AMCHP 2005 ANNUAL CONFERENCE
DELIVERING RESULTS, IMPROVING PREGNANCY & BIRTH
February 19-23, 2005
MARIAN WRIGHT EDELMAN: Thank you. I am very, very honored to be here. I knew Vince Hutchins. He was my friend. I can't think of anybody whose award in his memory and honor that I would rather receive, and we'll all miss him a lot and that kind of dogged, dedicated, creative spirit and commitment to serving mothers and children and the poor, no matter what is what we have got to continue. So thank you for this honor. We are all grateful for Vince Hutchins' life.
I am also very grateful for the words of Dr. McQueen, who was the director of our child health specialty clinics. He was a pediatric neurologist, who educated the public and advocated to children with special health needs, so the combination of this luncheon is quite wonderful. And thank you for that wonderful introduction.
We are living in one of the most dangerous times since the Children's Defense Fund began. Our work is cut out for us. I want to thank you, all of you here for all you do for mothers and children. Let me tell you, don't get discouraged, just get together and hold on to the progress we made. It has been significant, but we are in great danger and we have to keep our eyes not only on defending what we have achieved, but finishing what we have begun. And we will not finish it until every child and every parent and every child has health coverage and that is something we must never lose site of public health has made a remarkable improvements over the years for women and children though I never thought it would be so hard to get us to do what makes senses morally and what makes sense fiscally. As you know, working together with you, we have seen Medicaid expand to cover millions of children in the EPSDT program which is so important. It has been established along with the State health insurance program, SHIP, which has expanded health eligibility for uninsured children and working families, and along with these efforts and your efforts, more than 30 million children, poor children, who otherwise would be unable to get health services have gotten it. Medicaid is the single most important source of coverage for maternity services accounting for 1.4 million or 37 percent of all births in our hospitals. And healthcare access for children has increased thanks to your work through public health programs like Title V. Maternal and children health services block grant. Your program has been instrumental in the reduction of infant mortality, increased access to comprehensive prenatal and postnatal care and the provisions for preventative primary healthcare for children including immunization and nutritional and developmental services. Your MCS program provided health services to over 80 percent of all newborns, 50 percent of pregnant women and 50 percent of children in the United States.
The increased healthcare access to public health insurance and MCS program has contributed to significant progress in children's health status with improvements and many indicators. Infant mortality has declined by 75 percent over the past three decades, but it is still much too high. Our country prides itself in being number one in military expenses, being number one and being the richest nation on earth and yet we are content to lag behind most other industrialized nations in keeping our children alive. We have to change that.
The percent of babies born to mothers receiving late or no prenatal care has declined by more than half, but we are still not doing what we ought to do. And I still can't get over the fact that our two years old we've got, despite our progress on immunizations which have increased over three quarters over the last decades, we still have too many children at preschool ages and at age 2 who are not immunized. My goodness, we know immunization saves money, it saves child suffering and child’s lives, and we know we have a job in tackling health disparities because black infants are still more than twice as likely than white infants to die before their first birthdays and more likely to be born with low birth weight, so we have to close the gap.
So in this challenging time, we should o applaud what we have done and determine we can hold on to it, but more importantly determine we build a movement to make America what America ought to be.
I often quote Detrick Von Hoffa who was a great German Protestant theologian who died who believed the test of morality of a society is how it treats its children. The United States is flunking Von Hoffa's test. A child is abused or neglected every 35 seconds. A child is born into poverty in the richest nation on earth every 36 seconds. The majority of them live in families who are playing by the rules working, just can't get them out of poverty. A child is born without health insurance every 51 seconds, 90 percent of them live in families where somebody is working.
A child is killed by firearms every three hours, almost eight a day and is killed by abuse or neglect every seven hours. I think we can do better than this and it's an abomination that the assault weapons ban was allowed to lapse.
Every minute a baby is born to a teen mother every four minutes to a mother who had little or no prenatal care and every 22 hours a baby's mother dies in child birth.
