I remember Hope’s blonde 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 her multiple physical challenges and live a healthy and full life. I kept the drawing Jacob made me, showing me how his Tourette’s calmed when he tapped into the creative spaces in his brain, allowing his near constant tremors to subside, and draw clean, unbroken lines. I also have a bookmark from Ryan’s family, who told me their son passed on his 16th 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 almost ten years ago as a health policy advisor in the US Senate.
Hope, Mira, Jacob and Ryan represent hundreds of families that I had the privilege to meet 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 to shape public policy; stories communicate 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 public policy and kids' health. We’ll discuss legislation at the state and federal level that has a major impact on kids’ health and well-being, 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 to take inspiration from Hope, Mira, Jacob and Ryan's families to 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 that an adult will dismiss out of hand new policies or programs that are designed to benefit kids. In fact, 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 are often 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 maintain focus on why a particular policy matters for children. Often the dialogue is redirected to focus on how that policy may affect adults in the near-term, by instituting new regulations, or reallocating funding, or closing off loopholes. Partnering with policymakers on a continual basis elevates awareness of how policy affects kids overall, and prepares voters, candidates and elected officials to evaluate individual positions on issues of importance to child health.
Public policy shapes kids’ lives
Public policy ranks alongside popular culture and technology as powerful, societal factors that shape kids’ lives. In some ways, public policy is so interwoven with the daily life of raising kids that it becomes invisible to us. 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 require minimum standards for health care vaccinations and screenings, benefits, access and quality for kids.
- Public health policies create protections for lead exposure, motor vehicle injuries, and safe 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 major impact on critical years of development from birth to age three, affordability and access to programs and services, and oversight of 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 is driven by our culture. Many Americans simultaneously hold these two beliefs; 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). There is no cohesive philosophy or set of policies that describe a standard for the American childhood, and accountability to set particular expectations or to intervene during crises is spread across township, city, county, state, and federal jurisdictions. This creates a passive dynamic. In practice, 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 - rather than proactively establish policies that prevent or minimize harm. Partnering with policymakers helps to raise awareness and momentum to proactively set or amend policy for kids.
Policy for kids is a great return on investment
Policies focused on kids are often viewed as a long-term investment, where policies for the general population (mostly adults) tend to focus on the near-term reward. When these two types of policies compete against one another, it is understandable that it is often more compelling to be responsive to (adult) voters and generate immediate benefit in the form of fewer regulations, lower taxes, or more benefits. There is a reason Ben Franklin wrote “an ounce of prevention is worth a pound of cure.” It’s human nature to value the immediate reward.
There is an opportunity to build on this reality and shift the paradigm. Kids need adults who recognize that voting for policies that improve child health and well-being is a vote that accrues benefit today over a generation, for kids adults. How does this work? Consider Medicaid. It’s in the best interest of kids’ health today to have a comprehensive safety net program like Medicaid. Not only does it mean they have the best opportunity to grow into healthy adults, but it means that parents have the ability to fulfill their child’s current health care needs with less financial and emotional stress. Parents are more likely to maintain employment 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 immediate and long-term benefits.
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 info@genesishealthconsulting.com.