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America's Two Most Troubled Sectors: Health and Education
RCM ^ | 07/23/2013 | Isabel Sawhill

Posted on 07/23/2013 7:45:17 AM PDT by SeekAndFind

By now almost everyone knows that the U.S. has fallen badly behind other advanced nations in the kind of health care and education it delivers to its citizens. We spend twice as much per capita than most other countries on health care and don't get better outcomes as a result.

We also spend twice as much per full-time equivalent student on higher education than other OECD countries, and 38 percent more on elementary and secondary education with disappointing results in terms of what students know at the end of the process, according to international assessments of learning.

What has been less recognized are some of the similarities between these two sectors that help to explain why they are not performing better. These include 1) fee for service instead of pay for performance, 2) low productivity, 3) third-party payment, and 4) entrenched institutional and professional interests that mitigate against change.

Some have advocated a pure market-based approach to each. In my view, although some greater market pressure might help, these solutions are neither realistic nor without their own flaws. These are both sectors where consumers are too poorly informed and societal costs and benefits too great to leave decision-making entirely in the hands of individuals. Moreover, health and education are arguably goods that should be available to everyone in a rich country with commitment to equal opportunity. That said, there's no reason that well-regulated access to each needs to be so expensive.

In both sectors, providers are paid based on what they deliver and not on the outcomes they produce. In education, teachers and professors are paid based on hours spent in the classroom and not based on what their students learn and in health care, providers are paid based on treatments prescribed and not on whether patients get well.

(Excerpt) Read more at realclearmarkets.com ...


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: education; health

1 posted on 07/23/2013 7:45:18 AM PDT by SeekAndFind
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To: SeekAndFind

America’s two most troubled sectors are the White House and the Senate.


2 posted on 07/23/2013 7:46:45 AM PDT by Hoodat (BENGHAZI - 4 KILLED, 2 MIA)
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To: SeekAndFind

According to Liberals, both areas that need to be designated as “no profit zones”.


3 posted on 07/23/2013 7:53:04 AM PDT by Buckeye McFrog
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To: SeekAndFind

Truth is the US does a better job of educating people of European ancestry than anyone in the world. The US does a better job of educating people of Asian ancestry than anyone in the world. The US does a better job of educating people of African ancestry than anyone in the world. The US does a better job of educating people of Latin American ancestry than anyone in the world.

It is only when you compare an American average to a European average or an Asian average that we fall short.


4 posted on 07/23/2013 7:56:18 AM PDT by donmeaker (Blunderbuss: A short weapon, ... now superceded in civilized countries by more advanced weaponry.)
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To: donmeaker

Really? And 73% of 8th

Really? And 73% of 8th graders in public schools in Detroit cannot pass basic reading tests?


5 posted on 07/23/2013 8:02:10 AM PDT by MrChips (MrChips)
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To: SeekAndFind
These are both sectors where consumers are too poorly informed and societal costs and benefits too great to leave decision-making entirely in the hands of individuals.

Isn't that why we employ teachers and physicians? I guess the argument is that government education has made Americans too stupid to make decisions about their heath care and education so we need more government education?

When people have to pay out of their own pockets for either education or health care, you can bet, that no matter what, the decisions will be far superior on average, with higher quality and lower cost, than some bureaucrat.

6 posted on 07/23/2013 8:02:53 AM PDT by ALPAPilot
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To: SeekAndFind

The more government gets involved in something, the more expensive it becomes.


7 posted on 07/23/2013 8:04:32 AM PDT by volunbeer (We must embrace austerity or austerity will embrace us)
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To: MrChips

I refer my learned FRiend to the answer I gave some moments ago.

There is a similar story in health care. Black women, for some reason, give birth to low weight babies and those babies have health problems. Compare Americans of European ancestry to Canadians, and US health care looks pretty good.


8 posted on 07/23/2013 8:06:15 AM PDT by donmeaker (Blunderbuss: A short weapon, ... now superceded in civilized countries by more advanced weaponry.)
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To: donmeaker
Well, I detest Obamacare. But, we do have problems that need solving, such as runaway costs and those who cannot get health insurance.

But, I was speaking more to education. Our system keeps reforming itself with grandiose programs like "No Child Left Behind" and now "Race to the Top," all of which have their own pluses and minuses, but which are really just window dressing for an irredeemable system. The Blob rolls on, devouring whole cities in its wake . . . cities like Detroit.

9 posted on 07/23/2013 8:14:59 AM PDT by MrChips (MrChips)
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To: SeekAndFind

the two sectors of the economy that have had, more than any other sectors of the economy

the most state interference and regulation in their marketplace

the most taxpayer funding and taxpayer subsidies

the most government dictats on their operations

the most federal interference, regulation and subsidies

and all of the above increasing for sixty years straight

BEFORE OBAMACARE even

and all the above was done to bring both sectors of the econony to their knees

in order that the call for total federal takeover could be made

as if that was needed to rescure them from themselves

when what was needed was to rescue them FROM GOVERNMENT.


when you hear the political class discuss the problems
with education, are their arguments ever truly about the unjustified high cost of education?

NO. It is always predominately about NOT questioning what education costs, merely about how to saddle taxpayers with more of the costs of keeping up with the demands of the education industrial complex.

