Category Archives: Current Affairs

Chapter 5 – Journalled review of Diane Ravitch’s Reign of Error. “The Facts about Test Scores.”

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In Chapter 5 of her monumental work, Reign of Error, Diane Ravitch offers the results of The National Assessment of Educational Progress (NAEP) assessments as compelling evidence that “students in American public schools today are studying and mastering far more difficult topics in science and mathematics than their peers forty to fifty years ago.” On the basis of this evidence she believes that “Test scores are at their highest point ever recorded” and, therefore, claims that “the educational system is broken and obsolete” are simply not true. It may be true that scores are higher than ever for the students at the elite end of the academic continuum but it ignores the stark reality that is the performance of the majority of American school children.

It is somewhat ironic that Ravitch is critical of the value of standardized testing in assessing the efficacy of public education on the one hand but cites NAEP results as evidence of the health of public education in America on the other. Her argument is that the NAEP assessment process is a different sort of testing and is far more meaningful that they typical standardized competency examinations used in states throughout the U.S. About this she is correct and we will examine the NAEP assessments and their results, shortly.

It is also important that we examine the context in which Ravitch’s arguments are made. Like most educators, Ravitch is frustrated at the savagery with which our schools and teachers are being blamed for the perceived failure of public education in America. Being attacked, even when criticisms are justified, is far more effective at putting educators on the defensive than it is as a catalyst for meaningful educational reform. When the criticisms are unfair and based upon claims that are unfounded or prejudicial, the intensity of one’s defensive posture is magnified.

As we have said throughout this “journaled review of Ravitch’s Reign of Error,” she is right to challenge the basis for such claims and also the solutions proffered by the “evil corporate reformers.” Where she is wrong is to insist that the documented improvements in the performance of our public schools, as measured by NAEP, are acceptable and that they prove that public education in America is not failing. We would suggest that the NAEP results prove rather clearly that public education is, indeed, failing.

Let us digress for a few paragraphs and take a look at the NAEP assessment process. Ravitch is correct that the NAEP assessment process is a meaningful tool and that the NAEP, which is part of the US Department of Education, and its independent governing board, the National Assessment Governing Board (NAGB) are a highly reputable, bipartisan body comprised of educators, elected officials, business people, and members of the general public.

The NAEP measures student performance in reading, math, and other subjects over time and reports results in two ways. The first is by scale scores, ranging from zero to 500 which reflect what students know and can do, without making judgments about whether the performance is good or bad. To use the vernacular, the results “are what they are.”
The second component is that Achievement Levels have been established in an attempt to put the raw results into some sort of meaningful context. It is acknowledged that these achievement levels are somewhat arbitrary and have created opportunities for over-interpretation.

On the NAEP assessments, an “advanced” level of achievement denotes “superior performance at each grade assessed.”
“Proficient” is defined, by the National Assessment Governing Board (NAGB) as “solid academic performance for each grade assessed. This is a very high level of academic achievement. Students reaching this level have demonstrated competency over challenging subject matter, including subject matter knowledge, application of such knowledge to real-world situations, and analytical skills appropriate to the subject matter.”

The NAGB defines “Basic” as “partial mastery of prerequisite knowledge and skills that are fundamental for proficient work at each grade assessed.”

The NAGB “believes, however, that all students should reach the Proficient level; the Basic level is not the desired goal, but rather represents partial mastery that is a step toward Proficient.”

“Below Basic” represents students who are unable to demonstrate even partial mastery of the work at each grade assessed.

We must maintain an awareness that these achievement levels are determined by the judgment of a panel of people on the basis of the performance of actual testers using percentiles. In effect, we are superimposing a distribution curve over the scores in order to make it more meaningful for us. As we shall see, later, the results tell us how much students know but it does not even begin to tell us where they should be performing at a given grade.

We can draw meaningful conclusions from the scores that will help us chart a course for the future, however and we will discuss this in some detail.

An important distinction with respect to NAEP results is that the scale scores of 0-500 change very little over time and actually show how students are moving up the scale, i.e. from the 4th grade assessment to the 8th grade assessment. In essence, the assessment shows how much kids know and can utilize at a given point in time. It might be helpful to think of it as a continuum along which students move as they gain increasing levels of mastery over the subject matter with no ceiling as to how far they can progress other than topping out at a score of 500.

Now, we want to compare the NAEP assessment process with state competency exams and we will use Indiana’s ISTEP+ simply because of the author’s relative level of familiarity with it.

Right out of the gate, be aware that we are going to over-simplify this process but it is the logic of the process that we want to illustrate.

On ISTEP+ for Grade 3 Math, for example, there is an expectation that a given number of areas of content will have been presented to the students by the time the ISTEP+ for that grade level is scheduled to be administered. The primary question the ISTEP+ is designed to measure is whether or not students “have learned what we expect them to know.” Specifically, what they are expected to know is defined within the context of state standards. What is not obvious from the published data are such questions as “How were passing scores determined?” In other words, how high was the bar set? For example is passing 60 percent? Eighty percent?

