Pre-Existing Ignorance – Healthcare vs. Education

My last post on the difficulty of educational reform got me thinking about that other massive system we are trying to reform – healthcare. One way to understand the healthcare system is to compare it to education – where we have had universal single payer access for over 100 years.

In that vein – what would education look like if if it were run like the healthcare system? By transporting our healthcare practices to another environment we can strip away the patina of familiarity and acceptance and see some of the insanity in our system in a harsher light.

Well meaning people can disagree strongly on the specifics of what is needed (and they do). I found as I wrote this that I had to examine my own pre-conceived notions. For example – state funding for education creates some of the same problems the system of private monopolies in medical insurance forces us to wrestle with. The public option in healthcare is the mirror image of charter schools in education – both aim to open up competition and provide alternatives.

There is more than enough idiocy go around here – in what follows we don’t spare Doctors/Teachers, Patients/Students/Parents, Politicians, Insurance Companies, and Lawyers.

THE SYSTEM

• We would spend twice as much as any other industrialized country on education and our results would put us at the bottom of the list in learning outcomes. Despite this, many would go around touting that we have the best education system in the world, providing walking talking evidence that we need a better educational system.
• Most people before the age of 65 would not qualify for public education. It would ALL be private schools funded by insurance largely paid for by employers. Parents out of work? See you at the mall kid.
• 18%, or 9.7 million kids, would not qualify for schooling. Enrollment would require evidence of Education Insurance. The uneducated would be encouraged to pull themselves up by their bootstraps by trust fund pundits in the media. Most would have no clue what a bootstrap is (pundits or illiterates).
• Pre-existing ignorance would bar you from receiving affordable education insurance. Failure on any test, quiz, or paper – ever – would be cause for termination of coverage if not disclosed in advance. Students would routinely be subject to recision for ignorance of their own ignorance. This would make sense to people.
• 60% of all bankruptcies would be due to Learning Disabilities and Special Education needs. 60% of these people would have Education Insurance when they discovered their child needed special attention. In order to qualify for subsidized care you would need to go bankrupt, lose your home, or get divorced.
• For uncovered people any learning needs would be covered by intensive personal tutoring provided at “Emergency Learning Rooms.” Services in these facilities would cost 10x what regular classroom instruction costs and would be passed on to the insured population as part of their premiums.
• Hordes of 4 year olds getting socialized government education would show up at congressional town halls and throw tantrums about keeping government out of their socialized education….
• While taxes were cut by $1,500 a family per year over the past 10 years private education costs would have risen by over $5,000 per family – a net increase of $3,500. Public subsidized education, which would be a net savings to the average family, would be popular with over 70% of the people. Despite its popularity politicians would refuse to consider it. The profits of their major donors in the education industry would be a higher priority for them.
• Schools would be overflowing with supplies. No need – however specific – would go unmet. Meanwhile, patients in hospitals would be encouraged to hold bake sales for things like sheets, syringes, and bedpans.

EDUCATION INSURANCE

• Education Insurance would consume 25% of the money spent on education for administrative overhead and profits. Free market zombies would earnestly argue that this is efficient. By comparison, administrative costs for socialized education take an average of 5% [as true for Medicare as it is for Education].
• If you needed access to an expert on a particular subject (economics?) you would need permission from your Education Insurance company. This permission would be routinely and randomly denied by insurance company “Ignorance Panels” even if your Homeroom Teacher thought you really needed the information. The bureaucrats making these decisions would fund fierce lobbying efforts to keep more efficient government bureaucrats out of their turf.
• Education Insurance CEO’s would each make enough to fund an entire school district every year. Despite the gross inefficiency of their companies [see above], any attempt to challenge this allocation of resources would be met with resistance.
• Education Insurance Companies would operate as monopolies within large sections of the country. Over 90% of the coverage in many states would come from one “provider.” Due to strong lobbying efforts congress would exempt these companies would from anti-trust laws.

STUDENTS

• 70% of the money spent on education would occur in the last year of life. Heroic efforts would be made to teach doddering seniors philosophy and particle physics in their waning days. Family savings would routinely be wiped out by intensive technology based instruction over the last couple of weeks of life.
• Efforts to get families to think about spending money at more appropriate developmental stages would be decried as “Ignorance Panels” and would be stripped from any legislation. Grandparents would beg their heirs to keep them from memorizing the state capitals in their final hours.
• There would be no incentives for people with access to insurance to make good educational choices. If you have education insurance there would be no difference in cost regardless of the lifestyle choices you make. Reality show addicts who avoid anything involving the written word would pay the same as those who watch PBS or do crosswords. Ignorance would be bliss.
• The concept of preventive learning to help people better themselves would be seen as an non-reimburseable personal choice under most Education Insurance plans. Electives would only be available to the economic elite.
• Many of the wealthy would purchase cosmetic learning – fooling no one but themselves.

TEACHERS

• Teachers Unions would be some of the strongest advocates for reform. They would beg for more accountability and a rigorous focus on outcomes.
• Teachers would charge by the learning objective and would make commissions from the testing and textbook companies. The faster they rush through lessons and the more tests and materials they could order during the process the more money they would make.
• It would take 8 years to become a teacher, including a couple of years of 24 hour teaching shifts.
• Teachers would not receive a tenured position after 2-5 years on the job. They would be subject to the labor market fluctuations just like everyone else.
• But – as licensed professionals – teachers would be paid 2-3 times what they make today.
• Society would accept a system of Educational Malpractice suits against teachers. “We’d signed him up for Chemistry but it conflicted with Calculus” complained a typical set of parents. “So they slotted him into English Literature and now he wants to be a Romantic Poet. The lifetime costs of this tragic shift in interest are in the millions of dollars – its only fair that we get some help with this.”

IN CLOSING

I hope this attempt to examine this question with a little humor has opened some eyes. It could have gone on much longer – but I hope this makes my point. Universal access to education has on the whole been a huge success in our society. We should have universal access to healthcare as well for many of the same reasons. But the most fundamental reason to reform healthcare is that it is a moral challenge to our culture, in the same way education is.

Analogy is an effective educational strategy – with the ability to speed comprehension in the same way a power drill speeds home repair work. But it also has its limits. This has been a fun post to write – but I have no doubt it offended some people I hold near and dear. If I have – my apologies.

Education has its own share of thorny issues – and the pressure there is in the opposite direction of healthcare – towards more privatization. But given the out of control costs, gross inequality, and life and death impact, healthcare is the higher priority. It is good that we are tackling it first.

The fight over education reform will come up next year when the education act is up for renewal. Perhaps then we’ll reverse this lens and see what Healthcare would look like if we ran it like education.