwing the babies in the river and try to stop him." The moral of this old story is that we need to prevent that child from being thrown into the river. Prevention and early intervention. Good ideas. I used to think they were enough.

I’m now reconsidering. Maybe we have to look more closely at the nature of the river into which these babies are being thrown. Instead of thinking of the river as a medium for carrying babies, let’s think of the river as the ether, the electronic air space in which we all live and to stretch the metaphor a bit more, let’s think of each of the babies as the embodiment of the societal message that says "you can do this on your own with nobody’s help." We don’t need government. So where are these "messages" coming from? Where is the source of the river?

A recently completed study by the National Committee for Responsive Philanthropy reported on the giving patterns of 12 core conservative foundation for the years 1992, 1993 and 1994. During those years, these 12 foundations awarded $210 million in grants. In its conclusion, the report states, "…the heavy investments that conservative foundations have made in New Right policy and advocacy institutions have helped to create a supply-side version of American politics in which policy ideas with enough money behind them will find their niche in the political marketplace regardless of existing citizen demand." It should not be a surprise to us that a constant stream of anti-government messages emanates from the recipients of these grants.

My point today is that the water—the air waves—is being contaminated and that we must pay attention to this environment—to the river’s source—if we are to understand the American people’s current and future sense of government and its possibilities.

So here is where I believe we are. The free market is leaving too many children behind. In the year 2000 too few children will arrive in school ready to learn. We need the public trust and government resources to help these children attain their full potential. But if the airwaves are contaminated with all this anti-government talk, creating all this anti-government feeling, how will we secure the resources that children and families so desperately need? I believe this question is our most serious challenge. And I do acknowledge that these message streams come from many different sources, including labor unions. But the preponderance of anti-government messages overwhelms the other messages.

A friend of mine recently wrote a book about the stock market in which he talked about people who try to discern patterns in the marketplace. He writes, "The human mind is a pattern-seeking mind. We are all descended from people who were good pattern finders because at some point our ancestors were walking around with some fellow hunters and there was a little rustle in the tall grass 100 feet ahead. And Og said, ‘That’s the wind.’ And Magog said, ‘I think it’s a leopard.’ And Og marched forward and was leopard lunch. Your ancestor is Magog, who read that rustle right. We are all descended from people who were very good at finding patterns in things."

Three Patterns

If we want children to do much better, I believe that there at least three patterns we must face and understand as we move into the future.

Pattern 1: Competition for scarce resources between the poor and the working poor. The reason that the politics of health insurance for uninsured children was so good, was that the benefits accrued to a highly appealing electoral segment: the working poor. Republicans and Democrats both wanted to help this electoral block. (36% of voters have a family income of less than $30,000 a year. 35% of voters have a high school or less education.) Furthermore, most Americans are fair and believe that anyone who works hard and plays by the rules ought not to be living in poverty and ought to have health insurance available for his or her children. If you will, these are the "deserving poor." Since Medicaid already covered poor children, there was no need to raise "the deserving poor’s" concerns about health in the health care debate.

It will be interesting now to see how the child care resource allocation debate plays out. Will the poor who do not have enough quality, affordable and accessible child care have to compete against the working poor for the meager resources that will be put forth? With what results?

Pattern 2: Competing schemes for allocating future government resources. Right before the recent market plunge there was talk of a budget surplus possibility in the next few years. There are at least four different approaches being discussed on how to spend this money:

1) Transportation funds to build more highways

2) Tax cuts

3) Paying back the multi-trillion dollar debt

4) New and expanded programs for the needy

Does anyone seriously believe that the last category can win out over the other three?

Pattern 3: Anti-government / smaller government messages. I have already discussed this pattern—the constant, intentional drumbeat against government and the need for government investments. I believe the future for poor children in this country cannot improve sufficiently until this perception is reversed.

What Can We Do?

First, we must continue to work hard to discern and discuss these and other patterns with anyone and everyone who will listen.

Second, we must work together, both within the Academy and across coalition lines, to offer alternative views to this anti-government crusade—particularly because of its harmful effects on children and families.

Finally and most important of all, we must commit to making sure that each of us finds time in the next year to make at least five phone calls and arrange for five meetings: one to each of our U.S. Senators; one to our Congressperson; one to our state Senator and one to our state representative. We bring to them the wisdom and passion of our experience. Effectively communicating your experiences with children and families and the essential role of government in building the future of our children and our country can make all the difference. Children really need your help—our help.

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updated April 13, 2000

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