Talking Healthcare

The Right is floundering in the healthcare “reform” debate. It’s complicated, but it need not be. How do you make the water cooler case? Tell ‘em “before we let them do anything stupid, we could fix healthcare in 5 easy steps”:

  1. Let people buy health insurance across state lines. I live in North Carolina. If folks in my state could buy insurance in Idaho, we would cut our premium almost in half. New Yorkers could reduce premiums by about 2/3 buying in other states. Everyone would have access to the lowest rates in the country. Competition would bring costs way down. Why won’t the government let us?
  1. Give poor and working class people tax credits (vouchers) to buy insurance. It’s not hard. Help the poor. Keep the competitive market, too. But for goodness sake, don’t make us pay for rich people’s healthcare and bankrupt private insurance all at once. (A high-risk pool can help people with pre-existing conditions, btw.)
  1. De-couple health insurance from our jobs. (Change the tax code.) This coupling is an artifact of WWII wage controls. When your company chooses your insurance, it limits competition and choices. It's very costly, but you don't see the cost. And under the current system, you lose your insurance if you lose your job. Wealthier, employed people get subsidized to get insurance. Unemployed or independent contractors get nothing. 
  1. Give greater access to health savings accounts for use on the small stuff. They can save money for old age, or purchase out-of-pocket healthcare. They’ll be more careful with their spending. We’ll eliminate much of the “split-the-check” effect where people over-consume and cost-shift. (For example: Prilosec OTC costs $15 at the store. Prescription Nexium costs a $15 copay (but $150 in reality). These drugs are almost identical. Yet people choose Nexium without a second thought. Why shouldn’t they? Still, $135 unseen gets dinged to the risk pool, so premiums go up.)
  1. Stop driving up costs with regs and mandates. In some states, the government forces insurance companies to charge everyone the same rate whether they’re young and healthy, or sick and old. This is terribly costly. High rates mean young people go uninsured. Also, forcing companies to insure people after the fact is not “insurance” and drive up costs even more. Again, carrots for consumers to get insurance are far better than sticks against insurance companies and employers. Of course, consumers pay for those sticks, anyway.

On No 5, the Left has consciously been using these kinds of regulations to drive up costs. This limits people’s “access.” They don’t care. They want medical socialism no matter the cost. The plan is, and always has been, either to hasten the destruction of the insurance market and/or to drive up costs so we’ll cry uncle. Once we cry uncle, they’ll usher in the age of bureaucare. Functionaries will make our healthcare decisions. Bureaucrats will decide if and when you need a drug. You will wait in medical bread-lines for care. Innovation will dry up. Just go to a Cleveland hospital. Find Canadians getting MRIs because Canada has made them wait. 

 

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Comments

Tort reform........

Cost to providers to provide medical malpractice insurance: $180 billion.  Most medical lawsuits (approximately 95%) are bogus suits.  The solution... sue all you want, but if YOUR lawsuit is found to be a bogus suit, then YOU are responsible for the entire bill (to include the hospital and provider's cost)

Um, no.

Insurance and lawsuit payouts are not the same thing.  In the article I linked in my post below, the Texas community evaluated has more than twice the average cost.  Texas has capped payouts for years now.  It's worth your time to read, but here's a quote:

"...“It’s malpractice,” a family physician who had practiced here for thirty-three years said.

“McAllen is legal hell,” the cardiologist agreed. Doctors order unnecessary tests just to protect themselves, he said. Everyone thought the lawyers here were worse than elsewhere.

That explanation puzzled me. Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?

“Practically to zero,” the cardiologist admitted..."

 

Um, no.

Functionaries will make our healthcare decisions. Bureaucrats will decide if and when you need a drug. You will wait in line for care.

This is an exact description of the status quo, except that profit vice medical need drives the decisions.

This all boils down to who writes the check and how much we pay for writing the check.

Common sense says that 3-4% (public option) overhead vice 30-40% (private insurance) is a much better deal.

Private insurance is pure unnecessary overhead that adds absolutely no value to health care.

Once we get thru this, next stop is "fee for service" and vertically integrated providers.  This is really good read ahead:

www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

Status Quo or Radical?

One lefty accused me of being radical when I proposed similar solutions on a local TV show. Now this comment lurker accuses me of being status quo. Sigh. 

Status Quo or Radical?

I give you five stars.

You're absolutely correct. Individual ownership, and an HSA/car insurance model, so that the insurance companies are taken out of the maintenance transaction are critical. The Heritage Foundation has dealt with the issue of higher overhead for private insurers, and has debunked the lower-government-ovehead claim.

Something needs to be done about chronic conditions to prevent financial ruin and about death-spiral pools resulting from self-selection. Cato Institute has some good ideas about these issues.

Health care is an economic good, so there needs to be some method of rationing to balance demand and supply. It is critical to remove the market distortions that result from government involvement as much as possible. I prefer price signals resulting from pricing transparency at all levels, together with individual insurance policy ownership, as I wrote earlier. This means that some people will be able to purchase more comprehensive insurance than will others, but I would prefer that individuals retain control over their own care. I think that the first result of this would be a reduction in capacity utilization, leading to lower costs.

One possible result of what you (I) advocate would be a lower level of investment in health care services, health care facilities, medical equipment, and, possibly, pharmaceuticals. As a consequence, we might expect companies in those sectors to oppose this kind of reform.

It is argued "that we spend too much on health care". Given the market distortions that exist, primarily because of government involvement, we pay exactly what the market demands. What we need to do is to improve the incentives and remove the distortions and perverse incentives that abound today. What we don't need to do is "cut costs", which to me means "squeeze the greedy providers." That will result in rationing and a reduced level of care.

Shorter version:

Are there no workhouses, no prisons? Then, let them die and decrease the surplus population.

...let them die...

That's the UK and Canadian approach, isn't it?

In my opinion, your snarky question has no place here.

Not MY question...

I was paraphrasing the archetypal conservative.

Your points are thoughtful but why the name calling?

 I read your comments with great interest and then felt that my trust had been betrayed when I got to the last paragraph in which you just couldn't resist turning what could have been a mature exchange into a US. vs. THEM ideological slap in the face.  And later on there you are again referring to someone as a "lefty," a clearly derogatory label in this context.  This is childish and only takes away from the interesting points you make.  We are at a stage in the history of our country when healthcare reform MUST occur to avert personal and collective financial ruin.  Like passengers on a sinking ship, we have to put aside the luxury of ideology and come together in an effort to save everyone from the impending disaster.  We can have honest differences over which reforms should be effected, but silly name-calling doesn't advance anyone's agenda.

Wait Times and Cost-cutting

Wait times in Canada: http://www.fraserinstitute.org/commerce.web/product_files/WaitingYourTurn2008.pdf

1. If people could choose their own insurance plan, they could cut their premiums by 10-20 percent just by purging their plans of mandated items - i.e. stuff they don't need but gov't forces them to buy.

