Overview of Congressional Interest in Children's Health Services Research

Peters D. Willson

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 Harbor, Inc.

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!

Internet Citation:

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