The Obama Presidency - 2008 & 2012

[Arles]

A quick question, but outside of a desire to reduce an enormous national debt (something both parties in congress have put on their priority scale somewhere between cleaning out toe jam and getting an un-needed root canal) - what's the motivation for congress to keep costs down in a national plan?

It just seems to me that cost will be far behind all the "positive political" gains in other areas and never change under a public plan. Without the need to turn a profit or stay in business, why does anyone think that congress will give a rat's ass about cost?

Then, once again, all of us with good jobs and with good health insurance (a majority of Americans) will see our buying power continue to decrease as congress prints money (or raises taxes) to band aid their own system that is hemorrhaging cash because it's not politically acceptable to reduce coverage/increase cost on those on the plan.

If a company/doctor has a terrible business practice and loses money, they go out of business or are forced to restructure (with someone else taking the business). What happens when a public health care system has the same issues? When you have unlimited cash backing and a government mandate to succeed, I can't imagine things being run with the same urgency as private business.

[SportsDino]

I agree that Silver is oversimplifying things a bit too much. For one, most people can't gather up 30,000 in a pinch, and applying for a loan when you just got cancer... not very feasible. If anything else, I'm pretty sure that such liquidity issues were a big motivation between the insurance market taking off in the first place.

There is some water to the growth rate concern (9-10% is an insane growth rate in costs, double every 7 years or so, yikes). Also I would argue that dumb consumers and hidden subsidies have an impact on the market (encouraging the growth in costs as I mentioned in my long blabfest).

I'd argue that customer service has declined in quality, costs have increased, overhead has increased, and the base product itself has been compromised (by insurers unwilling to man up and pay up their side of the contract, the critical point of the product!). I fall into the public option line of thought simply because I know our government is too easily corrupted to get the private companies in line. Sadly, inefficient administration would still be preferable to outright collapse (which occurs not with the public option, but unmitigated private solution falling apart entirely).

[JonInMiddleGA]

Originally Posted by flere-imsaho

In your defense, I did edit the post to add that in later, so you might have missed that.

Yeah, I never saw that until just now, will have to review in a bit.

(Holiday? What holiday? At least half the annoying gits in my work life seem to be hard at it already)

[flere-imsaho]

Originally Posted by Arles

A quick question, but outside of a desire to reduce an enormous national debt (something both parties in congress have put on their priority scale somewhere between cleaning out toe jam and getting an un-needed root canal) - what's the motivation for congress to keep costs down in a national plan?

Using this line of thought, why allow Congress to approve any ongoing programs that spend money?

Then, once again, all of us with good jobs and with good health insurance (a majority of Americans)

Ah, this canard again. Your good health insurance is only good up until the point that you develop something really expensive and your insurance company starts looking for ways to get rid of you. And that's not even mentioning lifetime benefit caps.

[JPhillips]

Wow. Evan Bayh is retiring. Wonder if he's looking at a challenge to Obama in 2012 or is simply leaving politics.

Strange timing after he and the DNC have been beating the hell out of Dan Coats since his announcement.

[flere-imsaho]

Originally Posted by JonInMiddleGA

Yeah, I never saw that until just now, will have to review in a bit.

Yeah, my bad. I posted, re-reviewed what I quoted, saw that it was tangential to my point, and decided to add some stuff to clarify my point.

[JonInMiddleGA]

Originally Posted by JPhillips

Wow. Evan Bayh is retiring. Wonder if he's looking at a challenge to Obama in 2012 or is simply leaving politics.

Judging from his statement, I suspect he knows that there's a university presidency waiting for him somewhere. And a "non-profit" charity job waiting for him to fill any downtime before that academic spot is ready.

But watching someone launch a challenge to Obama for the nomination would be decent popcorn munching fun.

[rowech]

Originally Posted by JonInMiddleGA

Judging from his statement, I suspect he knows that there's a university presidency waiting for him somewhere. And a "non-profit" charity job waiting for him to fill any downtime before that academic spot is ready.

But watching someone launch a challenge to Obama for the nomination would be decent popcorn munching fun.

There's still a strong part of me that believes you'll see Hillary run for president.

[Arles]

Originally Posted by flere-imsaho

Using this line of thought, why allow Congress to approve any ongoing programs that spend money?

I don't think the government does a good job with Education and can't see health care going any better. At some point, the government needs to stop trying to perform the same services as private groups and simply subcontract them. it's the only way to get the best quality of service, high level of accountability and best cost.

Ah, this canard again. Your good health insurance is only good up until the point that you develop something really expensive and your insurance company starts looking for ways to get rid of you. And that's not even mentioning lifetime benefit caps.

About 60% of people have employer-supplied health care, 8-9% have non-group coverage, 28% are already in a public-sponsored government plan (some of that number is included in the employer number) and 15% are uninsured. So, if you count everyone in non-group coverage and the unemployed (many of which are kids are single people with no dependents), just 24% of people don't have coverage either provided by a company or an existing government plan. That's where the focus should be on improving coverage and I have no problem if the government wants to provide incentives/strings for subsidies on covering unemployed/self-employed/pre-existing people.

