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Critic Assail Cuts in Health Program

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Child Health Day came and went quietly Oct. 5, but most of the witnesses at a hastily convened special Congressional hearing on child health agreed that there was little cause for celebration anyway.

The Presidential proclamation naming the day was issued Sept. 28, the same day the Administration called for another round of budget cuts in domestic spending programs. If passed, witnesses critical of the reduced funding said, the budget cuts could lead to the demise of numerous child-health programs.

The President's proclamation said: "Our future as a nation lies in the healthy development of our children. That development must be fostered from the earliest stages so that our twigs and saplings will grow into straight and strong trees. We must actively promote child health through the positive approach of preventive care, such as early prenatal care for mothers, assured immunization against dangerous childhood illnesses, and early identification of handicapping conditions."

The hearing was called by Congressman Henry A. Waxman, Democrat of California, who chairs the House Subcommittee on Health and the Environment.

Mr. Waxman praised the President's action but said that he could not "reconcile these stated policy goals with the actual priorities reflected in the Administration's budget. I find," he continued, "the actions of the Administration to run in precisely the opposite direction to the lofty sentiments of the President's Child Health Day proclamation."

On the state level, most of those testifying said, federal budget cuts would not only eliminate programs directly funded by the federal government, but would have much broader effects. They expressed particular concern over proposed cuts in the Maternal and Child Health Block Grant, for which funding could decline between 25 and 37 percent.

In Vermont, for example, a 25-percent cut in funding would force the state's health department to immunize 3,574 fewer children, according to Dr. Richard Narkewicz, a practicing pediatrician from South Burlington. A 37-percent reduction in funding could mean 5,290 fewer immunized children.

In Mississippi, which has the highest infant-mortality rate in the United States--18.3 infant deaths per 1,000 births--the proposed 25-percent cut would significantly reduce or eliminate many of the services provided for mothers, infants, and children by state and county health departments, according to an analysis released by subcommittee staff members.

Services Eliminated

A 28-percent cut would force the state to eliminate essential services for mothers and children; a 37-percent cut would "virtually destroy" the entire structure of health care for low-income mothers and children.

New York City would also be forced to cut programs for children and youth that emphasize preventive medical care, according to the analysis. The city's various projects for these groups logged more than 496,000 visits from low-income persons, the subcommittee report said. With a 37-percent budget cut, the number of users would be reduced by 50 percent.

State officials said they are sensitive to the tight federal-budget situation. William L. Kempiners, the director of the Illinois Department of Public Health, said he approves of the Reagan Administration's budget-cutting measures.

"All of us are in a budgetary bind which must be dealt with in such a way that the people of the nation and states will not have to sacrifice necessary and essential services. This, of course, includes child health programs," Mr. Kempiners told the subcommittee.

"The real question facing us," he said, "is how are resources to be distributed and which programs will be considered priorities in the eyes of the decision-makers."

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