I have been very worried about the trends of what's happening to minority children and particularly black children. Black preschool baby born in 2001 has a one in three chance of going to prison before he reaches 30. And if we don't begin to break up the cradle to prison pipeline that starts almost before birth with lack of prenatal care and nutrition, lack of early childhood stimulation, lack of healthcare, lack of school readiness, we will see the total disempowerment of the community, the black community, but more importantly a tragedy in the entire American society and we cannot have that happen. And I will show you at the end of my speech, we are about to do a report on the Cradle To Prison Pipeline, but all of us have to continue to name it and see how we each in our own way can begin to dismantle it and give our children hope.
Today 580,000 black males are in prison and fewer than 40,000 black males graduate from college each year. And from the looks of the number of folks, black men and children who are under the supervision of juvenile justice and the correctional provision system it is quite amazing. One and three and girls and women are the fastest growing group of detained juveniles. Black youth are 48 times more likely to be incarcerated than white youths for drug offenses and the combination of poor, dysfunctional and stressed families, lack of community health and mental health and other support services, too few positive alternatives to the streets contribute to too many poor and minority children to be sucked into this cradle to prison pipeline and it is exasperated by zero school tolerance. A lot of things usually sent to the principals office in 9th grade and 4th grade are now being criminalized and they are expelling first graders and sometimes we hear about the expulsion of preschool children. What in the world do you do when a 5 or 6 year old is not able to function within the most basic educational, institution.
More than 70 percent of the blacks in prison never completed high school, and even when they do graduate from high school they have a greater chance of being unemployed than a white person who dropped out of elementary school. We've got to deal with schooling, but health affects schooling. Children who can't see or hear or are not feeling well will not do well in school and children do not come in pieces and one of the things we have to continue to emphasize is the need to address the needs of the whole child and the context of the family and the context community. Something is fundamentally wrong with the values of a nation where the only child policy we have is that we will guarantee a jail or detention cell after a child gets into trouble. Our state spends three times more on average per prisoner than for public school pupil. We won't guarantee them all prenatal care or immunization or healthcare or head start or early childhood experience, but we will guarantee more prison ells and we have to change or turn that policy on its head.
These facts are not acts of God, they are moral and political and economic choices. We can and we must change them. Over the past four years, child poverty has increased each year among all races, especially Latino and black children, and the infant mortality rates have increased for the first time in 44 years. How did our nation leaders respond? By choosing to give massive tax cuts to millionaires and billionaires while proposing to impose budget cuts and blocked grants to destroy already inadequate investments in children's health and early childhood development, in education and after school programs and safety. But every other wealthy industrialized nation provides its children. I think our nation's morale compass needs resetting. We are sliding backwards, teetering on the brink of destroying at home and around the world the very values of freedom and justice that make America America. A Pandora's box of greed, terrorism, torture, moral corruption, intolerance and disregard for the rules of law and justice have been opened. It must be closed, less the world we pass on to our children and grandchildren be indelibly sullen. I'm a grandma now and I tell ya, it has radicalized me all over again, and I don't want my grandchildren to grow up in a nation that says that greed is a national value, that fear is a national value, that deception--
I want to teach them that deception is not a national value, that hypocorism is not a moral value that violence not a moral value, and that picking on children to help the strong and rich is not a moral value. And I want my children and grandchildren to know that we love them enough and value them enough that we'll stand up and fight back for them.
