Monday, October 15, 2012

Education

Discuss Chapter 14: Education, Health, and Medicine
 
EDUCATION


Formal instruction in knowledge and skills culturally deemed important.

Distributed UNEQUALLY – school means "leisure" in Greek, because only the rich who didn't have to work for a living could get it.

Chart on p. 377- huge trend in U.S. Over past 100 years.

WATCH RSA EDUCATION VIDEO
Should we penalize kids for losing attention in boring class?
Are we aneasthitizing them?
Are schools organized around factory lines, is age the most important thing they have in common?
What does it mean that its in the gene pool of education to kill our capacity for divergent thinking?


Functions – page 376, but note Evaluation – structural functionalism glosses over problems and the perpetuation of inequalities. 

Symbolic Interactionism – Thomas Theorum and self-fulfilling prophecy
Jane Elliott's elementary school eye-color superiority experiment
labeling categories of students as "slow" or applying other race/gender stereotypes


kids internalize social structures that authority figures present as true, then literally create interactions that reify and perpetuate them.
Parallels with Philip Zimbardo's Stanford County Prison Experiment?

SITUATIONS THAT ARE DEFINED AS REAL BECOME REAL IN THEIR CONSEQUENCES.






Much of a child's success in school is determined by the time they are 6, and it has to do with how parents treat them and use language...


costs vs benefits of college...

education perpetuating class position, and obstacles to lower-income college students...









What does it mean to "ration health care"?

What is health insurance? (find old CAN blog entry)
According to the U.S.Census Bureau, the proportion of our population that lacks health insurance is at an all time high.  We're talking about 50.7 million of our fellow Americans who have no coverage whatsoever.  The cost of health insurance has been spiraling out of control for decades, going up ten times faster than wages since 2000. Meanwhile (dare I say “Therefore”?) industry profits (that's profits, not gross revenue or anything) have been skyrocketing up 250% in the same period.  Last year saw profits at an all time high after increasing an additional 56% in 2009 alone!  This is why the U.S. Congress had to pass the health reform law last year.  For-profit insurance companies have been gaming the system to increase profits by pricing out the poor and the sick, which needless to say is bad for society.

Why would they do such a thing?  The health insurance industry is not easy to understand.  The point of insurance in general is to distribute risk through a population, so that individuals are not ruined by unpredictable disasters.  Health insurance in particular also serves the function of helping people bear the predictable costs of maintenance and prevention (check-ups and medicine to cure minor illnesses before they lead to major social disruptions).  Both of these are socially useful functions – they keep people productive and society running smoothly.  But in an industry of private health insurance, companies must make a profit.  Profit-making is their purpose.  In order to do that, they use society's demand for the above functions to raise the price at which they can sell their supply of services.  But their fundamental purpose is not to distribute risk, nor to help people maintain their health – it is to make profits.  If theyare not distributing risk optimally, and they are not helping people maintain their health in the best way, but they are still making profits, then they are still fulfilling their raison d'etre.  For decades, the “free market” has been rewarding them for sub-optimal service, so it doesn't make sense to say they're "failing," exactly.  What does make sense is to change the rules of the game, to give them motivation to actually provide socially useful services, and that is what the health reform law is meant to do.

Here in Wisconsin, BadgerCare was started by Republican Governor Tommy Thompson in 1999 to provide health care to the working poor.  It has since become very popular.  In 2008 it became BadgerCare+ and expanded to cover more children.  Combined with BadgerCare+ Core, the programs cover 770,000 of us, helping Wisconsin have one of the highest rates in the country for health insurance coverage (90%).  So, we're more socially optimal than most other states. But the current administration wants to kick these people off the rolls and have them get insurance through their employers instead. (Um, how is adding this huge cost onto a business going to help them expand and create jobs?) 

