December’s issue of Health Affairs is dedicated to the subject of children’s health, particularly how children fare in the national health care system.
The Scheduled Squeeze On Children’s Programs: Tracking The Implications of Projected Federal Spending Patterns, written by Urban Institute scholars C. Eugene Steuerle and Julia B. Isaacs, reviews how the federal government funds programs for children. The authors provide an assessment of how children are faring in the context of the federal budget as well as an overview of how government choices on the budget for spending on children have shaped the current fiscal landscape.
Since 1980, federal health spending on children has grown modestly. Yet, according to the authors’ analysis, only about 10 percent of the federal budget is currently spent on children, compared to 43 percent spent on Social Security, Medicare, and Medicaid alone. At the same time, children in the United States have had worse health and other outcomes such as educational attainment than children in other wealthy nations. Also, children in the U.S. had higher poverty rates than other age groups.
The authors posit:
Thus, despite the modest growth in the percentage of total government spending appropriated to children’s health, the inexorable growth in the share of total government spending for overall health care forced most children’s programs to compete for an ever-shrinking share of the remaining pie.
The authors caution about the “consequences for children’s programs of continuing on the budgetary path now largely laid out.” With the exception of Medicaid and Social Security, most spending on children’s programs – like education, child care, and housing – require annual appropriations and “lack the permanence of spending entitlements.” In other words, means-tested programs do not automatically grow in response to the environment (economy, wage growth, inflation, etc.).
For a list of other articles that touch on issues in children’s health, check out the Table of Contents from the December issue.
