"Covered lives" or patients? pondering the essence of an international organization.

I recently attended a meeting where a physician was discussing the future of medical schools. In talking about the issue of supply and demand for doctors, the speaker indicated that there was currently an oversupply of doctors in New York State. I promptly asked how "oversupply" was determined. The doctor responded that oversupply in the medical field is determined by a ratio of the number of physicians available for every 100,000 "covered lives."

I was then confused about what constituted a "covered life." Was it a person awaiting surgery, for example? Or, was it a person who was "covered" by insurance? Noting my puzzlement, the speaker volunteered that a "covered life" simply meant a "patient." I thought the choice of words, "covered lives" rather than "patient," said more about the future of the medical profession than anything else that was shared the remainder of the evening. While "covered lives" may be a useful term in making calculations, the concept does not convey the essence of an individual patient in need of care.

Medical professionals have no monopoly on standard terminology that misses the essence of a given concept. How many times, for example, have we heard day care rather than child care, domestic engineer rather than mother / father, sanitary engineer rather than garbage collector or even "baby's work" rather than play? Words ARE important. If someone were to ask about the meaning of the word "international" in our organization's name, what would be our response? Such a question goes to the heart of what constitutes an international organization for children.

This question is far from fictitious. It was frequently asked during my trip to Hungary last February. While meeting with our new Hungarian Branch, Jaszbereny ACEI, and discussing plans for the upcoming ACEI World Conference in Sopron, several teachers questioned how many of our members were from outside the U.S. When I replied that only about 5 percent were in this category they were quick to say that the main reason behind our low international membership was "the high cost" of joining.

In Hungary, child care teachers make the American equivalent of about $114 per month, which is also the average cost to rent a two-bedroom apartment. Costs for utilities, food, transportation and other expenses are generally extra. (It should also be noted that Hungary's economy is fairly good by Eastern European standards.) It is evident that our chances of expanding international membership are minimal, at best, without using a differential fee schedule. Dr. Bela Teleki, ACEI World Conference Chair, further emphasized this issue in saying that last year he had 60 Hungarian professors who expressed great interest in becoming ACEI members. Upon hearing the cost of membership, however, they quickly lost interest.

Another question frequently asked during my travels is "What does ACEI have to offer us?" In the U.S. ACEI is among the best "bang for the buck" of any comparable organization. Publications and meeting discounts, relatively close proximity of state and national conferences, easy access to Headquarters through a toll-free number and E-mail, and the clout amassed through the hard work of so many members make ACEI a great investment. All these benefits might not be as attractive to Americans, however, if English was not the language used for our publications and conferences. Although many world colleagues speak English, many other potential members do not.

While in Hungary, still another colleague asked how many members from outside tile U.S. serve on our organization's decision-making bodies. I was extremely proud to say that a Hungarian, Student Representative Judit Tamas, is on the Executive Board and that Jillian Rodd, from the United Kingdom, is co-chair of the International/Intercultural Committee. The I/I Committee now requires that one of its co-chairs be from outside of North America. The lack of such a requirement on the Executive Board permits the possibility that an "international" organization might be without a non-U.S. voice. Such concerns are of major importance in considering the essence of what it means to have an international organization.

A major advantage of having scarce resources is that it forces people, companies and organizations to focus on what they do best. Perhaps if we listen more to our colleagues throughout the world, we might be able to find a niche that clearly sets us apart in a meaningful way from other organizations with which we frequently compare ourselves. Much has been accomplished over the past 105 years by a long line of ACEI leaders from North America. With careful planning, commitment and ingenuity, we have the potential to expand ACEI's leadership to other continents. In doing so, we can become the world's most effective voice for children, thereby maximizing the essence of our international focus and title.

Executive Board Service Awards

At the Business Meeting during the Annual International Conference in Portland, Oregon, two retiring Executive Board members were given recognition and sincere thanks for their dedicated service to ACEI. Those honored were Sue Wortham, outgoing President, and Mary McKnight-Taylor, outgoing Vice President for Later Childhood/Early Adolescence.