School Choice a Major Election Issue

 

The Wall Street Journal calls this “The Year of School Choice.”  Former Secretary of State Condoleeza Rice has called school choice “the civil-rights issue of our time.” What brings these people to such dramatic statements?

The recent GOP convention called special attention to the issue of school choice. Republicans rightly see this as an issue that crosses political lines and could bring them a significant increase in black and Hispanic voters’ support. In previous elections, Democrats have enjoyed greater than 90% support from black voters, but school choice is the issue that could significantly alter those numbers.

Democrats have thrown their support to the teachers unions that oppose school choice because it threatens their livelihood. Charter schools, which are taxpayer supported, do not allow teachers unions. The more these schools prosper, the worse it is for union coffers. Although charter schools frequently outperform their public-school counterparts, especially in poor minority communities, the teachers unions insist this is only because charter schools “cherry pick” the best students.

This argument doesn’t hold water since charter school admissions in large cities like New York are determined by lottery, not by student achievement. Furthermore, the number of unsuccessful lottery students who remain in the public-school system far exceeds those who are successful. In New York over 50,000 students annually apply for a lottery position.

The GOP convention highlighted this situation with testimony from those who have been affected. Terra Myers expressed her gratitude for an Ohio scholarship program that allowed her to find the best school for her son who has Down’s Syndrome. Rebecca Friedrich, a long-time California public school teacher, recalled her battle with unions that force teachers to pay dues to finance causes they don’t agree with. She lamented the cost of unions spending “hundreds of millions annually to defeat charter schools and school choice, trapping so many precious, low-income children in dangerous, corrupt and low-performing schools.”

 Black speakers were especially effective in their messaging. Kim Klacik, a Republican running for the Baltimore seat of the late Rep. Elijah Cummings said, “We want school choice.“ Former NFL star Jack Brewer said, “For the sake of our children, we can’t allow concerns about President Trump’s “tone” to allow Biden and Harris to deny underserved black and brown children their school of choice.”

The results of school choice cannot be denied. Charter schools routinely outperform public schools in the same community, often operating in the same buildings. Studies have even shown that choice causes public schools to improve. In Washington, D.C., where about 44,000 low-income kids are enrolled in charter schools and 1,800 receive private school vouchers, the share of fourth-graders and eighth-graders who scored proficient in math last year on the National Assessment of Educational Progress exams doubled from 2009. Yet Joe Biden, whose sons attended Catholic Archmere Academy in Delaware, wants to eliminate the D.C. scholarship program. The only reason is his pledge of support for the teachers unions.

Mississippi, long considered a state of underachieving public education, has shown the largest learning gains in the country since establishing education-savings accounts in 2015. These accounts let parents purchase private educational services. The achievement gap since 2015 has fallen by half between whites and Hispanics and 15% between whites and black.

While the Democratic party claims to be greatly concerned about social justice, nothing matters more to social justice than educational opportunity. Too many public schools fail to provide it, especially in low-income urban neighborhoods. Joe Biden and the Democratic Party has chosen to support the teachers unions and ignore the needs of the parents and their children.

The Failed Lockdown Experiment

 

Epidemiology is not an exact science. This is good to remember in these times when everyone is “looking to the science” for answers to the Covid pandemic.

President Trump brought in the nation’s most respected epidemiologists to advise his Corona Virus Task Force on the best way forward to respond to this pandemic. Dr. Anthony Fauci and Dr. Deborah Birx are both highly respected in their fields. They called for an immediate lockdown to “slow the spread” of the virus and to prevent overwhelming the healthcare system with viral patients that might lead to rationing of critical care.

When the spread of the virus was deemed under control, President Trump rightly called for reopening to stimulate the depressed economy. These same experts devised a plan for this reopening to avoid a resurgence of viral cases. In some parts of the country this was more successful than others. Differences in population density, the numbers of elderly versus youth, and local government policies were all blamed for this variation in virus control.

But how much did the lockdowns really slow the spread of the virus and did reopening really contribute to a resurgence of cases?  These are critical questions that should be answered because a better understanding should govern future policy.

One man says he has the answers to these questions. His name is Donald L. Luskin and he is the chief investment officer of TrendMacro, an analytics firm. Writing in The Wall Street Journal, Luskin says his firm has analyzed both the lockdown and the reopening and have come to unexpected conclusions on both. He says, “The results are in. Counterintuitive though it may be, statistical analysis shows that locking down the economy didn’t contain the disease’s spread and reopening didn’t unleash a second wave of infections.”