[flere-imsaho]

Originally Posted by Arles

I don't think the government does a good job with Education and can't see health care going any better.

Are private companies doing any better with education? I've heard plenty of complaints about charter schools, for instance.

At some point, the government needs to stop trying to perform the same services as private groups and simply subcontract them. it's the only way to get the best quality of service, high level of accountability and best cost.

Otherwise known as a single-payer system. Contract out all the administration of the program, but the government pays and provides oversight (in an ideal world oversight is done by panels of nonpartisan experts, such as how doctors set treatment guidelines for Medicare).

About 60% of people have employer-supplied health care, 8-9% have non-group coverage, 28% are already in a public-sponsored government plan (some of that number is included in the employer number) and 15% are uninsured.

Yes, but how many of them have good insurance? How high is the average deductible for people? How many will be dropped by their companies when they develop critical problems? Etc....

[Greyroofoo]

Originally Posted by Arles

I don't think the government does a good job with Education and can't see health care going any better. At some point, the government needs to stop trying to perform the same services as private groups and simply subcontract them. it's the only way to get the best quality of service, high level of accountability and best cost.

As a guy who works with government contractors...

:

[Dutch]

I work with govt contractors and they are some of the most knowledgable bad ass muthers on the planet. YMMV.

[miked]

Originally Posted by Dutch

I work with govt contractors and they are some of the most knowledgable bad ass muthers on the planet. YMMV.

Hopefully not the ones that charge 200% of what it costs because they are no bid jobs, or not the ones who rape and kill. Other than that, I guess we're cool.

[Arles]

Originally Posted by flere-imsaho

Are private companies doing any better with education? I've heard plenty of complaints about charter schools, for instance.

We're looking at Private schools for Jackson (starting Kindergarten soon) and the differences are pretty major. We are in a very good school district for Arizona (Kyrene) and here's a breakdown of testing results for the private school we are looking at compared to one of the top districts and state overall:

Met or exceed standards for AIMS testing in 2009:

Math
Private: 100%
Kyrene: 85%
Arizona: 73%

Reading
Private: 100%
Kyrene: 82%
Arizona: 70%

Writing
Private: 100%
Kyrene: 90%
Arizona: 78%

I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.

Otherwise known as a single-payer system. Contract out all the administration of the program, but the government pays and provides oversight (in an ideal world oversight is done by panels of nonpartisan experts, such as how doctors set treatment guidelines for Medicare).

Not quite. I would say the government should provide tax subsidies based on certain situations to individuals and to insurance companies. The onus is on the individual to find the right health care plan, but once they do the subsidies can be applied (even as an incentive for the company to accept the person - ie, some pre-existing situations).

Outside of the tax code, the government isn't involved.

Yes, but how many of them have good insurance? How high is the average deductible for people? How many will be dropped by their companies when they develop critical problems? Etc....

This is always an interesting question. What is "good insurance"? Everything is always paid for - no questions asked? 80% paid? 50% paid?

If you look at what health insurance should be used for (ie, catastrophic care mitigation), then most people have pretty solid coverage. If you look at it for what a lot of people want it to be (minimal out of pocket for nearly every service/ health situation), then it's probably a bit lacking in some cases.

I would be willing to bet that most of the 60% with current employer coverage will be the same or worse under a public plan. Most certainly won't have better insurance and it definitely will not cost less. So, once again, a public system throws the baby out with the bath water to improve coverage for small portion of society while making it more expensive (wait time, coverage, needing private to get back to what you had) for the majority with good coverage.

[Arles]

Originally Posted by Greyroofoo

As a guy who works with government contractors...

If the government can't manage groups they can hold up to a certain standard of accountability, make compete against other private groups, fire and replace - what makes anyone think they can manage groups where no accountability exists?

[Hoosierbuckeye]

Originally Posted by miked

Hopefully not the ones that charge 200% of what it costs because they are no bid jobs, or not the ones who rape and kill. Other than that, I guess we're cool.

What the heck does this mean? Especially "the ones who rape and kill."?

[flere-imsaho]

Originally Posted by Hoosierbuckeye

What the heck does this mean? Especially "the ones who rape and kill."?

KBR, Halliburton.

[flere-imsaho]

Originally Posted by Arles

If the government can't manage groups they can hold up to a certain standard of accountability, make compete against other private groups, fire and replace - what makes anyone think they can manage groups where no accountability exists?

There are parts of the government that manage their contractor relationships well and get value for money, and there are parts that don't. Sometimes even within the same branch of government.

As with all government programs, present and future, we need to demand better non-partisan scrutiny and overview.

[JPhillips]

Originally Posted by Arles

We're looking at Private schools for Jackson (starting Kindergarten soon) and the differences are pretty major. We are in a very good school district for Arizona (Kyrene) and here's a breakdown of testing results for the private school we are looking at compared to one of the top districts and state overall:

Met or exceed standards for AIMS testing in 2009:

Math
Private: 100%
Kyrene: 85%
Arizona: 73%

Reading
Private: 100%
Kyrene: 82%
Arizona: 70%

Writing
Private: 100%
Kyrene: 90%
Arizona: 78%

I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.


