Disability in America Toward a National Agenda for Prevention (1991) / Chapter Skim
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Appendix B: Dissent and Response
Appendix B: Dissent and Response
Pages 328-339
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From page 328... ...
The sponsors and funders of the study asked the committee to prepare a broad agenda for disability prevention; however, they structured the task and exercised influence over the committee and staff so as to produce a report that would bolster their own political agendas.
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From page 329... ...
A recommendation for universal health insurance that had been in earlier drafts was dropped from the final report. No recommendation deals with access to health insurance for people with chronic disease and disabilities, despite the acknowledged severity of this problem in Chapter 8.
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From page 330... ...
5. There is also a major national effort to prevent what might be called secondary learning disabilities, in the form of the Education for All Handicapped Children's Act and the early intervention program added in the 1986 amendments to that law.
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From page 331... ...
Advocacy groups are mentioned a few times, notably the National Council on Disability, which cosponsored this study, but there is certainly no analysis in the report of the number, range of activities, or effectiveness of advocacy groups in preventing disability. The report mentions a few private employment programs for people with disabilities as good examples, but there is no inquiry into the scope of these programs, how many people they employ, whether they are costeffective, and whether they have lasting effects.
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From page 332... ...
3 and 5) specifically asked the committee to "develop recommendations for" establishing a national surveillance system and applied research programs, and for a "strong, effective, coordinated effort for prevention of disability." One task (no.
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From page 333... ...
Early in the course of the study, I was concerned that the emerging report neglected the whole topic of prenatal diagnosis and abortion. I made a presentation to the committee documenting the importance of access to contraception, prenatal diagnosis, abortion, and prenatal care in the prevention of developmental disabilities.
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From page 334... ...
As welcome as these techniques are to many parents and public health advocates, they are very objectionable to some in the disability rights community, as well as to people who oppose abortion on any grounds. Prenatal genetic testing, mass screening for genetic defects, and abortion of affected fetuses have been major topics of debate in both the scientific and popular press, and they will continue to be important topics in the 1990s.
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From page 335... ...
A large portion of her paper concentrated on calls to keep abortion legal, require Medicaid programs to pay for abortion, implement gun control policies, and establish some form of national health insurance. Her covering note stated, "I'm sure not everyone will agree with my views, and it may be that I will want to write a minority report to accompany the main committee report" (emphasis added)
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From page 336... ...
Such scrutiny is required before a report is approved for release to ensure that the committee has addressed its charge appropriately and substantiated its conclusions and recommendations. The committee process is notable for the extent of its discussions, debates, and even arguments about available evidence and the conclusions to be drawn from it.
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From page 337... ...
(4) Evaluate the need for a framework for setting priorities for disability prevention programs based on incidence, prevalence, preventability, and economic cost to society, and consider the role of the federal government and other sectors in implementing disability prevention activities.
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From page 338... ...
led to the committee's recommendation that the existing Disabilities Prevention Program at CDC be expanded to serve as the focus of a National Disability Prevention Program. In arriving at this judgment the committee called on the expertise and knowledge of its members to compare administrative structures and operations of some of the federal agencies that might accommodate a National Disability Prevention Program.
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From page 339... ...
By infrastructure, we mean the leadership, coordination, surveillance, research, personnel development, and public support needed for such a program, which would provide a framework for a long-term, comprehensive, and coordinated effort involving specific interventions. Thus, we did not formulate exhaustive lists of interventions for each area of disability addressed in the report (although the "focus chapters" on developmental disability, injury, chronic disease, and secondary conditions do present information on various types of intervention strategies, including some primary prevention, and their development status or proven effectiveness)
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