So, in the case of NAEP we are assessing how much a child of a given age knows and can utilize, without regard for how his or her classmates might be doing. For the ISTEP+ we seem more concerned about how a given student’s performance compares to the performance of his or her classmates.

Returning to our discussion of how NAEP results are to be interpreted, Ravitch disagrees with those who “assume that students who were not “Proficient” on the NAEP were “below grade level”.” “That is wrong” Ravitch insists and she suggests that having “76 percent” or some comparable percentage of the student population at “basic or above” is something to be touted.

I tend to agree with the NAGB that “Basic” is not our desired goal and that all students should reach the “Proficient” level of achievement, which is a point at which they have “demonstrated competency over challenging subject matter. . . .” and can apply “that knowledge to real-world situations. . . .”

Think about the difference, here. Ravitch is stating that the NAEP results in which 71 percent of eighth grade students are at “Basic or above” is validation that our schools are not in a state of crisis.

I would suggest just the opposite, and the NAEP would seem to agree, that it is clearly unacceptable that only 44 percent of eighth grade math students are “Proficient or Advanced.” Why would we ever think our job is done when any student has achieved only “partial mastery of prerequisite knowledge and skills that are fundamental. . .” to achieving proficiency rather than “Proficiency” itself? Why would we ever think it acceptable that 56 percent of eighth grade math students are not at a point where they have mastered the material sufficiently to apply that knowledge to real world problem-solving?

And, let us not forget about the 29 percent of eighth grade math students who have yet to demonstrate even partial mastery of the material. The two realities taken together spell crisis in this author’s mind in bold upper-case letters.

Other points of concern include:

The fact that we have no sense at all about whether or not the bar has been set sufficiently high;
The fact that only 6 to 8 percent are performing at an advanced level;
The fact that the variance between the 10th percentile and the 90th percentile is a cavernous 94 points (for eighth grade math students); and
The fact that the performance gaps between white students and their black and Hispanic classmates remains at an unconscionably high rate and that closing the gap from 32 points to 25 points for African-American students over a twenty plus year period is an accomplishment about which we should feel embarrassed rather than proud.

In American educational thinking, we are caught up in the idea that only 6 to 8 percent of students can be A students. In the business world, no production manager would be content to have such disparity of performance. The expectation would be that 75 percent of more of employees are working at the highest level of productivity and that those employees who are not are receiving aggressive remedial attention.

What we can say with some certainty, when talking about American public education, is that few if any students are performing at the highest level of which they are capable and the vast majority are nowhere close to achieving their potential. Helping individual students reach the highest tiers of their potential should always be the goal of our schools and teachers and we should not be squandering a single second worrying about whether Child “A” is keeping up with his or her classmates.

The NAEP Assessment tools appear to offer a high level of utility in judging the efficacy of our systems of public education. What we need to focus on is closing the gaps and raising the bar.
Let us not forget that the biggest fallacy in over-reliance on standardized testing, of any kind, as the ultimate measure of accountability for schools and teachers is that schools and teachers are only a small part of the equation for academic excellence.

To suggest that our current level of achievements provide evidence that no crisis exists in American public education is nothing short of absurd.

Charter Schools Are Not the Solution to Public Education in the US

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While I would enthusiastically support the concept of creating a charter school to test a new instructional model and would certainly approve the use of incentives to encourage families to place their children in that school, that is not the way charter schools are being utilized here in Fort Wayne, Indiana nor, I suspect, in most other communities in the US.

The Charter schools with which I am familiar are might posture themselves as innovative but, in reality, they are little more than lifeboats floated out into the murky sea of public education to give the few families that are so inclined a place to which they can escape from the public schools.

There are insufficient numbers of these lifeboats to accept more than a miniscule percentage of the total population of children who are in the figurative “damaged ships” that are our urban public schools; thus, such schools can have no more than a marginal impact on the challenges facing public education in America.

The fact that we create these avenues of escape for the most motivated families and their children and still expect the teachers of the abandoned school to improve scores on standardized competency examinations is absurd. Charter schools may be a lifeline for a small number of families but they are a virtual sentence of death, or at least imprisonment, to the abandoned schools and to their students and educators.

The message this sends to the community at large is “we cannot do anything to fix our most challenged public schools so let us, at the very least, help a few families and their children escape.

The practice of using school vouchers is also creating its own series of adverse impacts. Not only do vouchers drain scarce tax dollars out of the accounts of our most challenged schools, those dollars are not creating outcomes that are significantly better for the students as, at least locally, the performance of charter schools on competency exams is disappointing. Worse yet, is that a portion of the tax revenue siphoned out of the budgets of our public schools is being utilized for purposes other than the education of our children.

