An Op-Ed As Published by the Sacramento Bee
In the final months of 1945, Charles de Gaulle embarked on the process of rebuilding postwar France. For the second time in the 20th century, his nation had been devastated by its hostile German neighbors. Scores of young men had been killed, birthrates were low, and maternal and infant mortality rates were frighteningly high. The future of a generation of citizens was at stake – and was at the mercy of a nation in ashes with a broken health care system.
Out of this smoldering crisis, de Gaulle provided leadership to conceive and implement the French Maternal and Child Health system, called La Protection Maternelle et Infantile. PMI evolved as a prevention- and wellness-oriented system for mothers, infants and children, and relied upon regional-local administration of a program with national goals.
The system intuitively recognized that critically important services such as pediatrics, preschool, child care and child welfare had to be seamlessly integrated around the needs of parents and families. The key success measure for the system: improved maternal and infant mortality, and other prevention indices.
More than a half-century later, the French PMI and health system serve as the envy of maternal and child health in the industrialized world. Despite the challenges of poverty and immigration, France has consistently maintained infant mortality rates that rank among the lowest of its global counterparts.
If a crisis can serve as a catalyst for innovation, then an opportunity presents itself here in California to spur public-private partnerships to re-engineer our woefully dysfunctional systems. It makes sense for the federal stimulus package to emphasize the creation of jobs and the rescue of vital services that address human needs. But California's state and local elected leaders should take a little time to identify strategies that provide short-term economic boost in combination with long-term strategic value. For example:
• A "100 percent" enrollment campaign targeting children and families in public programs that combat poverty: the SCHIP/children's health insurance program, the earned income tax credit program and the food stamps program. Let's ensure that every Californian eligible for these federal programs is enrolled, and let's overhaul the systemic and bureaucratic barriers that have stymied effective enrollment of California's families for years.
• Green jobs and health jobs training: worker training in the high-growth and emerging industry sectors of green and health jobs, respectively, has the potential to transform how work force development and educational efforts prepare current and future workers – especially underrepresented youths of color. Work force training dollars could be coupled with other activities supported by stimulus package money, such as green construction, health information technology infrastructure and strengthening of the primary health care system.
• Schools as community centers: In many low-income communities, the local school serves as the bastion of community activity and civic engagement. Construction dollars could be used to help upgrade and transform schools so they provide a long-lasting benefit to all community members, not just children. They could provide English as a second language capacity, adult education, and financial literacy and physical fitness facilities for kids and community residents after hours.
As state, county and city leaders weigh how they will deploy an unprecedented level of federal spending in distressed communities, the safe and easy path will be to quickly infuse spending into the fragmented, shortsighted efforts that constitute business as usual. It is our sincere hope that our leaders resist this temptation. Leveraging new ideas, new partnerships and new rules focused on results will provide immediate doses of hope – in combination with a more sustainable economic future for California.
Times are indeed tough for many Californians. But history has proved that crises are blessings in disguise.
Robert K. Ross, M.D., is president and CEO of the California Endowment, a private, statewide health foundation. John Hope Bryant is founder, chairman and CEO of Operation Hope Inc. and vice chairman of the President's Advisory Council on Financial Literacy. They both live in Los Angeles.