“If you really want to have an impact on the nation’s health,” said Dr. Mark McClellan, “start with children.” And to help kids grow up healthy, he added, you have to go beyond traditional medical approaches and address what’s making them sick.
Dr. McClellan shared his views with Children’s Law Center over breakfast at the Sidley Austin law firm on June 4. The discussion, moderated by Executive Director Judith Sandalow, brought together about 50 leaders from the legal, business and healthcare communities to discuss healthcare reform.
A senior fellow at the Brookings Institution and former director of the Centers for Medicare & Medicaid Services as well as the Food and Drug Administration, Dr. McClellan has spent his career thinking about healthcare reform. His views also have been shaped by his experiences as a medical doctor, an economist and a parent of children growing up in DC.
To improve children’s health, Dr. McClellan urged solutions that move beyond expanding healthcare coverage – where much progress has been made, including in DC. Children in DC have high rates of healthcare coverage, thanks to the District’s expansion of the Medicaid program that insures low-income children and families.
Even so, many DC children struggle to achieve better health. For example, more than 1 out of 5 children in DC have asthma – that’s twice the national average – and children in DC’s poorest neighborhoods are 10 times more likely to end up in the emergency room because of their condition.
To improve children’s health in DC and beyond, Dr. McClellan urged a national shift to “invest in a life-long foundation for children’s health” by addressing the root causes of and contributors to young people’s poor health. These include issues like childhood stress and trauma, poor and unstable housing, the lack of school readiness and not finishing high school, drug use and teen pregnancy. At its core, these are many of the issues facing children living in poverty.
Addressing childhood education and poverty may seem outside of traditional healthcare but it is necessary, Dr. McClellan believes. It is also doable, he said, when health institutions partner within their communities.
PHOTO LEFT TO RIGHT: Sidley Austin’s Dave Wharwood and James Stansel, Dr. Mark McClellan, and Sidley Austin’s Becky Troth
For example, Children’s Law Center was an early pioneer of the medical-legal model to find and fix barriers to children’s health. Our lawyers currently work side-by-side with pediatricians in six community health centers within Children’s National Health System, Mary’s Center and Unity Health Care. That’s where we have met hundreds of children whose asthma wasn’t getting better because of unsafe housing filled with mold, rats and roaches. Or, thousands of children with learning disabilities that weren’t being addressed in school. Our tenacious lawyers fight for these children and ensure they have safe housing, good educational support and safe and stable families.
“Those of you working with Children’s Law Center are seeing innovative health solutions for vulnerable children put into practice,” Dr. McClellan said.
To make solutions like medical-legal partnerships available to more families, Dr. McClellan urged that ongoing health reform efforts address healthcare financing. He believes payments to hospitals and other providers should be tied to health outcomes and not just specific medical interventions.
In addition, healthcare providers, educational institutions, legal providers and others should think of children’s well-being as “shared goals” and forge shared solutions. Solving children’s long-term health will require working across sectors, he said.
Dr. McClellan’s talk was part of Children’s Law Center’s ongoing series to discuss trends affecting children’s well-being in DC and the nation. Previous breakfast speakers have included Education Secretary Arne Duncan, former Vermont Governor Howard Dean, and former director of the White House Domestic Policy Council Melody Barnes.
For more information about Children’s Law Center and how we help DC’s children grow up with a loving family, good health and a quality education, read about our approach.