Just suppose in 1998, "We the people of the United States, in order to form a more perfect union" enacted laws to carry out what The Declaration of Independence proclaims: "that all men are created equal." We would affirm our daily pledge of allegiance to "one nation under God, indivisible, with liberty and justice for all." Those words should stick in our throats if we do not mean them. Laws to express the fundamental and unique goals of our founding fathers would change society. They would help sustain families, create functional communities and bring together the people of the country—as nothing else can.

The time is ripe for taking action. The 21^st century is rapidly imposing revolutionary demographic changes in our lives. It will take bold action to stay ahead of the curve. America, proud to be a nation of immigrants, should accept its destiny to be the first meaningfully to acknowledge the essential equality of all human beings. President Clinton noting that "in another generation the United States will encompass minorities from across the world" and that already Hawaii and California do not have a majority of any one race, created the President’s Advisory Board on Race to address the troubling problem.

Dramatic advances in science and technology have put us all in a world where individuals have instantaneous business and social contacts throughout the planet with people of different customs, nationalities and races. An unprecedented flow of information is available through the Internet. Our children speed by jet travel to all corners of the earth, only now it is a globe in constant motion. No longer limited to the girl or boy next door, many of them are marrying individuals of foreign nationalities with unfamiliar cultures, creating a new citizenry to confound race classifications for census takers. It is time to admit we are all one race: the human race.

Instead of attempting to eliminate ingrained prejudice in adults, let us begin at the beginning with the children. Treat every newborn American child alike, without discrimination of any kind. Make available to each and every one of them the same medical care and educational opportunity for success in life.

It has been scientifically demonstrated that the first few months of an infant’s life are crucial to physical, emotional and intellectual development and potential. There will never again be a fairer or more level playing field to start competitive, successful lives.

During the past four years of talk about the national health-care system, there was a chorus in the background crying for children, children, consider the needs of children! No attempt was made to analyze the dependent situation of children in society and the resulting special needs. Children up to age 18 comprise more than one-fourth of the population. Their fate is essentially at the mercy of grown-ups who must make wise and generous decisions for their futures. Children are like a brood of birds in a nest with their beaks wide open waiting for their parents to fill them with food continuously. Our children need huge investments in health and education freely given during their youth before they in turn contribute substantially to society. The division between children and adults is obvious and causes no confusing questions about who qualifies for investment. Health services for children are cheapest, deliver greatest benefits during childhood and may last through a long life. Our children can not wait while we squabble over adult health plans. They keep growing every day.

Who is responsible and able to make the tremendous investment required for all our children, the visions of our future country? Parents? Insurance companies? The Federal Government?

Too many parents of all classes today, not themselves well-trained and responsible, are products of generations of social neglect. The Carnegie Commission on Children in 1994 concluded "millions of infants and toddlers are so deprived of medical care, loving supervision and intellectual stimulation that their growth into healthy and responsible adults is threatened." Parents without means are frustrated and distraught. Unprecedented numbers of fathers abandon their families. Hardly able to earn enough to keep themselves alive, they cannot hope to invest what is required for the health and education of their children without outside assistance.

Can insurance companies solve our problems? They are neither investors nor educators. In fact, judging by their present system, they are not in the business of insurance anymore. They do not deserve the title they use. They now demand payment—up-front—as "premiums" for exaggerated estimates of the year’s possible expenses for the insurer. They act more as bankers, advertising that any excess paid in premiums can be considered savings for vacations or any other desire having nothing to do with health. But, Medicare, the federal health plan, paid from wages, is involved in this scheme, and Medicare funds should be used exclusively for health!

Contrast the present health-insurance system with what health insurance used to mean. We each paid a small premium into a large risk-pool to insure medical care in case of an unfortunate accident or illness. Webster’s Dictionary defines insurance as: "being insured against loss: a system of protection against loss in which a number of individuals agree to pay a certain sum (premiums) periodically for a guarantee that they will be compensated under stipulated conditions for any specified loss by fire, accident, death, etc."

Basically, insurance is a gamble. You win if you lose your premium to the risk-pool for the year in which you have no need to make any claim. Does anyone know? Can anyone know how long he or she will live? Or, what his physical condition will be next year? Even whether an "act of God," a devastating calamity such as a hurricane, flood or earthquake will strike his area, destroying his home, his family and his life’s savings? These are still three of the mysteries of life that call for true insurance. Companies often pay out more for emergencies than most individuals could possibly save in a lifetime.

Insurance policies will do very little for children but will cost their parents and society a lot. There is sparse empirical evidence that policies improve children’s health. Health policies cover diagnoses and treatment but no education in prevention: the self-care practices of human behavior to avoid lifelong medical conditions that drain the resources of Medicare in later life.