I love Sijourney Truth who is a brilliant but a (inaudible) slave women who had a knack for getting to the heart of the matter. One day she heard a speaker commenting about the United States government and Constitution and she asked him by alluding to a bull weevil epidemic that destroyed many thousands of acres of crops in the midwest that year. She says, I goes out and I's talks to God in the fields and in the woods this morning, I was walking out and got over the fence. I saw the weevil over there with his head looking very big. I goes up and I took hold of it. Do you believe it, there was no wheat there. I said God, what is the matter with this here wheat. And he says to me, he says Sijourney, there's a little weasel there. Now I here's talking about the Constitution of rights of man and I take hold of this Constitution. It looks mighty big and I feels for my rights, but there ain't any there. So I says God, what ales this Constitution? And God says to me, Sijourney, there's little weasel in it. My bottom line message to you today is that there are some big weasels eating away at America's Constitution. They are eating aware at America's Constitution, at our professed values, at the integrity of the gospels, the Kuran and all great things , and unless we name them and understand them, challenge them and pluck them out, they are going to destroy our nations souls, our values, our children's futures and squander them away into millions of people in our globalizing world.
We are all aware that the United States Homeland Security Department has a color coded threat level system to communicate with public safety officials and the public at large. Through a threat based color coded system so that protected measures can be implemented to reduce the likelihood or impact of an attack. The threat condition has economic, physical and psychological effects on the nation. So the homeland security adviser system can place certain geographic regions or industry sections on a higher alert status than others based on very specific threat information. As you're aware, it has five levels of danger: Red which is severe, orange high, yellow elevated, blue guarded and green, low. Well, I want to issue a code red alert for our children. This is the most dangerous time, as I began, for children and the poor since the Children's Defense Fund began. And our children need all of us now to wake up and to stand up and to work together, to protect the framework of the laws and the safety methods (inaudible) decades so that we can get to a new place again.
I want to name a few of these big weasels that are threatening our children and our nation's values. The first weasel is the powerful special interest weasel that demands and receives first call on government resources at the expense of poor children and the powerless. Now, we hear a lot about class warfare whenever anybody raises the issue of the growing gap between rich and poor. Now, I don't begrudge anybody their first tenth, or tenth million or even billion if they are earned on a fair playing field and after our children's crucial survival needs to healthcare and education, to housing and nutrition, preschool, childcare, after school and safety are met. But something is out of balance when just three of our wealthiest Americans possess greater wealth than the tax revenues of 25 state governments with 50 million citizens. They and others in the top one percent of super rich Americans did not need the huge tax cuts the Bush Administration and Congress gave them in 2001. They did not need another huge set of tax cuts in 2003, and still another in 2004. And boy, look at the new budget, they don't need any of these irresponsible tax cuts accelerated or made permanent as the presidents new budget and congressional propose.
The tax cuts for the top one percent that they have not yet received and are scheduled between 2005 and 2010 should be repealed in light of growing infant mortality, extreme child poverty, a soaring federal deficit and costly wars in Iraq and Afghanistan. If they are not repealed, if we do not stop them being accelerated and made permanent, the federal government will be starved to death with nothing left to provide our children healthcare and to educate our children, not giving millionaires and billionaires future tax benefits they should not have received in the first place and not a tax increase as proposed contend. And if you look at the new budget, and I urge you to do that, you should also look at the reports that we are issuing that will be on our web site shortly, but the senate budget and priority has done an analysis that may have indicated that the increase in spending over the last four years that has gone to programs for the poor and for children has increased only six percent. That the incredible spiraling deficit, 48 percent of it comes from the first round of tax cuts and the rest of it comes from the increases in defense spending.
If we don't stop these tax cuts and if we see them increase and be made permanent, then I will tell you there will be nothing left. And the long term consequences, if you look at the budget carefully they talk about one year cuts and freezes, but if you look over five years and ten years and 15 years a growth of rate of revenue from the tax cuts and the continuing cuts in discretionary programs, there's not going to be very much left, because they were not going to cut defense unfortunately, and if these tax cuts which are now being used or put in such a way that they are just passing through the budget process, one of the things that are most dangerous is that they are trying change the budget rules and we have one set of budget rules for the rich and another for the poor, but the new tax cuts are being sent directly to the tax ceiling and they have to have an offset source of funding. That is true, the supplemental request for the war, they are off budget and go straight to that debt ceiling, and if you want to get two more cents for the poor children and their healthcare or for Head Start you do have to fight an offsetting firm. You know justice and (inaudible) and you have one set of budget rules for the poor and another for the rich and powerful, and we've got to wake up and say that's not who we are as Americans.
