Handling of Infant Mortality Report Criticized : Health: Children’s advocates say the government is delaying release because programs would be costly. The White House says it is ‘refining’ the document.

Advocates for children accused the Bush Administration on Monday of sidetracking an internal Administration report on infant mortality on the grounds that it would be too expensive to pay for the prevention programs the report recommended.

The report, which White House officials insist was just a preliminary draft, called for a $500-million increase in spending to reduce infant mortality. It said it would be possible to prevent 10,000 infant deaths a year and 100,000 disabling conditions.

“It is without question one of the most tragic documents I’ve read,” said Sara Rosenbaum of the Children’s Defense Fund. “Not only because of the findings . . . but because of the fact that this report has been at or near completion for almost a year.”

“I think the problem was that it was going to cost money,” said Jennifer L. Howse, president of the March of Dimes Birth Defects Foundation. “(But) I don’t think that, in and of itself, is enough reason to not issue a report.”

The draft report by the White House Task Force on Infant Mortality was dated Nov. 30, 1989. It was obtained by the New York Times, which reported Monday that it came from an official who supported the recommendations and felt they were being ignored.

Alixe Glen, a White House deputy press secretary, countered Monday that the leaked report was simply an early, now obsolete, draft. She said the report is being “refined” according to standard procedures so that it will “represent Administration policy.”

Glen likened the process of refining task force reports, which she said can take up to a year, to the process of editing an article: “If it ain’t right, you’re going to fix it. If it isn’t just so, you’re going to make it better so it’s exactly what you need.”

Glen called any suggestion that the report had been scuttled “untrue and false and inaccurate.” She added, “The federal government does not solve every problem. There’s something called personal accountability. Those go hand in hand.”

The claim that the report is simply being polished was challenged Monday.

In a letter to U.S. Secretary of Health and Human Services Louis W. Sullivan on Monday, Rep. John D. Dingell (D-Mich.) contended that government documents suggest that task force activity, such as policy-making, came to “a virtual standstill” after late November.

“This sequence of events raises the question whether high-level White House officials vetoed the report during critical Administration budget deliberations in late 1989,” wrote Dingell, whose subcommittee had been trying since April to get drafts of the report.

“Our constitutional system of checks and balances does not sanction the withholding of documents for political reasons,” Dingell wrote, reiterating his request for all drafts of the report as well as communications between federal health officials and budget officials.

The 100-page report noted that nearly 40,000 babies die each year before their first birthday, and another 400,000 develop chronic or disabling conditions. While the infant death rate is at an all-time low, it is higher than that of 21 other developed countries.

“Infant death and disability are not intractable problems,” the report stated. “This country has the knowledge to save 10,000 additional infant lives each year and to prevent an untold number of disabilities among infants.

“To do that, we as a nation must apply what we know about illness prevention and health promotion and ensure that the women at greatest risk of having an unhealthy baby have access to high-quality primary health and social services,” the report said.

“Other nations, and indeed some states, have significantly reduced infant mortality by doing so,” it said.

Toward that end, the task force called for a raft of programs, most of which have been repeatedly suggested by health experts. They range from making health care more accessible to poor women and children to expanding alcohol and drug abuse programs.

Among other things, the task force suggested expanding the Medicaid program to include women living at up to 150% of the federal poverty level, and expanding private health insurance offerings to include prenatal, maternity and infant care for the entire household.

The group also urged better dissemination of information about how to prevent infant mortality through health education programs in schools and a nationwide public information campaign emphasizing the need for prenatal care and “healthful maternal behaviors.”

The task force was set up in July, 1989, under the Domestic Policy Council, the President’s forum for developing domestic policy with the help of the Cabinet and senior advisers. The task force included members of 10 federal departments and agencies and six offices within the Office of the President.

“The only conclusion I can reach is that it’s clear that the Bush Administration does not want . . . to pay the money they know will be necessary to prevent infant mortality,” said Rep. Henry A. Waxman (D-Los Angeles).