Health Care and Education
Atul Gawande in an op ed piece in today’s NYTimes says that the “The American health insurance system is a slow-creeping ruin, damaging people and increasingly the employers that hire us.” There are many who say something quite similar about the American system of public school education, perhaps not a “slow-creeping ruin,” but, for too many young people just starting out in life, clearly a failure.
The irony is that no two national issues are more on the minds of our politicians than education and health care. Irony because, in spite of constant attention, or at least lip service, given to both, the inadequacies of both are no less present today than they were over a generation ago when all the talk began.
Perhaps no two issues, when it comes to judging the worth of our American civilization, are more important. How are people cared for when they are sick (and when they are well)? And how do the young acquire the requisite skills and knowledge they will need to find a job and earn a living wage? When there are large numbers of Americans who are left out in one or both respects this negatively impacts the lives of us all.
Of the two clearly health care takes up a much larger slice of our economy, this year that slice being some 2 trillion plus dollars or 16% of our 13 trillion dollar gross national product. Educational expenditures in the United States are less than half that amount. Expenditures on K-12 education are about one half of that, or about 4% of GDP.
The spending difference stems from the fact that the need for health care is obviously no less with us when we are old than when we are young, health care and health maintenance becoming more and more important as we age. Education, on the other hand, is mostly with us when we are young, in the first quarter of our lives, becoming (alas!) less and less important as we age.
And interesting thought experiment would be to consider the result if the expenditures were reversed. It may be that the very best health maintenance program would be more education and not more hospital visits.
The present 4 to 1 ratio between health and education expenditures is at present the way things are not necessarily the way things should be. Our schools in their mission statements clearly articulate the importance of life long learning for their graduates, but our society does little or nothing to encourage and make such learning a reality. As a result most people see their learning as being limited to their years in school and ending for the most part with the end of school. Again, alas!
Perhaps the greatest flaw in our educational system, is the fact that we think of education primarily as schooling, and confine it to the first quarter of our lives. Whereas this is the time when school and classroom learning are probably least effective. This is the time when children, who are learning as they breathe, all the time, and probably learn much more out of school than within the school and classroom walls.
Those of us who have taught both children and adults know how much more motivated and attentive than the children are the adults in our classes, how much more they enjoy and profit from the lesson.
I believe that it is by relegating education, a.k.a. schooling, to the early years that we do the most harm, for in so doing we try to pack into those years everything a child of Rousseau, Jefferson, Dewey and Einstein, among many others, needs to know.
And it doesn’t work. That’s much too much. And the readiness is by and large not there. We are not turning out those who are well versed in words and numbers, let alone capable of assuming responsible and productive roles in society.
You don’t believe me? You need only to speak with the deans and professors in our community colleges, with all those who do the hiring, with the military recruiters, with the police departments in our large cities, and others such, to know it doesn’t work. Too many of the kids who begin high school don’t finish. Too many of the kids who finish high school don’t finish college. Too many kids who have spent as many as 13 years in school end up by having very little to show for it.*
What to do? I think the answer is clear. Make schooling, or rather education, like health care, make it life long. But how? First of all we can stop trying to put everything into the first 13 years. And we can also take more into account what the kids are really learning as they grow up, what’s present, and a big part of their lives during their school years.
We should no longer pretend that children’s learning stems mostly from what we do, or try to do, with or to them in the school and classroom. For if you’ve been close to young children you will know that it doesn’t. Rather than "what did you do in school today," ask, "what did you do today?" That way you might get closer to where they are.
Most of all we can stop trying to transform children into the kind of thinking and responsible and caring and imaginative and entrepreneurial etc. adults that we would like them to me (the kind of adults we’d like to be ourselves). And instead we could make sure that they pick up a few useful skills at the very beginning of their journey, a journey that for the most part takes place, even when young and materially dependent on us, outside of our reach and ken.
Our much more modest goals during the school years should be once again reading, writing, and arithmetic. And our greatest challenge should still be to get them to believe that these skills are important for them to possess.
Finally, in the larger society out there, we should talk less about school, and more about education, and we should provide more opportunities for education. We should talk as if education were much more something that began following the completion of the first 13 years of schooling, than something that ended at that moment in time. For education, no less than health care, ought to be with us throughout the length of our lives.
* See Tough Choices, Tough Times on the number of kids who don’t finish high school and college.
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