Overview of Congressional Interest
in Children's Health Services Research
Improving Children's Health
Through Health Services Research was a special 1-day meeting held June 26, 1999, in Chicago. The state of the science in children's health services research
was explored, including public and private funding opportunities, networks for
conducting research, and uses of research in policy and practice. The meeting
was co-sponsored by the National Association of Children's Hospitals and Related
Institutions (NACHRI), with the Agency for Health Care Policy and Research (AHCPR),
the American Academy of Pediatrics (AAP), the David and Lucille Packard Foundation, the
Association for Health Services Research (AHSR), the Robert Wood Johnson Foundation, and Data
Although Congress is interested in
appropriate Federal interventions related to the health care of children, its
interest in child health issues is not of the same magnitude as its interest
in social security, defense, and Medicare. The Vaccines for Children program
in the first year of the Clinton administration and increasing maternal and
child health coverage, particularly through the enactment of the State Children's
Health Insurance Program (SCHIP) in 1997, are two examples of national initiatives
that have had considerable Congressional interest in recent years.
To effectively influence Federal
policy affecting child health services research, we must ask a number of questions:
- Why is Congress interested in
child health issues?
- How can Congress be motivated
to be interested?
- What Federal interventions are
most appropriate in child health services research?
- What are the challenges to advancing
child health services research with Congress?
Congress, with its interest in national
economic security, is interested in children as the future workforce and as
productive members of society. Congress is also interested in children given
their responsibility as fiscal agents for national health care programs for
children, such as Medicaid and SCHIP and the high return on investment which
comes from assuring healthy children. The Federal government also has a responsibility
to intervene when the market fails to provide for social goods such as with
child health services research and child health care in general. Members of
Congress, given their interest in political survival, respond to the opinions
of their constituencies as reflected by the "soccer mom" issue in
recent elections. Also to be considered in furthering the role of the Federal
government in child health services research are the personal interests of a
number of legislators.
The Federal government can play a
number of roles in influencing what happens with the health care system—they
can inform, facilitate, exhort change, model, invest and regulate. All of these
methods can be used to foster child health services research. To get Congress
to act, one needs to appeal to the motivations mentioned. Obstacles include
the politics of budgets—including competition for research dollars—partisanship
and earmarking. In addition, the importance and value of health services research,
particularly that related to child health care services, is not well understood.
As children's health services research
is but one of any issues, the community of child health services researchers
(and other stakeholders needing the types of information generated by this research)
needs to be motivated to use their resources to influence Federal policy. The
case should be made as to how child health services research related to the
concerns of Congress and the nation. Participants were encouraged to write to
members of Congress to promote legislation to fund child health services research,
such as was sponsored by Sen. Mike DeWine (R-OH) in the 105th Congress.
If you don't ask, you won't get!
Willson P.D. Overview
of Congressional Interest in Children's Health Services Research. Presentation
Summary, Improving Children's Health Through Health Services Research, Chicago,
June 26, 1999. http://www.ahrq.gov/research/congint.htm