I know, personally, of two Catholic parishes in Fort Wayne that have found vouchers to be a profitable enterprise and have used the revenue to pay off the parishes debts to the Dioceses or to address non-school related financial concerns while requests for school related uses of the funds have been denied. Now that this practice has come to light, that unfortunate and inappropriate practice will be discouraged, hopefully, if not discontinued.

We say that our purpose is to fix public education and that is expressed in our collective mission statements. Our behavior suggests that we have given up on at least our urban public schools as lost causes.

The fundamental problem with education reform is that it amounts to little more than tinkering with obsolete educational processes that contributes, greatly, to the failure of its students and the overwhelming majority of educational reformers, “corporate reformers” or “traditional,” seem oblivious to this reality. No matter how many times we keep re-shuffling the same deck we will continue to get the same 52 cards. Unfortunately, they are the wrong cards.

If the reader can allow his or her mind to consider, imagine that we have landed on another planet with a couple of million families and we want to set up schools for our children. If we were to take advantage of this unique opportunity and design and educational process from scratch, would it appear anything like public education looks in the United States of America, today? If we were to apply any amount of imaginative, exponential thinking the answer would be that the system we would create would bear little resemblance to what we have here and now.

The saddest fact of all is that reinventing our educational systems and processes would not be all that difficult if only we would open our hearts and minds to a new way of thinking about education. With but a few exceptions, most of the things we would do differently would require nothing more than a majority vote of the local school district.

I am proposing that we apply a systems-thinking approach utilizing present day business principles to reinvent education in America. I am not talking about such business principles of the corporate board room as financial incentives, competition, privatization and entrepreneurialism. In fact, these are the exact wrong business principles.

The business principles to which I refer are the principles learned in an operational setting such has: focus on one’s customer; identifying and focus on one’s mission, structuring the operation to meet its objectives, problem-solving, teamwork, integrating quality assessments into the learning process, and giving the people on the production line (teachers and administrators) the tools and resources they need to do the best job of which they are capable.
In my book, Reinventing Education, Hope, and the American Dream: The Challenge for Twenty-First Century America, I offer a comprehensive blueprint for change.

My request to educators and reformers alike is: let us pause for a moment, clear our minds, and listen to the ideas of someone with a fresh perspective. What do we have to lose other than a few minutes of our time? This is something else smart businesspeople have learned. They often seek out consultants with a broader perspective to challenge their assumptions and paradigms. They even pay for this service, which is the best indicator of its perceived value.

Things Positive Leaders Can Do, Part 4 – Be Active in Your Community

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How much time and energy one devotes to one’s community will vary greatly according to the time of one’s life. What is important is that each of us acknowledges a responsibility to our community, to society, and to the world as a whole.

Remember to think about things in the context of our most basic values:

1. That every human being on the face of the Earth is a child of Creation and deserves our respect and concern,
2. That the Universe is the Creator’s gift to us, and
3. That every job well done, great or small, adds an element of beauty to the world.

We have an unyielding obligation to cherish life and the Universe. Everything we do must be judged in this context:
“Does it or does it not affirm life.”

We must:

• Respect all life and each and every human being,
• Reject racism,
• Conserve and protect the Earth’s resources:
• Participate in our government at the local, state, and federal level by:
• Help our neighbors
• Take care of our property
• Support the less fortunate with our energy, compassion, time and money
• Support our economy by doing our job to the best of our ability
• Give something back to our community

None of us can afford to live in isolation or to abdicate responsibility for the world and its challenges. Whether we accept it or not, the problems of the world will have an impact on our lives and on the lives of our loved ones. None of the world’s problems can be effectively resolved without the help of each of us. None of us are insignificant and each effort on the part of every individual makes a difference.

Remember the thoughts of Jane Goodall,

“The most important thing people can do for the future of the world is to realize that what they do matters.”

Every child that grows up hungry, angry, ignorant, illiterate, and estranged from the mainstream of our society threatens the safety and quality of life of the entire community. These children are our responsibility and the sooner we acknowledge that responsibility the better our chances of making a positive impact. If every gainfully employed man or woman would reach back to help one disadvantaged child, there would not be enough disadvantaged children to go around.

Most of us look out at the immense problems in the world and feel overwhelmed and powerless. This is a normal human feeling but it is just that—a feeling. We are not powerless and we need not feel overwhelmed. We have the power to make a difference if only we will do whatever is in our power to do; if only we will take the lead as a positive leader.
Give of yourself fully and practice the principles of positive leadership.

Former President George H. W. Bush’s 1988 campaign strategy of promoting “a thousand points of light” was an important acknowledgement that our government cannot solve all of our problems. In fact, just the opposite is true. More often than not our government tends to create more problems than it solves. When government attempts to solve our problems for us it tends to create dependencies rather than foster both independence and interdependence. The best solutions to our problems rest in the hands of individual men and women, acting in concert with their friends and neighbors, and acting on principle.

You can make a difference. More importantly, you must make a difference. The whole world is counting on you. Be a positive leader!

