Truths about Healthcare and Education
Today two op ed writers, Bret Stephens in the Wall Street Journal and William Easterly in the Financial Times, express fundamental truths, the one about education and the other about health care, truths not shared or even recognized by our politicians, but that if they ever were could become powerful driving forces behind significant education and health care reforms, both of which at the present time seem to be going nowhere.
Bret Stephen’s truth about education? Education is not, as too many of us would like to have it, the solution to whatever be the problem. There is certainly no evidence that good schools make for a better world, or that just by attending school kids become good citizens. There is ample evidence on the contrary that schools, in particular the failed and failing schools of the inner cities, of which there are myriads, may be making the world worse.
The truth? Stop looking to education for what it can’t do. Look to it, at best, for what it should be doing, imparting skills and knowledge. With some we do this very well, in particular with those who attend our elite colleges and universities.
With others, with far too many, we do this very poorly. All our school reform efforts ought to be directed entirely at making whatever changes are necessary to enable larger numbers of kids to acquire new skills and knowledge. We ought not to be looking to the education of our kids to solve our adult problems.
Here is how Bret Stephens in today’s Wall Street Journal, A Perfect Nobel Pick, The committee didn’t recognize Truman, after all, puts it:
The “Goodists” are the people who believe all conflict stems from avoidable misunderstanding. Who think that the world’s evils spring from technologies, systems, complexes and everything else except from the hearts of men, where love abides. Who mistake wishes for possibilities. Who put a higher premium on their own moral intentions than on the efficacy of their actions. Who champion education as the solution, whatever the problem.
And William Easterly’s truth about health care? A right to health care cannot be, in spite of all the rhetoric to the contrary, a fundamental right, like those of freedom of movement, speech, association, equal protection under the law etc.
Why not? Because there is no reasonable end point to that right. When, for example, has one received all the care that could possibly improve one’s physical and mental systems? There will always be another test one might undergo, another new treatment one might try, another medical opinion one might seek.
At some point the right to health care has to be ended because the cost of providing the care will have exceeded our ability to pay for it. Either there will be those who will be left out entirely, as now in the case of the uninsured or those with “pre-existing conditions,” or treatments will be strictly rationed, in accordance with what acceptable criteria?
When only some speech is allowed we might do well to avoid the expression a right to free speech. Because what we really mean is a right to say certain things, and not others. That’s not so much a right as a permission from those who make the rules.
Similarly when the right to health care means only a right to certain generic drugs, physical exams, one or two xrays a year etc., or some more realistic combination, we would do better not to talk about a right, but rather, as in the case of limited free speech, of the treatments that are currently permitted by those in power, these at best being at least those we can pay for.
Here is how William Easterly puts it, in the Financial times of October 12, Human Rights are the Wrong Basis for Healthcare. The BOLD is mine:
The pragmatic approach – directing public resources to where they have the most health benefits for a given cost – historically achieved far more than the moral approach. In the US and other rich countries, a “right to health” is a claim on funds that has no natural limit, since any of us could get healthier with more care. We should learn from the international experience that this “right” skews public resources towards the most politically effective advocates, who will seldom be the neediest.
