The Question of Options – The Health and Education Debates in the U.S.

Ideological and partisan mindsets can do much to foster inconsistent (and I daresay illogical) positions by people on all sides of the political spectrum. Below are examples of the initial phrase used in such ‘cart before the horse’ thinking:
– I’m for it because the Democrats …
– I’m a Republican and therefore am against…
– It’s socialist and …
– That’s crazy – it’s a market solution…

The issue of options in American public policy is a victim of this phenomenon. The issue of a public option in the present debate on health care reform in the U.S., and that of choice for parents and students in school education highlight how ideological and pre-judicial positions lead to completely inconsistent policy positions on the left and the right. There are good reasons why people in electoral politics maintain these inconsistent positions. What doesn’t make sense is why the general public follows their lead.

What is the general logic for expanding options (as the term is used in the health care debate) or choice (the preferred term in the education debate)? In one word, competition. If the present system results in an outcome where a large number of people are being ill-served, and if there is a prima facie case that the unsatisfactory outcome is because of monopolistic or oligopolistic market structures, then expanding options and choices will provide competition to the status quo providers of the services. Essentially, expanding options (or choice) is a policy intervention that deals with a market failure caused by a lack of competition.

Let us apply this logic to health care in the U.S. The present health care system is too expensive in general and a large number of people are not capable of receiving adequate medical attention when they are sick. One major reason for this is a lack of insurance, caused by how costly private insurance is. A solution to the problem of high cost of insurance is to introduce a public option – the ‘public’ meaning it is provided by the government, and ‘option’ meaning that those who prefer what the government offers to what the private sector offers may choose it. If the public option is affordable and attractive relative to what the private sector offers, then people will gravitate towards the public option. The obvious result will be that the private insurance market should respond to the much more attractive public option by becoming less expensive and offering better services. At the end of the day (I don’t get why this is a much reviled phrase), the general public will get a better insurance product at a cheaper price. The policy intervention (the public option) will help correct a market failure (lack of competition – interestingly, in great part a result of an act of Congress, the McCarran-Ferguson Act of 1945, which exempted insurance companies from federal anti-trust laws).

If the public option is competition enhancing, then why are most Republicans and some Democrats (RASD) in Congress against it, given that in principle they claim they are for competition? Apparently, their objection stems from the public part – that the government is doing it. In which case, RASD will do well to provide a non-public solution to the lack of competition problem in insurance markets, as they oppose the public option. Unfortunately, they have not done this. You don’t need deep training in political economy and a team of investigative journalists to figure out that those who oppose the public option have deep connections with insurance companies and dollars are involved. Opponents of the public option are trying to protect the market power of the insurance companies, at the expense of millions of folks getting more affordable healthcare insurance. Using the argument about the proposed option’s public nature is simply a ruse to kill the option to protect the interests of the insurance companies. A not so bad strategy in a country where bad-mouthing government and labeling many government programs ‘socialist’ works quite often. It makes sense that the RASD opposes public options – but why do a whole host of others follow?

However that does not mean that those who are for the public option in the health debate are always on the side of those who are getting a raw deal. They have their interest groups to protect too, and will sell the common person short in doing so. Here I’m thinking about the education sector. A great majority of K-12 students in the U.S. attend a public school. Public schools are run by local school boards funded by a combination of local, state, and federal tax dollars. There is a big range in the quality of these schools, and a not so small number of students receive a bad education in what are simply bad schools.

In most cases where you live determines which school you attend. Unfortunately if you are not well off financially then you get to live where you can afford to and your children go to the neighborhood schools. There is a strong correlation (with much causal underpinnings) between income level of neighborhood and quality of school – poorer the neighborhood, poorer the quality of the school. The way relatively wealthy families with school-going children determine where they live is to a great extent based on the quality of the school. So the relatively rich get to choose the school for their children, even if their children are going to public schools. And if your family has to stay in a neighborhood which has a bad public school, often there are expensive private school options which the family can avail. Very rich families who are dissatisfied with their very good public schools send their children to very expensive (and presumably very good) private schools. Put simply, if you are born into a poorer family the chances are much greater that you go to a worse school.

This wouldn’t be all that bad if the schools in poorer areas were relatively worse, but were decent in some absolute sense. However in a number of cases, enough to matter, the schools are terrible by any standard. One way to help students in bad schools (majority of whom will be from poorer families) is to give them a choice of either attending another public school in another neighborhood (or another school district), or by giving them the resources (vouchers) to attend private schools instead of a public school.

By and large such a policy move in education is opposed by a majority of Democrats in Congress (MOD), and close to no Republicans. The objection of the MOD comes from their interest in preserving the public aspect of education. They claim that their fear is that if competition to the public schools is introduced in the form of school choice for parents and students then a number of people may choose private schools (taking advantage of the vouchers) thereby weakening public schools. They surely must realize that the only reason a family will take advantage of a voucher to a private school is because it provides a better education than the public school. But even if there is some reason why there is a compelling State interest in preserving public education, that is only an argument against vouchers to private schools, not giving families and students the choice to attend any public school.

