Susan Stabile, a law professor at St. John’s University and a contributor to Mirror of Justice, analyzes the current state of health coverage in the United States in light of Catholic social teaching in this article. I have quibbles here and there along the way, but on the whole the approach and the conclusions are sound. She is probably right that Health Savings Accounts (HSAs) have limited value, though my reasoning would be a little different. I would say that, in principle, they represent a helpful idea—increase the operation of the market within health care—but they are such a small foray into a vast and complicated world beset with market distortions on every side, that they end up exhibiting the deficiencies that Stabile identifies.
Jim Aune, blogger-in-chief at The Blogora, complained yesterday about his health care treatment. He says, “I have been in constant pain for 36 hours. I actually used a cane to go to the office yesterday for some meetings. The problem? I have a trapped nerve in my abdomen from a double hernia repair a year ago. I got shot up with steroids about 3 weeks ago, and that worked for about 5 days, but I still can’t walk without a ripping sensation (as if my right leg were being separated from my side).”
Yes, I realize that no one likes the current version of the Comprehensive Immigration Reform bill. But it is possible to make constructive changes without being comprehensive. Here are a couple of recent examples:
Monopoly #1: I was somewhat shocked the other day when I heard a strong critique of the much-vaunted Canadian national health care system on NPR. I wasn’t dreaming – here’s the link to prove it. The report notes that “after 50 years, the Medicare dream has turned nightmare for many” – something that many advocates for socialized health care in the US would do well to take note of. It also takes note of the recent precedent-setting court decision in Quebec which gives residents who are on waiting lists that jeopardize their health the right to opt out of the public system. (You can listen to the report in Real Audio format by clicking here; previous posts on the topic here, here, and here.) Government health care in Canada seems to be teetering on the brink.
Monopoly #2: The same can not be said for the governmental education monopoly in Florida. Last Thursday, the state Supreme Court struck down Florida’s statewide voucher system.
In a 5-2 ruling, the high court said the program undermines the public schools and violates the Florida Constitution’s requirement of a uniform system of free public education.
This is unfortunate, for the simple reason that the introduction of vouchers has been an effective education reform measure in Florida. The Wall Street Journal noted the positive effects of the program back in June:
The saga began in 1999, when Gov. Jeb Bush signed into law the first money-back guarantee in the history of public education: the Opportunity Scholarship Program. Under the program, whenever a public school receives two failing grades on Florida’s academic performance standards, state educational officials come into the school with a remedial program, and the students are allowed to transfer to better performing public schools or to use a share of their public funds as full payment of private-school tuition.
Six years later, only 750 children are attending private schools using opportunity scholarships. But their footsteps have reverberated across the state, prompting failing public schools to reform. Steps taken by failing schools have included spending more money in the classroom and less on administration, hiring tutors for poor performing teachers, and providing year-round instruction to pupils.
Defenders of the status quo insist that such reforms were already under way. But a freedom of information request by the Institute for Justice from school districts that lifted schools off the failing list revealed ubiquitous reference to the dreaded V-word: Without such measures, school officials warned, we wind up with vouchers. The rules of economics, it seems, do not stop at the schoolhouse doors.
The results have been stunning. Even with tougher state standards, nearly half of Florida’s public schools now earn “A” grades, while a similar percentage scored “C’s” when the program started. A 2003 study by Jay Greene found that gains were most concentrated among schools under threat of vouchers.
Most remarkable has been minority student progress. While the percentage of white third-graders reading at or above grade level has increased to 78% from 70% in 2001, the percentage among Hispanic third-graders has climbed from 46% to 61%, and among blacks from 36% to 52%. Graduation rates for Hispanic students have increased from 52.8% before the program started to 64% today; and for black students from 48.7% to 57.3%. Minority schoolchildren are not making such academic strides anywhere else.
And so we revert to the status quo. Sadly, the ones most harmed by the status quo are the ones most in need of the reforms that school choice would bring – the poor.
My predictions: As Canada introduces more market oriented solutions to its health care problems, the quality of care that Canadians recieve will rise and fewer Canadians will have to head south of the border to obtain it; and until American public schools face genuine competition, the quality of the education they provide (especially in inner city and poor areas) will increase negligibly if at all. Read more on A Tale of Two Monopolies…