He concludes that the lockdowns were economically costly and created well-documented long-term health consequences beyond Covid that were not justified based on their analysis. He acknowledges that public health officials acted in ways they thought were prudent, but evidence now proves were an expensive treatment with serious side effects and no benefit to society.

How did they come to these conclusions?

TrendMarco tallied the cumulative number of reported cases of Covid-19 in each state and the District of Columbia as a percentage of population, based on data from state and local health departments aggregated by the Covid Tracking Project. They then compared that with the timing and intensity of the lockdown in each jurisdiction. That was measured not by the mandates put in place by government officials, but rather by observing what people in each jurisdiction actually did, along with their baseline behavior before the lockdowns. That was then captured in highly detailed anonymized cellphone tracking data provided by Google and others and tabulated by the University of Maryland’s Transportation Institute into a “Social Distancing Index.”

Measuring from the start of the year to each state’s point of maximum lockdown – which range from April 5 to April 18 – it turns out that lockdowns correlated with a greater spread of the virus. States with longer, stricter lockdowns also had larger Covid outbreaks. The five places with the harshest lockdowns – the District of Columbia, New York, Michigan, New Jersey and Massachusetts – had the heaviest caseloads.

Is this a case of which came first, the chicken or the egg? Did the lockdowns come before the heaviest caseloads or because of them? Lushkin acknowledges this question, but states the surprising negative correlation persists even when excluding states with the heaviest caseloads. Furthermore, the analysis remains the same when factoring in such variables as population density, age, ethnicity, prevalence of nursing homes, general health or temperature. The only factor that seems to make a demonstrable difference is the intensity of mass-transit use.

Lushkin stands by his data and says they repeated the experiment and analysis a second time with the same conclusions. He summarizes their results in these words:

“The lesson is not that lockdowns made the spread of Covid-19 worse – although the raw evidence might suggest that – but that lockdowns probably didn’t help, and opening up didn’t hurt. This defies common sense. In theory, the spread of an infectious disease ought to be controllable by quarantine. Evidently not in practice, though we are aware of no researcher who understands why not.”

Apparently, they are not the only researchers to see these findings. In July, a publication of Lancet published research that found similar results looking across countries rather than U.S. states. “A longer time prior to implementation of any lockdown was associated with a lower number of detected cases,” the study concludes. Those findings have now been enhanced by sophisticated measures of actual social distancing, and data from the reopening phase.

Joe Biden wants to resume lockdowns “if the science calls for them.” In the light of this recent analysis, his comments are worth remembering. Just which “scientists” would he be listening to? Lushkin closes with these words of warning: “But there’s no escaping the evidence that, at minimum, heavy lockdowns were no more effective than light ones, and that opening up a lot was no more harmful than opening up a little. So where’s the science that would justify the heavy lockdowns many public-health officials are still demanding?”                                                                                                                                                          

I began this post by saying that epidemiology was not an exact science. What more proof of that do you need?

Medicare for All is Medicare for None

 

Most seniors like their Medicare. While it is far from free, it does cost less than private health insurance because it is federally subsidized. Since nearly every doctor accepts Medicare, there is rarely any difficulty finding access to healthcare.

Therefore, when people hear progressives like Vermont Senator Bernie Sanders speak about his socialized medicine program called Medicare for All, they believe he simply wants to extend the same healthcare benefits to all Americans. Nothing could be further from the truth.

Recently, I had lunch with an old friend and attorney and we discussed this very issue. His comments about Medicare for All revealed many misconceptions about what that would mean to our healthcare. It occurred to me that if this educated man could be misinformed, many others would be, too. To address this misinformation, I have listed some of his questions and their answers:

If Medicare is good for seniors, won’t Medicare for All be good for everyone?

Although Medicare is mostly funded by taxpayers, it is not strictly a government system. It was formed originally by providing a standard benefit package offered by Blue Cross in 1965. It has always been privately administered, mostly by Blue Cross, which continues to provide private insurance to non-seniors. In recent years, one third of all seniors are enrolled in plans offered by private insurers such as Cigna, Humana, and United Healthcare under a cooperative program called Medicare Advantage. The success of the Medicare Advantage program is mostly due to the competition between these private insurers which lowers costs and improves the quality and range of services provided.

