A Sickness of Change Revealed in the Healthcare Debate

The US is currently debating health care reform. And after listening to the President’s national address on the issue, realized a common ailment that exists in most change initiatives.

Although, it is widely agreed that there is a need for healthcare reform in the US., Americans are generally happy with the healthcare they receive. Which in fact is among the best healthcare in the world.

So, the problem and therefore the focus of reform should not be in the service, but in access.

Access to healthcare is primarily limited by cost. The very little that we know about the Health Reform Bill that the President is pushing is that it will increase access to healthcare by lowering cost to the public.

So what’s the problem?

The problem is a sickness that pervades most development/reform/change programs around the world. There is an addiction in development in treating the symptoms, rather than working on cures. Is it not about WHAT will be done, but about HOW.

The symptom in healthcare is high cost. Therefore the solution should include ways to deal with the REASONS for those costs. The current bill does not. It merely addresses the issue by simply finding more creative ways to pay for it. In other words, a glorious way to simply throw money at it.

Problem solving, healing, and real change means getting to the core of the problem, and dealing with it at its source. Can one deal with poor education by lowering test standards? If one gets a rash on their skin, should they just cover it with make-up? If there are problems at home, is it solved by drinking? You and your spouse are fighting a lot, is the answer simply not speaking? If you’re over-weight, should you just take a pill? (although, that would be nice)

Once, I was involved in a program to deal with drug problems among teens in a local community. After research, I proposed a program that dealt with core issues: a lack of role models, a lack of future prospects, lack of constructive activities and support in which to develop strong social skills, coupled with cooperative law enforcement. It was cost affective, used resources currently available in the community, sustainable and therefore long term. However, the plan was rejected because the quota was for an anti-drug program rather than a community development program which mine appeared to be.

On a separate issue, I was asked to work on development for a crime-laden area. After research, the proposal came back as a socio-economic development program for the entire region. But again, rejected because the quota was slated for dealing with the “problem people” and my program dealt with the community at large.

In working to improve educational standards in another developing country I was met by resistance from educators who simply didn’t want to do more work.

Recently, a friend kept complaining about her weight, yet refused to do anything about it that constituted sacrifice or sweat.

Change is a good topic, but the sickness lies in the denial to do what is really necessary. Why? Because real reform takes work, real growth comes from pain, real change means removing that which currently holds power. It is not always nice, it is not comfortable, it is never easy.

If the President is really serious about Health Care Reform, it should address malpractice lawsuits (tort reform), rising insurance costs, separating medical insurance from work, and encouraging healthy lifestyles.

Want to increase an economy? Encourage companies to invest and grow and limit government to regulation.

Want to improve education? Deal with the teacher/education unions and keep teachers accountable.

What to lose weight? Adjust your eating habits and EXERCISE!

Involved in community development? Do the research, instead of simply copying a program from another culture.

Unfortunately for most development, instead of doing the work, it’s a lot easier and more popular to take it easy and just throw money at the symptoms.

The Dumbing Down of America

Working with international education, I’ve helped a lot of foreign students prepare for international exams and exchange programs to the US. On average, most European students function 2 years higher than their American counterparts at the same age.

A 2003 international study ranked the US students 25th among participating OECD countries including those in Eastern Europe which fund schools and teachers at a fraction of US spending.

Internationally, the US is in the top 3 in per student spending, yet students continually score only average among developed nations in terms of basic skills in math, science and reading.

The issue of improving US education is not new, and recently started the rise of outcome-based education, which requires an expected level of performance as a result of investment. Not dissimilar to business and sports.

In 2001 GW Bush passed the No-Child Left Behind (NCLB) act which is built off the principles of outcome-based education. The key premise to the act is a standardized test measuring the acquisition of skills and learning at various levels set by each state. Basically it means a student passing the 4th grade should be able to demonstrate basic and minimal 4th grade level skills. Makes sense, right?

Critics, primarily coming from the Teacher’s Unions, complained that new curriculum was necessary and held out for more money. Weird. If what they currently did wasn’t good enough for meet minimal levels, it begs the question of what they were doing in the first place.

Another solution also introduced in the during the previous administration was the voucher system. This gave students the choice to choose the school they wanted to attend, lifting the burden of being locked into a poor school system based on where you lived. The federal funds for that student would then go with the student. It is a hybrid between private schools. Schools that have a large exodus of students basically close down for lack of funding.

A schooling system which polices itself through market-demand, a system that thrives on competition? Sounds like the US collegiate system, which is the best in the world. Sounds like capitalism.

This program had seen great success in Washington D.C. which is notorious for the worst schooling systems in the US. Yet, despite that success, despite the fact that the program cost 7500 USD per student vs. the public system which costs 15000 per student, the program was recently killed by the Democratic congress in passing the Omnibus-bill, questioning if the voucher system was a “good-use” of federal tax dollars. Ironic.

Michigan recently began a similar voucher system. However, this program has been showing different results.

Many of the teachers I interviewed had left or were in the process of leaving. Not because of competition, but because they claimed they couldn’t teach. Competition among schools, which normally motivates and drives performance, had changed focus from increasing quality to quantity. The schools were catering to students’ felt wants, instead of market needs.

In so doing, the schools changed marketing from the best education to the most pleasant experience. If you’re a 16 year old kid, what do you want? Less homework, easier classes, more free time, fewer annoying teachers. I was shocked. The teachers were left with little to no authority, no recourse for discipline and thus effective classroom management, and in some cases were forced to pass failing students.

Yes, this area does not support NCLB and therefore does not submit itself to statewide comprehensive exams. So, their only accountability is enrolled students measured by meeting costs.

We can only assume that the school administrators are either ignorant and irresponsible or intentional.

Ignorant and irresponsible capitalism focuses on the short-term bottom line, money, ignoring the long-term gains from running a quality program. In this case, the corruption in the system comes from the lack of measuring minimal standards, what NCLB was meant to do.

But what if it is intentional?

When talking about change and development, it is naïve to assume the current situation is unknown. That means, things are the way they are, because the powers to be benefit from keeping it that way.

So the question is, who benefits from a lack of standardized measurement of school performance? Who benefits from keeping Americans dumb, ignorant, unquestioning, and undiscerning?