2. If I could buy my insurance in another state, I could cut my costs significantly. 

3. If people didn't get so much of their healthcare from their employer, they would be more cost conscious both in selecting their plans and in the way they spend within those plans.

4. If people had large HSAs they would be reluctant to buy anything they can con their doctors into writing a scrip for. That would cut costs tremendously.

5. Competition erodes profit margins. 

6. Adminstrative costs are largely an artifact of government control and government designed care. It's just a myth that the government would lead to lower costs, whether in admin or advertising. Under a single payer system, no one would know how much anything costs. Suppliers and doctors would charge whatever they wanted until the government got into the political favors or price control game. 

7. Just look at Medicare... How is this a good model? It's expensive and insolvent. It's rife with fraud. Admin costs? Up there. So there you go.

8. I'm starting to think single-payer fetishists are willfully ignorant or control freaks. Not sure which. Stay out of my healthcare, please. Take your nannies and rent-seekers with you.

9. LIke PPOs, single payer gives away free or low-cost stuff until overconsumption drives bureaucrats to ration--which would be rather quickly. Replace one third party problem with another. Under a consumer-driven model, docs, hospitals and suppliers have to respond to (gasp) shoppers!

10. 75 percent of the US healthcare market is controlled by someone besides the consumer - 50 percent by the government, and 25 percent by state-created insurance monopolies. How is this a market? More markets, more market forces will relieve most of the pain. Don't believe me? Look at Singapore. MSAs and higher copays keep their healthcare spending at around 3 percent of GDP. They have great health outcomes too.

Links to your assertions would good.

In the meantime:

1. If people could choose their own insurance plan, they could cut their premiums by 10-20 percent just by purging their plans of mandated items - i.e. stuff they don't need but gov't forces them to buy.

Source? How do people know what they need until they need it?

2. If I could buy my insurance in another state, I could cut my costs significantly.

I agree.  There are states with only one or two insurance providers.  A national public option solves this problem without the unnecessary, non value added overhead.

3. If people didn't get so much of their healthcare from their employer, they would be more cost conscious both in selecting their plans and in the way they spend within those plans.

Health care should be disconnected from employment -- the remainder does not logically follow.

4. If people had large HSAs they would be reluctant to buy anything they can con their doctors into writing a scrip for. That would cut costs tremendously.

HSAs assume you have sufficient income to save.  Lots of us don't.

5. Competition erodes profit margins.

Yes it does.  And can't come soon enough.

6. Adminstrative costs are largely an artifact of government control and government designed care. It's just a myth that the government would lead to lower costs, whether in admin or advertising. Under a single payer system, no one would know how much anything costs. Suppliers and doctors would charge whatever they wanted until the government got into the political favors or price control game. 

Facts say otherwise.  Every other industrialized country pays far less for far better outcomes.

7. Just look at Medicare... How is this a good model? It's expensive and insolvent. It's rife with fraud. Admin costs? Up there. So there you go.

Medicare has a shitty risk pool (old and sick).  Making it available to everyone would be the simplest and cheapest option.  We'll get there eventually.

9. LIke PPOs, single payer gives away free or low-cost stuff until overconsumption drives bureaucrats to ration--which would be rather quickly. Replace one third party problem with another. Under a consumer-driven model, docs, hospitals and suppliers have to respond to (gasp) shoppers!

The link you provide actually makes a different point than you attempt -- consistent with fee for service and integrated providers driving increased costs I pointed out elsewhere.

10. 75 percent of the US healthcare market is controlled by someone besides the consumer - 50 percent by the government, and 25 percent by state-created insurance monopolies. How is this a market? More markets, more market forces will relieve most of the pain. Don't believe me? Look at Singapore. MSAs and higher copays keep their healthcare spending at around 3 percent of GDP. They have great health outcomes too.

A source would be good for your assertions.  I know I wouldn't want to live in Singapore.

Interesting discussion

Vern, your NewYorker link was very interesting; however "Every other industrialized country pays far less for far better outcomes" is not true.  "A source would be good for your assertions."  The US has better cancer survival rates for one example.

CNN has a story about a Canadian woman who had to get a second mortgage, second job for her husband and borrow from friends to get cancer treatment in the US because she would have had to wait upwards of four months to see a specialist about a brain tumor that was quickly making her blind.

The Heritage Foundation has some good health care ideas.  Like everything else competition and transparency are the key.

 

 

 

 

Here you go...

Here is a 2007 report prepared for congress:

http://assets.opencrs.com/rpts/RL34175_20070917.pdf

 

 

The United States spends more money on health care than any other country in the Organization for Economic Cooperation and Development (OECD). The OECD consists of 30 democracies, most of which are considered the most economicallyadvanced countries in the world. According to OECD data, the United States spent $6,102 per capita on health care in 2004 — more than double the OECD average and 19.9% more than Luxembourg, the second-highest spending country. In 2004, 15.3%of the U.S. economy was devoted to health care, compared with 8.9% in the average OECD country and 11.6% in second-placed Switzerland.

There are lots of great charts, too.  Figure 20 on page 30 is especially relevant.

And this:

http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2007/May/Mirror--Mirror-on-the-Wall--An-International-Update-on-the-Comparative-Performance-of-American-Healt.aspx

Among the six nations studied—Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2006 and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, efficiency, and equity. The 2007 edition includes data from the six countries and incorporates patients' and physicians' survey results on care experiences and ratings on various dimensions of care.

 

And a timely and relevant personal story from my local paper:

http://seattletimes.nwsource.com/html/northwestvoices/2009434900_health_care_weighing_in_on_hb.html

Canadian health care would be a welcome change

Opponents of a public-health-insurance option caution that such a plan would result in "Canadian-style" health care. In support of this, here is a true story.

A cautious, self-employed Seattleite, I pay for the best private health insurance available. Good thing, because at 43 years old, after being diagnosed with an aggressive breast cancer, I received treatment at two top regional facilities: surgery at University of Washington Medical Center and chemotherapy at Seattle Cancer Care Alliance.

Weeks after my diagnosis, a lifelong friend in Vancouver, B.C., was diagnosed with a virtually identical cancer -- same tumor size and characteristics, same lymph node status, etc.

After tumor discovery, I received diagnostic tests after more than 30 days. Her tests took three. I waited five weeks for surgery; she was scheduled in two. Post-surgery, I waited five weeks to begin chemotherapy. Her chemo started in three.

In the end, my out-of-pocket expenses exceeded $30,000. Her bills were in the hundreds of dollars.

The UW just hired my reconstructive surgeon from the University of Toronto for his education in pioneering techniques. My friend's surgeon was Canadian, too.

So will a public plan result in Canadian-style health care? I truly hope so.

