Community pediatrics from the federal government's perspective

Community pediatrics has enjoyed remarkable success in recent years. While I have touched on some of that progress and some of the current issues in child health care, it is apparent that many challenges continue to face the field. In the coming months, one can expect many of these issues to enter the health-care reform discussions. The questions that will arise are not unlike those about mental health care: how large will the benefits package be, what kind of reimbursement system will be used, and who will be the provider? Optimism about the answers doesn't reign every day. In the chairman's preface to Beyond Rhetoric, the final report of the National Commission on Children, Senator John D. Rockefeller IV wrote: It is time for our country to recognize the pressing need to ensure accessible, affordable health care, and take the necessary steps to enable children to be born and grow up healthy and to become able, productive adults...(H)istory will judge this generation of Americans harshly if we allow futile debate to take the place of action. For millions of children and families, the hour already is late. One can look at numerous reports on child health over the past 30 years and find similar impassioned calls to action--with little subsequent action. I hope it will be different this time.