Wednesday, March 24, 2010

The Problem Without the Public Option

To understand why so many were fervently against the removal of the now notorious public option, hindsight is the best teacher. The worst part of the new health care legislation is its mandate to purchase insurance or face financial penalty. Insurance mandates in and of themselves are nothing new. States mandate at a minimum liability insurance on vehicles because the use of vehicles carries inherent risk. Homeowners’ insurance is also mandated, again because of the inherent risk—not necessarily for the owner/occupants, but for the mortgage holders and in some ways communities. From a public health perspective, which should really be the primary perspective in controlling and reducing health care costs, risk protection strategies and mandates are necessary and long overdue in the US.
When someone without insurance exhibits risky behavior through poor diet, sedentary lifestyle, reckless motorcycle use, or heck let’s face it just living within our crime ridden nation, and they visit the emergency room instead of seeking care from a primary or urgent care facility, the public pays dearly. The government already pays the tab on 42% of health care costs, anticipated to reach 50% within a year without reform. So something had to be done. In the US we practice curative care or care after the fact of disease or chronic condition onset. Other nations with healthy universal coverage systems devote more resources to preventive care and spend a smaller percentage of their national budgets on health care. Because we invest very little and have no comprehensive or organized system to incentivize preventive care, we pay the cost in much more expensive curative care.
The public option as part of the current legislation would have worked to curb costs in the long run more effectively than the legislation that passed because it would have modeled successful systems in other nations which provide public universal coverage with options to purchase additional private insurance for perks like private rooms (in the US we don’t like being told to share, we believe that passive sharing through checkbooks is enough). With the public option, the insurance mandates would not have been the burden that they are likely to become. However, the insurance industry flexed some muscle and in this capitalist economy cried “unfair”. Well, life isn’t fair, but opportunity should be equal. Capitalism in the US requires entities to compete among both public and private. The Germans manage a successful universal system with a much older population and are much happier than with it, spending quite a bit less than we do. Of course the propaganda machines rarely if ever mention Germany or Japan; only Canada and the UK are mentioned usually with only anecdotal references.
To understand this, one must examine cultural differences, a lengthy examination no doubt, but the nuts and bolts of it are that the US is a staunchly individualistic society that prides itself on individual achievements over collective ones intra-nationally. Collective achievements are only lauded internationally. Is the reform an expensive endeavor? Yes. The debt was already on pace to be catastrophic and would have cut into defense and capital projects budgets without reform sooner than it will now. The insurance mandate without the public option is a bad idea, but with our pay per procedure (capitalist) medical system, we will be paying through our you know whats anyway. Rationing already occurs in the fact that those with less money and little to no insurance do not receive the same level of care as those with good insurance and/or money. Moreover, the public option along with mandates or incentives to reduce or eliminate the practice of pay per procedure, would effectively reduce costs in the long run.

Health Care Reform 2010

It has taken me some time to compose a coherent response to the passage of the Health Care Reform Bill, not because I oppose it, because I’m befuddled at and ashamed of the behavior of its detractors. The similarities between the current response and the responses of a significant number of citizens and legislators from the period of Reconstruction through and even after the passage of the Civil Rights Act of 1964 are disconcerting if not frightening. Before some of you decry “race card”, please continue to read. It was Rush Limbaugh who first publicly coined the bill as the “new Civil Rights Bill” and “reparations” and thanks to his and his comrades’ spewing of such propaganda, the public is responding accordingly. Dr. King, Presidents Kennedy, and Johnson were accused of communism and socialism just as President Obama, Senators Pelosi, and Reid are today. This is not coincidental for it foments the creation of the most powerful barrier to thinking and change: fear.
Today, there is certainly an element of race involved as minorities, particularly those of African descent are often associated with poverty and consequently welfare. Because this bill is an entitlement policy, deemed by those on the right as wealth redistribution (a nice way of saying the government is playing Robin Hood—robbing the rich to give to the poor. This does not mention how the impoverished are often robbed of opportunities and disenfranchised by policies designed to assist the wealthy in maintaining most of their wealth through tax shelters and off shore accounts, but I digress). I am not saying that the wealthy are exclusively greedy and undeserving, nor am I saying the poor are exclusively downtrodden and deserving. I am only stating the obvious which is that separate and unequal still exists and it is a matter of class and not simply race. However, separate and unequal is a fundamental component within capitalism. It must be. There can be no pursuit and attainment of wealth and the upper echelons of society without there being lower and middle classes. If all was equal, there would be nothing for which to strive. Again, I digress.
Since when did it become appropriate to spit at legislators or anyone for that matter because you disagree with their politics? Scream xenophobic epithets at them? Accuse them of treason? The law has been followed even with the strong arm tactics employed. Many want to make an issue of the division 219 to 212. This is still a majority, albeit a slim one, similar in fact to the slim majority that elected Bush in 2000. Democrats were incensed, particularly following a Supreme Court ruling which solidified the Electoral College’s decision. Nonetheless, the law was followed and the judicial branch, as it is designed to do, ruled on the legality of the decision. Such is the case here. The law has been followed. The bill has been passed by a slim margin. President Bush was elected by a slim margin. The best thing the country can do is get over both decisions and make the best of them.
I do not agree with everything in the bill, particularly mandatory purchase of insurance without a public option (which is the “backroom deal” everyone should be angry about—a topic for a later blog). There are always going to be obstacles to progression. After reconstruction, many states passed Jim Crow Laws to obstruct the 14th and 15th Amendments effectively nullifying the 13th Amendment all the while proclaiming the supremacy of states’ rights. Citizens spat on and protested the Little Rock Nine—black school children who were simply following federal law desegregating schools. The people angry about the Health Care Reform Bill are acting the same. It is truly a shame. This is exactly the level of anarchy the republicans seem to have desired for if it were not, they would have actively participated in the design and composition of the bill instead of the hatemongering they exhibited. LBJ and Senator Dirksen (ironically from IL) had to strong arm Congress to pass the Civil Rights Bill of 1964 with a vote of 290 to 130. Does this mean that since 130 (44.8%) voted against the bill, that it should be repealed? Some of the pundits today would have you believe so. This is not a popularity contest. Lincoln made an unpopular move to sign the Emancipation Proclamation; Kennedy, Johnson, and Dirksen made similar moves and usurped states’ rights and even some private rights to provide equality for all citizens.

