Possible long-term consequences of changes in the provision and financing of health programs and implications of "New Federalism" for child health care advocates are explored. Preliminary discussion focuses on general problems of resource scarcity, describing how the new awareness of scarcity affects thought patterns and attitudes. Reference is made to the manner in which the notion of scarcity is being used to buttress ideological agendas that are not tied to, and do not necessarily stem from, the perceived decline in America's economic growth. Discussion then turns to the uncertain character of the New Federalism. Largely pessimistic assumptions regarding likely outcomes of the evolving relationships between levels of government are identified; these assumptions point toward a gradual cutback, sorting out, and devolution of federal programs. Receiving particular attention is the changed role of child health care advocates in working to obtain funding, meeting needs for the acquisition and dissemination of information, and participating in the debate about the restructuring of intergovernmental relationships and responsibilities. Concluding remarks focus on five recommended lines of action, by which advocates can alter constraints under which they operate. (RH)