Can education reformists borrow strategy and language from the health care reform movement?
A piece in the Wall Street Journal today argues that
In health care and education, measuring and paying for quality is still novel. Being a teacher or a doctor once was seen, by practitioners and the public, as a calling, not a job. Doctors and teachers were said not to be motivated by money. For some, that’s still true. But for many, the world has changed: Their jobs more closely resemble those the rest of us have. The argument that there is something wrong in principle with paying them for quality is losing force.
The parallels are interesting, and in the WSJ piece are extended to the business sphere as well, what with Obama’s emphasis on quality assessments that are measurable, consistent, and efficient. Some good quotes from Arne Duncan’s speech to the NEA, where he drove home the point that effective teaching should be measured and awarded accordingly.
Yesterday the New York Times ran a couple of pieces on the economics of health care reform, including one by David Leonhardt where he used his current fight with prostate cancer as a “litmus test” for different health reform tactics. He quotes Ron Wyden, an Oregon Democrat on the Senate Finance Committee, who says, “There has not been adequate attention to changing the incentives that drive behavior.” Leonhardt continues.
Plenty of good alternatives exist. Hospitals can be financially punished for making costly errors. Consumers can be given more choice of insurers, creating an incentive for them to sign up for a plan that doesn’t cover wasteful care. Doctors can be paid a set fee for some conditions, adequate to cover the least expensive most effective treatment. (This is similar to what happens in other countries, where doctors are on salary rather than paid piecemeal — and medical care is much less expensive.)
The answer isn’t obvious. But this much is: The current health care system is hard-wired to be bloated and inefficient. Doesn’t that seem like a problem that a once-in-a-generation effort to reform health care should address?
What if we took the passage from the Times article and substituted “schools” for “hospitals,” “students” for “consumers,” “teachers” for “doctors,” “choice of schools” for “choice of insurers.” The passage would read something like,
Schools can be financially punished for making costly errors. Students can be given more choice of schools, creating an incentive for them to sign up for a system that doesn’t cover wasteful services. Teachers can be paid a set fee for some typical students, adequate to cover the least expensive most effective instruction. (This is similar to what happens in other countries, where teachers are compensated differently— and education is much less expensive.)
The answer isn’t obvious. But this much is: The current education system is hard-wired to be bloated and inefficient. Doesn’t that seem like a problem that a once-in-a-generation effort to reform education should address?
You get the idea. It’s the same thing. Employ assessments that measure competence, efficiency, and healthy results, and then compensate practitioners in kind. Easy, right? Basic economics. Too bad the NEA has more clout than the health insurance industry.