Response to the Column on Culture and Poverty by Eugene Robinson of the Washington Post

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Bravo for the rejection, by @eugenerobinson of the @washingtonPost, of Rep. Paul Ryan’s assertion that culture is to blame for poverty in the U.S. It is what I have been trying to say in my book, Reinventing Education, Hope, and the American Dream, but Robinson has said it better. Such proclamations do, indeed, provide an excuse for doing nothing. Such thinking also provides fodder for corporate reformers of education who want to privatize our schools and minimize the amount of influence a local community will have over the schools their children must attend.

Ironically, when traditional educators challenge such corporate reform agendas they make the same excuses by claiming that poverty is the cause of the problems with public education in America and, yes, I know this sounds counter-intuitive. Blaming poverty gives educators license to lower their expectations because “there really isn’t anything of significance we can do until our government effectively addresses the problems of poverty.”

I wish I could go back and add Robinson’s comment on culture, in the section of my book where I say that the problem with education in America is not poverty, it is the hopelessness that so often accompanies poverty. That hopelessness and powerlessness also contribute to a cultural devaluation of education on the part of a growing population of Americans; citizens who have become effectively disenfranchised and have given up hope that a quality education can create a better life for their children.

I wish I had done a better job of saying that the problems of poverty and educational failure are not the result of the many subcultures of American society; whether African-American, Hispanic-American, or other ethnic groups.

Why can we not recognize that this cultural diversity is not a weakness of American society but rather a strength that adds rich textures, flavors, sounds, and perspectives to a pluralistic democracy.

Blaming poverty for the problems in education, like blaming culture for the existence of poverty, is convoluted logic that blinds us to pragmatic solutions and is nothing more than an excuse for continuing to make the same mistakes we have been repeating for generations. Until we change this thinking our schools will continue to chew up and spit out huge numbers of American school children.

Even though this cultural devaluation is prevalent in many African-American communities in cities and poor rural communities throughout the U.S., it transcends race and exists anywhere that people have given up hope and no longer believe that they can exert control over the outcomes in their lives.

Poverty and the problems with education in America are symptoms of the same pathology as is the cancerous, cultural devaluation of education. They are all functions of hopelessness and powerlessness. The operative question becomes, “why don’t we attack hopelessness relentlessly.”

In my book, I suggest that education not only provides a barometer with which we can measure the severity of the problem, education also provides our society with the best opportunity to alter this reality. Make no mistake, if we continue to allow the spread of hopelessness it has ominous implications for the future of America. This is particularly true given the emergence of whole new economies that are challenging American supremacy in the dynamic and highly competitive world marketplace of the Twenty-first Century.

We must transform the educational process in America from a system that is focused on failure to one that acknowledges the cavernous disparity with respect to the level of motivation and preparation that young children carry with them on their first day of school. We must have a system that puts teachers in a position to help their students learn how to be successful rather than the current system that sets up huge numbers of children for failure and humiliation. And, then, we wonder why they begin to lose hope that an education provides a pathway to better opportunities.

We must urge Americans of all backgrounds and economic circumstances to believe that we are anything but powerless to change the outcomes that flow from our society’s shortcomings.

Reinventing Education, Hope, and the American Dream: The Challenge for Twenty-First Century America, offers a blueprint for change that outlines thirty-three specific action strategies for transforming American public education and also for infusing hope and faith in the American dream in the hearts and minds of every American man, woman, and child.

We Must Be Willing to Believe in the Possibilities if We Wish to have Better Outcomes

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One of the things that distinguishes positive leaders from the rest of the crowd is the belief in the possibility of things. How many times, when presented with a new idea for solving a problem have you heard the response, “That’ll never work!” “You will never convince them of that.” “Management will never go for something that grand!” “You are biting off more than you can chew!” “You will never get the funding!” “What makes you think they will be willing to listen to you?” “That’s impossible!” “You are spitting in the wind!” You’re dreaming!”

We could go on and on with similar examples of the excuses people use for not trying. Every great idea in the history of the world began in the fertile imagination of an individual human being who looked out at the world with a fresh perspective. A huge percentage of these great ideas were perceived to be impossible by the dreamer’s contemporaries, by the wisest people of their time; by those in power whether a king, emperor, general, or president; by the religious authorities of that time in history, and even by their closest friends and family.

Very often the dreamer was persecuted for his or her revolutionary ideas, ideas often branded as heresy and blasphemy.

Not uncommonly, these history changing ideas were not even spoken or written about, initially, because their proponent underestimated their own ability to make a difference in the world around them. Often, such ideas lay dormant in the deepest recesses of the proponent’s mind until something happened that compelled the individual to act, even in the face of great opposition.

Listen carefully! Whether an idea is big or small, each and every one of us has, within us, the power to ask why not. Each and every human being has far more ability to alter the world around them than they give themselves credit for.

