Partnering with Policymakers to Improve Child Health

I remember Hope’s blond curls, and the mix of awe and fear that still showed in her parents’ eyes when they described her surgeries to treat her hypoplastic left heart. Mira, with her sweet smile and playful brothers, visited a year later. Mira is short for Mira Cale, a reminder of how hard so many fought to help her overcome multiple physical challenges and live a healthy, full life. I kept Jacob’s drawing for me, showing how his Tourette’s calmed when he tapped into the creative spaces in his brain, letting his near-constant tremors subside and draw clean, unbroken lines. I also have a bookmark from Ryan’s family, who told me their son passed on his 16^th birthday after a long battle with brain cancer, and advocated for more cancer research and more affordable health care. The bookmark features their son’s picture, a quote from John 3:16, and the call to “FIGHT ON!” I spent about 30 minutes with each of these children and their families over 15 years ago as a health policy advisor in the US Senate.  

Hope, Mira, Jacob, and Ryan represent hundreds of families I had the privilege of meeting while working in the Senate. These families traveled to Washington, DC, to share their stories with elected officials and policymakers, most often with the goal of changing public policy to prevent other children and families from experiencing the same hurts, missed opportunities, stresses, or losses that their family shouldered. There is a reason that personal stories are the most consistently powerful tool for shaping public policy; they speak directly to our values and our shared human experience. When we balance these stories with data that represents our best, fair accounting of policy options, we have the greatest opportunity to enact policies with integrity.  

In this month leading up to our next national election cycle, Genesis Health Consulting is featuring a series of articles on why partnering with policymakers is critical to ensuring every child has the opportunity to thrive. We’ll discuss legislation at the state and federal level that has a major impact on kids’ health and wellbeing, and share resources to help you assess how your local candidates stack up on kids’ issues. We’ll also share our personal experiences working in government and healthcare, and what we learned in the process.  

This week I am reflecting on why it is so important for all of us – regardless of our personal or professional roles – to consistently partner with policymakers to help improve kids’ health.  

Here are three reasons why:  

Kids can’t vote 

To start with the obvious, kids can’t vote. The currency of a representative democracy is the vote, and kids rely on adults to use their time, voice, and vote for their interests, too. In theory, this is an easy ask. In my years working in child health, it is rare for an adult to dismiss new policies or programs designed to benefit kids out of hand. Standing alone, policies for kids tend to be remarkably nonpartisan and supported by voters. But policymaking exists in a political world with scarce resources. The reality is that kids’ issues often get lost in the national dialogue, drowned out by issues important to larger, better-funded voting constituencies. And when kids’ issues do capture national attention, it can be difficult to stay focused on why a particular policy matters for children, instead of redirecting the conversation to how that policy may affect adults in the near term by instituting new regulations, reallocating funding, or closing loopholes. Partnering with policymakers on an ongoing basis raises awareness of how policy affects kids overall and prepares voters, candidates, and elected officials to evaluate positions on issues important to child health.   

Public policy shapes kids’ lives

Public policy ranks alongside popular culture and technology as a powerful societal factor that shapes kids’ lives. In some ways, public policy is so interwoven with the daily life of raising kids that it becomes invisible. Here are just a few examples of how public policy affects childhood in America:  

• Medicaid is the largest insurer of kids’ health care, covering nearly two out of every 5 American kids (38% coverage).  

• Health care policies set minimum standards for vaccinations and screenings, benefits, access, and quality for kids. 

• Public health policies protect against lead exposure, motor vehicle injuries, and unsafe drinking water.  

• Consumer safety policies affect which toys children play with, the food they eat, the medicines they take, and the transportation they use. 

• Education policy determines access to education, governance and funding of public schools, and curriculum standards.  

• Child care & parental leave policies have a major impact on critical years of development from birth to age three, affordability and access to programs and services, and oversight of the quality and safety of child care institutions.  

• Child welfare policies determine when and how to place a child in protective custody, and set expectations for safety and service delivery while in out-of-home care.  

Even with these examples, it is also true that accountability for child health is fragmented in the United States. Some of this stems from our culture. Americans hold these two beliefs at once: care for a child is primarily the responsibility and domain of the parent, and the government should protect those who are most vulnerable (e.g., kids). No cohesive philosophy defines the standard for American childhood, and accountability for setting expectations or intervening during crises is spread across township, city, county, state, and federal jurisdictions. This means that often our country is much more likely to set policies in reaction to a crisis – whether the crisis occurs because of a failure of existing policy, or an absence of policy altogether. Partnering with policymakers helps to raise awareness of opportunities to set or amend policy proactively.  

Risks and rewards 

Policies focused on kids are often viewed as a long-term investment, whereas policies for the general population (mostly adults) tend to focus on the near-term reward. When these two types of policies compete, it is understandable that it is often more compelling to respond to (adult) voters and deliver immediate benefits in the form of fewer regulations, lower taxes, or more benefits. It’s human nature to value the immediate reward.  

And yet, we can build on this reality and shift the paradigm. Kids need adults who recognize that voting for policies that improve child health and wellbeing is a vote that accrues benefits today and over a generation, for kids and adults. How does this work? Consider Medicaid. It’s in kids’ best interest to have a comprehensive safety-net program like Medicaid. It not only gives them the best chance to grow into healthy adults, but also helps parents meet their child’s current health care needs with less financial and emotional stress. Parents are more likely to keep their jobs and miss fewer days of work. Children are less likely to be chronically absent from school. The list goes on. Partnering with policymakers helps to identify ways that policies to improve child health can align with other priorities and generate both immediate and long-term benefits.  

A final thought: this article focuses entirely on public policy that is debated and decided in a public space. We also have meaningful opportunities to partner with policymakers in a private setting, whether with our employers, schools, or clubs and associations. Consider who sets policy for groups of which you are a member, and how you might evaluate policies for their impact on kids.  

Genesis Health Consulting has deep experience navigating the intersection of health care and policy. Learn more about our experience analyzing and developing policies for public and private institutions by contacting us at [email protected].