Democratic Candidates: What To Do For The Kids

Posted: May 03, 1991

Each Friday, the Daily News' Childwatch editorial - produced with the help of the child advocacy organization Philadelphia Citizens for Children and Youth - presents a single fact about area children.

Together, these facts form a picture of the lives of many of the city's most vulnerable citizens.

The Daily News has asked each of the mayoral candidates to respond to four recent Childwatch editorials.

On Wednesday, the Republican candidates gave their plans for aiding Philadelphia's children. Friday, its the Democrats turn.

Here are the Childwatch editorials to which the candidates responded:

March 29: There are no publicly supported weekend or evening clinics providing pre-natal care in Philadelphia. Between 27,000 and 30,000 babies are delivered a year.

April 5: Four of the eight city health centers which provide pediatric care have waiting lists of more than three weeks for an appointment.

April 12: Almost one of every 10 babies born in Philadelphia is born at low birth weight - about 5 1/2 pounds - a prime indicator of child illness or death

April 19: There are approximately 45,000 children without health insurance in Philadelphia. The city's clinics are open only once a week in the evening to begin to provide for this population.


Philadelphia's children are bearing a shamefully disproportionate burden of Philadelphia's budget problems. They are also paying a tragic price for our city's inability to deliver essential health care services efficiently.

Of course, we must continue to pressure Harrisburg to begin paying a fairer share for children's health care, but the next mayor cannot count on substantial new state or federal funding to solve this crisis.

Here are some immediate actions I'll take, and principles I'll follow, if I'm elected mayor:

* Restructure city health care programs to put the bulk of our resources into prevention, rather than treatment.

We simply don't have enough health care dollars to address all health care problems for children from low-income families. But prevention is far more cost-effective than treatment - especially where acute illnesses are concerned. Money spent up front for such things as pre-natal care, inoculations and early childhood medical check-ups will very quickly translate into children with fewer - and less costly - medical problems. The savings

from preventing even just a few premature and low-birth-weight babies, for example, could run well into the millions of dollars.

* Considering contracting out more city health care services.

Many experts claim that private (non-profit) hospitals could do a better job of providing the basic health care services now provided by the city, and do it for considerably less money.

* Streamline paperwork and administration, and overhaul the entire service delivery system to eliminate waste and make health care services more efficient.

Our social service delivery system is in shambles.

If we put our heads together, I'm confident we can find ways to save enough money quickly to allow us to keep most city clinics open during evening hours.

* Institute a "managed Medicaid" program, beginning with a pilot project for Philadelphia children.

* Stop pretending that the teen pregnancy problem will go away if we ignore it, and make our public schools significant providers of pre-natal care and parenting education for teenaged mothers and fathers-to-be.

* Increase private sector involvement in city health care and social services to children.


No one can truly claim to care about the future without caring about the future of our children.The budget crisis will come and go.The crime rate will rise and fall.But our children will always remain the key to our future.

As mayor, my position will remain consistent with the one I have always taken throughout my public service career: adequate health care is a basic right everyone should be entitled to, particularly our children.I marched to protest the closing of Philadelphia General Hospital because it provided many of the medical services we no longer have.

How can we make plans for the 21st century without first addressing the fact that no clinics are available for prenatal care of 30,000 babies delivered each year?There are waiting lists of three or more weeks for pediatric care.There are 45,000 children without medical care.

I would put an end to health care deprivation among our children.I would enlist the assistance of the private sector and religious organizations to help supplement funding for health care facilities for our youth.I would initiate an aggressive health care education program that would reach out to pregnant women.This program will inform them help is available, and encourage them to seek that help.

I would strongly encourage our schools to become more active in making sure children receive adequate health care, not only by employing comprehensive medical teams, but also by initiating more frequent testing for childhood diseases.

As mayor, I would make a personal commitment to assure every needy child will have access to health care facilities.


There is nothing more important to our city's future than our city's children. But too many of those children fail to receive the health care they need to go on to healthy, happy, and productive adult lives.