Governor Walker appointed this old white guy with a history of trashing Medicare to head up the Department of Health Services.  He says states should stop covering the poor, because it's expensive.  What he doesn't seem to realize is that when poor, struggling workers get sick or injured, they're not going to crawl under a rock and die.  They have a job to do and a family to support, so if they can't see a normal doctor they're going to head for the emergency room.  This kind of care is far more expensive, and since the poor don't have that kind of money, guess who the hospital will stick for the bill?  If you answered “the state,” you are correct.  So we'll end up paying more money for emergency health care, and we'll be keeping almost 1 in 5 Wisconsinites from getting access to basic preventative medicine, which means more minor issues will progress to major problems requiring more of that expensive emergency-room care! 

Wisconsin can't afford that, socially or financially.  Tell your representatives you want them to leave BadgerCare alone.




NEW LECTURE, SAME GRAPH

According to the U.S.Census Bureau, the proportion of our population that lacks health insurance is at an all time high of about 51 million.  That's approximately 1 out of every 6 Americans who lacks any sort of coverage.
The reason for this all time high is that the cost of health insurance has been spiraling out of control for decades, going up ten times faster than wages. The graph below illustrates this trend for the decade prior to the Great Recession.  Since then, it's only gotten worse (INSERT GRAPH HERE)
Meanwhile, industry profits ticked up 250% in the same period. This is why the U.S. Congress finally passed a health care reform law in 2010, after more than a decade of discussing different possibilities.
Those who have criticized our health care system argued that for-profit insurance companies have been "gaming the system" to increase profits by pricing out the poor and the sick, which is bad for society.
Why do they say this is bad for society?  When poor, struggling workers get sick or injured, they're not going to just crawl under a rock and die - they usually have a job to do and a family to support, so they're going to head for the Emergency Room. This kind of care is far more expensive, and since the poor obviously can't afford it, the hospital has to stick the taxpayers with the bill.  So we all end up paying more tax dollars for emergency health care, and this system keeps about 1 in 6 Americans from getting access to basic preventative medicine, which means more minor issues will progress to major problems requiring even more of that expensive emergency-room care!  A stitch in time saves nine, as they say.
That doesn't seem very efficient.  So why would our system do such a thing?  Have our health insurance companies failed us?
The health insurance industry is not easy to understand. The point of insurance in general is to distribute risk throughout a population, so that individuals are not economically ruined by unpredictable disasters. You get car insurance or home insurance just in case a rare bad thing happens, and the small amount you pay per month goes to help the small fraction of people who actually have that bad thing happen to them.  This is a social good, because individuals who are ruined become unproductive, and a drain on everyone else. 
Health insurance in particular also serves a second socially useful function: helping people bear the predictable costs of health maintenance and prevention (check-ups and medicine to cure minor illnesses before  they lead to major socio-economic disruptions).  And this is a key feature: unlike car or house insurance, which you hope to never have to use, you almost certainly WILL use your health insurance somehow or another.
So, both of these are socially useful functions – they keep people productive, and that keeps society running smoothly.  But in an industry of private health insurance, companies must make a profit. Profit-making is their purpose. In order to do that, they use society's demand for the above functions to raise the price at which they can sell their supply of services. But their fundamental purpose is not to distribute risk, nor to help people maintain their health – it is to make profits
This is true of all profit-making private businesses and corporations under a capitalist economic system; for example, the fundamental purpose of McDonald's is not to feed you hamburgers - it is to make money for their shareholders.  Selling you hamburgers is simply a means to that end.  If they can make higher profits by selling you sub-optimal hamburgers (and I can think of many places that have better burgers!), then they will do that - that is the ironclad logic of capitalism: companies must rationally seek to maximize their profits.

So, back to health insurance businesses.  If they are not distributing risk optimally, and they are not helping people maintain their health in the best way, but they are still making profits for their shareholders, then they are still fulfilling their raison d'être.  For decades, the “free market” has been rewarding them for sub-optimal service (i.e. record profits) so it doesn't make sense to say they "failed," exactly.  What proponents of the PPACA say does make sense is to change the rules of the game, to give these private health insurance companies motivation to actually provide socially useful services.  That is what the health reform law is meant to do.  (Whether it will work or not remains to be seen, of course.)



OK so what DOES the law actually do? Well it's a bit complicated, but basically something like this... Click here for the comic (ELI5)

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