In our case, we are talking about reinventing education in the US. Yes, it is an enormous challenge, but it is well within the scope of possibility. We can move the odds of any given idea from “possible” to “probable” just by expanding the number of people who are willing to open their minds. We can change education in America, if only we will open our hearts and minds to new ways to looking at the educational process; to new ideas.

Think about this for a moment. If we were to decide to start over, to build an educational system from scratch that would do all of the things that we want and need it to do, I can guarantee you it would look entirely different than the way the system looks today.

Begin with this question in your mind. What if there was a way to do things differently that would accomplish all that we want while preserving the integrity of the system and its professionals?

If there is a way, wouldn’t it be worth our time and energy to find out? Is not education sufficiently important to the ongoing welfare of our society that we should leave no stone unturned in our quest for a answer?

Let Teachers Lead Students to Success

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Below is a guest column by Ron Flickinger that appeared in the March 10, 2014 edition of the Fort Wayne News-Sentinel referencing my book, Reinventing Education, Hope, and the American Dream: The Challenge for Twenty-First Century America.

“Abandon Current Focus on Failure, let teachers lead students toward success.”

A Response to Diane Ravitch Blog Post, Poverty Matters

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Poverty Does Matter, but not the way we like to think!

Poverty is important and it does matter, very much, in fact. And no, poverty is not a state of mind; it is a tragic condition in which millions of Americans languish.

Poverty is also an excuse for throwing up our collective hands as if the outcomes are out of our control. It is an excuse for continuing to do the same things we have always done, unquestioningly, convinced we are doing the best we can for the children in our classrooms, under adverse circumstances.

We cry out: “If only Congress would raise minimum wages; change the tax structure to more equitably spread the burden; if only they would find a way to lift the horrible mantle of poverty we could really help these kids.”

And, before you rush to stereotype reformers and their pseudo-counterparts and shut down your minds, I grew up in a low-income family and attended a school that, sixty years ago, was 30 percent black and 50% impoverished. In my first job as a juvenile probation officer I sat across a rickety card table that served as the dinner table for a mother striving to rear 4 children on welfare, drinking coffee while trying to find a way to keep her sons in school and out of the juvenile detention facility.

I sent my own three children to city public schools so they would learn to feel at home in the midst of diversity and not grow up to be elitist, upper-middleclass Americans, out of touch with how so many of our fellow citizens must live.

What I have learned from my own parents and from a lifetime of experience is that it is not poverty that keeps children from succeeding in school. For generations there have been children from the poorest families who have somehow learned how to excel academically; and these were not outliers to be discounted as not relevant to our discussion. Almost without exception there is a characteristic common to all of these youngsters. These children are blessed to have a parent or guardian who somehow still clings to hope that their child can have a better life.

Let’s cling to no illusions about the difficulties these parents face or that such parents are always successful. Sadly, many do fail in spite of the heroic efforts that are made . What matters, however, is that many do not fail and, as a result, their children enjoy some level of academic success.

It is not poverty that keeps children in poverty, it is the hopelessness that so often accompanies poverty. Poverty is, indeed, a very real condition but hopelessness is very much a state of mind. The operative question is why we do not attack hopelessness, ferociously. Hope and expectations are inextricably connected.

As much as I admire and respect public school teachers our public educators, as a whole, whether policy-makers, professors in college departments of education, administrators, or teachers cling to the traditions of an early twentieth century educational process that is woefully inadequate in a twenty-first century world; totally unaware of how what they do contributes to and reinforces the hopelessness of our nation’s disadvantaged.

These educators are blind to the fact that our educational process is focused on failure and sets the most vulnerable of our nation’s children up for failure and humiliation. Is it any wonder that these youngsters grow up to spawn new generations of children with little if any motivation to learn and even less hope for a better life.

For the love of all that is precious in life, can we not abandon our outdated assumptions and biases and open our hearts and minds to a new way of thinking about education in America? If only we will relinquish our obsession with tradition and open our minds to new possibilities we will discover answers that have existed, right in front of us, just beyond the illusory horizon of intransigence.

To you, Diane Ravitch, who for so long has been one of our best and brightest advocates for excellence in education, we need you seek to understand rather than rebut. We need you to think exponentially and to provide a whole new level of leadership in a fresh paradigm.

I am not suggesting that there is a perfect solution to the challenges of education in America; there is no such thing as a perfect solution. With each stride down a new avenue of thinking, however, we will discover new and better ideas and each new answer will lead to whole new sets of questions followed by even more answers and even better ideas.

You know better than any of us that time is of the essence. We must act before those who are rushing to privatize education, place even more reliance on standardized competency examinations, and who want to separate our schools from the communities they exist to serve lead us to disaster.

