Washington's resolute band of budget-cutters and reformers are urged repeatedly these days to avoid throwing the baby out with the bathwater.
The caution comes from defenders of endangered social programs, a seemingly all-inclusive category.
Because one concession leads to another, politically speaking, the quality of mercy is not high. If you save one program, you
may have to save them all. Government would continue out of control and so on.
Still, the advocates will try to be heard, arguing that economies can be achieved in many ways and that balanced budgets are only one important national priority.
When the cutters get to nutrition programs such as WIC, for example, they will be urged to see the links among health, cost savings and personal responsibility. WIC is the acronym for the federal Special Supplemental Nutrition Program for pregnant Women, Infants and Children.
WIC's babies are real, in other words, and its defenders will say there is no bathwater.
Hardly anyone disputes the pro- gram's effectiveness. It was designed to give the children of poor and low-income Americans a healthy start. Though it may be regarded as a welfare program, many recipients are employed.
Successes can be stated clearly: in measurable increases in birth weight, in near-elimination of iron deficiency anemia in infants, in reduction of infant mortality, in hospital cost savings of $3 for every $1 spent on food, in the preservation of human potential. In Maryland, 80,860 women and children are being served at a cost of $36 million per year.
This program and a dozen others would be folded into nutrition block grants and returned to the states to permit flexibility, efficiency and approaches more closely tailored to local needs.
In a speech to the U.S. Chamber of Commerce, Rep. E. Clay Shaw, a Florida Republican who is a leader of the welfare reform movement in Congress, explained the underlying rationale for changes the Republican Party is pursuing.
"The welfare state failed," he said, "because for too may years, Congress equated compassion with money. It failed because Congress equated solutions with one-size-fits-all bureaucratic remedies. And it failed because Congress was afraid to make the tough decisions."
According to the U.S. Department of Agriculture -- which may also be an endangered species because it administers many of the nutrition programs -- Maryland will see a cut of 30 percent in its feeding program allowances from Washington. "Our perspective," says Dr. David Paige, head of the Governor's Commission on Nutrition, "is that this represents an assault on children. It looks as if this generation of lawmakers and citizens have lost perspective because nutritional health is much better. But they're better because of these programs."
Conceptualized and tested in Baltimore 26 years ago by Dr. Paige and others, the WIC idea was to make food available along with advice about nutrition, immunizations and other preventive care dispensed along with the food vouchers at various WIC sites.
Food and antibiotics
"Food was prescribed in the same way antibiotics are," he says.
Then a resident at the Johns Hopkins Hospital, Dr. Paige was working in the Cherry Hill neighborhood, where he saw many women and children suffering from iron deficiency anemia, a debilitating nutritional condition.
"Neural connections [in the brain and nervous system] are maximal in the early years. You have to develop them. That's why the infant has such a rich capacity to learn. But if you don't use them, you lose them."
Five years after Dr. Paige's program redefined the link between food and health, he sent a report of his findings and the program's results to the U.S. Senate's Senate Select Committee on Hunger, chaired by George S. McGovern and Hubert H. Humphrey. A national program was begun immediately.
Dr. Paige wonders where similar leadership will come from today.
"I'm waiting for the president to rally the country behind those federal programs that do work," he said. "If you want children to be able to compete in a technological environment [a stated goal of the Clinton administration], these cuts are absolutely wrong."
Representative Shaw says: "Much like tough love, our bill faces welfare's most difficult problems directly and sends a powerful signal that the government cannot and will not solve everybody's problems."
Meanwhile, WIC finds itself competing with demands for deficit reduction, with proposals for middle-class tax relief, with calls for personal discipline embodied in the Personal Responsibility Act -- an element in the "Contract with America" -- and with other government programs.
Some of these have names more familiar than WIC: food stamps; the school breakfast and lunch programs; and Meals on Wheels. Most, if not all, would face cuts under the current block grant proposal.
Programs for the elderly defend themselves by pointing to the days a generation ago when older Americans relied on pet food for nutrition.
School lunch advocates observe that many children have their most nutritious meal of the day in school. Food stamps were a response to graphic demonstrations of hunger in America, and by many accounts they solved the problem. They are now vulnerable to cuts because they have been, on occasion, abused.
Opposition to these cuts may well be seen as more noise from special interests. If all government programs are defined as "handouts" that threaten self-sufficiency, what good are arguments about effectiveness? Welfare has virtually no defenders, and every government program looks like a form of welfare: all bathwater, in other words.
In some cases, the federal cuts will land on top of state cuts. Maryland is in the process of eliminating a $48 million program for persons too sick or disabled to work.
Prospect of more cuts
Less money and tighter eligibility restrictions will limit or eliminate access to these programs, depending on how states choose to respond. Beyond that, if legal entitlements are erased, programs will be more susceptible to federal budget-balancing or downsizing cuts in the future. From the reformers' viewpoint, that is the point: Real cutting cannot proceed if entitlements block the way.
In the first round of cuts, Maryland stands to lose more nutrition funding than all but four other states. In a sense, this state will be penalized for its efficiency: It offers some feeding programs not available in other states.
And an across-the-board cut will cost more in states like &L; Maryland where welfare limits are relatively low. Since Aid to Families with Dependent Children is 50 percent state-funded, Maryland has kept its costs down by offering lower AFDC payments and supplementing them with food stamps, which is a 100 percent federal program. Now though, more aid means a bigger cut.
Thus, WIC and other programs will be forced to reduce the amount of food for distribution or make eligibility more restrictive. Many of these programs are already running at capacity. A cut might mean that a baby like Cory Staab, age 3 weeks, might get turned away.
Cory came to the Brooklyn WIC center on Thursday with his mother, Andrea Smolak, and brother, Jesse Staab, age 3. Jesse was already enrolled and Andrea was getting Cory signed up. The Brooklyn program is operating now at 102 percent of capacity, which it can do because several other sites are below capacity. If cutting proceeds under the current plan, that flexibility may be lost.
After a recession and a decade of government downsizing, Maryland's food program operators say a new round of cuts will be difficult to absorb. Eligibility restrictions are already quite high and many recipients are employed.
"I see us getting into a fairly dramatic triage situation where people have to make Solomonic decisions," says Linda Eisenberg, director of the Maryland Food Committee.
Personal responsibility is an admirable goal, Dr. Paige observes, but the question is how and where to pursue it.
"These children will have no opportunity to be independent and responsible unless we provide a nutritional head start. If we make these cuts, we'll lose another generation of citizens. We have to make sure the most vulnerable are cared for.
"Some states will do a good job. One or two may do better. But the majority will not be able to match what we're doing now."
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C. Fraser Smith is a reporter for The Baltimore Sun.