Not quite. I would say the government should provide tax subsidies based on certain situations to individuals and to insurance companies. The onus is on the individual to find the right health care plan, but once they do the subsidies can be applied (even as an incentive for the company to accept the person - ie, some pre-existing situations).

Outside of the tax code, the government isn't involved.


This is always an interesting question. What is "good insurance"? Everything is always paid for - no questions asked? 80% paid? 50% paid?

If you look at what health insurance should be used for (ie, catastrophic care mitigation), then most people have pretty solid coverage. If you look at it for what a lot of people want it to be (minimal out of pocket for nearly every service/ health situation), then it's probably a bit lacking in some cases.

I would be willing to bet that most of the 60% with current employer coverage will be the same or worse under a public plan. Most certainly won't have better insurance and it definitely will not cost less. So, once again, a public system throws the baby out with the bath water to improve coverage for small portion of society while making it more expensive (wait time, coverage, needing private to get back to what you had) for the majority with good coverage.

But those numbers don't mean much because the student bodies are different. Private schools before better in part because of the more engaged parents. I haven't seen any evidence that shows private schools performing better with identical student bodies as those of public schools.

[flere-imsaho]

Originally Posted by Arles

This is always an interesting question. What is "good insurance"? Everything is always paid for - no questions asked? 80% paid? 50% paid?

How about "coverage whose out-of-pocket expenses don't result in bankruptcy for the insured should they develop an expensive condition (including instances where the insurance company subsequently finds reasons to deny coverage)"?

[gstelmack]

Originally Posted by flere-imsaho

Are private companies doing any better with education? I've heard plenty of complaints about charter schools, for instance.

Yes, they are. My daughter is getting a MUCH better education in her private school than she would get locally. I don't really want to go into details or examples, but the teachers pay attention to each and every child's needs and interacts heavily with the parents, while the local public school teachers have classes too big and too many disruptive kids to do the same.

Charter schools aren't quite the same as private, and magnet muddies the water, but I can guarantee that my wife and I are very happy with what we get, even though it stretches our budget to the limit, compared to what friends in public school are getting.

[JPhillips]

Originally Posted by Arles

We're looking at Private schools for Jackson (starting Kindergarten soon) and the differences are pretty major. We are in a very good school district for Arizona (Kyrene) and here's a breakdown of testing results for the private school we are looking at compared to one of the top districts and state overall:

Met or exceed standards for AIMS testing in 2009:

Math
Private: 100%
Kyrene: 85%
Arizona: 73%

Reading
Private: 100%
Kyrene: 82%
Arizona: 70%

Writing
Private: 100%
Kyrene: 90%
Arizona: 78%

I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.


Not quite. I would say the government should provide tax subsidies based on certain situations to individuals and to insurance companies. The onus is on the individual to find the right health care plan, but once they do the subsidies can be applied (even as an incentive for the company to accept the person - ie, some pre-existing situations).

Outside of the tax code, the government isn't involved.


This is always an interesting question. What is "good insurance"? Everything is always paid for - no questions asked? 80% paid? 50% paid?

If you look at what health insurance should be used for (ie, catastrophic care mitigation), then most people have pretty solid coverage. If you look at it for what a lot of people want it to be (minimal out of pocket for nearly every service/ health situation), then it's probably a bit lacking in some cases.

I would be willing to bet that most of the 60% with current employer coverage will be the same or worse under a public plan. Most certainly won't have better insurance and it definitely will not cost less. So, once again, a public system throws the baby out with the bath water to improve coverage for small portion of society while making it more expensive (wait time, coverage, needing private to get back to what you had) for the majority with good coverage.

Insurance should also be there for chronic care management.

[gstelmack]

Originally Posted by JPhillips

But those numbers don't mean much because the student bodies are different. Private schools before better in part because of the more engaged parents. I haven't seen any evidence that shows private schools performing better with identical student bodies as those of public schools.

"Identical student bodies" is difficult to indentify. However, when I'm looking at a teacher-to-student ratio guaranteed to be under 20:1, and often closer to 8:1 (my daughter's first grade class is 15 kids with two teachers, and they typically will split into two rooms with two teachers once they reach around 30 kids, so worst is usually 15:1), as opposed to the legislature-mandated 24:1 that is often granted exceptions to cut costs, that makes a HUGE difference in how closely the teacher can tune the experience to individual children.

[gstelmack]

The fundamental problem with health insurance is that despite talking about risk groups and spreading the burden around, most insurance works off much smaller groups. Instead of "everyone under BCBS-NC being in one risk group", we get each individual company under its own risk group, with costs varying widely among companies.

A key issue with paying for healthcare in this country is that in order to receive quality care outside of a major trauma incident (and I have close experience with the fantastic care an uninsured person can get without any isurance in such a case) you need to have insurance, in large part because the insurance companies negotiate very low payments for services compared to what an individual walking up with cash would pay, even though that's less paperwork.

