The "Healthy Start" program

You might have seen the front page article in the Oregonian today singing the praises of the 'Healthy Start" program. Healthy Start was first funded in the 2001-03 budget as a high priority of Gov. Kitzhaber.

In his budget proposal that session, Kitzhaber described Healthy Start as a program to "Screen every first born child in Oregon for medical and psycho-social risks." Then, when risk factors are present, Healthy Start basically becomes a partner in helping the parent bring up the child.

According to Kitzhaber, up to 60% of Oregon families have some risk factor that warrant some level of services from the Healthy Start program.

Does this sound like the appropriate role of government? The government is going to insert itself as a partner in 60% of Oregon homes because it deems the parents to be in some way deficient?

When you start digging into the details of the Healthy Start program, it gets downright scary. The roots of the philosophical underpinnings of the program are overtly totalitarian.

Here's how it works: Healthy Start workers hang out in maternity wards, and pop in on the new mothers, bearing gifts of useful things like breast pumps, baby bottles, diapers, etc. The worker conducts a "verbal screen," by asking a series of intrusive questions about the mother’s marital status and history, education, socio-economic status, family background, and the like.

If the worker identifies any "risk factors," a followup home visit is scheduled, where a more complete risk inventory is conducted based on information the worker gleans from more intrusive questions and by observing the home environment.

There are a few different instruments the workers use for this inventory. One of the most widely used is called the Kempe Family Stress Checklist (KFSC) which is a list of ten invasive, open ended questions that are asked of both parents, and is supposedly geared toward identifying parents who are predisposed to child abuse.

The KFSC, as the name implies, was created by C. Henry Kempe, who was an interesting fellow. He wrote the 1968 book "The Battered Child," which brought child abuse to national attention. He was an unabashed proponent of the view that children are the property of the state, and he proposed a universal, compulsory home visitation program to keep an eye on what parents were doing with their children.

The model he proposed back in the 1970's was endorsed wholeheartedly by Hillary Clinton in her book :"It Takes a Village," and is basically the framework for the Healthy Start program in Oregon and other states today.

Kempe believed that parents are essentially just agents of the state in the upbringing of children, and thus their custody could be ended by the state at any time. He was clearly an admirer of totalitarian societies:

"Where the state is supreme, the particular problem is easily managed; in a dictatorship each child belongs to the state and you may not damage state property. The really first-rate attention paid to the health of all children in less free societies makes you wonder whether one of our cherished democratic freedoms is the right to maim our own children."

Of course he was dead wrong about the "first-rate attention" kids got in communist countries. The orphanages in Soviet controlled Romania were horrifyingly squalid cesspools where thousands of children died of malnutrition. The Red Chinese government run orphanages had a mortality rate of at leasat 72% according to Human Rights Watch - Asia in 1989.

Dr. Sam Watson, who co-wrote a book about home visit early intervention programs, once said:

"Kempe, despite his reputation as a great humanitarian, praised totalitarian states and urged that we adopt a totalitarian child care policy. The seed of Kempe’s vision has been planted, it has been watered with taxpayer money. Whether it will grow to fruition depends upon the American public. It is vitally important that we educate families and parents about the dangers of home visitation programs, and the totalitarian nature of the vision behind those programs."

OF COURSE the Oregonian would try to help it grow by watering it with a paean of praise.