Insurance cannot activate the amazing benefits of early childhood development. The Clinton Administration deserves great credit for its efforts to explain and promote recent studies that prove it to be the basis for physical, emotional and intellectual competence of children. This is a vast new field of endeavor crucial to rearing children to their full potential. In today’s world infant nurturing and learning experiences in daycare and play schools in the first years of life are essential to the foundation for formal schooling. To improve our national educational system, safe buildings and good teachers will not be enough. Good teachers will still need healthy children who have been properly prepared for continuing learning.

Who is to oversee the children’s health policies and claims for them? Do you, dear reader, understand the benefits and costs in your own policies? Should we relinquish to insurance companies the power to control the costs and quality of care for innocent children? Premiums are expected to rise at least 5% to 10% every year. Such rising expenses come out of wages through the payroll taxes of employees who can ill afford them. Workers are themselves already tied to their employers who make the health contracts with insurers. (The fact that wages are tied into healthcare is a separate fascinating argument about the fallacy of treating health as a commodity to be bought and sold like soap or cars.)

It is a serious mistake to chase after health policies for children. Many complicated, inequitable schemes are afloat to scramble for funds to pay the voracious insurance companies. Taxes on cigarettes, a known hazard to health, will be used to protect children’s health! Uncontrollable block grants to the states, and even outright payments of federal dollars for policies are planned.

Health and education are the matrix for social reform. Insurance policies do nothing for education and little for improved health. The fact is, however, that health and education are too closely allied to be separated. You don’t get one without the other. Without good health, children cannot learn; without an education youngsters can not succeed; and without successful citizens the nation cannot prosper.

There is a spark of hope in these suggested changes. We may yet set the county free from the evils of the present health system. Children up to age 18 are not, in general, entrapped by employers or insurance companies. Therefore, we have a rare window of opportunity to focus all remedies for the systems on them. We can start incrementally, by giving all children access to free health and education through their formative years. Whichever plan we choose, we adults will pay for it one way or another. The assignment is to make the system fair to all and at the least cost for complete care.

The Federal Government is the proper a best custodian of America’s children, our nation’s heritage. Americans speak with great reverence of our Founding Fathers but deny common respect and trust to present-day democratically elected leaders. However, whenever the American people are challenged by incredibly complex, difficult jobs, they call on the government. Given the authority and adequate funds, they have come through with flying colors. This is the nation that led the world to the moon and stars; the country that conceived of and executed the Marshall Plan, which provided vital support to foreign countries to save them from devastation after World War II. Many professional leaders of today give credit to the GI Bill for what it did for them as veterans since World War II. These were all highly costly federal investments. Congress did not nickel‘n dime the costs, and the benefits have repaid society many times over. Neither can we forget that for the past 30—even more than 60 years—the health and life of America’s seniors was successfully insured by government-administered Medicare and Social Security. It is now up to us seniors to show our gratitude, by voting en bloc, to do as much for our children.

Screams will be heard loud and clear: "We don’t want any federal government messing in our health and education." Nonsense. Don’t believe it. These are the same voters who demand immediate legislation to correct anything they don’t like in the health-care system. They insisted on passage of a law to allow mothers a reasonable stay in the hospital after giving birth. They now want the same for mastectomies. They applauded when, with unexpected good luck, both political parties approved the Kassebaum-Kennedy Bill that allows workers who change jobs to keep their health insurance. (Unfortunately, no limit was put on the questionable high costs to the workers.) Our congressional leaders in Washington, without qualifications or competence in the art of medicine are making laws about our health. For months they have debated ad nauseam, the medical procedures used in the thorny questions of late-term abortion. What a waste of their time and our money! These are decisions for physicians to make in consultation with their patients. Lacking any proper means of controlling costs and quality of care, we are on a slippery slope to endless congressional legislation and litigation with no chance of improving the health of Americans. The country is in desperate need of an independent national Health Board to be composed of physicians, psychiatrists, scholars, ethicists and eminent citizens to oversee the whole issue of American’s health.

It is clear, children need federal help—as a right. Young parents embarking on their own careers do not have the funds to invest in their children. Insurance companies are neither investors nor educators. Only the federal government, subject to the will of the voters, can take on this daunting assignment. Let Congress pass legislation for the Health Board to provide comprehensive services and all necessary education for every American child, from the cradle to the voting age of 18. Any costs over and above what is currently spent on children will come from general tax revenues. That’s how the National Aeronautics and Space Administration (NASA) and the Federal Emergency Management Agency (FEMA) are funded. The Administration becomes the insurer of all children, holding funds to be paid for legitimate claims. It is called the "single-payer system," greatly desired by a likely majority of voters. The single-payer system with tangible and substantial benefits is also an easy way to reestablish the original, true meaning of insurance. Start incrementally with children who are most in need and the base on which to build a healthy nation.

Use FEMA as an outstanding successful model to create a federal agency for children. It has done a fantastic job with quiet efficiency to restore the damaged infrastructure, business enterprises and especially a multitude of family tragedies resulting from earthquakes in California, floods in the Middle West, hurricanes in the Eastern States and tornadoes in the South. Who pays those tremendous costs? We all do, painlessly, through general tax revenues, fairly collected. FEMA illustrates a federal insurance that works perfectly, with much credit due to Director James Lee Witt. Note that in true insurance, only those who are harmed receive financial help from the risk pool.

