It’s heartening to see that, among the many executive orders President Biden has signed during his first days in office, there’s one that makes clear that children are among his primary concerns. Indeed, his plan to significantly expand benefits for children in low- and middle-income families will make a meaningful difference if enacted, mitigating poverty’s corrosive impact on millions of the youngest, most-vulnerable people in our country.
We believe that’s only a start, however. There’s a complementary action he can take that will even more pointedly, systemically jump-start fulfillment of his promise to “Build Back Better.” It is this: Issue an executive order to begin coordination of the numerous, disconnected programs and systems that aim to improve the health, safety and well-being of children.
Even at this deeply discordant time in our history, we believe nearly all Americans could support that goal. It would be the “moonshot” of our generation, with positive impact that would last far into the future. While there would certainly be costs to fully implement it, the launch would be relatively inexpensive and the return on investment would be enormous.
Today, government systems that provide healthcare, social services, education, housing and other programs that assist children and families operate mostly independent of each other. That means parents struggle to get the help they need — or even to figure out where to look for help — while service providers lack the ability to get a full picture of what needs have to be addressed. And that will remain the case even if Biden’s plan to increase tax benefits for children is enacted.
The solution is to connect programs and systems with the same methodology that has sparked innovation and yielded positive results in other sectors, including technology, banking and manufacturing. It is called “interoperability” and, quite simply, it means enabling the routine exchange of information across the various “silos” in which data are currently held.
We strongly urge the new administration to use an executive order to jump-start a national interoperability initiative that would initiate the seamless, secure and confidential exchange of information as a hallmark of Building Back Better.
The Affordable Care Act of 2010 (ACA) envisioned just this kind of approach to stimulate integration and coordination across the myriad agencies and organizations that serve children and families; indeed, some interoperability efforts were made during the Trump administration. Despite a broad consensus that this approach works, however, it hasn’t been widely implemented for a variety of reasons, many of them cultural and political.
An executive order — including creation of a Children’s Advocate in the White House — could mandate actions for states and localities that most already believe are worth taking. Furthermore, provisions of the ACA specify that the federal government can pay up to 90% of a state’s costs of implementing interoperability, which would enable structural changes to permanently connect the relevant systems. The political lens through which some states have viewed the ACA has impeded wider use of those provisions, but a presidential mandate could shift that reality.
It isn’t just children who would benefit. By its very nature, an interoperability initiative would lead to systemic changes that would contribute broadly to more-efficient and -effective programs and services for people of all ages, races and socioeconomic groups.
But children are the right initial focus. Helping them should be a cause that all sides of the political divide can agree upon and, quite simply, it’s the right thing to do.
The prescription we’re suggesting is not controversial. Interoperability has been enthusiastically embraced by the private sector and governments at all levels, irrespective of their leaders’ political leanings. It entails bringing a proven methodology to scale, beginning with leadership from the top, so we can get moving ASAP.
Taking this action would improve the lives of tens of millions of children who don’t get enough to eat, don’t have a decent place to sleep, don’t receive equal educational opportunities and, more generally, don’t have routine, equal access to the building blocks of health, well-being and life prospects.
Every politician says it: Children are our future. The new administration has the opportunity to demonstrate that they are also our priority.
David A. Ross, ScD, is President and CEO of The Task Force for Global Health. Daniel Stein is President of the Stewards of Change Institute