The second big weasel is the deception weasel. The administration simply took our legally trade marked words, leave know child behind, and used them as a smoke screen to hide unjust budget and tax policies that hurt children and that deny resources to those left behind.
I just learned today, I was reading my weekly memos, that the new Kettering Institute was used --labeling a new effort to turn Social Security into, my view, a lottery, and that we don't really have a real crisis there, that's something that needs to be prevented over the long run. But the answer is not to spend trillions in transactional costs which they don't tell you about and again are off budget, but they call these new individual savings account a Children's Defense Fund account, and I want to you know that that is not so, folks. We have to challenge rhetoric that is couched in wonderful phrases but which leave now rich child or millionaire or powerful special interest behind while leaving millions of our children behind in poverty and poor health and poor schools. We must not get caught into the rhetoric of compassionate conservatism. What we've got is radical, uncompassionate actions and we must challenge it.
In the first year, the president said, I'm making education my top priority. Yet the choices put 25 times more into the tax cuts that benefited mostly the wealthy than into education and the no child left behind act which is not the children's defense fund act, we have the absolute no child left behind which spent 75 billion dollars a year in children's health and children's nutrition and children's education, but they have underfunded the no child left behind act by over 40 billion dollars and another 12 billion this year. And as you know, those of you who are struggling at the State level, poor children families are being assaulted twice and thrice by federal and state and local budget cuts, in education and healthcare, and food and housing and childcare, in child welfare and juvenile justice systems and that is that will only get worse.
The number of uninsured children will continue to rise even though we've been holding even because Of Chip and Medicaid, but Medicaid is under severe threat right now and you have really got to make your voices heard less we end up with a Medicaid spending cap or a Medicaid block grant, and so you've got information in your seats but you should call your friends and members of your congregation, but let your Governor's know that children and poor did not cause this deficit in Medicaid. I know they are all facing escalating Medicaid cost, but children are half of the Medicaid budget but about 20 percent of the Medicaid cost. And cutting cost effective children's programs will not solve the Medicaid program. So we really must speak up. I am deeply concerned about the trends in states and eroding health coverage for children. The Texas (inaudible) leading the nation in eliminating child health coverage. Over a half million Texas children have lost coverage entirely or lost dental and mental health benefits. We are trying to get it back step by step. Last year Florida topped enrolling new applicants for it's Kids Care Health Program which has led to a waiting list of more than 100,000 children and now everybody has begun to stop having waiting lists so we can't document who's not getting services.
We worked very closely for a number of years, very positively with New York Governor (inaudible) to simplify and to expand and facilitate enrollment and healthcare coverage for children, but now we are beginning to see that state put back into place or attempt to put back into place bureaucratic barriers that would deny children's healthcare and not save money.
State funding cuts are being made and have already starved infant, toddler, preschool and after school programs despite their proven importance to healthy child development and their cost effectiveness.
So longer waiting lists, restricted eligibility, reduced provider payments, increased parent fees and co-pay, decrease spending of quality (inaudible) increased the burden on low and moderate income working families and their children. Not only have more children fallen into poverty, the United States is now becoming a place where it is harder to get out of poverty than it would be in other industrialized countries. The American dream has always been about upward mobility, but that mobility has begun to stagnate. You're fully aware of the efforts on Medicaid, they are proposing to inflict at least 45 billion at least, and we are toying to use 45 billion or 60 billion, but we'll use 45 billion at the moment in federal Medicaid which threatens children's coverage that's putting a massive squeeze on the program that currently serves 25 million children, and the administration is proposing increased flexibility in Medicaid. But we are so eager and so concerned about preserving the framework of the laws, if we lose the framework of the laws, and it has been so hard to get, it will take decades to get it back. So our first priority is to preserve Medicaid's law and guarantees for children. To preserve Head Start as we know it. To preserve child health guarantee funded for neglected and abused children, and then to stop these absolutely unjust tax and budget choices which will starve all of the path of the federal government to service these children.