Tuesday, March 2, 2010

NCLB Striving to be Average

No Child Left Behind is really a misnomer. The federal initiative is perhaps more appropriately termed, Every Child Average, Set the Bar Lower, or Teach to the Test and Forget Substantive Learning—the latter was probably too long and not catchy enough.

I’m not too far removed from grade school education; I graduated from high school in the late 90s. When I was in elementary, there were two required tests: The California Achievement Test (yes, I know, who would want to live up to CA’s less than lofty standards?) and the Stanford Achievement Test. Today, we have state developed/approved and state specific tests. PBS provides great descriptions of how these state tests are different from achievement tests. At the rudimentary level—which let’s face it, is the most important—achievement tests measure content knowledge; criterion referencing tests (i.e. NCLB state tests) measure students against state set benchmarks or acceptable ranges. In other words, achievement tests measure how well or poorly students are learning or mastering concepts; criterion referencing tests simply make sure that children are at least average or on par with state minimum standards. Understanding these fundamental differences provides insight as to how and why instructors have abandoned teaching concepts which are applicable across a broad range of subjects and life for teaching test taking 101.

I am neither staunchly for nor against standardized tests. What I am against are benchmark tests which are means of testing only for the sake of testing. I am averse to multiple choice and true/false tests as they are lazy means of measurement, but I understand the need for them especially in an effort to glean insight. These tests should not be used as the primary means of making determinations of admission or advancement, nonetheless. Further, studies have demonstrated that gifted children have difficulty with multiple choice tests because of their ability to make connections to broader concepts and inability to diminish concepts to the smaller framework/parameters allowed in multiple choice.

I recall one of my best and hardest working teachers deplored the use of multiple choice—Mrs. Barksdale. For our weekly vocabulary tests, we were required to write the meaning of each word or if given the meaning, provide the word—no multiple choice. Her goal was mastery, the enhancement of vocabulary and ultimately our knowledge. This should be our collective strife, mastery of concepts, not a race of whom can be the best of the worst.

Backwards Georgia

To be clear, I am not a native Georgian. This is certainly evident by my regular use of sentences with subject verb agreement, my use of the helping verb “have” with its appropriate main verb to make the perfect tense, and my lack of Appalachian twang. Until last night, I thought Georgians' lack of command of the English language was due to some genetic predisposition or the mountain air.


I have children in grade school who are required by the State of Georgia to complete the Criterion-Referenced Competency Tests (CRCT) annually. Allegedly, this grade specific test is used to assess students’ grasp of standardized curricula and the quality of Georgia education. Well Georgia, you deserve a D-. From October through April, each teacher in Georgia, instead of teaching fundamental concepts (which I thought was the purpose of educational institutions), teach methods of getting passing scores on the CRCT because school funding and teacher assignment may be significantly based upon the results. So each week, my children receive worksheets designed with questions which are likely to be on the CRCT. Imagine my sheer disappointment and outright anger when one of my children’s worksheet packets had five egregious errors. These were not printing errors, rather grammatical errors. Might one please explain to me how an instructional device is fundamentally flawed in its purpose and execution—comprised of errors pertaining to the very concepts and topics of instruction? Here are the egregious errors:

EX 1

That is the funniest movie I ever ______.

A. saw

B. seed

C. seen

In the above example there is no option which provides for completing the sentence with the verb having the appropriate tense. The sentence should be changed to read, “That was the funniest movie I ever_____” or the choice C should be changed to have seen.

There is another question which appears to be either an algebraic equation or a simple addition problem. However, there are no instructions even though each of the prior and subsequent problems have specific directions.

EX 2

87 + 42=

F. 129 – 42

G. 42+87

H. 42-87

I. 87+129

I’m guessing the purpose of this question is to demonstrate that number arrangement in addition is of no consequence to the sum?? This is a guess, nonetheless, something I should have to do before I even begin to work the problem.

Finally, each of the three fraction questions was structured with subject verb disagreement. I’ll provide you with one example.

EX 3

What fraction of the balloons are shaded?

Even as I type this, MS Word recognizes the error. Perhaps the authors and editors of the worksheet use typewriters. This is a really simple concept. Fraction is the singular subject and therefore takes a singular verb which in this case should have been is. The phrase, “of the balloons” is the prepositional phrase and it does not change the number of the subject or the verb.

I shared this with my mother who replied, “Wow, so do they teach the same way they speak in Georgia?”

Apparently so.