Health News Digest

November 14, 2011

Comparing Education And Health Care:  More Similar Than You Might Think

Being patient

By  Michael D. Shaw

Do you remember the “Compare and Contrast” assignments from your high school days? These remain popular because they deepen our understanding of the two items under consideration. So, let’s apply this approach to two of the largest institutions in the country.

The cost of health care and education are both staggering, and are increasing at an alarming rate. Expenditures in the United States on health care surpassed $2.3 trillion in 2008, more than three times the $714 billion spent in 1990, and over eight times the $253 billion spent in 1980.

Getting the numbers for education is a bit more difficult. School districts had total expenditures of approximately $596.6 billion in 2007-08. But, we need to add the cost of higher education to this, and these figures are not compiled as frequently. The total cost of all higher education in 2002 was $289 billion. No doubt, this has increased quite significantly in the past nine years.

Keeping it all in nice, round numbers, we are probably looking at $2.5 trillion for health care and $1 trillion for education each year in the US. Bear in mind that the gross domestic product in 2010 was $14.6 trillion.

Our per capita spending on health care is by far the highest in the world, but the outcomes rank well down the list in most areas. Comparison of primary and secondary education costs between countries is difficult for a variety of reasons, but we do know that post-secondary (that is, higher education) expenses in the US—on a per capita basis—are also the highest in the world. Likewise, you will hear few rave reviews about American college graduates.

Education and health care are both subject to massive amounts of government regulation, and a substantial portion of their budgets are devoted to administrative personnel, whose sole duty is to ensure compliance.

Even though there is widespread discontent with the results produced by education and health care, nearly all attempts at reform are doomed to fail because of politics, an entrenched bureaucracy, rapidly changing demographics, and a series of long-broken models still being utilized. Moreover, the intractable problems of society including the breakdown of the family, erosion of personal responsibility, and our unwillingness to deal with death have been added to the burden of education and health care.

Politicians tapping into public discontent have done little more than increase the size and inflexibility of the bureaucracy, thus exacerbating the very problems they purport to be solving. Why did so few people notice that Obamacare provides for tens of thousands of bureaucrats, but not a single additional doctor or nurse? Why did so few people realize that the metrics of No Child Left Behind would narrow the curriculum, encourage cheating by administrators, and lower standards?

Virtually all health care expenses are paid by a third party, and a large portion of higher education costs are covered by federally-subsidized student loans. You don’t have to be a genius to figure out that such payment schemes will only drive costs ever higher, while creating no incentive for the providers to improve their services.

In both cases, the emphasis has always been on the process, rather than the results. Every American child must have a “good education,” whatever that is, and most of our citizens will tell you that our health care system is “the best in the world.” The emphasis is on the process, of course, since that’s where the money is. Yet, in most other fields of endeavor, the money is based on results. Do you see a problem here?

This column has discussed numerous ways to improve health care, so this week, we will present some ideas on how to improve education. I recently spoke with Yovel Badash of Brooklyn, NY based NaMaYa, Inc., an online Platform as a Service provider, that believes it can revolutionize how people study and learn.

Badash issued a white paper in September entitled “No Child Held Back™: Putting a New Face on 21st-Century Education Reform.”

What if the focus of the education system were to help all children reach their full personal and academic potential—to make sure that no child is held back from optimal achievement? Consider No Child Held Back (NCHB) versus No Child Left Behind. The subtle nuance in language masks a seismic shift in what this change in focus would mean for teachers, students, and academic achievement levels.

New research shows that student-centered, customized learning is the most reliable model for enabling students of all cognitive abilities to achieve academic success. No Child Held Back embraces this paradigm and encourages a dynamic shift in teaching, community partnership, and technology adoption to support an educational model based on foundations of positive reinforcement, healthy competition, individualized learning, student and parent responsibility, course variety, quality instruction, and fostering growth for both students and educators.

Badash is passionate about using the Internet to bring world class instructional content to the classroom. In the white paper, he cites the example of Sal Khan, who created videos to teach math to a relative, which became extremely popular via YouTube. Khan now operates a free online school.

Badash asks us to compare a teacher from 100 years ago to a teacher today, and consider the challenges facing them and the tools we provide them. “The challenges are completely different, and even though there are more resources today, what we provide them is pretty much the same. If we move to a No Child Held Back approach, I think the teachers are going to be more inspired and more excited about their job. Teachers are the key for anything we do.”