Give me a system where costs are fixed no matter who you are for a particular treatment, prescription, or visit, and I think we can work out the insurance / government part of it. But I don't believe the government will do any better than private insurance (note that as medicare cuts payments, folks are getting out of accepting medicare) since they are both playing the same game. We need costs to be separated from who is paying FIRST. Then we need a far more streamlined system for billing and paying that doesn't require huge office staffs to maintain, thus continuing to drive up the costs. And let's get all the pharmaceutical sales people out of a job and let the medical folks decide what meds need to be used when (and avoid having the doctor's day get interrupted by some salesperson walking in while there are patients all over the waiting room).

I'm not in favor of our current health insurance system by a longshot, but I'm not seeing a whole lot better proposed, either.

And let's not forget that we don't have enough doctors to treat every possible patient as it is.

[flere-imsaho]

Originally Posted by Arles

We're looking at Private schools for Jackson (starting Kindergarten soon) and the differences are pretty major. We are in a very good school district for Arizona (Kyrene) and here's a breakdown of testing results for the private school we are looking at compared to one of the top districts and state overall:

I'm having trouble understanding the statistical relevance of comparing one school to an entire school district or even an entire state's worth of schools.

I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.

I'm not sure how true any of those statements are.

For instance, witness the phenomenon of "absentee" wealthy parents who send their kids to expensive private schools but care less about the quality of education received there than the day-to-day movement in their stock portfolio.

Likewise, there are plenty of school districts with significant involvement from parents (who are also taxpayers). Sure you might see this less in the cities, but there's a reason school boards generate such significant political drama in the suburbs.

Secondly, although private schools compete against other private schools, they also compete against good public school districts. For instance, our district found that during the last recession the influx of kids from private schools (whose parents couldn't afford them, temporarily), generally stayed within the district due to the quality and value.

If anything, your examples point to the value of direct public engagement in the value they're getting for their tax dollars. But if that's the case we should stop having insurance provided through employers, because none of the insured really look at the costs. Make everyone pay for their insurance out of pocket and decide how much risk vs. cost they're willing to bear, and let the market set that rate, right?

Which sounds great in theory until the 90% who then don't get insurance flood the publically-available emergency rooms.

[flere-imsaho]

Originally Posted by Arles

I would be willing to bet that most of the 60% with current employer coverage will be the same or worse under a public plan. Most certainly won't have better insurance and it definitely will not cost less.

Then why does it cost less in every other country in the world (per capita)?

So, once again, a public system throws the baby out with the bath water to improve coverage for small portion of society while making it more expensive (wait time, coverage, needing private to get back to what you had) for the majority with good coverage.

It may be a "small portion" without any coverage whatsoever, but the number of insured people who incur significant expense due to coverage maximums, insufficient coverage or even just the insurance companies weaseling out of their part of the contract is significantly higher.

And do please trot out that "but wait times are more and care is worse" argument, which always rings hollow with anyone who's actually lived in one of those systems.

[Greyroofoo]

I'm more inclined to think that someone who got a good paying job due to their education is more likely to instill the value of a good education in their kids, which includes paying private school tuition.

Someone who has a bottom-feeder job or is on welfare is more likely to not get involved with their kids education.

[SportsDino]

Originally Posted by gstelmack

The fundamental problem with health insurance is that despite talking about risk groups and spreading the burden around, most insurance works off much smaller groups. Instead of "everyone under BCBS-NC being in one risk group", we get each individual company under its own risk group, with costs varying widely among companies.

A key issue with paying for healthcare in this country is that in order to receive quality care outside of a major trauma incident (and I have close experience with the fantastic care an uninsured person can get without any isurance in such a case) you need to have insurance, in large part because the insurance companies negotiate very low payments for services compared to what an individual walking up with cash would pay, even though that's less paperwork.

I'd also add to this point, all the work to process these different price structures and verify the insurance is way too cumbersome to be done cheaply. Simpler price structures, set prices based on cost to perform the care, NOT complicated charts of what the insurance companies want to pay for whatever item... would help to decrease overhead and processing costs. Also it would make it a lot clearer where cost savings can be found (once fixing a broken leg returns to the expense of having a doctor in a room, some cast materials, and whatever the painkiller shot costs... its a lot easier to reduce expenses for everyone).

Originally Posted by gstelmack

Give me a system where costs are fixed no matter who you are for a particular treatment, prescription, or visit, and I think we can work out the insurance / government part of it. But I don't believe the government will do any better than private insurance (note that as medicare cuts payments, folks are getting out of accepting medicare) since they are both playing the same game. We need costs to be separated from who is paying FIRST. Then we need a far more streamlined system for billing and paying that doesn't require huge office staffs to maintain, thus continuing to drive up the costs. And let's get all the pharmaceutical sales people out of a job and let the medical folks decide what meds need to be used when (and avoid having the doctor's day get interrupted by some salesperson walking in while there are patients all over the waiting room).

I'm not in favor of our current health insurance system by a longshot, but I'm not seeing a whole lot better proposed, either.