-- Kathleen Duke, Seattle

"the U.S. is last on dimensions of access, patient safety, effic

The article you quoted is carefully worded to not say last in treating conditions.  The US does better in treating heart related conditions and cancer.  The US has worse outcomes for lifestyle related diseases because our population is much different than Canada's, with higher rates of drug abuse, violence and obesity than Canada.  The US life expectancy also gets dinged with higher infant and child mortality which for the most part have nothing to do w/ healthcare.  These will not change if the gov't takes over health care.

Also Canadian healthcare has lower costs because they can go to the US and use our expensive machinery without owning it and use low cost drugs w/ out letting the co.'s recoup the cost it took to develop them.  These things could change if the US were publicly financed, too.

The escalating cost issues in your NewYorker article were all demonstrated within the Medicare system without any measures in place to keep those costs down.  In fact, the further you go into gov't provided health care in the US the higher the expense, and the longer the wait times.  Also, administrative costs are much higher in the US than Canada.  So there is no evidence that somehow magically the gov't could make costs come down if it ran everything.

And for the personal story-- I'll give you a personal story that shows a very different side of the Canadian health system http://www.cnn.com/2009/POLITICS/07/06/canadian.health.care.system/index... .  I don't think that you can generalize from Ms. Duke's story to others.  I have two close friends who are being treated for cancer and they have experienced virtually no wait times for any of their many many procedures.  Sometimes they have to wait 'til Monday for their next treatment, but that's it.  Statistically wait times are longer in Canada, and more Canadians believe their system needs major changes.

What the US needs is HSA's (maybe subsidized for the poor) that force people to comparison shop and care how much things cost and force medical providers to give quality and price information. 

You'll never convince me Vern, I've been to a gov't run VA hospital, those things are the depths of despair and the level of medical errors there are unacceptable.

 

 

 

 

"...You'll never convince me Vern..."

Believe me, Ann, I had no illusions.

Oh, the horrible Canadian and European Government-run Systems!

I am an American who lives in Canada and one who has also lived in France, so I don't have to depend on CNN to tell me what I should think about those bad, bad, aweful socialist systems.  No national healthcare system is perfect, but my lengthy experience has shown me that the Canadians and French I know would NEVER give up what they have for the unnecessarily expensive capitalistic, for-profit, private-insurance-industry driven dysfunctional American model.

OK, so CNN has found a Canadian unhappy with her national health care and who has experienced financial ruin as a consequence of imperfections in the system.  If 76% of Americans want something different from what they have now, would that not suggest that a whole ton of them would have stories to tell even more poignant than the one reported on CNN? 

And then there's how the argument against healthcare reform is being framed.  We are warned against "government bureaucrats" who would be making life-and-death decisions. Well, aren't bureaucrats making just those decisions now?  Does it make any difference that they are insurance companies rather than the "government"?  And just who is the "government" anyway?  In a representative democracy aren't WE the government?  During the 90's fear-mongering with its incessant references to a "big-government, socialist take-over" of healthcare torpedoed reform, but that dog's won't hunt this time around because an overwhelming majority of Americans are NOT satisfied with the status quo and don't seem so easily frightened by the "big-government" bogeyman.  

Oh, the horrible Canadian and European government-run systems!

I am an American who lives in Canada and one who has also lived in France, so I don't have to depend on CNN to tell me what I should think about those bad, bad, aweful socialist systems.  No national healthcare system is perfect, but my lengthy experience has shown me that the Canadians and French I know would NEVER give up what they have for the unnecessarily expensive capitalistic, for-profit, private-insurance-industry driven dysfunctional American model.

OK, so CNN has found a Canadian unhappy with her national health care and who has experienced financial ruin as a consequence of imperfections in the system.  If 76% of Americans want something different from what they have now, would that not suggest that a whole ton of them would have stories to tell even more poignant than the one reported on CNN? 

And then there's how the argument against healthcare reform is being framed.  We are warned against "government bureaucrats" who would be making life-and-death decisions. Well, aren't bureaucrats making just those decisions now?  Does it make any difference that they are insurance companies rather than the "government"?  And just who is the "government" anyway?  In a representative democracy aren't WE the government?  During the 90's fear-mongering with its incessant references to a "big-government, socialist take-over" of healthcare torpedoed reform, but that dog's won't hunt this time around because an overwhelming majority of Americans are NOT satisfied with the status quo and don't seem so easily frightened by the "big-government" bogeyman.  

Fraser Institute?

Here's what wiki says:

The Institute has been a source of controversy from the beginning. Some charge that Michael Walker, an economist from the University of Western Ontario, helped set up the institute after he received financial backing from forestry giant MacMillan-Bloedel, largely to counter British Columbia's NDP government then led by Premier Dave Barrett. The relationship, though, was short-lived as MacMillian-Bloedel broke ties with the Institute when it published a book opposing wage and price controls. The CEO of MacMillian-Bloedel at the time supported wage and price controls. 

Critics of the Institute and other similar agenda-driven think tanks have claimed the Fraser Institute's reports, studies and surveys are usually not subject to standard academic peer review or the scholarly method. Institute supporters claims their research is peer-reviewed both by internal and external experts. The Institute's Environmental Indicators (6th Ed) has an academic article devoted to its flaws: McKenzie and Rees (2007), "An analysis of a brownlash report", Ecological Economics 61(2-3), pp505-515.

In 2002, a study by Neil Brooks of the left-wing Canadian Centre for Policy Alternatives claimed the Institute's widely promoted Tax Freedom Day, described as the date each year when the average Canadian's income no longer goes to paying government taxes, included flawed accounting. The Brooks study stated that the Institute's methods of accounting excluded several important forms of income and inflated tax figures, moving the date nearly two months later in the year. The Institute counters that Professor Brooks confuses the aggregate tax burden with the tax burden borne by those who actually pay tax.

In 1999, the Fraser Institute was attacked by health professionals and scientists for sponsoring two conferences on the tobacco industry entitled "Junk Science, Junk Policy? Managing Risk and Regulation" and "Should government butt out? The pros and cons of tobacco regulation." Critics charged the Institute was associating itself with the tobacco industry's many attempts to discredit authentic scientific work.

 

Flawed Analysis..

1. Let people buy health insurance across state lines. - Two problems with this: First, part of the reason health insurance is cheaper in Idaho than North Carolina is that healthcare is cheaper in Idaho than North Carolina. While that may benefit you, it hurts people in Idaho, and the net national effect is nil. This is not a solution to the national healthcare problem. Secondly, what ever happened to states' rights? You are suggesting that the feds forcing the states to accept a federal standard is the "Right" thing do to, rather than allowing states to set their own standards.

