The United States was once on the road to taking care of its children’s health.

In 1957, a medical student named Jack Geiger went to sub-Saharan Africa to study “Community-Oriented Primary Care” with doctors Sidney and Emily Kark. That innovative pair were perfecting a model health care program, the Pholela Health Center, designed to care for people’s health while strengthening the community itself.

Inspired, Geiger finished medical school and set to work replicating the model in South Boston, at the Columbia Point housing project, and again in Mound Bayou, Miss. These centers were initially staffed with the obvious professionals — primary care physicians, an internist, pediatricians, a psychiatrist — but over time, pharmacists, visiting nurses, physical therapists, social workers and community liaisons also came on board. Geiger’s community health center approach caught on quickly across the country.

This story comes from The Nature of Health, by Dr. Michael Fine and James Peters, which I found riveting since our heath care “system” takes wretched care of the nation’s children, overall. Poor health, their own and their family’s, undermines kids’ ability to perform well in school — if that’s all you care about.

The authors write, “Healthcare consumes over 16 percent of our gross national product, but many people are left out and very few Americans are truly secure in our access to medical services. Compared with other industrialized nations, we spend through the nose on medical services and have little health to show for our spending.”

Outside the United States, annual health spending per capita in the highest-spending country, France, is $3,374, according to the Organization for Economic Cooperation and Development. The average for all the OECD countries (the 30 most industrialized nations) is $2,759. The U.S. average per person is $6,401. Even so, we have shamefully high infant mortality and comparatively low longevity, for all the emphasis our system puts on extending life.

The authors propose reviving the community health center approach. “Population-based primary care is that system of health care distribution that assigns every person in a geographical area to a primary-care practice accessible to that geographical area, and makes every primary-care practice responsible for the primary care of every person in that defined area. ... [It] looks more like public libraries, public schools, and local police stations than it does like the hodgepodge system of private practitioners stacked in medical office buildings that we have now. Each neighborhood, town or village of 10,000-20,000 people would have a primary-care center, providing robust primary care that includes 90-95 percent of the medical services used by that community’s inhabitants.”

Painfully, this dream scenario looks much like where we were going back in the 1960s.

By 1967, the U.S. Department of Economic Opportunity and the Department of Health, Education and Welfare had financed 150 health centers across the nation, and had plans for an additional 1,000 centers, expecting to serve 25-million people by 1973.

“Many people inside the community medicine world understood the value of the health center approach, and quietly planned to expand the health center model to develop a national health service system for the United States. Such a system would in some ways resemble healthcare systems in Britain and elsewhere around the world that focus on providing primary care to everyone, but the system would be uniquely American, locally controlled and democratic, and able to improvise solutions for the communities the health centers served.”

But, “1967 brought the wrath of the private medical community.” Private practitioners, essentially medical entrepreneurs working with the American Medical Association, fought and almost defeated Medicare and Medicaid and did manage to get Congress “to smother the movement by allowing the centers to provide free service only to the poor.” By restricting the percentage of paying or non-poor patients to 20 percent, the centers were marginalized as the health care of last resort, only for the indigent.

The 20-percent law was reversed in 1974, but by then the damage had been done. The Nature of Health goes on to detail the evolution of the hideously expensive, ineffective so-called system we have now.

In a phone interview, Fine, a primary-care physician, said, “The reason insurance companies don’t want a community-based approach is that it cuts the amount of money you spend in less than half. Their issue is to make money.”

The book explains rather clearly how even — or perhaps especially — in our current financial crisis, cities and states could begin organizing health centers for themselves. If not because it’s the moral and effective thing to do, then because it would cut costs dramatically.

Fine said, “If we started population-based primary care, in three years we could close the current budget gap in [Rhode Island]. The thing that really kills me is that our health care system is deeply part of the problem, not the solution. Nationally, this approach would free up one trillion dollars to spend in other ways.”

When American students look bad in international tests, no one notes that the kids in those other countries usually have intact extended families caring for them, or national health care systems, or both. Those countries’ kids go to school with eyeglasses, hearing aids, asthma medication and whatever else they need. Just as important, they go to school reassured that the folks at the nice health center are doing everything they can to care of their sick dad, mom or grandma.

Please don’t let anyone tell you one more time that the Finnish schools are the best. What the Finns are best at is taking care of their families.

When our kids go to school in as good shape as the Finnish kids, then we’ll have a legitimate academic horse race.

Julia Steiny, a former member of the Providence School Board, consults for government agencies and schools; she is co-director of Information Works!, Rhode Island’s school-accountability project. She can be reached at juliasteiny@cox.net , or c/o EdWatch, The Providence Journal, 75 Fountain St., Providence, RI 02902.