A Vote for Repeal of Health Care Reform is a Vote Against Children (and so our country's future)

My forthcoming book, that has a publication date of September 2011, offers over 150 pages of evidence, based on more than 30 years of research as well as my 25 years of experience as a pediatrician, that supporting parents' efforts to be fully emotionally present with their children, to be curious about their children's minds and the meaning of their behavior, will lead to a generation of citizens who are emotionally healthy, resourceful, and adaptive to a complex social world.

The last chapter, entitled "Beyond Medication" places this view up next to an alternative paradigm offered by the combined forces of the health insurance industry and pharmaceutical industry. I am currently in the final stages of editing this last chapter. This morning I came upon this sentence, that occurs following a section in which I describe obstacles to quality care for children and families. The sentence reads:

Often when I see a family in my office [with a mental health concern] we can clearly see what is needed but cannot get from here to there. I believe there is hope, however, in this age of health care reform.

As I write this, repeal of health care reform is being debated in the House. Fortunately repeal is unlikely to happen, given its support in the Senate and Obama's veto powers. So I probably won't have to take that sentence out of my book. Still, the fact that repeal is even being discussed makes me very uneasy.

Health care reform as it stands does not directly address these obstacles to care, but is, in my opinion, a critical beginning. Next must come a renewed value on prevention, primary care and mental health care. These changes will serve to promote our children's healthy emotional development.

A vote against health care reform is a vote for the insurance companies. The powerful health insurance industry together with the pharmaceutical industry obstruct true progress in promoting children's healthy emotional development, because both support the quick fix over more difficult, yet safer and more lasting relationship-based interventions.

In this last chapter of my book, I also describe the 40 fold increase in the diagnosis of bipolar disorder in children and the exponential increase in prescribing of atypical antipsychotics, a highly profitable class of drugs, to very young children. I put the issue in perspective by including a sentence about the influence of the pharmaceutical industry on Joseph Biederman, the child psychiatrist at Harvard who is primarily responsible for this phenomenon. Here is the sentence I added this morning.

Further complicating this story is the fact that Biederman was found to have earned at least $1.6 million in consulting fees from companies that make these drugs, while reporting only $200,000 of this income to his employer, Harvard University. He is currently under investigation for possible violation of federal and university research rules designed to police potential conflicts of interest.

The health insurance industry and the pharmaceutical industry often seem not to have our children's best interests in mind. Yet as Nobel Prize winning economist James Heckman has argued, an investment in young children is an investment in our country's future. Health care reform as it stands is an essential first step in the right direction.