And let's not forget that we don't have enough doctors to treat every possible patient as it is.

I think its impossible to get the bureaucracy out of the private system right now, they seem thoroughly convinced they can make profit better through paperwork and denial of coverage than through providing coverage at simpler overhead and perhaps even higher price. In fact, the paperwork makes their job seem more necessary than it is... I'd prefer if we get insurance companies back to being closer to a financial pool of money and out of the approving/disapproving health care business which is so expensive and frivilous lawsuit based.

One thing a public system could do is insist on fixed costs and changing supply side at the hospitals. It will be ugly and corrupt like any government interference, but it would actually move instead of the entrenched position the insurance companies are in at the moment (they do not feel they have to or its in their best interest to move, hence paralysis). The government would also have an incentive to get the flow of new doctors into the economy to increase, and opening up the borders for drug importation, and other known economic fixes that the private companies are fighting tooth and nail, for no good reason (other than their bottom line). Only government restriction prevents us from cutting drug costs by importing from Canada.

Getting rid of all the medical marketing would help in the long run as well, doctors should be deciding whether you need Lipitor or not, its pointless to have a commercial.

Do we need public run health care to do this, no, but do you see any company volunteering to do any of this for the public good? They are too stuck in their mindset to move, and have no financial incentive to push them out of it until it hits catastrophic levels. At which point they'll whine for a bailout like every other company.

Bring a big bully to the room in the form of a public option, give it some teeth, and then bring some stick along with the carrot so that private options have grounds to compete on quality of service (but change the marketplace so cost-reducing competition and paperwork streamlining becomes a necessity). If done right, the public option becomes a quaint little safety net that anyone with money sneers at for being 'common' and the private industry makes a tidy profit on rich people that can maintain a contract.

The cost will be government coverage of the commoners, the value gain would be in reduced costs of health care itself (that is, public and private costs for services decrease). That won't come from scale by itself, in fact scale can crush the already stressed health system. It needs to come from a fundamental change in how companies do business (less overhead, reduce costs to materials and labor instead of the implied costs of paperwork which are factored into those rosy statistics the insurance industry keeps posting about 80% of money being applied to claims).

[sterlingice]

Originally Posted by Arles

I don't think the government does a good job with Education and can't see health care going any better. At some point, the government needs to stop trying to perform the same services as private groups and simply subcontract them. it's the only way to get the best quality of service, high level of accountability and best cost.

I just don't buy this. The federal government has very little to do with education in this country, far less than most things it has its hand in. It sends down unfunded mandates and that's about it.

The much bigger problem with education in this country is that it's handled in that "push the buck down, let the states/local government handle it" crap. Your funding is done at a local level and aside from asinine junk (re: unfunded mandates) like NCLB testing, almost all decisions are made at a local or state level for schooling, not a national one. Education in this country is as decentralized a "government" institution as it gets.

And, guess, what- the item most like the model so many small government folk like to push is one of the most effed up in this country. When you're hiring with a local budget with no uniformity and no structure, you get much more wildly varying degrees of quality.

SI

[JPhillips]

Originally Posted by Greyroofoo

I'm more inclined to think that someone who got a good paying job due to their education is more likely to instill the value of a good education in their kids, which includes paying private school tuition.

Someone who has a bottom-feeder job or is on welfare is more likely to not get involved with their kids education.

Can you provide any data that supports that? You being inclined to think it doesn't make it true.

[sterlingice]

Originally Posted by Arles

We're looking at Private schools for Jackson (starting Kindergarten soon) and the differences are pretty major. We are in a very good school district for Arizona (Kyrene) and here's a breakdown of testing results for the private school we are looking at compared to one of the top districts and state overall:

Met or exceed standards for AIMS testing in 2009:

Math
Private: 100%
Kyrene: 85%
Arizona: 73%

Reading
Private: 100%
Kyrene: 82%
Arizona: 70%

Writing
Private: 100%
Kyrene: 90%
Arizona: 78%

I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.

Correlation does not imply causation.

How many students below the poverty line are in the private school? How many students in that private school have parents working 2 jobs to put food on the table and a roof over their heads and thus can't spend as much time helping the child in school.

If there are "dumb students" going in the door to the private school, do they suddenly get smart? Probably not. It just turns out that if you can afford to let your kids go to a private school, you're probably more likely to be engaged with your kid. The private school is self-selective, based on the cost of going to said private school.

If the private schools had to take the same demographics as the public schools then their numbers would be similar. Plain and simple- it turns out that if you can afford to send your kid to private school, you can spend more time with them which gives them an edge on the "nurture" half of the equation and, for the "nature" side, they're likely ahead genetically because you were about the smart threshold to get a good job because otherwise you wouldn't be able to afford to put them in the school in the first place.

Yes, among the private schools, it will be that one school is better than another school because competition breeds better performance. But the reason why they perform better on the whole is because they're skimming the best students off the top. If there were a public school that was doing the same thing, I'm guessing the scores would be similar.

SI

[DaddyTorgo]

Originally Posted by sterlingice

Correlation does not imply causation.

