In 1991, child safety seats prevented 185 deaths and 72,000 injuries in the U.S. They saved $3.5 billion, including $220 million in medical care costs. Universal child seat use would save another $2 billion annually, including $90 million in medical care costs. Each dollar spent on child seats saves $2 in medical care costs. Each dollar also saves $6 in other tangible expenses and preserves quality of life valued at more than $25. The return on seats was computed using a bulk purchase price. Attacking seat misuse makes economic sense for both auto insurers and private health insurers. Auto insurers also may find it cost-effective to subsidize child seatpurchases. Because use is so high among their policyholders, however, subsidizing child seats does not make economic sense for private health insurers.About 60% of child occupants age 0-4 who are Medicaid recipients travel unrestrained. Only 11 % of other children age 0-4 are similarly endangered. This difference occurs despite comparable safety belt use in these two populations. Public action is needed. Poverty should not deny children safety. Public action also is goodbusiness. Medicaidclaimscost savings would exceed the cost of providing convertible seats for all Medicaid babies. Reduced disability payments and emergency services demand would yield added benefits. This analysis uses a $38 seat cost, equal to the typical bulk purchase price plus 20% to cover local distribution and training on correct use.