Besharov on pre-school programs

Universal preschool is a loser. Targeted nurse home visits are a winner.

My friend Doug Besharov of AEI gave a great talk on school readiness prograns today at UCLA.

Bottom line: a universal school-based preschool program would cost about $60 billion a year, and its benefits would be marginal. Kids entering school are more likely to have behavioral problems than strictly congnitive ones — as one kindergarten teache is supposed to have said, “Their problem is that they’re sad, mad, and bad, not that they can’t add” — and fixing that requires at least a two-generation approach, which is hard to do in a school-based program.

A program of nurse visits (starting before birth) and continuing for the first three post-natal years could cover about a quarter of each birth cohort — the kids most at risk, based on family factors — for maybe a third of that amount, and the likely benefits would be large. (And include crime reductions as well as improved school performance, I might point out.)

The nurse-visitor programs that work, both here and abroad, involve highly-skilled and relatively highly-paid ($80,000/yr.) public health nurses, not LPN’s from the registry. A big program would run into personnel shortages at first; that’s a serious problem, though not, probably, an insurmountable one.

If each nurse can cover twenty kids, then the direct salary cost of the program would be $4000 per kid per year, times three and a half years of coverage is $14,000 per child. Mark that up 50% for fringes and program overhead and we’re at about $20 billion per year.

About half of the cost could be covered by dumping the WIC program, which distributes mediocre advice and very unhealthy food for about $10 billion a year.

Right then. Dump WIC and spend an additional $10 billion a year (1/1000 of GDP) to make a major impact on the lives of about a million poor kids per year.

That proposal ought to appeal to all the compassionate conservatives and all the hard-headed liberals in Congress. The way I figure it, that would leave us only about 150 votes shy of a majority in the House and maybe thirty-five votes short in the Senate.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com