How many students below the poverty line are in the private school? How many students in that private school have parents working 2 jobs to put food on the table and a roof over their heads and thus can't spend as much time helping the child in school.

If there are "dumb students" going in the door to the private school, do they suddenly get smart? Probably not. It just turns out that if you can afford to let your kids go to a private school, you're probably more likely to be engaged with your kid. The private school is self-selective, based on the cost of going to said private school.

If the private schools had to take the same demographics as the public schools then their numbers would be similar. Plain and simple- it turns out that if you can afford to send your kid to private school, you can spend more time with them which gives them an edge on the "nurture" half of the equation and, for the "nature" side, they're likely ahead genetically because you were about the smart threshold to get a good job because otherwise you wouldn't be able to afford to put them in the school in the first place.

Yes, among the private schools, it will be that one school is better than another school because competition breeds better performance. But the reason why they perform better on the whole is because they're skimming the best students off the top. If there were a public school that was doing the same thing, I'm guessing the scores would be similar.

SI

seriously - i'm surprised you had to post this. i would have assumed it would be common sense.

[sterlingice]

Originally Posted by JPhillips

Can you provide any data that supports that? You being inclined to think it doesn't make it true.

One of the chapters of Freakonomics hit this pretty hard (ch 6, iirc). Basically, it turns out parent income, which correlates quite strongly to intelligence is a great predictor of future education.

SI

[sterlingice]

Originally Posted by Hoosierbuckeye

What the heck does this mean? Especially "the ones who rape and kill."?

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SI

[rowech]

Originally Posted by sterlingice

One of the chapters of Freakonomics hit this pretty hard (ch 6, iirc). Basically, it turns out parent income, which correlates quite strongly to intelligence is a great predictor of future education.

SI

Yes...and an offshoot of this is the highest educational level obtained by the mother.

[JonInMiddleGA]

Originally Posted by sterlingice

If there are "dumb students" going in the door to the private school, do they suddenly get smart? Probably not.

Entirely anecdotal of course but I've never been able to identify the students on financial aid from the rest of the student body based on academic performance at the best of the three schools we've dealt with nor at the least of the three, you could do it a little bit at the middle one I'd say but it was a parochial schools that had the most lax standards of the three.

[panerd]

Originally Posted by sterlingice

I just don't buy this. The federal government has very little to do with education in this country, far less than most things it has its hand in. It sends down unfunded mandates and that's about it.

The much bigger problem with education in this country is that it's handled in that "push the buck down, let the states/local government handle it" crap. Your funding is done at a local level and aside from asinine junk (re: unfunded mandates) like NCLB testing, almost all decisions are made at a local or state level for schooling, not a national one. Education in this country is as decentralized a "government" institution as it gets.

And, guess, what- the item most like the model so many small government folk like to push is one of the most effed up in this country. When you're hiring with a local budget with no uniformity and no structure, you get much more wildly varying degrees of quality.

SI

None is this is even close to being true. Try again. NCLB has absolutely taken control of every aspect of education. I will state as a teacher in a "rich" school district in St. Louis County it is a major part of every single thing that we do and I know this is true in every neighboring district that I have worked with people in. So go ahead and show some pie chart about what percentage the federal government contributes to education and I will invite you to go to any school and talk to them about the one size fits all testing standards that every state and local government has developed to meet and to try and comply with a bunch of bureaucrats in Washington DC. (Its a lot more comlicated law than anyone can possibly fathom) I am willing to engage in spirited debate but once you tell me that I am wrong I refuse to waste any more time responding to someone who has no idea what they are talking about (pie charts, unfunded NCLB doesn't really mean anything) telling me the realities of my job. <--- This last sentence is important. I don't necessarily think that you will do this SI but I have had plenty of people do it. And I don't need to waste my time explaining how for the past 7 years I have heard about this bullshit almost daily to somebody who has done nothing more than typed NCLB into wikipedia.

(Don't even get me started on what this has done to our history classes where kids are being double dealt math and reading at the expensive of actually being taught US history, world history, civics, economics, etc to figure out how fucked up the government is actually becoming.)

And if we want to take it a step furthur we can next look at the impact of IDEA and special education (again federal mandates that were not thought out at all) in the past 20-30 years.

[RainMaker]

Originally Posted by JonInMiddleGA

Because they aren't in the business of providing medical treatment, they're offering a risk management opportunity. They're a business that exists solely for the purpose of making money for the owners/investors just like real estate or advertising and it boggles my mind that so many people seem not to understand that or to be in some state of denial about it.

Actually they are. They have to approve hospital stays, duration, procedures, and prescriptions. They are just as important, if not more important than your doctor in providing medical care.