2. Give poor and working class people tax credits (vouchers) to buy insurance. - The problem with vouchers is that they encourage price escalation. If you're going to have truly universal coverage, than the maximum voucher must pay the entire bill (a large "working class" family without employee health insurance cannot be expected to spend a single dime). If the vouchers are big enough to do this, then there is no incentive for lower prices, as you've taken out exactly the free-market element that you are trying to reproduce by using vouchers instead of nationalized insurance. This really doesn't address the problem either. Like pure communism, this sounds nice on paper, but doesn't work in reality.

3. De-couple health insurance from our jobs. (Change the tax code.) - Given a solution that involves at least some private health insurance, this is probably sensible, but politically difficult. How do you do this without raising taxes or increasing the national debt? If you give a tax deduction that covers the cost of insurance, this will keep taxes roughly the same for everyone, but you haven't addressed the problem of those without insurance, because the deduction will not pay for much or any insurance for the currently uninsured (again, you must assume that at least some people are uninsured and cannot afford a single dime). If you give a standard credit to pay for insurance to everyone, including the currently uninsured, and wages are adjusted accordingly, now you are collecting less tax money and increasing the national debt. If you don't give a tax credit/deduction at all, or give a tax credit/deduction that is smaller than the current average insurance cost, and start taxing peoples' employer provided health insurance, you're increasing the taxes of people who currently have insurance. As long as the right screams that the left is raising taxes and inflating the debt, the Democrats, who have the control right now, have no incentive for this last option, even if it makes sense. It's political suicide.

4. Give greater access to health savings accounts for use on the small stuff. - HSAs, like FSA's and IRAs, are a boondoggle. Administrative costs for these "special accounts" are quite high for small businesses and entrepreneurs. These only serve to keep people busy pushing paper, but not to actually address the problem of getting sick people well. We need to be removing paper-pushers from the process, not adding them. This is exactly they type of bureaucracy that should be being fought against by the Right, not promoted by it.

5. Stop driving up costs with regs and mandates. - The "medical bread line" argument is pretty flawed. The study cited, from a biased institute rather than a legitimate university study, states on page 39 that wait times in America are "0 months" and "0 weeks" for all heart procedures based on 19 year old data. A similar level analysis would be necessary to make reasonably accurate statement, which has clearly not been performed here. Anyone who has had a specialized problem in the US knows that wait times can be quite long here, too, due to the need for insurance referrals, congested doctors schedules and operating rooms, etc. Just because the "waiting list" in Canada is official and the one in the US isn't, doesn't mean wait times are zero in the US. If this afternoon my doctor tells me I'm going to need bypass surgery, you better believe I won't be on the operating table tonight unless it is urgent. The same thing is true in Canada. If there is any difference, more than likely that difference has as much to do with patient-to-doctor, patient-to-bed, and patient-to-machine ratios as it does have to do with how insurance is administered in a given country. Canada, arguably, has a much better developed triage system than the US as a result of the nationalized system. Outside of those who can afford procedures out of pocket, wait times are only positively affected by this system because they are better matched to need and urgency rather than our random system here, which in based on how well your doctor can twist arms and/or wine-and-dine to get an OR and operating team. While it may be nice from an ideological perspective to think that those born with silver spoons in their mouths (and the rare rags to riches case) should get first dibs on medical procedures, the Right is not going to win many votes from the middle class taking this approach. It may be good for convincing the Cato Institute crowd, but they were already convinced, so you're going to have to come up with something better than that to convince more people that the Left is wrong on this. The Cleveland comment is also pointless; such anecdotal evidence does little to prove a point, since there's always a counter-example (e.g. doctors in Seattle postponing scheduled surgeries in the US to fly up to Vancouver to perform emergency surgeries on Canadians).

Sorry "Malevolence," but thanks for playing...

1. Insurance is more expensive in North Carolina largely because we have 47 mandates on our insurance policies. Idaho has fewer than 20.

2  People could put voucher funds into their HSAs which would control any costs. No price escallation there, particularly as many of the uninsured are young and starting out -- having been priced out of the market by old sick people cashing in on mandates like in NY.

3. Politically infeasible? Come on.... you can do better. Socializing medicine is more politically feasible than simple correcting a curious artifact of WWII healthcare policy?

4. HSAs? Boondoggle? HSA/HDHP premiums have gone up by one percent next to PPOs/HMOs that have gone up by about 8% per year. (OH >> My family and I actually own one. It's not a boondoggle.)

5. You have ignored my point about the costs of community rating and guaranteed issue mandates - never mind, alcohol abuse treatment, pastoral counseling, boob jobs, etc. etc. etc. You then launched into something nonsensical about Canadacare waiting times.

My work is done here.

he's right on some small points

1- I agree with your main point, but (a small) part of the problem is the difference in cost he alluded to. An eye exam in NC should cost the same as an eye exam in Idaho...does it? I doubt it. Same with any other standard procedure. Having a nurse check your blood pressure should cost (relatively) the same in each state. There are differences in pay due to cost of living differences, but huge discrepancies exist and are part of the confusion.

3- this is more politically feasible now than ever....with such high unemployment, people should be eager to separate their healthcare from their employment status. the GOP could make a serious push on this front, and not from a "cost to the employer" side, but from a "risk to the insured" side. play up the emotional side (women, children, etc). Most people don't realize this would save money because the GOP talking point is usually about the business perspective ie: "it makes companies less competitive", or "employers have a huge burden"

these are good ideas, the GOP just needs to communicate better using real world examples. Lance Armstrong lost his coverage when he was diagnosed with cancer....that is scary and would definitely bankrupt almost any family. There was a plumber I read about whose wife had a premature baby and their insurance didnt cover whatever costs they had and now they are filing for bankruptcy. Any real world example would help illustrate these points....most people don't follow the details and healthcare is so complicated to begin with that the larger points are lost on the general public. good luck passing your ideas along....

"Max Borders"

Why the quotes? Are you trying to be childishly degrading or something? It's not like Max Borders is your real name, so why the need for quotes when addressing me by my handle? I'm not the "so called Malevolence." I'm just Malevolence. That's my handle, thanks.

1. So you admit you're against state's rights. Every state should be forced to apply the same standard of the state with the lowest bar for entry into an industry, and that should be enforced by the federal government. Do we really want no regulation in health insurance? That worked out so well for the banking industry. I don't get your point. The cost of living and the level of need for different places is different, so why should to government be putting price controls in place that would degrade that? Why should rural Iowans subsidize more expensive care in San Francisco? And to the other poster: no, prices should not be the same everywhere because the cost of living is not the same everywhere.

2. So you're advocating welfare for those in lower cost areas (i.e. some may get more money than they need for healthcare, so they get to shove it in a savings account to use to buy an RV when they retire)? Talk about government waste.

3. Yes, socializing medicine is more politically feasible - depending on the poll, somewhere between a plurality of Americans to more than 3/4 want a public option (I've seen numbers ranging from 49%, with >2% undecided to 76%); meanwhile only about 40% support removing the benefits tax exemption. Based on those numbers, you tell me which one is more politically feasible. Like I said, what's being advocated isn't the best solution in my opinion, but I don't let my ideology get in the way of assessing the situation and realizing that sometimes what we'd like to see done isn't always realistic. This is one of those cases.