Today, the United States faces a nationwide calamity greater than any yet encountered by FEMA. No area, rural, urban or suburban is exempt from tragedy. It affects every class and strata of society with broken families, poverty, child neglect and abuse, poor schooling, drugs and crime. Consider for a moment how these are all intractable problems closely related to children not yet 18 years old. In saving them from this catastrophe, we will build a nation of healthy children, strengthen families and create livable communities with an improved educational system. As a bonus there will be substantial savings from costs for remedial classes, overwhelming legal fees and costs or prisons. And, it will save children’s lives.

No one agency or government working alone can solve the problems. It takes an amalgam of all the agencies working cooperatively, as FEMA does to reestablish communities. Community is defined as "a group of people living together as a smaller social unit within a larger one with interests in common." It is not difficult to determine those common interests: infants and children, health and education, security and safety and available jobs. What is missing is the means to work together in mutual cooperation to achieve those vital goals.

In the last century, the free public schools were the place for parents to meet, get to know their neighbors and work on projects together. We now know that kindergarten is already too late for intrinsic early education. Is too late as well for preventing the most horrible happenings in the communities, such as selling drugs and committing crimes, shootings--even an 11-year-old killing a 5-year-old. Basic invaluable education starts at birth, requires follow-up supervised daycare and preschool experiences with other children in order to compete for success in life. Such a background, plus good health are the basis for effective schooling in the K through 12 grades.

A United States Child Health and Education Agency should create Child Centers, similar to medical centers where all related activities come together. Centers must be widely distributed in the most accessible area of every school district across the land. They would establish the framework for a clinic, a supervised daycare center, a prekindergarten playschool and the traditional elementary school, all preparing the children for high school. It will be the best and cheapest way to extend the amazing benefits of early childhood development, universally to all children in neglected open farm areas as well as crowded cities.

High schools, which may or may not be physically connected to the Child Center, should prepare children for productive life styles. In addition to continuing academic studies and preparation for college, children should be offered after-school classes in useful entry-level jobs. The revitalized communities will require many new workers. The youngsters will be instructed in basic good work habits while they learn to care for infants and children at all levels. Good work habits will also apply in classes to learn practical skills for maintaining clean safe buildings, sanitation, carpentry and glazing to replace broken windows. These jobs must be taught; they do not come naturally. The community provides excellent opportunities for early, supervised experience at real work. Whenever possible local residents should be hired and trained for the many openings in the center. There might even be a mini-employment office to recommend certified reliable babysitters and handymen. Individual interests in the arts and extracurricular activities should be revived and encouraged in high schools by after-school clubs for music, drama, athletics, cooking, baking and so on.

Every state in the Union has developed excellent private programs to improve health and education for specific groups of children. Their promoters should be invited to be integrated into the nation’s efforts for universal care. As with free public schools, no one is compelled to use the government free services, but no government funds should go to private enterprises.

Possibilities for success are immeasurable. It was 1994 when the late beloved director of UNICEF, James P. Grant said: "Investing in children is a way of jump-starting solutions to seemingly intractable problems and it is a chance the world cannot afford to miss."

Using a database, the modern marvel of technology, each Child Center will report valuable information to the national administration for cost and quality control, comparing all sections of the country. The database also protects the privacy of medical and other personal records. Starting with children promises the rest of us an escape hatch. One day we, too, may share in the security of true National Insurance for our health needs.

Frivolous objections are anticipated from young, inexperienced congressmen who are so sure—and so mistaken—that we can all take care of ourselves without government and the need to pay taxes. They claim to know best how to spend their own money. How can they expect us to buy that argument when society is suffering because the gap between rich and poor is greater than ever? The richest 1% holds 35% of the nation’s wealth. These are growing numbers of homeless Americans without health insurance; more children live in poverty; wages are kept low through downsizing. Unfortunately, there are too few Americans on the order of Aaron Feuerstein, owner of Malden Mills in Massachusetts who, after his mill burned down, assured workers he’d stick by them until the factory was rebuilt.

Will the American people, who like to boast of putting Neil Armstrong on the moon, enter the 21^st century claiming they cannot provide essential care for our children? Don’t our golf-loving congressmen know that taxes are like golf club dues? They pay for what services we get. Do these same congressmen objet to paying higher dues for superior conditions on the fairways? Could the fabulous auto industry contribute to the national economy if taxes didn’t pay for building and maintaining free roads open to everyone? That’s all the children are asking for—a free open road to maturity and a livable society.

Some original, pertinent thoughts on health and education for children, from a nonagenarian.

March 1998

Eugenie Ahders

The Quadrangle

3300 Darby Road

Haverford, PA 19041