As a nation, we are overlooking the most fundamental step required to provide for our economic welfare and quality of life in the next century. It is not a matter of protecting the commerce in oil or reducing our national debt, as important as these may be. We can fulfill our responsibilities to the next generation and maintain our competitive posture in the worldwide economy only if today's children become healthy, productive adults. This requires that children have adequate health care during their early years, giving them a proper foundation for succeeding in their education.
Meeting this goal demands that we take a longer view than the next budget cycle. Statements by the administration to the effect that we can't afford major new initiatives now to deal with those living in poverty (40 percent of whom are children), or the 31 million who don't have health insurance (a third of whom are children) are missing the point. For our own well-being, as well as theirs, we cannot afford to ignore the children in these groups. The number of workers supporting each retiree has decreased fourfold in the past 50 years, and we will need workers with a greater capacity to develop skills in the next 50 years than ever before. We can't afford to squander our natural human resources by failing to produce physically and mentally healthy children.
There are honest differences of opinion over what should be done about many important educational and social issues that adversely affect children, especially those living in poverty. However, there is no debate about the proposition that all children should be provided basic medical care. Good health is a prerequisite to being able to learn, to develop normally and to being able to work to one's full potential.
Ensuring a healthy, well-educated next generation is our best and perhaps only way of guaranteeing future national security. At the very least, we should start now by providing all pregnant women and newborns with a basic health insurance plan.
We propose the following: 1) A health benefit package similar to that proposed by the American Academy of Pediatrics should be required for all insurance policies and should be included in every employee's health insurance benefits package. 2) For those children whose parents cannot afford a policy directly or through employers, coverage should be purchased through a combination of income-graduated, parent-paid premiums, public funds financed by a payroll tax on employers and employees, and allocations from state and federal budgets. It is reasonable that the public funds come from those whose families will benefit in the future from the good health of all children. 3) The plan should include appropriate cost-saving measures such as managed care.
This plan would not require dramatic changes in the private insurance system of current health delivery systems. It would require a new public-private collaboration to provide care in underserved areas. The program could be phased in one year at a time for all pregnant women and newborns. This would not only keep the initial costs down but also provide an opportunity to field-test the program and work out unanticipated problems. Medicaid expenditures for pregnant women and children could be phased out and the savings used to partially offset the cost of the new program.
The cost of a program limited to health care for children would be far less than taking on the burden of universal health care in this country. It would cost a small fraction of what we currently spend on the elderly through Medicare and Medicaid nursing home care. But, most importantly, it would contribute to future productivity by fostering a healthy beginning for our most vulnerable group of children, who could benefit most from providing effective prevention and treatment.
Children are our future, and the future is now. Every CEO knows that today's decisions determine tomorrow's bottom line. Failure to act as well as think strategically leads to loss of productivity or competitiveness, or both. Failure to address the health needs of today's children is similarly insidious in its consequences. We mortgage our future as a nation to a much greater extent by this negligence than by our failure to reduce the federal budget deficit.
David Packard is board chairman of Hewlett-Packard Co. and president of the Packard Foundation. Richard Behrman is director of the foundation's Center for the Future of Children.