4. Yes, these accounts are costly. You can't compare HSAs to HMOs, that's like comparing ATM fees to loan rates, the two pairs are totally unrelated other than that they both relate to insurance and banking, respectively. I don't know what you mean by saying you "own one," I presume that you mean that you have an account, not that you own a company that administers HSAs. A Health Savings Account is an account, that I presume in your case is provided by an banking institution chosen by your employer. Your employer pays a fee for the administration of that account and/or the saved money in that account is used to generate revenue which pays for the account's administration. You may not see it, but you're not getting as much money as your investment is worth because of these administrative fees that are built into your interest/investment earnings (as is the case with an IRA mutual fund, which returns less than the individual stocks would outside of the account). There's no such thing as a free lunch. That extra paper pushing is costing someone money, so at the end of the day, this is not a good deal for anyone but the paper pusher/fee collector.

5. I'm not sure what you're trying to say here, but you're the one who brought up "Canadacare" in your original post, not me. Not to mention "boob jobs," who's off topic here? Anyway, sharing the burden is the point of insurance. You can split it into different pools, but at the end of the day you have the same total risks and costs (if you're arguing that mandates are keeping healthier people from getting insurance, which is making the insurance pool less healthy, then I agree this does have some marginal effect). But, if you're young now and pay more so that you pay less when you're old, what difference does that make in the grand scheme? Sure it'd be nice for people like me and you who don't have high healthcare costs now to pay less, but we'll hopefully be old someday, too. If we're trying to solve a national healthcare "crisis" that involves both the young and the old, I don't see how removing mandates to permit the shifting of risk pools really helps reduce overall costs.

You say "My work is done here." You do realize that's a classic sore loser statement? How cute, you're mad, so no one gets to play now; you're taking your ball and going home. Please spare me the drama.

you forgot "Public Option"

We need access to a form of health insurance that won't immediately cancel our policy when we get sufficiently ill. There is no private-sector solution to that very real problem.

 

what about a public safety net

if you have a job, and if you are on time with your insurance premiums, if you have some odd situation where you lose coverage or cant afford the bills, you could work with the government/insurer to set up a payment plan. that way responsible, low-risk people don't have that overhanging risk of bankruptcy.

duplicated...

sorry

 

I Love This

This is EXACTLY why the Right is on the defensive and obviously, completely, on the wrong political side of this issue.  The million-plus dollars a day being spent by the health cartel to move the ball towards their end zone of maintaining the status quo is third and long, we know their plays, and we have their offensive players back on their heels and going nowhere fast.

Vern: thanks so much for making these points, which I knew full well, and every sentient American can get easily and quickly from a number of different sources.

It ain't 1993 any more, where the GOP and their bosses took over the megaphone, then the  stage, and finally the message.

i can't wait each day to be King of MY water cooler, lol!

Cartels? Think about that...

Insurance companies are cartels precisely because the government - particularly state governments - have created intra-state monopolies. That's why I put #1.  It's so funny how linear leftists are in their thinking. Do you guys understand economics and the benefits of competition? Do you know what deadweight loss is? How prices work? I'm not sure you do. But worse, I'm not sure you care.

Cartels?

The entire Health Industry is a cartel because they have colluded to manipulate both the access to the product and the means of delivery of the product.

It is beyond repair because the cartel will do whatever it has to do to keep its chokehold.

HSA's do NOTHING to control costs.  Tort reform does NOTHING to control costs, according to several studies, including one by the Bush-era CBO.

The only control to cost in any industry is fair competition in an open and legitimate free market, where entrepreneurship, innovation, and new ideas can drive product quality, service excellence, and user satisfaction to lower costs and gain market share. 

This is the model that has served us so well in the past, and the model that must be found again if we are ever going to get out of this morass.

The only fix to the problem we are in, where we are facing an unholy, collusive price-fixing alliance of insurance companies, HMO's, huge Corporate Hospitals and Medical Centers and Global Pharma is to demand necessary, drastic Government intervention to bust the monopolies and restore and correct the health-services market.

How we get there is still being discussed and negotiated.  Opening the state-to-state controls on Insurance is just one small piece of how we get there.  The major, game-changing, paradigm-shifting piece is a government-sponsored health insurance plan like Medicare, that can put pressure on the cartels by taking market share away from them.

But get there we must.

Bingo, Max.

The Mackinac Center published an article last year that said almost exactly the same - http://www.mackinac.org/article.aspx?ID=9331

Do conservatives support Health Insurance Exchanges?

One of the major ideas for improving access, coverage and controlling costs in the current health care reform debate is regularly overlooked. That is the idea of health insurance exchanges. Indeed, the whole public option debate is addressing whether or not there will be a public option in the health insurance exchange(s), yet for all we hear about the public option, we hear very little about what is by far the more important reform initiative of the exchanges.

On the right Heritage supports them while on the left Ezra Klein assets they are the most important element of reform currently being debated. Under different names and in different forms Health Insurance Exchanges figure in every significant bill currently working its way through Congress. 

Regarding conservative support for health care reform, the exchanges touch on at least four of the key issues Max raises above. Namely, increased competition, promotion of genuine market efficiencies, decoupling insurance and employment and national vs. state market scope. I am therefore curious why conservatives interested in reforming the current system aren't pushing the idea harder and finding common ground with those on the left who see exchanges as the central reform mechanism.

I would be interested to hear commenters thoughts on this aspect of the reform debate.

This is a great question.

I look forward to its answer(s).  I was also intrigued by Ezra's discussion of funding options, here:

http://voices.washingtonpost.com/ezra-klein/2009/07/an_inside_look_at_the_senate_f.html

Preliminary CBO Score on Public Option ($150B Savings)

According to a pair of Capitol Hill sources, preliminary estimates from the Congressional Budget Office suggest that a strong public option--the kind that the House of Representatives is putting in its reform bill--should net somewhere in the neighborhood of $150 billion in savings over ten years.

Here: http://blogs.tnr.com/tnr/blogs/the_treatment/archive/2009/07/10/exclusive-early-cbo-score-on-public-plan-it-s-good.aspx

The Public Option

I'd like someone who is in favor of it to explain to me why the enormous and complex field of health care, alone of all economic enterprises, would be best managed by the government, which has run the portion of that market that it manages now into the ground.

I'm in favor of health insurance exchanges, and Mr. Butler makes a persuasive case for state exchanges rather than a national exchange. At the risk of making the perfect the enemy of the merely good, I'd prefer a national exchange without coverage or provider mandates.