So why the opposition? Because the powerful teacher’s union the National Education Association (NEA) wants to ensure that the monopoly of public schools in education is maintained. The NEA is deeply connected with the Democratic Party and the adults are serving each other’s interests when many a child suffers. The detrimental effects of having a strong teacher’s union, and no choice for parents goes a long way in perpetuating incompetence in many a public school. I do not know the NEA’s position on competition across public schools (both across neighborhoods in the same school district, and across different school districts), but suspect that they are do not strongly support it. I’ll be happy to be corrected on this, but my suspicions are because if they were for it, it would have happened! Again, it makes sense why the MOD are opposed to school choice – but why do a whole host of others follow?

Isn’t it interesting… by and large in Congress, those who are for the public option in the health insurance market on the grounds that increased competition is good, oppose school choice and vouchers; by and large, those who are for school choice and vouchers in education on the grounds that increased competition is good, oppose the public option in the health insurance market? Special interest groups have made ‘public’ and ‘private’ interests dominate the debate – when the real issue is competition.

Finally, to put my cards on the table – I’m for options and choices – both the public option in health care, and public and private choice in education. Looks like we’ll get neither in the near future, given that the cart will be placed before the horse by many an American.


3 thoughts on “The Question of Options – The Health and Education Debates in the U.S.

  1. Thanks for this. I always enjoy hearing what you have to say about questions like these. I hope you won't mind if I make a few comments and generally dive into the debate uninvited (just like old times!).I've worked in public schools in diverse capacities for over four years, three of which preceded my time as your student. You and I often talked about education in general and the question of school vouchers in particular, on which question I was pretty firmly "anti." Now I'm a little less certain, mostly due to my increased exposure to a greater variety of public schools. I always have to preface any comments on this topic by saying that I think we need a much broader examination of our ideas of education and of our educational system. In my opinion, our model of education fits our understanding of how children learn and grow very poorly. (That is, to the extent that we understand these things at all, and to the extent that that is some sort of consensus.) So to me discussions like these, important as they are, are a little like discussing the finer points of a particular tax policy when there is serious doubt about, say, property relations and their legal framework: there are fundamental questions that demand reevaluation. In this case, some of these are, What exactly does it mean to educate? For whom do we educate? With what purpose? Do our methods (on macro and micro levels) serve our goals, and how should we evaluate the results? But obviously, as with fiscal policy, we still have to address the problems before us with what we have.I think you paint with too broad a brush when you speak of "incompetence in many a public school." Certainly, there is incompetence (oh my goodness, have I seen it). But when we consider the broad array of variables that can influence (note I do not say determine) a student's performance in school, I find it hard to justify laying the all the blame for an unsatisfactory outcome on the teacher, which again is not to say that there are not awful teachers out there or that the NEA is not a pretty backward organization at times. We have to ask, What goes on at those schools that have NOT been deemed incompetent? What sort of resources and training have those schools received? What kinds of communities do they serve, and how might their children arrive better equipped to succeed in the school system than those in under-performing schools? Questions like these suggest remedies short of dismantling the entire public education system. They point to issues of how schools are funded, how teachers are trained, and how other issues (say, of culture and economic equality) bear on issues of education.(And yes, I do think a voucher system is one more step toward dismantling the public school system, a process that has been underway for a while. I wouldn't go so far as to categorically condemn a voucher system, and there are plenty of things wrong with the current system. But as you say, a lot of people's lives are wrapped up in the public school system: almost 25% of the US population is under the age of 18, and millions more teachers and support staff. The introduction of a radical structural change like a voucher system deserves careful consideration, including some attention to the questions I posed above.)…to be continued, since apparently I'm too wordy for blogspot.

  2. And here again, we must raise questions of evaluation: how is competence assessed? To say (as does much of the current relevant educational regulation) that a competent teacher is one whose students return ever-increasing standardized test scores is to ignore the complex reality of students' lives and the many challenges faced by under-performing schools. Just take a look at the conditions faced by North Central High School teachers, the resources at their disposal, and contrast those with conditions at Arsenal Tech High School. The differences in material resources, atmosphere, and attitude toward education, are pretty striking. Compare both of those to the struggling California high school where I taught last year, and you'll find that "teacher competence" as measured by test scores is a woefully inadequate, hopelessly limited way to address school performance.Well, I think I'll stop this for now. Maybe I'll even continue it on my own blog, which is still waiting patiently for a first entry. Thanks for a stimulating post–I hope to get to continue the discussion sometime soon.D.E. '08

  3. Nicely framed. There are some distinctions in the "choice" debate with schools. Intradistrict choice is actually enacted in several states (MN ans NC for example). There, students may choose any public school within their district. Charter schools are another form of public "choice. I know many educators who are for increasing public forms of school choice (Deb Meier) for example. There is a difference between these, public forms of choice, and vouchers and other forms of privatization. Vouchers enter into tricky separation of church/state issues as well as the fact that private schools may "skim" the best students, legally, without recourse. The analogy with health care is an apt one. What some of us want is "multiple publics"– that is competition and choice but in a reasonably constrained system with regulation, checks, balances, and minority protections. Requiring all individuals to be insured without some protections against price gouging is not "fair." Conversely, a "government run" system with no incentive for innovation (public schooling today in the US) is also not "fair" for the end user. To paraphrase Reagan on another matter: "choice… but verify!"

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