HEALTH CARE/Joan Retsinas

Children? We Love Them Seasonally

At last the holiday of pretend is over. Not just pretend-that-Santa-and-elves&endash;are-sleighing-in. But pretend that we adults really want to play Santa. We do of course spend millions on toys and doodads. Briefcase-toting women morph into Martha Stewarts, tying mistletoe, sprinkling reindeer-shaped cookies &endash; trillions of them &endash; with red sugar, turning front yards into Son et Lumière displays. Families play board games. Plus, smiling semi-incessantly, we drone on about the innocence and beauty and magic of childhood.

At last the season of hypocrisy is over. We can relax, giving in to our true Dickensian scroogeness. We don't need to feign avuncular joy anymore.

Here are some statistics that Scrooge would understand.

1) Lots of American children &endash; 7.2 million &emdash; have no health insurance. Under the Children's Health Insurance Program, the states and the federal government share the tab for insuring the children of parents who cannot get insurance through their employers, yet earn too much to qualify for Medicaid. The results are impressive: CHIP now enrolls 3.8 million children, 27.2% of all children, up from 23.4% in 2001. Yet the most optimistic experts don't expect CHIP ever to cover all children. Universal national insurance, though, is feasible. We just haven't done it.

2) Our infant deaths mock our wealth. Statistically, babies stand a better chance of surviving to toddlerhood in lots of other spots on the globe &emdash; even poorer ones. At 7.2 deaths per thousand live births, we rank just above Slovakia and Kuwait, but beneath 27 other places, including Hong Kong (3.2), Japan (3.6), France (4.6), the Czech Republic (5.2), Israel (5.7), and Cuba (7.1). Within the United States, infant mortality ranges from 16.0 to 4.8; 17 states have rates above 7.5. To lower our numbers, we would need to invest in prenatal care (made easier with universal insurance), as well as fight the war on poverty Lyndon Johnson never won.

3) Although we have vaccinations for tetanus, mumps, rubella, whooping cough, polio, measles, and influenza, only 80% of toddlers are immunized. In minority neighborhoods, immunization rates are lower. More pediatric clinics, with longer and more convenient schedules, would help.

4) Peeling lead paint in older houses can harm young children. Physicians have documented the harm. Yet we play a complicated "blame toss", throwing the responsibility from paint companies to landlords to parents. The simplest recourse would be for the government to pick up this tab.

5) Second-hand smoke can harm children -&endash; another documented harm. Yet even though many American children learn to read fast-food menus before they master primers, communities rarely bar smoking in restaurants. Solons cite the financial harm to the adult-owners, the libertarian harm to the adult-patrons.

We do love children for their role in bolstering the economy. Children consume. Every Barbie sold will raise investors' bottom lines. The nation's restaurants, theaters, and malls needed the spirit-of-Santa to pump up revenues in a recessionary fall. Children are crucial economic props.

Indeed, drug companies have recognized children's economic potential. To date, adults have been the serious medical consumers: they are hospitalized more, and take more medications. Recently, though, the FDA allowed Eli Lilly to market Prozac to children. According to the press release, 25% of American children are depressed. Given our overall low regard for children, perhaps this statistic is not surprising. But instead of taking childhood depression as a signal to spend money on education, on income supports, on recreation, or on health insurance, we are making it easier to medicate children out of their misery. As drug-consumers, children merit our attention.

Like Scrooge, we love children when they enhance our income, not deplete it.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I.

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