And as you know that the budget proposed black funding of 724 million, 126 million less than the authorization level of 850 million for your maternal and child health block grant.
The budget would also cut 5 million from the healthy start program. We all talk about flexibility and putting them altogether, but don't be fooled by what you will be faced with over the long years, over the future years, where ten million dollars that was ear marked for newborn screening for early detection of hearing deficiencies are being consolidated or eliminated. So we do need to pay attention and we need pay attention to the history of block grants, most of whom have shrunk over time and so under the guise of flexibility and so what you are seeing is the (inaudible) of the safety net protection which are already inaccurate.
The lead paint poisoning is another example of that. The budget proposed is cutting that completely. The present budget is cutting the lead hazard control reduction program by 48 million dollars.
The bottom line is I think that we have to stand up and say it is just wrong to ask poor children and poor families to bear the burden of tax cuts for millionaires and billionaires and bear the burden of balance and budget deficit that they did not cause. It's just not right to have the poor children bear the burden and we must speak up.
The second weasel I want to mention is the insatiable military weasel. Every American wants to be safe. We all want to be protected against terrorists both within and without. And Dr. King warned us about continuing to invest more and more in weapons of death while millions of people in America and around the world need weapons of life. They need peace, and food and clean water and healthcare and an end to poverty. The military budget is at it's alltime high including in the supplementals of about 529 billion dollars or 1 million dollars a minute. Between fiscal years 2004 and five, the military budget increased 39 billion dollars alone. Just that one year military increase. That was enough to close the poverty gap for 10 million children for a year. Just a months worth of this military budget increase in just one year would have provided health coverage for 71,000 children for a year. A days worth of this increase would have provide health coverage for 71,000 children.
I think we have to talk about choices and understand everything here really is a trade off. In fact, we are looking at the new military increase that is being proposed and just a week of it could provide health coverage for another 233,000 children, but Eisenhower a long time ago spoke a long time ago that these are trade offs, that every time you build a new warship or every time you built a new bomb, you were taking away food and healthcare from those who needed it. So I hope we can a robust debate about choices in America and debate which way our country is going because I believe that freedom and justice are threatened and bombs and bullets are more important than babies and mothers.
I want to mention the false patriotism weasel because there are so many people afraid to speak up and all of us love our country so deeply and we should love it so much that we want it to be just and live by it's professed ideal, we want to conserve its human and natural resources for future generations, and that is our children. I love to quote Albert Cumming who when France was bombed down in the war in Algeria said I don't want just any greatness for my country, particularly a greatness born of blood and falsehood. I want to keep my country's ideals alive by keeping justice alive. I believe that freedom and justice are dying when our leaders and citizens think that patriotism is blind acceptance. A policy of any party during war or peace and I don't believe that patriotism overrides the mandate of the profits and of the gospels to bring good news to the poor and the orphaned and the widowed.
I hope we will not have fear. The weasel of fear make us not speak up. But I also hope we challenge the two last weasels I want to mention. The I have the only right way truth and word from God weasel in our wonderfully diverse world and in our nation which by 2054 will have no racial majority. Any attempt to impose any single ideology or religion on all of our nations or people's is falling. I like to keep remembering and pointing out that the angel Gabrielle was God's messenger, that Abraham, Mohammed and the Virgin Mary and all great faith and civilized societies impose a duty to protect children. How do we all fulfill our personal and collective human responsibility to all children each of whom I believe is sacred
The final weasel I want to mention is the Charity Can Substitute For Justice weasel. The administrations rhetoric suggests that important and needed charitable giving by individuals and religious community can meet all the needs of poor and vulnerable children and families and eliminate the need for just government politics and investments.
