Path: bloom-picayune.mit.edu!snorkelwacker.mit.edu!news.media.mit.edu!americast.com!americast.com!usa-post Newsgroups: usa-today.issues,americast.usa-today.issues From: usa-post@AmeriCast.Com Organization: American Cybercasting Approved: usa-post@AmeriCast.com Subject: issues Tue, Sep 8 1992 Date: Tue, 8 Sep 92 04:30:16 EDT Message-ID: 09-08 0000 DECISIONLINE: Issues & Debate USA TODAY Update Sept. 8, 1992 Source: USA TODAY:Gannett National Information Network Here are some of the issues and topics being debated across the nation Tuesday morning in USA TODAY: Prenatal care, Private school. TODAY'S DEBATE - PRENATAL CARE: USA TODAY'S OPINION: Some of society's largest problems tip the scales at under 5 1:2 pounds. They're low birth-weight babies. As articles ... in (Tuesday's) Life section point out, they create costs far out of proportion to their dimensions. Because so many are born to the poor, taxpayers pay much of their $2.5 billion annual bill. And that's nothing compared to the emotional toll. The tragedy: Low birth weight is largely preventable, but the numbers keep going up, to 7% of all births in 1989, the highest rate since 1978. ... Most causes and cures for low birth weight are known. What's needed is the money and will to make that knowledge work. The best place to begin is for the federal government to build on what's working in neighborhoods: Promoting prenatal care through home visits. Home-visiting programs dispatch trained workers - nurses, social workers, educators or community workers - to help families find their way to the social services they need. With expectant mothers, this means identifying those at risk because of age or habits - drugs, smoking, drinking - and steering them to treatment, nutrition and medical programs. The National Commission to Prevent Infant Mortality says this low-tech approach reduces the incidence of low birth weight and increases use of preventive health services. And a 1990 General Accounting Office report says home visiting saves money in the long run. So far, home-visiting programs survive on private, local, state and federal funds. They need more from all. Although home visits are a low-cost alternative to high-cost treatment in the long run, they will be expensive at first. For the tiniest babies, that's an investment worth finding the money for. OTHER VIEW: HARRY SCHWARTZ, a New York writer who specializes in medical topics: The beginning of wisdom is understanding that there are serious limits on what government can do. ... Those who look to government to stop the tragic epidemic of low birth-weight babies are doomed to disappointment. These optimists assume that if only suitable outreach gets word to at-risk mothers about prenatal care and proper diet, the problem will disappear. ... We've been trying to do this sort of thing for decades. In the early 1960s, one of the arguments for starting Medicaid was the prediction that by making medical care available to the poor, low birth-weight babies could be avoided. The insuperable problem is the existence of substantial groups of people who have deliberately distanced themselves from the norms of society and therefore from much of the help they otherwise could receive. I am thinking of the thousands of young women who regard daily promiscuity and crack addiction as normal. ... these poor women have no respect or concern for the babies they produce so often and at such young ages. We are applying the utmost of expensive, high-tech medicine to try to save the one-pound or pound-and-a-half babies that often result. The effort often fails and, when it is successful, the human being that emerges frequently has appalling disabilities. Here is an area in which benign neglect is probably the best we can do, especially if combined with a rule that Medicaid will not try to save any baby weighing less than 2 1:2 pounds. VOICES ACROSS THE NATION ON GOVERNMENT PAYING PRIVATE-SCHOOL COSTS: SILVER SPRING, Md., Laurie Perper, 49, statistician: No. Competition is fine within public schools, but I don't want the government to get involved with subsidizing religious and private schools. You really wouldn't have equal access to the more expensive schools because they would still hike their fees. CORONA, Calif., Maria Merchant, 29, sales representative: It's an opportunity for people who are financially depressed. I do worry that public education would suffer, but it's better that children are allowed to go to private schools. KALISPELL, Mont., Charles Van Dyke, 78, retired: I don't believe in that because the rich will still choose the private and parochial schools. The poor have no choice: $1,000 wouldn't be of any value. What we should do is have a national curriculum. We should study other countries, like Japan. JACKSONVILLE, Fla., Myron Taylor, 39, teacher: It would be a good idea as long as some kind of tracking system is in place to keep up with the candidates and as long as the funds are distributed equally so as not to discriminate as to race. Also, public school teachers should have the opportunity to teach in the parochial schools. OMAHA, Neb., Emily Edmunds, 20, student, model: I support it. It will put pressure on the public schools to decrease the ratio between students and teachers and put some pressure to bring them up to par with the private. Idealistically, it sounds great, but I also wonder where the money is going to come from. Issues & Debate Editor: Kate Coughlin. (1-919-855-3491) Making copies of USA TODAY Update (Copyright, 1992) for further distribution violates federal law. This article is copyright 1992 Gannett News Service. Redistribution to other sites is not permitted except by arrangement with American Cybercasting Corporation. For more information, send-email to usa@AmeriCast.COM