During the debate over health care, I have been frustrated by the apparent lack of interest in really finding solutions to what is clearly a growing problem. Both sides have engaged in their share of demagoguery instead of honest discussion. The RC's viewpoint is that while the Republicans have done this to some extent, the Democrats have been far worse.
One of the most frustrating elements of this is the complete refusal of the Democrats to entertain what seems so obvious to many of us: at least part of the steep health care costs curve is driven by the fact that doctors are forced to practice medicine while looking over their shoulder at lawsuits. This seems so obvious that it seems beyond doubt and ought to be uncontroversial.
It is not the whole problem, but it seems at least to be a substantial driver of health-care costs. At the very least, should it not at least be explored? Should we not at least listen to the doctors and consider what they say?
Having said that, I now want to talk about education reform. Seriously. Here's why. I submit that what malpractice costs are to liberals in the health care debate, class sizes are to conservatives in the education reform debate.
Let me explain.
It seems beyond obvious that a doctor who is worried about being sued will order unnecessary tests and that will drive costs up. To argue with that just seems unserious. At the same time, it seems equally obvious that a teacher with 25, 30, or more students will not be able to do a good job.
Is it the entire problem? No. Are there some bad, lazy teachers? Yes. Are there unmotivated students spoiled by absentee parents? Absolutely.
However, with healthcare, enacting tort reform would be a good starting point. Listen to what the doctors say--act to address the problem they bring up and then see what happens. We could address the other problems as the next step. Systematically eliminate an obvious problem, and then see what other problems remain.
Why not do the same thing with class size? Listen to the teachers and say, "Ok, we'll take you at your word. We'll reduce class sizes." Then, we are in a stronger position to address other problems in the system. It takes away an excuse, shows good faith, and actually addresses a real problem.
Part of my job is recruiting families to attend a private school. One of their first questions is about class size. Why? Because, while it isn't the sole factor, it is clearly an obvious marker of educational quality. No one would be willing to fork out five figures to be in a class of 25 or 30. That would be a joke. And yet, some conservatives argue with a straight face that class sizes are not a serious problem.
Having said that, the RC fully acknowledges that decreasing class size is not easy. It involves serious challenges to budgets and facilities. Still, if we are serious about improving education, we have to at least address and discuss the issue.
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Probably 20 to 25% of the cost of health care is defensive medicine the CBO estimates. Physician perception of their potential liability drives them--rationally--to protect themselves by over-ordering tests, and the payment incentives are to perform procedures, for which they're paid. They aren't paid for doing nothing. It's crazy not to address this issue.
ReplyDeleteI agree with your analysis on class size. But it is really expensive--$30M per kid per year statewide in UT. Still, when the economy recovers, we have to do more. One Harvard professor who has studied this thinks we'll never have the resources in public schools and that the answer is integrating computer-assited education adapted to different learning styles and speed.