Other People's Children: The Uninsured and Underserved

Even if you don't accept a moral obligation to serve the less fortunate, you can make a strong pro-growth business case for providing infrastructure including quality education and at least basic health care.
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There's a big overlap between the medically uninsured and the educationally underserved. Millions of kids caught in the Venn diagram most often live in or near poverty. Most are children of color. Some are children of undocumented parents.

When compared to other OECD countries, it's embarrassing how poorly we treat children of low income families. We've grown tolerant of failing schools and insurance as a benefit of upper middle class employment. Some people see these kids as a priority, other's don't seem to care. It comes down to what you believe about other people's children and how you think about economics.

The first question is, "do you accept any responsibility for other people's children?" If surveyed, I suspect a socially conscious majority of Americans -- some liberal, some conservative -- would say we have some responsibility to our brother and sister's children. They'd argue about whether it was a public or private responsibility, but they'd acknowledge that we need to do something for those in need. I find it incongruent with stated articles of faith that more religious leaders aren't leading the charge to insure the medically indigent (and that most religious conservatives seem to be opposed). And, other than a few urban church leaders, we don't hear much from churches about the education of urban kids as a moral issue.

On the subject of economics, I'm pro-growth: low taxes to and an opportunity platform that includes safety, transportation infrastructure, a strong public education system and basic health care. By 'opportunity platform' I'm suggesting the basics for encouraging prosperity; people who live here legally should have a fair shot at joining the economic mainstream (and folks here illegally, like those waiting to get in, should have a pathway to citizenship). The first part of this equation -- low taxes -- aligns with self-interest and has broad support. The opportunity platform requires investment and that demands a sense of civic obligation and/or the ability to think about return on investment over decades rather than months -- a tougher sell.

America is rapidly becoming less competitive in part because of a weak opportunity platform (and because the opportunity platform in other countries is rapidly improving). What's frustrating is that American spends a lot on education and health care -- the most in the world -- but neither works very well for low-income kids. We spend enough that we should have great health care and education for all, but we don't. Dramatically improving both delivery systems without spending a lot more money is where this gets complicated.

We seem incapable of discussing sacrifice. Of course there needs to be health care rationing -- even after we wring out some of the waste, we've got more pills and machines than we can afford. If you want to pay for them, fine, but expecting American businesses to pay for everything for everyone has already made us uncompetitive (e.g., GM). And now that I'm AARP eligible I can say this: we need to reallocate investment from the last 18 months of life to the first 18 years of life. We spend more on death than we do on adolescence. We are collectively irrational and individually selfish.

President Obama, while leaving the details to Congress, wants a health care plan that expands access and reduces cost. Congress has proven that it's not very good at solving complicated problems like this. Interest group pressure has been intense, intentional misinformation has been inexcusable, and partisan politics all to typical.

Even if you don't accept a moral obligation to serve the less fortunate, you can make a strong pro-growth business case for providing infrastructure including quality education and at least basic health care. We can do it for less money and cover more people. The alternative is a permanent recession with a growing underclass. We just need to make some tough choices in favor of other people's children.

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