The Wide Disparity of Pricing for Healthcare Services is Just a Taste of the Problems Yet to Come

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This past week, ABC News reported on the practice of the Northside Hospital System in Atlanta of charging outrageous prices for their services. They cited the bill of one patient where they did a line by line analysis of charges. What they found were many examples of line items for which the patient was charged exorbitant prices for things that the hospital could purchase through its suppliers for a tiny fraction of the cost. One of the most glaring examples was a pill for which the patient was charged several hundred dollars in spite of the fact that the hospital could purchase it for less than a nickel.

Hospitals across the country engage in such pricing strategies, to one degree or another, in order to make up for losses as a result of low reimbursement rates by health insurance, managed care companies, Medicare, and Medicaid and also as the result of the cost of doing business in a dysfunctional system.

This practice is considered a strategy of necessity by providers of many healthcare services simply because that is the way the fee-for-service, zero-sum billing game has evolved. Payers establish reimbursement rates that enable them to stay in business, which means making a profit. And, do not be confused by hospitals that claim to be not-for-profit for even these providers must be able make money if they want to stay in business. The only differences are the uses of the profits and the bank accounts into which the dollars must inevitably be deposited.

Every billable medical or hospital procedure results in high-stakes competition to determine where those dollars will end up. Health insurance, managed care companies and other payers set reimbursement rates and also make providers jump through hoops as part of the claims processing strategy to look for any reason to justify denial of the claim. This forces providers to develop coding and billing strategies to optimize their revenue generation and also requires them to file and refile claims. It is a zero-sum game in which there are winners and losers in the competition for each and every healthcare dollar, not counting the patients who almost always are losers in the billing game.

What charges are not reimbursed by the various third-party payers are then billed to patients. Some of the money is eventually collected and much of it must be written off. Families burdened by outrageous medical and hospital bills is the single greatest cause for most of our nation’s personal bankruptcies. The write-offs necessitate new and more innovative charging and billing strategies. It is a vicious circle that drives up the cost of care enormously. Although we have seen some improvement, in recent years, in the rate of increase of aggregate healthcare costs, for at least two full generation the rates of increase have been substantially higher than the Consumer Price Index (CPI). There have been many years when the rate of increase has been double- or triple the rate of the CPI. Higher costs require providers to increase prices, which requires insurers to increase premiums on a merry-go-round that is anything but merry to the patients.

When we think about the number of healthcare dollars that never end up in the hands of providers of actual medical, hospital, or ancillary care, it can be a staggering amount. The insurance, managed care, and government payers always underestimate the percentage of dollars that are allocated to the administration process relative to those spent on direct care to patients. That cost is not just the cost of doing business for the private and public payers (which for the private payers must include profits) it also includes every dollar spent by providers for the purpose of coding, billing, claims processing, and management of receivables.

It truly is an outrageous process but it is the inevitable companion to the practice of fee-for-service (FFS) medicine in a market driven by health insurers and other third-party payers and processors.

The process is so complex that, in spite of claims on the part of health insurance and managed companies to the contrary, there is no accountability. Incompetent and inefficient providers pay no penalty for their poor performance and both the best and the worst providers survive no matter what the level of patient satisfaction.

Free market forces, in the true sense of the concept simply do not function in healthcare.

The biggest problems in healthcare in America, whether speaking of quality, cost, or access are the inevitable outcomes of a system driven by health insurance, Managed, care and other third-party providers; both public or private.

That Obamacare or, more correctly, the Affordable Care Act, (or more appropriately the Affordable Health Insurance Act) commits us to a health-insurance driven market is a recipe for continuing and escalating disaster. The motivation of Obama and the members of congress who finally chose to act was admirable if misguided. We have tried to fix a system driven by forces that even our smartest people seem unable to comprehend with a solution that can only aggravate an already tragic reality.

It is, truly, a national embarrassment that so many citizens of what we consider to be the richest and most powerful nation in the history of the world must deal with illness and injury of themselves and their families without access to what we also describe as the highest quality healthcare on the planet.

What makes the situation most ludicrous is that it is our stubbornness and our prejudices that keep us from embracing a solution that will provide comprehensive healthcare and prescription drugs to every single American man, woman, and child, without relying on socialized medicine, at a cost that will save the American people trillions of dollars.

My book, Radical Surgery: Reconstructing the American Health Care System, lays out a healthcare plan that will give us everything we need, at a reasonable cost, without any of the things that the American people seem to fear, pathologically.

Don’t believe me? Check it out!

Reign of Error, by Diane Ravitch, a Journaled Review by Mel Hawkins, Entry #1

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This is the first installment of what will be a journaled review of Reign of Error: The Hoax of the Privatization Movement and the Danger to America’s Public Schools, by Diane Ravitch; her latest and possibly most important work.

In her Intro, Diane Ravitch says that her purpose is to answer 4 questions:

1. Is American Education in crisis?
2. Is American education failing and declining
3. What is the evidence for the reforms now being promoted by the federal government and adopted in many states
4. What should we do to improve our schools and the lives of children?