Before you make the case for lower administrative costs for the public option, please read this Verum Serum post of a Megan McArdle column about the subject:

http://www.verumserum.com/?p=7079

McArdle also focuses on public option to the exclusion of HIEs

McArdle's piece goes right to my point. She's very concerned about the impact of the public option but has nothing to say about HIEs. So concerned is she with the monopoly power of government that she fails to address the de facto monopolies and other deep disfunctions in what passes today for our private insurance markets:

Monopolies, government or private, are risk averse, slow to innovate, and generally run things for the benefit of themselves rather than their customers.  Hamstringing them with regulations can limit measurable outcomes, like excess profit-taking, but not unmeasurable ones, like the people who might have been cured by a drug the system didn’t invent.

The public option, if adopted, would be only one among many insurance plans in one or more health insurance exchanges. In too many instances, whether it is limited choice from an employer's plan offerings or near monopolies by insurers in certain states, etc., market reforms are desperately needed as a first step toward healthcare reform. Yet on the right and the left all anyone can talk about is whether a public option as part of a HIE is a satan's brew or a panacea with nary a word about the market exchanges in which any public option would exist.

It seems to me that conservatives would be much better served by focusing on how best to structure HIEs to gain maximum benefits from marketplace effects including all the ideas discussed in Max's post. But, like addressing bank insolvency, rather than taking the opportunity to lead we seem content instead to bicker along the margins.

a public option already exists

It's just restricted to seniors, the military and politicians.

 

I believe that the #1 cause of rising medical costs is the profit motive masked by group insurance rates.

Here's a simple example... we have been essentially uninsured for over a year since I became self-employed. My wife recently needed an MRI... the cost they normally charge for insured patients was $500... for uninsured, they cut 40% off and we paid $300.

Think about that. Medical companies mark up the cost of this very common procedure by 67% ($300 to $500) if you have insurance. Why? Because the insured pay the same amount  (the office copay) no matter how much the insurance company is billed. In other words, we have a very inelastic demand curve.

This overcharging leads to insurance companies raising premiums and aggressively cutting costs in order to maintain healthy profit margins for their shareholders. Let's be realistic -- insurance companies care far more about the financial health of their stockholders than the medical health of their customers.. it's the nature of the capitalist system.

This results in "high risk" customers being denied coverage through a variety of means. "High risk" can be someone with expensive medical problems, or simply someone whose potential health costs cannot be distributed among a larger pool of customers (individuals and small businesses).

How can this problem be solved? Well, to solve the problem you have to recognize that there are two problems -- demand inelasticity and profit motive.

A public option definitely removes the profit motive and consequently addresses the inelasticity. A government-run plan will most assuredly negotiate set prices for most procedures (private insurers do this already, so no crying about that), but will not eliminate coverage for high-risk patients or be so quick to raise premiums beyond standard cost of living adustments. This inflexibility in revenue will effectively stifle any attempts by the medical industry to gouge the public providers as they currently can with the private insurers.

This will force the medical industry to either stabilize their prices or to stop covering patients on the government plan. But the government plan will have enough customers to make the latter option very painful for them.

How will this affect private insurers? Well, their bottom line will benefit from stabilized medical fees and they will be more willing to boot their 'high risk' customers to the public option. This will allow them to compete, rate-wise, with the public plan while remaining profitable.

However, I have no doubt that a government plan will work successfully. The government has been running Medicare for a long time, and it is very successful.

Remember, the government isn't actually going to be in the business of providing medical services or doing medical research. They are simply taking the place of insurance, which is basically just paper shuffling and negotiating group rates. It's a lot more doable.

 

Air Jordan Nike Air Max shox

Republicans incapable of quality process control

A bunch of Karl Rove Wannabes set up Thenextright to talk about rebuilding the Republican Party with niche marketing and election gimmicks.  Yet, just like the failed Bush Admninistgraiton, the Karl Rove wannabes cannot be bothered with the day to day operations of a blog.

If the Republicans cannot even run a blog without it being taken over by spammers, then why would anyone want to trust them running the government.

 

It's a shame, really

I have enjoyed and learned at this site for several months, and appreciate the moderators' hands-off approach to the expression of varying viewpoints.  But the outrageous level of spam here now makes it barely worthwhile to even check in now and then, when here's so much garbage to wade through. 

It's especially disturbing that while this site is billed as the "Next" Right, it is poorly administered even in comparison to RedState.  While the Taliban-like enforcement of unquestioning adherence to the far-right orthodoxy of the administrators at RedState severely limits that site's usefulness for discussing issues and ideas, at least the "Old" Right there keeps the spam out.  This site's degradation doesnt' bode well for restoring trust in the Next Right's competence, as you pointed out.

...running Medicare for a long time, and it is very successful.

No, actually Medicare's costs are exploding.  And another Gov't experience w/ running healthcare-- VA hospitals don't perform well either.

Once the gov't is "insuring" people they will gradually take over, because they can subsidize their plan w/ our money and theirs will be the low cost-- taking on whichever benefits lobbying groups can squeeze in there.

Can you cite this?

Can you give a cite for VA hospital claim b/c it has been my understanding that the medical side of the VA is excellent.

I second.

Being a Vet, I second this.  Care is excellent.  Generalizing the VA ability to negotiate drug prices (i.e., reform Medicare Part D) to Medicare and elsewhere would be good.

Ann..

..has no clue other than knee-jerk stupid Conservative responses.

Medicare and Social Security are fantastically well--run insurance plans.  If Medicare is at risk, it's because the Health Industry cartels are colluding to raise prices and limit care, not because of how Medicare is run.

The overhead and administrative costs are among the lowest of all insurance plans, because there is no need to gain market share via promotions, advertising, or marketing, which now account for 10-20% of HMO costs.

 

Are your responses knee-jerk stupid liberal responses?

Do you ever step outside of the liberal box?  Seriously, any thinking person who has had experience w/ DMV, Social Security, the pub school monopolies would not believe that the gov't would likely make an industry more efficient and effective.  Also, we've had decades to show that market forces improve things and taking away financial incentives to perform does not.  How many times do we have to repeat that experiment?

What is really going on here is that the gov't gets involved just enough to screw things up (Medicare, medicaid, mandated coverages, employer tax exemption for health care) so that it can come in on a white horse and save everyone w/ more gov't intervention.  You see the same thing in school monopolies bringing education to such abysmal levels in urban areas that they have to "save" us w/ affirmative action.  Or guarantee purchase of low income loans through Fannie and Freddie so lenders don't worry if borrowers have the ability to repay the loans and then come in to save the banks and economy w/ stimulus money.

Power corrupts, we're giving them way too many opportunities to screw w/ our lives.

But maybe if we all just sat around chanting, "businesses are bad, big gov't is my friend" it'll all work out.

Once Again knee-jerk stupidity

In NYC, Mayor Bloomberg ("The Government") was granted almost total control of the NYC Dept of Education in 2003.

For six years in a row, he has improved graduation rates, decreased violence, cut down on Administrative costs, and made a difference.

