Epstein analyzes in detail the decay of the child welfare system through the case histories of Natalie and Adam, two children who have spent their lives in and out of foster homes and orphanages. He shows how few studies actually measure the child's real outcomes, and how unreliable social scientific research has ultimately been used to rationalize policies of public neglect. He condemns conservatives and liberals alike for their participation in this neglect, demonstrating that the now popular social efficiency model in welfare reform, designed to reduce public responsibility, does not and cannot provide adequate care.

In a media environment that focuses increasingly on the "undeserving" recipients of public aid, Children Who Could Have Been shines a light on the human side of the debate. Epstein's is a principled voice for this important social issue.