Ravitch says that American education is in crisis “because of persistent, orchestrated attacks on them and their teachers and principals, and attacks on the very principle of public responsibility for public education.” She adds that “these attacks create a false sense of crisis and serve the interests of those who want to privatize the public schools.”

This statement begs the question of why did the orchestrators of such attacks find it necessary to attack public education in the first place? While I agree with her that the evolving focus on privatization is a bad thing, there must be some acknowledgement of responsibility for the outcomes to which these unidentified forces are reacting.

While it is natural for educators to be defensive and feel unfairly blamed while in the midst of the criticisms raining down on them, claiming the criticisms to be unfair without addressing the outcomes about which the critics are concerned is simply not acceptable. Educators are no more able to fairly judge, unilaterally, the efficacy of their product than members of a production line in a manufacturing operation are able to judge the performance of the goods they produce outside the context of the customer who pays for those goods.

The only people who can fairly judge the value of education are the people who rely on the ability of public school students to perform in the marketplace upon completion of their schooling. As a former employer, I can tell you that it became increasingly difficult to find young men and women who have the minimal academic skills necessary to do the work for which we were prepared to pay them. Employers have a right to pass judgment on the performance of our public schools.

As an tester responsible for administering the Armed Services Vocational Aptitude Battery (ASVAB), I am in a position to judge the efficacy of an educational system that produces so many young men and women who are either unable to meet the minimum requirements for enlistment eligibility or who, if eligible, are able to perform the work required of them after induction in only the lowest career areas.

If teachers, particularly of middle and high school students, were able to set aside worries about who is to blame for the problem, they would be in a great position to tell us that far too many students are either unwilling or unable, either, to do the academic work on the one hand or display good citizenship on the other.

The question is not whether or not our systems of public education are in crisis, because it most surely is, rather it is what and who are responsible for the crisis.

Sadly, most of these critics assign responsibility for the poor performance of our public schools on the wrong things. We blame poverty, we blame racial discrimination and segregation, and we blame our teachers and our schools.

As was noted in my initial review of Ravitch’s book, as well as in my own book and blog, we misinterpret the causes of the disappointing performance of our public schools. Because of our incorrect assessment, we fail to see that teachers, rather than bearing the brunt of the responsibility for what is clearly a crisis in public education, are as much victims of the system as are their students.

As is always the case, if we are unable to come up with an accurate diagnosis of the problem, we are rarely able to identify meaningful solutions.

Were we able to discover and agree on the true causes of our educational crisis we would know, with a high degree of certainty that testing, privatization, vouchers and other tools to give parents more choices are not the solution to the problems of public education. These things make it more difficult for teachers and schools to do their important work rather than easier.

The true causes, as we have so frequently pointed out, are 1) a growing cultural disdain for the value of education on the part of far too many American parents and the resulting lack of a strong motivation to learn on the part of their children, and 2) that the educational process that has evolved, over the last century or more, is poorly designed and structured to produce the outcomes we so desperately need. The American educational process is the equivalent of early twentieth-century design and technology striving to compete in the Twenty-first Century. No amount of tinkering with the system with incremental modifications will work. The system must be reinvented to produce the outcomes we need from it.

Let us return to Ravitch’s purpose which was to answer her four questions. The American systems of public education are clearly in crisis and it is failing to meet the needs of both American school children and the society which will someday depend on their contributions.

As far as question number three is concerned, there is no evidence for the reform initiatives being promoted by the federal government and other policy-making forces as they are all premised on faulty logic. Any solution constructed on a faulty foundation must, inevitably, crumble.

The answer to question number four is that we must do nothing “to improve our schools and the lives of our children?” until we take the time to understand the root causes of the problems of public education in America. For that reason, finding the root causes is the categorical imperative of our time.

It was for this very purpose that my book, Reinventing Education, Hope, and the American Dream: The Challenge for Twenty-First Century America was written.

Ravitch, correctly, goes on to say that our schools are not “fine just as they are.” She then lists what she believes “American education needs,” and while none of these things are bad for our public schools, not a single one of them addresses the root causes for our system’s problems. As a result, they will not only make no appreciable difference, they will be harmful because of the opportunity cost they engender as they keep us from doing what we should be doing.

The sad thing is, that we already have the capability to fix public education in America even though it will be a formidable challenge.

Ravitch is absolutely correct, however, when she says that “The purpose of elementary and secondary education is to develop the minds and character of young children and adolescents and help them grow up to become healthy, knowledgeable, and competent citizens.”

She is also correct that the solution is to give schools and their teachers the resources that they need to do their jobs. We simply must rethink what those resources are.

Another area where Ravitch and other opponents of many of the “privatization” reform initiatives are wrong is in seemingly suggesting that schools and teachers should not be held accountable through the independent measurement of outcomes. As we will discuss later on, we need to develop an integrated quality system much like modern business organizations have done. What the skeptics will discover, if they make an effort to understand how such systems work, is that such quality systems actually help rather than hinder the worker’s ability to do his or her job. The same will be most assuredly true for teachers.