[sterlingice]

Originally Posted by panerd

None is this is even close to being true. Try again. NCLB has absolutely taken control of every aspect of education. I will state as a teacher in a "rich" school district in St. Louis County it is a major part of every single thing that we do and I know this is true in every neighboring district that I have worked with people in. So go ahead and show some pie chart about what percentage the federal government contributes to education and I will invite you to go to any school and talk to them about the one size fits all testing standards that every state and local government has developed to meet and to try and comply with a bunch of bureaucrats in Washington DC. (Its a lot more comlicated law than anyone can possibly fathom) I am willing to engage in spirited debate but once you tell me that I am wrong I refuse to waste any more time responding to someone who has no idea what they are talking about (pie charts, unfunded NCLB doesn't really mean anything) telling me the realities of my job. <--- This last sentence is important. I don't necessarily think that you will do this SI but I have had plenty of people do it. And I don't need to waste my time explaining how for the past 7 years I have heard about this bullshit almost daily to somebody who has done nothing more than typed NCLB into wikipedia.

(Don't even get me started on what this has done to our history classes where kids are being double dealt math and reading at the expensive of actually being taught US history, world history, civics, economics, etc to figure out how fucked up the government is actually becoming.)

And if we want to take it a step furthur we can next look at the impact of IDEA and special education (again federal mandates that were not thought out at all) in the past 20-30 years.

Obviously things have changed a lot in the last 10 years- I've heard quite a bit about it from my wife's mom (she's a high school math teacher in Iowa). But you haven't really refuted the point I was trying to make.

Please, correct me if I'm wrong, but we now have two separate mechanisms:
-the funding is still primarily done at a local level
-however, there are numerous unfunded mandates to test extensively, dedicate substantial money to special needs, etc so your local resources are now doing much more than they had to previously

Couple those with the gutting of state education funding by budget gaps in state legislatures and, yeah, public schools are getting brutally killed with less funding, more restrictions, and a weaker talent pool than "comparative" private schools which are not really a fair comparison at all.

(As an aside, so how's that "small government" Bush preached about working where he did this to schools? Hell, it's almost as if he wanted the public school system that much more stressed a decade or two down the line so we can go "see, we need privatization" which just basically serves to perpetuate and grow the gap between the haves and the have nots)

SI

[JonInMiddleGA]

Originally Posted by RainMaker

Actually they are. They have to approve hospital stays, duration, procedures, and prescriptions. They are just as important, if not more important than your doctor in providing medical care.

No, they approve whether or not they're going to pay for it under the terms of your relationship with them and/or the provider. They neither provide care nor do they deny anyone from seeking that care.

Point being, it's "insurance" not "free health care for whatever you damned well please". But generally it's become misdefined as the latter. For all the hand wringing about health insurance costs, I don't believe anyone actually wants to see what those rates would be if it was actually the latter.

[JonInMiddleGA]

Originally Posted by panerd

(Its a lot more comlicated law than anyone can possibly fathom)

I have to hope that someone can fathom it somewhere, or at least a group of someones who can fathom enough pieces between them to make the whole.

I'll be honest with you, I spent several years (ghost)writing most of the local newspaper coverage of it when it was rolled out, meaning only that I've probably read a lot more of the specifics in detail than the average Joe Q. Taxpayer. I found plenty of quirky governmental language* but didn't think it was that difficult to understand in principle or in big picture ways, and with time spent on the specific details didn't think it was that tough to grasp either.

Now, about that *asterisk. Sometimes, especially as things were tweaked since the initial concept, some of that governmental language reached the point of being pretty fucked up maybe even contradicting itself. But I don't think that's unique to NCLBA.

Full disclosure (for those who haven't seen me say this already), I'm about as unapologetic a supporter of NCLBA as you're likely to find in the general population. That said, that's increasingly become a matter of trying to find any sort of accountability for the massive amounts of money funneled into public education than about believing there's much reality behind what was perhaps a noble basic idea but when it's applied to reality it breaks down badly & quickly.

I'd be happy to work with anyone on coming up with a better method of accountability for those dollars but I'd still fight to my last breath to defend even a flawed NCLBA over a return to the previous state of affairs.

[flere-imsaho]

Originally Posted by JonInMiddleGA

No, they approve whether or not they're going to pay for it under the terms of your relationship with them and/or the provider.

Which is effectively the same as them approving care or not.

If your doctor says you need a CT scan but your insurance company says you don't, who's wins? And is that right?

[RainMaker]

Originally Posted by JonInMiddleGA

No, they approve whether or not they're going to pay for it under the terms of your relationship with them and/or the provider. They neither provide care nor do they deny anyone from seeking that care.

Point being, it's "insurance" not "free health care for whatever you damned well please". But generally it's become misdefined as the latter. For all the hand wringing about health insurance costs, I don't believe anyone actually wants to see what those rates would be if it was actually the latter.

But that's the purpose of health insurance. To have something in place to pay for something you would normally not be able to pay in an unfortunate incident. People don't have $150,000 lying around for when they come down with cancer. Just as homeowners don't have $300,000 lying around for when their home burns down. That is the sole reason you purchase insurance. Because without it, you wouldn't be able to afford a worst-case scenario.

So when insurance doesn't cover something, there is typically no other option for that person. Doctors are reluctant to take patients who don't have insurance and pharmaceutical companies don't sell their drugs on credit.