Medicare for All calls for the elimination of all private health insurance. There will be no competition and all healthcare decisions will be made by the government. The lack of competition will lead to lower quality, fewer services, and higher costs. With no competition, providers will be stuck with fixed rates and no means to appeal. As a result, providers will lose incentives to provide more than the minimum care needed. This trend is already prevalent in socialized medicine systems operating today in Canada and Great Britain.

We have the best quality healthcare in the world, though not the cheapest. Won’t we continue to have the best healthcare even with Medicare for All?

My friend and I agree that America leads the world in providing the best possible healthcare. He believes this will continue despite a change to socialized medicine. This is not the pattern we see when studying socialized medicine systems in other countries. Healthcare outcomes are dramatically worse in countries where the government controls all healthcare. We may have the best trained doctors in the world, but those doctors’ hands will be tied by government officials who will determine who gets care and what care they get. This is most dramatically seen in cancer screening and treatment.

Socialized medicine systems such as the United Kingdom and Canada don’t allow for expensive drugs and therefore these countries do not enjoy our cancer survival rates. The U.K.’s National Institute for Health and Care Excellence (a misnomer at best) has rejected immunotherapies because they are too expensive. Better healthcare comes at a price that socialized systems are not willing to pay.

As a result, these systems have lower cancer survival rates. The age-adjusted mortality rate is about 20% higher in the U.K. and 10% higher in Canada and France than in the U.S. Survival rates for hard -to-treat cancers are also higher in the U.S. than in most countries with nationalized health systems. The British medical journal Lancet  published last year that an individual diagnosed with pancreatic cancer between 2010 and 2014 had nearly twice the likelihood of surviving five years in the U.S. than in the U.K.

Here are some five-year survival comparisons:

  • Brain Cancer
    • S. – 36.5%
    • France – 27.2%
    • K. – 26.3%
  • Stomach Cancer
    • S. – 33.1%
    • France – 26.7%
    • K. – 20.7%

 

The availability of expensive drug treatments is only one reason for better survival rates in the U.S. Another reason is better methods of detecting cancer at earlier stages. MRI scanners are more widespread and available for earlier diagnosis. Other diagnostic advances include Google’s artificial intelligence (AI) that can now detect breast and lung cancers with better accuracy – meaning fewer false positives and negatives – than radiologists. AI systems are also enabling researchers to identify more genetic links and to personalize treatments.

With Medicare for All, all physicians will work for the government. Since we’ll have the same great doctors, won’t we still receive the same great healthcare?

Medicare for All will mean the government sets all prices for doctor services and approves or disapproves of all treatment. All doctors will have to accept the fee schedules set by the government or cease to practice medicine. Many older, experienced physicians will see this as an incentive to retire, or at least leave the clinical practice of medicine. This will strip many talented physicians from the work force.

They will be replaced by younger physicians without the experience or work ethic of some of our best physicians. These new physicians will be willing to accept the lower fees mandated by the government, but they will demand reduced hours and will produce less service. Combining these changes, the net result will be severe exacerbation of our physician shortage, which is already alarming.

But the real problem is the government will have to approve all treatment. It doesn’t matter how good your doctor is, he or she will be limited by government approval. Combining this feature of socialized medicine with an increasing doctor shortage leads to a common situation experienced in all socialized medicine systems.

All socialized medicine systems suffer from common ailments:

  • Delays in treatment– longer waiting times to see a physician
  • Rationing of healthcare– delays or denial of specialized care
  • Poorer healthcare outcomes– lower survival and life expectancy rates

 

Joe Biden tries to distance himself from Medicare for All by saying he just wants to “improve ObamaCare.” However, his platform calls for a “public option” to be added to ObamaCare, which simply means a slower timetable until socialized medicine is a reality. The end result is the same – total government control of healthcare.

Now he’s added Senator Kamala Harris to the ticket and she was one of the first presidential candidates to embrace Medicare for All, declaring openly it would mean the elimination of all private health insurance. Later, she tried to walk back her support when she received a backlash, but she will certainly support Biden’s move to socialized medicine over time.

Don’t be fooled. Medicare for All will mean the elimination of all private health insurance – which means Medicare for None.

 

(Note: For more on Medicare for All, use the Search feature on my blog to see earlier posts on this same subject.)