'Not My Department'


May 12, 1991|By RAY JENKINS

A new program at Johns Hopkins University, called the Policy Leadership Program, brought to Baltimore for two days last week selected officials from across the country for a spirited and thoughtful discussion of children's policy in the United States.

The conclusions emerging from the conference were not reassuring. Indeed, the unstated theme of the conference was a recognition that the U.S. simply has no coherent or comprehensive children's policy, which is the chief reason that one out of three children born in America today can expect to live in poverty at some point during their lives.

What we have, rather, is a mishmash of confusing and overlapping services, so complex that a college student posing as an impoverished, pregnant, single woman was unable to get any meaningful assistance as she tried to maneuver the bureaucratic maze. The answer she most often got was, "That's not my department." If a college student cannot penetrate the system, how can we ever expect a teen-age mother with only a grade-school education to do so?

There are many reasons for this deficiency in public policy. But it is produced chiefly byneglect at the federal level and inability at the state level to mount an effective policy.

Nor does there seem to be the political will to rectify the situation. The day after the conference ended, President Bush made a speech in which he denounced Great Society-style programs as a "failure" -- including, presumably, such demonstrably successful initiatives as Head Start, school lunch programs and the Women, Infants and Children (WIC) program which represented the last-gasp of liberal social programs before Ronald Reagan diverted all the money to the military. Mr. Bush offered no alternative solution beyond the empty rhetorical balm of "empowerment" of poor people.

More troubling still, the conferees concluded, children's programs have become inextricably entangled with the politics of race. There is a growing tendency, no doubt fostered by the policy of benign neglect over the past decade, for people to conclude that money spent on social needs goes to blacks; in fact, this is not the case at all -- and shouldn't matter even if it were true.

Add to this the politics of age. Because old people vote and children don't, a health care system has emerged in which a vastly greater proportion of limited resources is spent to extend the life of aged people by just a few weeks than is spent to give children the most routine preventive health care. As a consequence, health authorities fear that recent outbreaks of measles could be followed by outbreaks of polio. That dreadful disease was thought to have been virtually eliminated more than 30 years ago.

The conference included participants from France and Norway, and you could see in their expressions their amazement and disbelief at the deplorable state of social services for children in America.

The conferee from France was Olga Baudelot, a senior researcher with the Ministry of Education, who said that having no comprehensive children's policy in France would be as fTC unthinkable as having no foreign policy. She added that the issue of children's policy in France is no longer even politically controversial, that children are regarded as "national assets" rather than as "private property." France's centrally administered policy consists of a universal, comprehensive package which guarantees to every child housing, education, health care, social services and cash benefits. In short, she said, France has more or less achieved "the basic social infrastructure which assures every child a good start in life."

A similar picture was presented by Suerre Lie of Norway, who described the basic cornerstone of that country's health services. It is a remarkably simple system of "health stations" -- one for every 3,000 inhabitants, conveniently located throughout the country, operated by public health nurses who administer inoculations and treat minor illnesses, referring more serious problems to hospitals.

The "health station" system is so highly regarded in Norway, Dr. Lie said, that even members of the Royal Family use the services "because there is no better alternative." Yet the system costs only $20 per inhabitant per year and, overall, Norway spends only about 6.8 percent of its gross national product on health care. In the U.S., the health-care component of the GNP is nearly double that, and yet the services are not nearly so efficiently delivered. Life expectancy in Norway is two years higher than in the U.S.

Is it any wonder that the United States has begun to slip far down the list of developed nations in such measures as infant mortality? We can rest assured that if this neglect continues, it will not be long before there is a downturn in life expectancy as well -- just as there has been in the Soviet Union.

Ray Jenkins is editor of the editorial pages of The Evening Sun.

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