I'm not arguing costs or anything of that nature, just the notion that insurance companies are not the ones treating you. If your ever stuck in a hospital and your insurance company wants you there one less day than your doctor, good luck telling the hospital that "you're good for the extra $15,000" on the bill. They will make sure to have you out the day the insurance company wants you out. That is the insurance company making medical decisions and determining what is best for your health.

[flere-imsaho]

Originally Posted by JonInMiddleGA

Point being, it's "insurance" not "free health care for whatever you damned well please".

I'd argue it's neither. It's certainly not "free health care for whatever you damned well please" as anyone who's read their benefits booklet can attest. However, I'm not ready to call it "insurance" until the industry stop using a phalanx of lawyers to avoid or delay paying on big ticket items worded ambiguously in their contract and also employ thousands of bureaucrats to argue about medical care with doctors.

What we have now I'd call a "Semi-critical pre-payment reimbursement plan".

[JonInMiddleGA]

Originally Posted by RainMaker

But that's the purpose of health insurance. To have something in place to pay for something you would normally not be able to pay in an unfortunate incident. People don't have $150,000 lying around for when they come down with cancer. Just as homeowners don't have $300,000 lying around for when their home burns down.

Fine, we're in general agreement.

But

If your ever stuck in a hospital and your insurance company wants you there one less day than your doctor, good luck telling the hospital that "you're good for the extra $15,000" on the bill.

Neither is a homebuilder going to rebuild your home for more than the amount the insurance covered it for unless they've got guarantees that they're going to be paid for their work. There are policies for full replacement and you pay for those if you want them.

That is the insurance company making medical decisions and determining what is best for your health.

No, they're making decisions based on the agreement you have with them including being subject to financial limitations on their liability. Whether you pursue treatment beyond that, or even whether you have the financial ability to pursue additional treatment beyond those limitations isn't neither their problem nor their fault.

[DaddyTorgo]

Originally Posted by RainMaker

But that's the purpose of health insurance. To have something in place to pay for something you would normally not be able to pay in an unfortunate incident. People don't have $150,000 lying around for when they come down with cancer. Just as homeowners don't have $300,000 lying around for when their home burns down. That is the sole reason you purchase insurance. Because without it, you wouldn't be able to afford a worst-case scenario.

So when insurance doesn't cover something, there is typically no other option for that person. Doctors are reluctant to take patients who don't have insurance and pharmaceutical companies don't sell their drugs on credit.

I'm not arguing costs or anything of that nature, just the notion that insurance companies are not the ones treating you. If your ever stuck in a hospital and your insurance company wants you there one less day than your doctor, good luck telling the hospital that "you're good for the extra $15,000" on the bill. They will make sure to have you out the day the insurance company wants you out. That is the insurance company making medical decisions and determining what is best for your health.

i'm not sure why jon doesn't understand this? I wonder sometimes if he's playing semantical-games in order to avoid having to deal with the actual (legitimate) underlying question...?

[flere-imsaho]

Originally Posted by JonInMiddleGA

I'd be happy to work with anyone on coming up with a better method of accountability for those dollars but I'd still fight to my last breath to defend even a flawed NCLBA over a return to the previous state of affairs.

I'm all for accountability on ROI for tax dollars (hey, let's start with defense contracts!), but using standardized testing as a way to do this was always lazy and stupid.

[Arles]

Originally Posted by sterlingice

If the private schools had to take the same demographics as the public schools then their numbers would be similar. Plain and simple- it turns out that if you can afford to send your kid to private school, you can spend more time with them which gives them an edge on the "nurture" half of the equation and, for the "nature" side, they're likely ahead genetically because you were about the smart threshold to get a good job because otherwise you wouldn't be able to afford to put them in the school in the first place.

It would certainly be worse than what it is, but that doesn't mean it's not significantly better than an average public school. The place we checked out had a 6:1 student-teacher ration - sometimes having as many as 5 qualified teachers (plus 2 parent assistants) in classes of under 20 kids. I'm pretty sure that's more 1-on-1 time than your average public school.

- They also have a PHD expert on learning techniques that sets their curriculum based on data and studies on what works the best for each age group.
- They send out weekly packets going exactly through what their children will be learning so the parents can monitor progress.
- They give constant status reports on each kid and if someone is falling behind, they adjust the material for that specific kid to help them catch up.
- They have specific instructors for art, music, science and technology that specialize in those areas and take over each class when it's time to learn those subjects (as early as kindergarten)

We've taken tours of private schools and compared them to what is offered by a very solid public school in our area and it's night and day in terms of the learning environment. Now, that's not to say that a kid can't get a good public education, but the advantages they get in a private school are enormous.

Originally Posted by flere-imsaho

Then why does it cost less in every other country in the world (per capita)?

We have a higher expectation of health care and much larger population than most other countries. They don't mind waiting months for minor surgeries and have different health care expectations. Throwing money at it isn't the solution.

[Greyroofoo]

We're also fatter.

[Arles]

Originally Posted by Greyroofoo

We're also fatter.

Our fast food lifestyle with no exercise certainly doesn't help.