Editorial cartoon (12/26/2017)

It’s not uncommon for various organizations and causes to appeal to a public desire to help children in an effort to further their endeavors. Look at all the times children are featured in ads, speeches or mailings. Or, perhaps, the use of the overused, sometimes-laughed-at phrase, “But think of the children!” Sometimes this focus on children is come by honestly — for example, a non-profit whose entire reason for existence is to advocate for the well-being of children. Other times, kids are viewed as a more marketable aspect of a larger mission that’s being promoted to increase awareness, donations, or the like.

Whether we like this or not, there’s a strong, underlying principle that guides this — children are usually considered to be worth helping. We can (and have) made strong, evidence-backed arguments about investment in the early years as an excellent long-term societal strategy. We know that children benefit immensely from robust prevention strategies, with demonstrable payoff. And children seem to rise above the often-messy ideological battles that center around whether recipients of assistance are truly deserving of help — there’s a view across the political spectrum that children are innocent and didn’t create their own need for possible help. Children, indeed, are universally held out to be worthy recipients of our support as a society.

Or are they? Three things have happened — one long-term, two far more recent — that have made me doubt the above tenets. While I think they are still largely true, there are signs of erosion that we must guard against if we are to continue to protect the safety net that exists for children in the United States.

First, it comes as a shock to many to learn that children are the age demographic that is most likely to live in poverty in the U.S. About 13.2 million American children — 18 percent — live below the federal poverty level, and this rises to a shocking 41 percent if you consider those under twice that level to be poor, a more realistic measure of what is needed to cover basic expenses. Yes, in the most advanced country in the world, between a third and a half of our children grow up in need.

Second, the bipartisan Children’s Health Insurance Program (CHIP), which covers 9 million children, has always been readily reauthorized without controversy — until now. Its funding expired at the end of September, and rather than reauthorization we have seen almost nothing — except a brief few months of funding, which kicks this argument into early 2018. Nervous states are already making plans to tell CHIP-covered pregnant women and children they may not have coverage soon.

What’s the issue? The Senate introduced a “clean” bill (“just fund it”), but the House’s bill imposes cuts in other programs in order to pay for CHIP, pitting it against funding for public health programs and Medicare. (Keep in mind that funding CHIP would be a mere 1 percent of the predicted costs for the recent tax bill.) CHIP isn’t really what’s in question — it’s likely being used for negotiation on other, unrelated elements of policy. Children’s well-being should not be held hostage in this manner.

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Third, and perhaps most disturbing, is a reported plan by the White House to separate children from their parents when families are caught entering the country illegally. This appears to be primarily for the purposes of deterring unauthorized immigration. No matter where you stand on immigration issues, it is fairly clear that a policy of forcible separation of parents and children for such purposes is cruel, developmentally ignorant, inhumane, and will have long-term negative mental health consequences. Children should not be used for leverage to accomplish other policy goals.

All of these make me wonder where our priorities lie when we proclaim our love and support for the well-being of children but then consider enacting budgets and policies that use them as pawns. Budgets and policies are moral documents that show our true face as a society. Are we comfortable with what we see?

Dr. Dipesh Navsaria, MPH, MSLIS, MD, FAAP, is an associate professor of pediatrics at the University of Wisconsin School of Medicine and Public Health and also holds master’s degrees in public health and children’s librarianship. Engaged in primary care pediatrics, early literacy, medical education, and advocacy, he covers a variety of topics related to the health and well-being of children and families.

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