Insufficient funding and inadequate management of our health care system has placed the next generation of Philadelphians at risk. Approximately 37 percent of our city's children now live in poverty, where are they more likely to suffer illness, malnutrition and injury - and less likely to receive preventive care or have medical insurance.

Our city's district health services supply free medical care for those who are uninsured. But as the Daily News's "Childwatch" has observed, the wait for medical care at these centersis measured in weeks, not hours. Such underinvestment in the health and well-being of our city's children and

families is penny-wise but pound-foolish: Investment in preventive health care has consistently proven cost-effective in the long term. Every $1 in prenatal care alone saves $3 in hospital costs resulting from low birth weights and premature births.

We must therefore work with our leaders in Harrisburg to ensure that the state meets its moral obligation to properly fund the health of our children. Meanwhile, there is much that we can do here in the city to improve the delivery of health care for our kids.

We must bring a poorly coordinated variety of federal, state and city programs together under one roof wherever possible, and provide a case-worker system that can track each family's needs and help them through the maze of health care, housing and nutrition programs.


These statistics are shameful: the infant mortality rate in some Philadelphia neighborhoods is higher than that in many Third World countries. In a city which is one of the medical capitals of the world, these statistics compel a strong response by the next mayor.

The key strategy must be to secure appropriate state funding for health and human service needs.

I would initially seek to demonstrate to the state that my administration was capable of managing effectively. If this did not persuade, I would certainly be willing to take any measures - including legal action - to force the state to assume a greater share of these costs.

But it's all too easy to use Harrisburg's underfunding as an excuse . There are many avenues that we can pursue locally.

First, city health centers need to have hours more appropriate for the population they serve. Currently, most health centers are open only during regular business hours; we have to expand health center hours into evenings and weekends.

Second, we can't expect the city's health centers to do the job alone. Private hospitals should also take an active part in meeting the health needs of Philadelphia's low-income population.

Third, we can make better use of resources we already have in the public and private sectors alike. For example, the CARING program, established by Independence Blue Cross, is an innovative approach to providing private health insurance for low-income Philadelphians.

Fourth, we need to emphasize prevention in our children's health policy. Children need to have established relationships with health care providers at the earliest possible age - before a crisis (like the measles epidemic) overwhelms emergency rooms and health centers


The welfare of Philadelphia's children was always my top priority as the city managing director, and will continue to be as the next mayor.

A major part of this commitment to guaranteeing the well being of our children is the provision of medical care through the Department of Public Health's eight district health centers.Consistent with this recognition of the importance of these facilities, I have stated consistently throughout Campaign 1991 that, as mayor, I would not close or privatize any of these centers.

The following are my specific responses to the Childwatch editorials:

* Lack of publicly supported weekend or evening prenatal clinics.

As a direct result of my leadership as the city managing director from July 1, 1985, to March 31, 1990, the operating hours of five prenatal clinics were extended. My goal as mayor would be to have eight fully staffed prenatal clinics open at least two nights per week and also each Saturday.

* Four of the city health centers which provide pediatric care have waiting lists of more than three weeks for an appointment.

The long waiting time for new appointments is unacceptable, but is the result of a lack of adequate staff at the District Health Centers coupled with the increased patient load created by the successful efforts to encourage more patients to bring their children in for medical treatment.

I will aggressively pursue additional federal and state funding, as well as foundation grants, to enable the city to allocate sufficient additional resources to the eight District Health Centers so that the current waiting time for new appointments will be reduced to one week.

* More than one in 10 babies is born at low birth weight.

During my tenure as managing director, the Department of Public Health developed the High Risk Infant Follow-Up Program to provide home visits to low birth-weight infants and those at risk.I will expand this program to double its current caseload by the end of fiscal year 1993 by requesting an increase in the state grant and seeking foundation funding.

* There are approximately 45,000 children without health insurance in Philadelphia.

Many of the 45,000-50,000 children in Philadelphia who do not have health insurance are in families of the working poor.A large number of blue collar workers (especially women), do not receive health insurance with their jobs, but their wages put them above the Medical Assistance Eligibility level.They must, therefore, depend upon the District Health Centers for all of their medical care.Because of this, evening and weekend hours at the District Health Centers are absolutely necessary.

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