The economist Rebecca Blake of the University of Wisconsin pointed out that if we eliminated AFDC or TANIF, or food stamps the concept of replacing that government spending through charitable giving by the religious community would require each congregation to raise another 300,000 dollars a year. I don't think that's going to happen. She says if government spending on the poor declines and the increase in private support will make up only a small fraction of the loss in government dollars. I think we should remember, those of us who are people of faith, that the prophets and the gospel and America's creed require justice. The Declaration of Independence doesn't say liberty and charity for all, it says liberty and justice for all. And we must insist on justice for the poor and for our young.
I hope you all wake up, I hope you wake up everybody else that we know and stand up together as we face the most serious redefinition of our nation's values that I can remember since we have been working on behalf of children. I don't believe that any political leaders Democratic, Republican or Independent have a mandate to hurt children, not to plunder the poor and to mob justice. I don't believe any political leaders have a mandate to dismantle Constitutional protections, free speech or liberty or separation of church and state. I don't believe any of our leaders have a mandate to manipulate or to exploit our fears about terrorism for partisan or political ends. And one of the things I'm deeply worried about is while we are all preoccupied with the great big crises and the war in Iraq and now with the new manufactured crisis of Social Security and with the spiraling deficit that the quiet but equally revolutionary budget assault on the poor and on children in the backyard will get lost and that's why we have to be very, very vigilant at a time when children are the poorest age group. We should not let them totally dismantle the very, very thin protection. And nobody, I think, gave anybody a mandate to privatize Social Security and turn it into a risky stock lottery gain and break the fundamental social compact with our children and seniors so we must stand up and pull ourselves and insist on just budget policies for all of our citizens.
One of the anecdote I go back to Sijourney Truth about, and we talked about weasels and there are many more weasels that I have in the bucket in my office which we will make available to you, but I think the answers to the weasels are fleas. Sijourney Truth again talked about fleas. She got heckled one day when talking about slavery and about second class treatment of women. She got heckled by an old white man in the audience who said, old please woman, I don't care anything about your and fast labor talk anymore than I would for an old flea bite. And she snapped back and said, that's all right, Lord willing, I'm going to keep you scratching. Many of us get very, very discouraged and very overwhelmed because these are very big problems and we do have to have very big changes in our values and priorities as a nation. By we've got to remember that enough fleas biting strategically and very persistently, can make the biggest dog uncomfortable. So what I'm begging for today is everyone of us who are so committed to children will determine anew that we are going to become persistent fleas for justice for children. That we will bite with our phone calls and our e-mails, that we will get ten or 20 other people to send those e-mails and calls to our governors and senators when they are back home this week on Presidents week and when they come back on recess in March, they should hear from you about the need for full funding for the maternal child grant, that they should not talk about dismantling and capping Medicaid. Those calls, those visits, those e-mails matter. And so you should just be pests. You should make sure that you commit yourselves to the wearing down and biting without ceasing those who would treat our children unjustly.
You will see on your table a little thing about this week. Every Wednesday we try to do some kind of witness for children. And we hope you will begin to join us on Wednesdays. And it's just look 18, there's parable about the unjust judge and the weak widow and the unjust judge didn't care anymore about this poor widow begging him for justice and he just wanted her to go away, but she just wouldn't go away. So one day after she came one more time saying give me justice he decided to do it so she wouldn't continue to just wear him out.
So I hope as you go back, that you will look on Wednesday and see how you can say something, do something and provide a witness in a quiet way to get three or five or ten others, if we can continue to do that and I have watched the flea court for children grow over the last decade. It grew -- nobody thought you could move head start from 320 million dollars to 6 billion dollars. So let's not be discouraged and be fleas for justice. We can begin to get our country going back in the right direction.
So thank you for what you do, thank you for what you're going to do and I want to inspire you again by showing you a five minute video on The Cradle to Prison Pipeline and thank you again for remembering Vince Hutchins.