For six years, he has not been afraid to try Publicly-sponsored Charter schools, smaller class sizes, entrepreneurial bonuses and benefits to Principals, Administrators, and Teachers which are granted based on outcomes.  His innovations in the new "Children First " Entrepreneurial Consultant  model to School Administration has won prizes for their efforts, as well as support from the people on the front lines.  His controversial, but highly-succesful Principals' Academy program, which recruits leadership talent from industries outside the Educational system, has attracted proven leaders from many backgrounds, including Corporate and Financial.  He has met and overcome resistance from the Teachers' Unions and Parent Advocacy groups, and brought them onboard to a new vision in urban Education:  Whatever Works. 

It's something rare in this country, an old-fashioned virtue called "Leadership" that Mayor Bloomberg shares with President Obama.

NYC now has one of the highest-performing school systems in the country, and former Wall Street leader NYC DoE Chancellor Joel Klein was narrowly beaten out by Illinois home-court for National Secretary of Education.  NYC has over 325 public High Schools now, many different sizes and Educational models from 5,000-kid behemoth schools to 400-kid almost private Charter Academies, any and all accessible choices to any of its 40,000 8th graders choosing a High School this September.

Students choose from 1200 paths to a High School Diploma at these schools, paths which can include training in Hotel and Food Management, Microsoft and CISCO certification, Metro Transit apprenticeship, and FDNY and Justice-Law Enforcement training.  NYC Public High School kids are perennial winners or runners-up in National Science and Math competitions such as the INTEL Scholar programs and the National Merit Scholarships which ask for entries from all kids in this country, public, private, and parochial.

You have no idea what you are talking about when you say Government cannot run Education.  From your comments, though, it is clear that your opinions are guided by rote stupidity and slavish party ideology, not by informed judgment.

Ad-hominem much?

Ok, it's disheartening that you can't talk issues instead of just calling me stupid because my opinions don't agree with yours.  But I guess it's possible that I'm stupid, I have to let others be the judge of that.  But I will take issue with you saying I don't have informed judgement.  I am a product of public schools and I am very involved with them every day during the school year. I have also spent a lot of time reading about this issue.

The example you gave of the NYC pub schools I love to hear.  I'm so happy for those students.  Sounds like Mayor Bloomberg took his entrepreneurial experience and is using it to benefit lots of young people.  However, the reason that is news is because that is not standard for pub schools nationally.  My high school did not prepare me for college, and scores have been slipping since then.  Most urban areas do not have the benefit of Mr. Bloomberg's innovations.

In fact, in Washington DC, politicians recently recinded the Hope scholarships and barred disadvantaged children from attending any other schools than public; yet there are virtually none that feel public schools are good enough for their own children.  We are slipping behind the rest of the industrialized world in education of our children, and the public school monopolies only have the same idea that they have had for decades now, "throw more money in."  We already pay more than any other country.

My children have one of the best public schools in my state yet we still see them doing things like using textbooks based on a math standard that was disavowed years ago by the standards board that originally issued it.  Or I've experienced a school using a whole language reading program even years after California had to throw it out when their scores plummeted.  Teachers who waste class time are never effectively called on it because they have tenure and know they can't be fired.  If any private co. had this level of deterioration in quality it certainly would not be called success.

Any gov't enterprise will have similar issues because people's incentives are not inline with inproving quality.  But what do I know, I'm stupid.

So...

..I give you a clear example of excellence in Government, of elected leadership that produces results; I give you facts, names, dates, and figures anyone can check on line, and it makes no difference to you whatsoever. 

The Government-run Liberal-led Education departments of Blue states like Vermont and Massachusetts are always in the top 10% nationwide in methods, innovation, modernization, scores, and outcomes. 

Charter, for-Profit, and Privatized  systems and programs like the DC "Hope" scams have to cook the figures or cherry-pick them to match the achievement of comparable Public-School students.  The three Catholic High Schools in my District will expel students with no recourse if their 11th grade GPA drops below a C, and they get flushed right into the take-all-students Public School System, which STILL manages to graduate students with superior statewide grades than theirs, but no.

To you, "all Public Education" and "All Gov't Enterprise" sucks.

But relax:  Your positions and opinions are shared by most of the Right-wing posters here. 

It should be crystal clear to everyone reading this exchange why the GOP will continue to be in trouble.

Look I didn't want to criticize your example...

But since you're going to generalize one story about a good school system into-- gov't control works-- I'm going to have to.  NYC schools have definitely made progress from where they were, but they aren't all that.  See http://gothamist.com/2008/04/01/nyc_students_am.php to see that NYC public school students are 43rd out of 50th to graduate students in four years and some of the items praising the schools such as the invention things and National Merit scholars really are individual student accomplishments reflecting IQ and family education culture, which with the number of students these schools have-- they are bound to have a few.

But a bigger point is-- these pub school systems you mention are compared to what?  Other pub school systems is what.  The US school system now ranks behind countries such as Estonia and Russia in math and science, significantly behind Hungary and Latvia, I believe, and quite a few others, this despite spending the most of any country (exc. Switzerland).  Are we really OK with that?  Even the old socialist standard, Sweden has switched to school choice. 

Individual schools might do well, but I want the whole system to be brought up by competition.  This goes for health care, too.

Oh, and for the record, private schools have been cherry-picking students for a long time, because only rich families can afford to send their kids there.  Scholarships for poor families doesn't make that problem worse, it just makes the liberal politicians' kids rub elbows w/ less desirable kids.

Please criticize my example

..But use a little judgment in making your case.

The link you posted also said this, and if you don't clip and paste and cherry-pick the sentences you like, you would also have posted this:

 

"...But the study was conducted using data from 2004, and the Department of Education claims the city's graduation rate has risen six points since then. Also, each state has different educational standards, so comparisons can be a bit misleading. Still, who will be surprised that poor Detroit, which can't catch a break, would get the worst ranking, with just 25% of students graduating? At least New York students bested, in order, Dallas, Minneapolis, Columbus, Baltimore, Cleveland and Indianapolis. L.A. students managed to flirt their way past New York by 0.1% and snag the #42 slot. Number One? Mesa, AZ..."

 

How could you even post this tripe?  That study is ancient, it's from a non-entity, and the methodology is totally suspect.  There's LOADS of "studies" done by Corporations looking for a piece of the CHarter-school pie that "prove conclusively" that Public Schools suck.

