US Health care in perspective

The latest report from the Commonwealth fund (nice summary in the Atlantic) compares the US to 10 other similar developed nations and we’re just where you would expect (if you’ve been paying the least bit of attention)– dead last.  Here’s a handy chart of various rankings:

You can also see that Canada is in 10th of 11.  There’s a reason that health care reform opponents like to pick on Canada and not Sweden, Switzerland, or others. But still, better than us.  But, of course, this chart is the real killer– we are paying so damn much for worse care:

How anybody can justify this is beyond me?  Okay, not really.  Just the power of political (conservative Republican, in this case) ideology.

Obama is not a scientist either

But he certainly appreciates the value of science.  Love his response to the whole Republican “I’m not a scientist” silliness on climate change:

Speaking to University of California, Irvine graduates in Anaheim, Obama said lawmakers were failing to uphold the responsibilities of their office by not taking bold action to curb the harmful effects of carbon emissions.

“Today’s Congress, though, is full of folks who stubbornly and automatically reject the scientific evidence about climate change,” he said. “They’ll tell you it’s a hoax, or a fad.”

He criticized those who ducked the issue by claiming they weren’t qualified enough to speak on the matter, like House Speaker John Boehner (R-Ohio) and Florida Gov.Rick Scott (R).

“Let me translate,” he said. “What that means is, ‘I accept that manmade climate change is real, but if I admit it, I’ll be run out of town by a radical fringe that thinks climate science is a liberal plot.'”  [emphasis mine]

“I’m not a scientist either, but we’ve got some good ones at NASA,” he added.

I think Obama gets it about right.  And just depressing that this radical fringe gets to drive our policy.

Cantor and today’s GOP

The Post’s Stephen Stromberg argues that Cantor’s defeat is bad for the country.  I think he’s right:

Liberals, check your schadenfreude. House Majority Leader Eric Cantor (R-Va.), once a tea party Jacobin, has been politically guillotined himself,losing his primary race Tuesday to tea party insurgent Dave Brat. But this is not just a loss for Cantor, or for the Republican establishment. It is a loss for everyone outside of the unreasonable right.

Republicans already feared drawing primary challenges for failing to be adequately doctrinaire, which explains a lot of the dysfunction in Washington. For Republicans, the cautious move has been to refuse compromise with Democrats.Crude, across-the-board spending cuts were considered a victory. Voting over and over again to repeal Obamacare or passing a variety of bills too outre to become law has been worthless policy but attractive to Republicans seeking cover from the right…

For anyone who cares about immigration reform, cutting greenhouse gas emissions, adequately funding the government or a variety of much less contentious things that a faction of conservatives dislikes, this is not good news. The country needs a functional Republican Party, responsive to broad swaths of the nation and with leaders confident enough to cooperate with Democrats, to help face its problems — or, at least, to keep the lights on. Instead, the pressure Republicans will feel to choose ideological fuming over legislative achievement, on issues large and small, will now be even greater.

Yep.  We cannot accomplish anything as a country without a sane Republican party.  Insofar as this just gives further power to the voices of insanity, it is not good.  Meanwhile, the good news is that these voices are so overwhelmingly old people (and can thus only influence our politics for so long).  Will Saletan:

How do right-wingers like Cantor and Cochran lose to challengers even further on the right? The answer lies in the extremism of Republican primary voters…

What these two polls show is how white, old, and conservative the voters in these contests were, compared with the national electorate. Let’s start with race and ethnicity. Here’s how the Virginia and Mississippi GOP voters compare with the 2012 national presidential electorate, as reported in the national media exit poll. The national electorate is 13 percent black and 10 percent Latino. The Republican sample in Cantor’s district is 6 percent black and 1 percent Latino. The Mississippi Republican sample is 2 percent black, and everyone else is either white (96 percent) or “other” (2 percent)…

Next, look at the age difference. Seniors comprise only 16 percent of the national electorate, but they’re 43 percent of the GOP sample in Cantor’s district and 70 percent of the Mississippi GOP sample. The 70 percent figure is so high that I have to assume it’s distorted by oversampling. But if so, the distortion isn’t deliberate. These are the people who answered their phones and identified themselves as voters in the Republican primary. The Virginia sample looks more balanced, but check out the difference in youth. People under age 45 comprise nearly half of the national electorate, but only 17 percent of Cantor’s primary electorate.

And plenty good charts at Saletan’s post too.  There’s plenty of Republicans who are not old, white men, but they sure have hugely disporporationate influence in Republican primaries, and thus, the nature of today’s Republicans party.