What if We Are Asking the Wrong Question about Public Education in America?

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When we talk about public education and the challenges it faces and when we talk about reform initiatives there is a question at the center of those discussions. That question is: Why do children fail? Or, “What are the characteristics of the children who perform poorly in school?” Or, more often, “Who is to blame for the failure of education in America?”

We then talk about poverty, racial discrimination and segregation, deteriorating urban and rural communities: and, we talk about bad schools and bad teachers, teachers unions, about giving people choices with charter schools and vouchers; about Common Core; about holding teachers and schools accountable and standardized competency examinations. In the last couple of decades we have begun talking about the privatization of education and other related issues having to do with taking education from the control of communities and making it more accountable much like businesses are held accountable.

What if “Why do children fail and who is to blame?” are the wrong questions? Maybe we are looking at the problems of education from the wrong perspective.

Returning to the challenges of education in America, consider a different question, for just a moment.
“Why do children succeed in school?” Or, more specifically, “what do successful students have in common and what can we learn from those common characteristics?”

We will likely discover that it is not affluence because, while there are many successful students who are affluent there are also poor children who excel academically. Conversely, there are affluent students who fail as badly as some of their economically disadvantaged classmates.

We will discover that it is not race, because the list of the academically excellent includes white children, and black children, and children with skins that span all of the hues and colors in between.

We will learn that it is not fractured families because there are children who excel in school who live in single-parent homes or with families that are otherwise distressed just as there are children from intact families who fail, miserably.

We will learn that it is not bad neighborhoods because there are children from the most dreadful surroundings who somehow perform well in school just as there are children at the other end of the performance continuum who live in the best neighborhoods in America.

We will also discover that it is not bad schools populated by bad teachers, because students from both ends of the performance continuum can be found in our best and in our worst performing schools.

The one single characteristic that most links our best students, wherever we find them, is that they are supported by parent(s) or guardian(s) who are determined that their children will get the best possible education and who consider themselves to be partners, sharing responsibility with teachers and principals for the education of their children.
Now, flip the question around and ask, what are the common characteristics of children who are failing in school? If we are honest with ourselves we will discover that the single most common characteristic of children who struggle academically is that they are not supported by parents who are determined that their children will receive a good education. Many parents of struggling children might vocalize that education is important but they do none of things that determined parents do. They do not talk constantly about the importance of education. They do not make certain that their child has resources that will help them be successful in school. They do not ask, routinely, “How was school today?” nor do they ask to see homework or tests and other papers sent home by their child’s teacher. They do not call and talk to their child’s teacher to see how their son or daughter is doing or to ask what they can do to help and support the child? They do not go to parent/teacher conferences or back-to-school night. Whatever they might be vocalizing their actions provide no evidence that a real commitment exists or that the parent recognizes and accepts responsibility as a partner in the educational process.

Think for a moment, about how the answers to this new set of questions changes, profoundly, everything we think we know about the educational process.

The problem with education in America is that we have a burgeoning population of American mothers and fathers who live under a stifling blanket of hopelessness and powerlessness. These men and women are effectively disenfranchised and no longer believe in the American Dream for themselves or for their children. As a result, they do not stress the importance of education to their children and they make little if any effort to prepare their children for learning; they offer no support to the educators of their children and, in fact, view their children’s teachers and principals as adversaries. Many of these parents have lost control over their children and can no longer claim status as the guiding influence in the daily lives of their sons and daughters.

Because the quality of the education our children receive will determine whether or not the U.S. can maintain any semblance of a competitive advantage as we proceed through the balance of the Twenty-first Century, we are facing two challenges:

1. The first is that we must utilize every resource at our disposal to pull parents into the process as fully participating partners in the education of their sons and daughters. It is the absence of this partnership that results in the lowest level of motivation to learn on the part American children in generations and this is a reality that must be altered at all cost.

2. The second is that we must be willing to admit that our current educational process is poorly structured to get the results we so desperately need to achieve. It is a system that sets the overwhelming majority of students up for failure and humiliation simply because it starts all children out on the same academic path, regardless of the cavernous disparity in the preparation they bring to their first day of school, and it judges their performance against that of their classmates. We must create a reality in which children are given sufficient time to master their subjects before they are permitted to move on because we have no illusions that they all will have achieved the same things by the end of twelve years of formal education. We do not need them to achieve the same things. What we need is that they will have learned as much as they are able to learn and that they will be able to apply what they have learned when they enter the next stage of their lives, whatever that may be.

The first challenge is formidable because it demands that we strive to change the culture of American society to one in which the American dream is real and achievable, if not for every man and woman in the nation, at least for their children. It will require that we quit bickering and, instead, come together to achieve a common objective.

The second challenge offers no excuses for failure because the educational leaders in each of our fifty states has the authority to change, by decree, the educational process in their state.

If we continue down the same path, we place our entire future as a society in jeopardy.