The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

Tuesday, September 13, 2017

The Topic: Subsidies and Skyrocketing Medical Costs

The News Story: “Help Is On the Way” for Toronto Families Waiting for Childcare Subsidies

The New Research: Subsidizing Day-Care—The Medical Costs

 

The News Story: “Help Is On the Way” for Toronto Families Waiting for Childcare Subsidies

Mayor of Toronto John Tory pledged recently that “help is on the way” for families who can’t afford to send their children to day-care centers. 

The Mayor made the comments during a ribbon-cutting ceremony for a newly renovated and reopened day-care center in Toronto’s Scarborough district. Reported a Toronto news station, “Tory touted the city’s latest addition to its pool of city-owned childcare spaces is ‘progress’ but acknowledged that more needs to be done to alleviate the families who either cannot afford the growing cost of childcare or haven’t been granted a spot or subsidy.” “This particular centre,” the Mayor said, “is especially important . . . because it falls within the Scarborough Village neighbourhood where there is a high density of apartments and multiple family households and where 27 per cent of families are single-parent led families.”

Although it certainly wasn’t his aim, Tory unwittingly let out the big secret that progressives like to hide: as families fall apart, government intervenes to pick up the pieces. Alas for Big Brother, the system of day-care subsidies leads to other costs further down the road. 

(Sources: Rachael D’Amore, “‘Help on the way’ for Toronto families waiting for childcare subsidies, Tory says,” CTV News, August 31, 2017.)

 

The New Research: Subsidizing Day-Care—The Medical Costs

Government officials around the world recognize the direct budgetary cost of subsidizing the day-care centers now caring for millions of young children. What they might not realize is how putting these children in day-care centers is driving up medicals costs borne by both parents and governments. But two new studies—one from Denmark, one from South Korea—underscore the medical cost of the global rise in single-parent and/or working-mother homes.

Lauded by progressives around the world for its extensive system of day-care centers, Denmark now claims international prominence in a way it may not welcome: doctors now surgically insert ventilation tubes in ears in a higher proportion of young children in Denmark than they do in any other country on the planet. Such tubes are typically inserted only after children have repeatedly suffered from middle-ear infection (otitis media). 

Denmark’s unparalleled rate for the insertion of ventilation tubes was recently documented by a team of researchers affiliated with the University of Copenhagen and Denmark Universite Paris Descartes. After analyzing data for all Danish children who had ventilation tubes inserted in their ears between the 1st of January1997 through the 31st of December 2011, the researchers concluded that “nationwide the prevalence of VT [ventilation tube insertion] was 24% in children aged 0 to 3 years, with a significant increase over the study period.” In contrast, the researchers note, “in the United States [only] 6.8% of children have had VT before the age of 3.” The researchers indeed acknowledge that Denmark now has “the highest incidence [of such surgical insertions] recorded in the world.

Why does Denmark now stand out in this dubious way? The researchers identify a family history of middle-ear disease and the presence in the home of older siblings as predictors of ventilation-tube insertion. But they also acknowledge another significant cause, one raising questions about progressives’ enthusiasm for Danish reliance on non-maternal child care. The researchers report “early start in daycare” was associated in their data with an increased likelihood of ventilation tube insertion” (p = 0.0577), hardly an irrelevant association for this analysis given that “in Denmark, children are typically attending daycare centers within the first year of life.”

What the Danish scholars have established in their recent investigation harmonizes all too well with the findings of a recent study in South Korea on “the prevalence and economic burden of OM [Otitis Media] in Korea.” In Seoul as in Copenhagen, researchers looking at children suffering the ill effects of middle-ear infections end up looking at—and asking hard questions about—day-care centers as a substitute for maternal care.

Affiliated with Kyung Hee University and CHA University School of Medicine, the authors of the new Korean study parsed data from national health insurance claims for 2012. These data indicate that for the year in question 1,788,303 Korean patients received medical treatment for otitis media. The scholars calculate that the burden of treating all of these patients totaled 497 million US dollars, mostly the direct cost of the medical care itself but partly “indirect costs” such as “work-loss costs.” By way of comparison, the researchers note a 2004 study concluding that “the annual economic burden of OM in the US is approximately 3–5 billion US dollars (USD), although the real cost may be higher, because of underestimated indirect costs.” Though the total cost of treating middle-ear infections may run considerably lower in Korea than in the United States, with its much larger population, the Korean researchers stress that the economic burden incident to middle-ear infection in their country is still “substantial”:  “The economic burden of OM,” they point out, “accounted for more than half of the burden of breast cancer.”

But in Korea as in Denmark or any other country, middle-ear infections mostly occur in children.  Children under the age of nine years accounted for more than half (60%) of the patients identified in the Korean analysis and for more than half (55%) of the total consequent cost.

And like their Danish colleagues, the authors of the Korean study interpret their findings in part by relying on previous research showing that “daycare attendance is a significant risk factor for A[cute] OM.”

Because of the dominance of day-care-affirming progressive ideology in higher education, it must have taken some courage for the Korean scholars to wonder about “the Korean government . . . increas[ing] its funding of daycare centers, with approximately 77.3% of <5-year-old children attending a daycare center.” These scholars even have the temerity to call for “further research . . . to evaluate how promoting daycare may affect the prevalence and burden of OM.”

Middle-ear infections and the medical treatments required to treat them constitute but a small part of the harm inflicted by the global substitution of day care for maternal care. But asking straight questions about even that small part of the harm may start the overdue discussions—in Europe, in Asia, and around the globe—about just what burdens governments are placing on their people by promoting nonmaternal child care.

(Source: Bryce Christensen and Nicole M. King, forthcoming in The Natural Family. Studies: Tine Marie Pedersen et al., “Incidence and Determinants of Ventilation Tubes in Denmark,” PLOS ONE 11.11 [2016]: e0165657, Web; Young-Eun Kim et al., “The Economic Burden of Otitis Media in Korea, 2012: A Nationally Representative Cross-Sectional Study, “ Biomedical Research International 2016 [2016]: 3596261, Web)