Here is the latest OFFICIAL information, from the NYC DoE, dated Monday, June 22, 2009, THIS year:

MAYOR BLOOMBERG AND SCHOOLS CHANCELLOR KLEIN ANNOUNCE THAT HIGH SCHOOL GRADUATION RATE RISES ABOVE 60 PERCENT, MARKING THE SEVENTH CONSECUTIVE YEAR OF GAINS

 

More Students Earning the Regents Diploma

 

Graduation Rate Among English Language Learners Up More than 10 Percentage Points

 

Black and Hispanic Students Narrow the Gap with White and Asian Peers

 

            Mayor Michael R. Bloomberg and Schools Chancellor Joel I. Klein today announced that New York City’s four-year high school graduation rate rose to a new high of 60.7 percent in 2008, marking the first time the City’s graduation rate has surpassed 60 percent according to the State Education Department, which released the data today. The graduation rate rose 3.6 percentage points between 2007 and 2008, furthering a continuous rise since the Mayor won control of the school system in 2002. The rise in the graduation rate between 2007 and 2008 is accompanied by an equally large increase in the percentage of students earning Regents diplomas. Additionally, the graduation rate among English Language Learners rose more than 10 percentage points between 2007 and 2008. Black and Hispanic students continue to narrow the graduation gap with their white and Asian peers.  The Mayor and Chancellor were joined for the announcement in the Blue Room at City Hall by Council of School Supervisors and Administrators President Ernest A. Logan and United Federation of Teachers CEO Mike Mulgrew.

 

“After years of near stagnation, our reforms have increased the graduation rate each year since we’ve been in office—and I’m so proud to see that graduation rates are up again this year,” said Mayor Bloomberg. “This year, English and math scores went way up, schools got much safer, and many more of our high school seniors have earned their diplomas. This is a great day for New York City schools.”

 

The dropout rate also fell by 3.3 percentage points between 2007 and 2008 to a new low of 13.5 percent. Since 2005, when the State began calculating graduation rates using its current methodology, the City’s graduation rate has risen 9.9 points, and the dropout rate has declined by 8.5 points. This means that more than 7,800 additional students in New York City have graduated and 6,200 fewer students have dropped out since 2005.

“I’m pleased that the graduation rate is continuing to rise in New York City, and I’m especially pleased that more of our students than ever before are meeting the requirements for earning a Regents diploma,” said Chancellor Klein. “We want to thank the State for its leadership in setting a high bar for graduation.  We’ve worked closely with Commissioner Mills over the last several years to strengthen academic standards, and these results are further evidence that students will rise to meet high expectations.”

 

“Graduation from High School is necessary to be prepared for college, work and life. These numbers are encouraging, and I want to congratulate every student, teacher, principal and parent for their efforts, but I also want to say that we will never rest until all kids are achieving and graduating,” said UFT President Randi Weingarten. “Local diplomas will be phased out over the next three years, raising the standards our students will have to meet to graduate high school. In order to continue the progress we have made, we must ensure that our students, their schools and their teachers have the resources and support necessary to meet this new challenge.”

 

“Our principals and assistant principals are gratified as graduation rates continue to rise.  With attendance and graduation rates growing stronger, high achievement for all students becomes a greater possibility, and we have always believed in this possibility,” said Council of School Supervisors and Administrators President Ernest Logan. “The diligence and conviction of our school administrators, teachers, and parents have contributed to all the recent progress in New York City’s public schools. But when it comes to higher graduation rates, let’s give our students the greatest congratulations and a very big round of applause.”

 

The State Education Department reported that New York City’s four-year graduation rate in 2008 was 60.7 percent. This figure includes students who graduated in August after completing remaining requirements over the summer. However, because the State only recently began including August graduates in its calculation, comparisons to previous years must exclude August graduates. Excluding August graduates, the City’s four-year graduation rate rose to 56.4 percent in 2008 from 52.8 percent in 2007 and 46.5 percent in 2005. At the same time, the dropout rate fell to 13.5 percent in 2008, down from 15.8 percent in 2007 and 22 percent in 2005. The five-year graduation rate rose to 62.6 percent in 2008 from 58.8 percent in 2007 and 55.7 percent in 2006. The six-year graduation rate rose to 61.8 percent in 2008 from 58.5 percent in 2007.

 

            The rising percentage of students earning Regents diplomas matched the increase in the overall graduation rate. A new high of 40.9 percent of the class earned a Regents diploma in 2008, compared to 37.1 percent in 2007 and 30 percent in 2005—a 10.9 percentage point increase over three years. Students must meet more stringent graduation requirements, including higher scores on their Regents exams, to earn a Regents diploma. The percentage of students earning local diplomas fell to 15.5 percent in 2008 from 15.7 percent in 2007 and 16.5 percent in 2005—even as the overall graduation rate has increased.

 

            The percentage of English Language Learners who graduated in four years rose 10.7 percentage points between 2007 and 2008. The graduation rate among these students was 35.8 percent in 2008, up from 25.1 percent in 2007. This increase is particularly impressive because English Language Learners are often new to the country and must master English as well as meet all other graduation requirements.

 

            The graduation rate among special education students was 22.5 percent in 2008, up from 18.3 percent in 2007 and 17.1 percent in 2005. The one-year increase of 4.2 percentage points essentially matched the increase among general education students.

 

            The four-year graduation rate among black and Hispanic students is increasing faster than that of their white and Asian peers. The gap in the graduation rate between white and black students was 20.1 percentage points in 2008, down from 21.2 percentage points in 2007 and 23.9 percentage points in 2005. Including August graduates, the gap in 2008 closed to 18.9 points. The gap between white and Hispanic students was 22.8 percentage points in 2008, down from 25.5 points in 2007 and 26.6 points in 2005. Including August graduates, the gap in 2008 closed to 21.5 points.

 

Overall, 51.4 percent of black students in the class of 2008 graduated in four years, compared to 47.8 percent in 2007 and 40.1 percent in 2005. This 11.3 point increase over two years compares to a 7.5 point increase among white students and a 7.8 point increase among Asian students during the same period. Similarly, 48.7 percent of Hispanic students in the class of 2008 graduated in four years, compared to 43.5 percent in 2007 and 37.4 percent in 2005, an increase of 11.3 points over two years.

 

            The City and the State currently use a shared methodology to calculate graduation rates. Previously, the City used its own methodology, which has remained unchanged since 1986 and is still useful for comparisons over time. Using the City’s formula, the graduation rate rose from 58 percent to 66 percent between 2005 and 2008, an increase that tracks closely to the State’s calculation. Since 2002, using the City’s methodology, the graduation rate has increased by 15.2 points—from 50.8 percent to 66 percent. Before the start of the Bloomberg administration, the graduation rate had been essentially stagnant for a decade, hovering around 50 percent.

 

 

-30-

 

            Contact:           Stu Loeser/Dawn Walker         (212) 788-2958

                                    David Cantor (DOE)                (212) 374-5141

 

 

 

Better sharpen up your Google skills, kiddo, and find some better links to paste here.  You are looking like you're way out there in trying to support your rank and ignorant positions.

60% woohoo!!!!!

Detroit's a public school, too.  Whether you get a good education or not depends on whether you lucked out to be born in a good school district or not.  We could change that.