Jonathan Cohn is a senior editor at The New Republic and author of "Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price." His latest piece for TNR is "The Hell of American Daycare," which details the horrendous conditions many poor children face at day-care centers. We conducted this interview via e-mail on Monday. In the interest of full disclosure, Cohn was among my supervisors when I was an intern at TNR.

Dylan Matthews: Did you start writing the piece before or after the Obama pre-K proposal was released?

Jonathan Cohn: Long before. The subjects – child welfare, work-family issues – have been on my radar screen for many years. And this particular piece grew out of something I wrote in 2011. That article was about the new science of brain development and the importance of the first two years of life. I didn’t have the space to do a detailed, long-view treatment of child care in America, so I figured that’d be the next step.

DM: How did you hear about the Tata case? How did you find Kenya Mire?

JC: I remember hearing about it when it happened. The topic was on my mind, so I followed it closely -- along with some other stories like it from around the country. I was actually surprised the Houston story got so little national coverage. The local television stations were all over it. Two reporters from the Houston Chronicle did a terrific reconstruction of the day. But almost nobody outside of Texas seemed to notice.

As I learned later, the lack of national coverage was typical. I did a search of Newsweek and Time. As best as I can tell, they had one – just one – cover on child care going all the way back to the early 1970s. It’s possible there were more, and I missed them. But, in general, this issue doesn’t seem to get nearly the attention you would think, relative to the number of people directly involved.

As for the reporting, I reached out to the principal sources – including Kenya Mire – by phone, e-mail, and Facebook, although it took a while to find them and then gain their trust. Persistence helped, as did some intermediaries. I guess it was a mix of old and new reporting styles.

DM: A lot of readers probably don't know what exact subsidies there are for day care, or early childhood education. There's Head Start and Oklahoma, and the program in some parts of New Jersey, but besides that, if I'm a low-income parent, what do I have on offer?

JC: The biggest source of funding is going to be assistance that your state administers, usually through some sort of vouchers, but for which the federal government provides most or all of the funding. That money comes through the Child Care and Development Block Grant. The vouchers are extremely helpful, but they typically come with a lot of strings attached, and the supply is limited, so parents end up on waiting lists.

DM: Who all exist to evaluate facilities? Is this largely a state function?

JC: Yup, it’s primarily a state responsibility. Again, the federal government has some leverage, because of the funding it provides through CCDBG. But, so far, it hasn’t used that leverage to push the states on quality or standards.

DM: You mention that in Texas, home day-care facilities are only visited once every two years. Is that normal, worse than average, better than average, etc.?

JC: The clearinghouse for this sort of information is Childcare Aware, which used to be called the National Association for Child Care Resource and Referral Agencies. They do regular surveys of child-care regulation, breaking it down state by state. And they have found a lot of variation – not just among states, but also in how particular states treat centers vs. home day cares. Relative to other states, according to Childcare Aware, Texas was actually fourth best when it came to regulating centers. But its regulation of home day cares was sixth worse. I should add that the inspectors I met seemed to be making the very best of a weak system – using training classes and visits to teach providers about quality, even though the standards didn’t require it. But they could do a lot more with stronger laws or more resources.

DM: What can and can't inspectors do if they find a facility that they deem to be sub-par?

JC: That also varies by state, and I can’t really speak to what happens everywhere. In Texas, inspectors have a whole range of actions they can take. For minor infractions, the kind you find even at conscientious providers, usually it’s a request to fix the problem – and then a follow-up visit to make sure it was done. In the extreme cases, they can shut down an operation – although, as I wrote, it’s not always easy to do. Cases can end up in the courts, tying things up for months, unless regulators can show imminent harm is likely.

DM: Talk a bit more about past federal efforts here. My understanding is that Nixon was actually interested in a pre-K program before eventually vetoing the Democratic plan, and that there was a major push by Chris Dodd in the late 1980s. Why did both of those fail?

JC: Nixon’s veto of the 1971 child-care bill, which then-senator Walter Mondale had co-sponsored, surprised a lot of people. He hadn’t indicated previously that he was so opposed to it. The people I interviewed speculated that he was trying to protect his right flank politically, but, based on my limited research, I can’t say definitively what he or his advisers were thinking. Dodd’s push for a bill in the 1980s led to creation of the CCDBG, which is obviously a big deal – probably the single biggest thing that the federal government has done for child care in the last few decades.

DM: It's interesting that you note the military has among the best programs in this area, since VA health care is among the best in the country, as Philip Longman has pointed out. I don't know if this calls for speculation, but is there something about the institutional structure of the military that lets it run social programs more effectively?

JC: I’ve wondered about that. Institutional structure might explain it. My other theory is that the military can get away with big government because, well, it’s the military – and that inoculates it from attacks on the right. Military personnel value these services, which means – among other things – that you have military leaders testifying on Capitol Hill about their virtues. If you’re a member of Congress, even a very conservative one, do you seriously want to call that general sitting in front of you a “socialist”? Probably not.

DM: Is there a sense in which the twin goals of early childhood programs, namely freeing up women for work and providing enriching education, work at cross-purposes? It seems like pure warehousing is all you need for the former (although a lot of kids don't even get to stay in decent warehouses), whereas you need much more resources for the latter.

JC: In principle, they shouldn’t work at cross-purposes, in the sense that they are not mutually exclusive. A good child-care center should provide the kind of support and interaction that fosters intellectual development. And the setting for a good enrichment program should be a safe, nurturing environment for a young child. But the politics are complicated, in some subtle ways.

To take one obvious example, advocates for children and advocates for women share the same basic goal: Making sure every child of a working mother (and father, for that matter) can get affordable, high quality day care if they need it. But quality and affordability are in tension with each other – most things you would do to improve quality are likely to raise the cost.

The children’s groups are naturally going to focus more on the former, while the women’s groups are going to focus more on the latter, at least insofar as higher costs mean higher costs for individuals. Using taxpayer dollars to subsidize costs for lower income people is obviously how I’d prefer to reduce those costs, but that runs into a very different set of political obstacles.

One interesting note: In France, care for very young kids – infants and toddlers – is separate from care for preschoolers. The former is run by the agencies that handle health, the latter by those that handle education. That makes a lot of sense to me.

DM: How much do high-quality programs like the military or the French system pay per student? Would scaling that up be a tens of billions a year project or more like hundreds of billions over 10 years?

JC: I never got the per child figures for the military. (Note to self: Get the per child figures for the military.) I can tell you that the French don’t spend that much more on preschoolers, but they spend a lot more on younger children. I talked to some experts about what a true universal child-care program would cost. Nobody felt comfortable giving me a solid estimate. But you can extrapolate from the Center for American Progress proposal on universal pre-kindergarten, which they expected would be about $100 billion over the first 10 years. The assumption is that states would match that. That gets you a big chunk of the way there, but there’d be another big chunk to go. So I guess – and let me stress the word “guess” here – we’re talking hundreds of billions of dollars, across all levels of government, if it's mostly financed by the public. But, as always, remember that a lot of that would displace existing private spending.