The fights in Congress - on the ever rising costs of college - IGNORE the real problem and are always seeking more ways to cover the demands of the colleges. The arguments are always couched as “coming to the aid of the students”, but that is a lie. They are merely coming to the aid of the education industrial complex, continuing to prop up that industry and its perks and priveleges, which are very often undeserved and among sectors in the economy with the highest rates of inflationary cost increases for decades.


10 posted on 07/23/2013 8:58:25 AM PDT by Wuli
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To: ALPAPilot
Except that you will make a permanent under class even greater than the one you have now. There are whole cultures in the US who do not value education. If left to themselves, they would not ever go to school.

So what do we do with them?

Mandatory schooling is supposed to be a ladder to those in those groups who want out, but come from a family where they can or will be unable to pay for it.

11 posted on 07/23/2013 9:00:03 AM PDT by redgolum ("God is dead" -- Nietzsche. "Nietzsche is dead" -- God.)
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To: MrChips

Where the solution may be, I don’t know.

I do know the solution is no where close to the federal government that has no powers to regulate education, and no particular competence in exercising many of the powers that it has.

Good parents want good schools. Bad parents are less interested in good schools than they are in avoiding or postponing trouble if their bad son breaks rules, so they mostly are interested in being sure that discipline breaks down. Only if the school programs are controlled from on high can enough lag be put into the feedback loops to give the bad parents their desire.

Local schools can have discipline, or not, and if not, good parents have the ability to move their children from a bad school to a good one. Discipline is only maintained by the classroom teacher, perhaps with support from parents and administration.

That really bothers the teacher’s unions, who seek to prevent the feedback loops from giving justice to bad teachers.

Moving control of the schools to the state or federal government usually occurs alongside promises of better funding. All things being equal, better funding helps, but the strings attached to better funding prevents all things from being equal. Poorer funding and better teachers beats better funding and worse teachers every time.

I homeschool. My son and daughter are learning Japanese, and calculus.


12 posted on 07/23/2013 10:52:50 AM PDT by donmeaker (Blunderbuss: A short weapon, ... now superceded in civilized countries by more advanced weaponry.)
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To: redgolum
Except that you will make a permanent under class even greater than the one you have now. There are whole cultures in the US who do not value education. If left to themselves, they would not ever go to school. So what do we do with them?

Cut them off from Welfare - Duh. The permanent underclass was CREATED by the single payer educational system. Expecting that single payer education will fix the problem that it caused is beyond idiotic.

13 posted on 07/23/2013 1:33:37 PM PDT by ALPAPilot
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To: ALPAPilot

Read history.

What happens when the mob no longer gets their bread and circuses? When they feel that they have no real chance of success, and no real consequence of revolt?

The elite won’t cut off welfare. They live to close to the mob.

Again, what are we going to do with those people? That is the question we as a nation need to start working toward. The Irish came in as an under class, and became mainstream. Same with the Italians in many places.

Cutting off the flow of education and money won’t help. It will only increase the problem. How do you turn a growing underclass into producers?


14 posted on 07/24/2013 6:25:35 AM PDT by redgolum ("God is dead" -- Nietzsche. "Nietzsche is dead" -- God.)
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To: donmeaker
And I teach in a Classical/Christian school in which half of our students are partially homeschooled. It works. I teach Latin and European History.

In many cities, the consolidation of small public schools, especially in inner cities, into large, window-less factories on the edge of town, not only destroyed the whole concept of neighborhood schools, but also made it far more difficult for parents to be involved. Then, the tell us parents need to be more involved. What a joke! And it has increased, rather than decrease, the number of bureaucrats earning 6-figure salaries in the central office.

With respect to discipline, yes, it is crucial. But, when I talk to public school teachers, over and over again I hear the same story: lack of administrative support. One cannot discipline students when no one backs you up. Thus, again, it is the system. And because the problem is so systematic, I consider it to be an incurable disease. And I have written the system off.

The only reform that has SOMEWHAT worked is the creation of charter schools, but even there the tentacles of the state reach in whenever they can. I am a voucher supporter, instead . . . . vouchers and tuition tax credits and parental choice. That is the only answer.

As for healthcare, that solution is above my pay grade, but, I know that Obamacare isn't it.

15 posted on 07/25/2013 8:01:03 AM PDT by MrChips (MrChips)
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To: redgolum
Cutting off the flow of education and money won’t help. It will only increase the problem. How do you turn a growing underclass into producers?

I did not suggest cutting off the flow of education nor money. What I suggest is that parents are forced to pay for their children's education individually.

Some parents can afford and are willing to pay for a gold plated education. I live in Exeter, NH home to one of those gold plated prep schools. They have about 50 spots a year for local day students, kids who live within about a 30 minute drive from the school. Each year the get 1000 application from the locals willing to pay $35,000 per year in addition to the property taxes they pay for the local school district. In NH, that is a substantial tax, because there is no sales or property tax.

Right now the public schools do not have to compete against them because those 950 kids that didn't make it in have no where else to go that can add the value over the property tax.

If parents were able to use their tax money to choose a school, schools would be forced to compete. Where there is competition the quality improves and the costs decreases. Samsung had to substantially improve their phones to compete with Apple and Apple has had to keep their prices in check to compete with Samsung. Or you could make the comparison between the Ford Pinto, Fusion and the Toyota Corolla. Right know our education system is an AMC Pacer, and will remain there unless parents have to pay for it themselves.

Single Payer Government Schools will never educate children. Rachel Jenteel should make that painfully obvious to anyone.

16 posted on 07/25/2013 8:25:58 AM PDT by ALPAPilot
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