Over the past few weeks in my pediatrics clinic in southeast Washington DC, as I have wished Merry Christmas to my patients and families, I have pondered about the Three Wise Men who paid homage to Jesus, an infant born in poverty. As we all know, they traveled a great distance and came bearing meaningful gifts of gold, frankincense, and myrrh because of their belief in the promise of a child. The scripture has made me ask the question, are the self-proclaimed wise men of today giving the best of themselves for our children, especially those born in poverty? What would be the modern equivalents of gold, frankincense, and myrrh today?
The meaning of gold is obvious, and to me its modern equivalent is funding for programs and assistance that address the needs of our country’s children. It was tragic to watch some members of Congress squabble over how to fund unemployment insurance (which was a part of the bickering over the payroll tax cut), and other critical elements of the social safety net. Unemployment insurance (the average UI check is about $300 per week) provides vital assistance to 3.1 million Americans struggling to make ends meet, even if only temporarily. Maintaining this poverty-reducing support should not be as difficult as Congress makes it out to be.
Together the Child Tax Credit and the Earned Income Tax Credit (EITC) lift more children out of poverty than any other program. The American Recovery and Reinvestment Act in 2009 made improvements to the Child Tax Credit, providing up to $1,433 more for families earning wages at or just above the minimum wage. Similarly, the EITC was expanded for married couples and families with three or more children. These provisions, combined with others in ARRA, kept 2.4 million children out of poverty, but the future of these policies is uncertain after 2012.
Right now there are many who question whether we can afford to build upon these efforts and to develop new innovations in reducing poverty. My argument is that we cannot afford not to. Every year, child poverty costs our economy $500 billion dollars in health care expenses, lost productivity, and criminal justice. Parting with the “gold” for unemployment insurance, EITC, housing, and TANF is easier when it is rightly seen as an investment – in both our financial and our moral future.
To understand the significance of frankincense, it helps to know that it is a resin once used for medicinal purposes: healing wounds, treating arthritis, repelling mosquitoes, etc. It was (and still is) a symbol of health and life to many people. As a pediatrician, I feel the modern corollary to frankincense could be Medicaid, which takes care of multiple health needs for millions. Nearly all of my patients in southeast DC are enrolled in the program, which allows them to get regular check-ups, dental care, eye exams, mental health care, and much more. Today, Medicaid and the Children’s Health Insurance Program (CHIP) is the nation’s largest health insurance program for children, providing access to health care to 38 million children – that’s 1 in 3 – across the country.
Unfortunately, there are still 8 million uninsured children in our country, but 2/3 of them are eligible for Medicaid/CHIP. Sadly, certain members of Congress and other Presidential candidates want to convert Medicaid into a block grant program or apply unfair spending caps to it. These measures would allow the states the so-called “flexibility” of denying more children access to health care. Such ill-advised policies ignore Medicaid’s proven fiscal efficiency: costs of health care per patient in Medicaid have grown slower than costs per patient with private insurance: 4.6 percent versus 7.7 percent per year. Children make up half of all Medicaid recipients, but account for just a quarter of the program's total costs. Clearly, this program, even with its imperfections, should be valued as a gift. Rather than finding ways of undermining Medicaid and CHIP, our political leaders must find ways to support this lifeline to children, the elderly, and the disabled.
The Three Wise Men’s last gift, myrrh, is another resin, once used for mummification in ancient Egypt, for medicinal purposes, and it still has spiritual value to many cultures. It was a gift of faith in what Baby Jesus would grow to be and do for mankind. Such a gift does not require a modern equivalent, but I do question whether our society really demonstrates its faith in children. The above threats to their health care and their basic financial support reflect a commitment to maintaining spreadsheets and to political arithmetic, regardless of the costs to children in poverty – now almost 6 million, or 1 in 5. As a percent of total federal spending, investments in children fell to 8.4% in 2011. The fact that the policies and programs with proven service to children are consistently the first items on the budget chopping block is an indication of how shallow our faith really is.
If our political leaders had more faith in our children’s capabilities and aspirations, then they would open more doors than just the janitor’s closet when it came to creating job and career opportunities. Doing the hard work of providing health care, education, housing, and opportunity for children requires not just tough decisions over limited resources, but also a solid faith in our children’s potential. Such a commitment would lead us to readily provide our children with the best of ourselves.
There are obviously other interpretations on the significance of the Three Wise Men’s gifts, and I recognize how my experience as a pediatrician caring for children in poverty influences my perspective. However, regardless of one’s beliefs about this Christmas story, we find that when the Three Wise Men paid homage to an infant born in humble circumstances, their faith drove them to take action, to go the distance, and to provide resources. That is a timeless example for all of us to follow for all of our children.