Photo of the day

From a Wired space photo of the day last month:

May 7, 2014: Giant Eye Nebula NASA


The problem is not too many bad teachers, but too few really good ones

So, last week, a California judge struck down California’s teacher (K-12) tenure law.  Regadless of the legal points, this was a really, really dumb law.  Dana Goldstein:

Here’s where the judge is right: It is difficult—actually, close to impossible—to argue that California’s teacher-tenure system makes sense. Research shows that most first-year teachers are mediocre at best. But good teachers tend to make huge jumps in effectiveness by the end of their second year on the job, and those improvements are often visible through classroom observation and students’ rising test scores. Yet California evaluates teachers for tenure in March of their second year of work, before two full years of student-teacher data are available.

This means that under current California law, principals are forced to make high-stakes decisions about teachers without enough evidence. This disadvantages students, who might get stuck with sub-par instructors, but it also hurts teachers, who aren’t given enough time to prove their skill. Once a teacher earns tenure, it can cost tens or even hundreds of thousands of dollars—and countless administrative and legal man-hours—for a district to permanently remove him from his job. And in the event of budget cuts or school closings, California law mandates that the least experienced teachers be laid off first, even if they are more effective than their older colleagues, a policy known as “LIFO,” or “Last In, First Out.”

That said, I actually learned some things about teacher tenure I had not known:

Tenure has existed in K-12 public education since 1909, when “good-government” reformers borrowed the concept from Germany. The idea spread quickly from New Jersey to New York to Chicago and then across the country. During the Progressive Era, both teachers unions and school-accountability hawks embraced the policy, which prevented teaching jobs from being given out as favors by political bosses. If it was legally difficult to fire a good teacher, she couldn’t be replaced by the alderman’s unqualified sister-in-law.

And also from a great column by Katherine Rampell

Weakening job security in the absence of other reforms may even discourage good people from entering or sticking with the profession.

That’s because job security is one of the key forms of compensation that we still offer to educators as their salaries have gotten less competitive over time, thanks to a pesky combination of women’s lib and stingy taxpayers.

Think about it this way: Once upon a time, if you were a talented, educated, ambitious woman who wanted to work outside the home, few career options were available to you – basically teaching, nursing and not much else. Women’s opportunities have widened considerably over the past few decades, which, of course, is a very good thing. But this also means that teaching (still a predominantly female profession) is no longer the default path for the United States’ best and brightest women or, for that matter, for the best and brightest Americans of either gender. In the United States, only about a quarter of new teachers come from the top third of their college classes, and just 14 percent of those end up in high-poverty schools…

Part of the reason that teacher salaries have stagnated is that taxpayers are unwilling to shell out the dough required to give them raises today. So instead, politicians offer higher compensation tomorrow – funded by future taxpayers who can’t yet vote them out of office – in the form of more generous pensions. Which is where tenure becomes so important in retaining talent: The only way to credibly guarantee to teachers that they won’t get fired before their pensions vest is by giving them strong job protections.  [emphasis mine]

Both Rampell and Goldstein point out that firing bad teachers is only a small part of the problem.  Rampell:

But improving the quality of teachers who work with poor kids seems more about insufficient inflow of the talented than insufficient outflow of the untalented. One study, based on a policy change in Chicago, found that even when dismissal rules are relaxed, many principals still choose not to fire anyone – including at the worst-performing schools – perhaps at least partly because of the challenge of finding decent replacements.

And Goldstein:

But here’s where Judge Reulf’s theory is faulty: Getting rid of these bad laws may do little to systemically raise student achievement. For high-poverty schools, hiring is at least as big of a challenge as firing, and the Vergara decision does nothing to make it easier for the most struggling schools to attract or retain the best teacher candidates…

The lesson here is that California’s tenure policies may be insensible, but they aren’t the only, or even the primary, driver of the teacher-quality gap between the state’s middle-class and low-income schools. The larger problem is that too few of the best teachers are willing to work long-term in the country’s most racially isolated and poorest neighborhoods. There are lots of reasons why, ranging from plain old racism and classism to the higher principal turnover that turns poor schools into chaotic workplaces that mature teachers avoid. The schools with the most poverty are also more likely to focus on standardized test prep, which teachers dislike. Plus, teachers tend to live in middle-class neighborhoods and may not want a long commute.

Educational equality is about more than teacher-seniority rules: It is about making the schools that serve poor children more attractive places for the smartest, most ambitious people to spend their careers.

The most recent Slate political gabfest also had a great discussion on this issue.  They made the point (borrowing from Goldstein’s other writings, I believe) that the best performing school systems around the world have teacher tenure, teacher’s unions, etc.  These are not the problem.  The problem is that we do not treat teaching as a highly-skilled, highly-professionalized, highly-compensated career.  All the best educational system do.  We need to start there.  Of course, that means more taxes.  Oh well, so much for improving education.

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