School Design of My Dreams (Literally)

I had a dream about school design (as you do) and wanted to get up and model it to see if I could make it work financially.

Scenario: Middle/high school students are on a year-round semester schedule. They get a week off in July, October, December, and March/April. Semesters run July-December and January-June. Being in school year-round minimizes summer learning loss and takes the child-care/camp pressure off of parents over the summer. This is great for students but a tough sell for teachers: most are currently paid for 10-months of teaching time with 2 months for prep/PD/vacation. But what if…

What if teachers only taught one half of the year, 4 classes per day?

What if they had one quarter of the year off for vacation?

What if they had one quarter dedicated exclusively to prep, observation, and PD?

Students would be on a block schedule, taking 4 courses one semester and 4 courses the other semester. Each class would meet for 90-100 minutes per day.

I did a very rudimentary financial model to see if I could come close to making this work. I used $12K/pupil as the base funding (average U.S. per-pupil funding). I held back 7% for overhead and 25% for debt/obligations. This leaves $8,160/pupil for instructional dollars. From instructional dollars, I allocated 85% to personnel, and then 85% of that for teachers (holding back 15% for support/administrative staff). Teachers end up about 50% of the total per-pupil allocation. I used $85K as the fully-loaded average cost for teachers.

From here, 50% of the teachers would be “in rotation” for instruction, 25% would be on holiday, and 25% would be in their prep/PD rotation. Plugging in all of these variables, I think the minimum enrollment for this model to conceivably work is 500 students. At 500 students, you can keep class sizes at 30 and still have a discretionary non-personnel budget of about $600K (~$1,200/pupil).

Pros:

  • I would have loved this model as a teacher. I would almost certainly still be in a classroom. This would give teachers time to step back from the daily grind of lessons and grading in order to really take time to observe great teaching, explore new methods and strategies, think deeply about lesson planning and curriculum, and truly take embrace the professionalism of teaching.
  • I also LOVED having 90-100 minute blocks of instruction with my kids. 45 minutes is hardly enough time for deep-focus work. Juggling 6-8 classes a day is rough on teachers and kids – so much context-switching and homework and grading!
  • You could create the opportunity for students with low-proficiency in core subjects to double up on math/reading courses so that they were effectively getting two years of math and/or reading instruction in a single calendar year.
  • On the flip side, advanced students could move on to more advanced topics or electives if they show mastery of core material.

Cons/TBD:

  • Since it was 5am and I only had an hour, I didn’t model out the intricacies of complex demographics (specifically various Special Ed LRE scenarios) that could very well break this model.
  • It absolutely won’t work for small schools; 500 students I think is the minimum.
  • Probably only works for middle/high school, but I’m not sure.
  • This model would probably only work in a charter school because it requires very lean central support and overhead. Otherwise, districts would have to totally strip down central services to schools.
  • Teachers would have to give up their planning period during the day and teach 4/4 courses per day in order for the model to work.
  • I haven’t totally thought through how lunch would work, which is non-trivial. I think periods 2 and 3 each day would have to split up so that you would have four 45-50 minute lunch periods, in which case you would need a rotating schedule that could be confusing.
  • There would be a fairly limited number of course options that would be almost entirely driven by enrollment, which could be tough at the High School level in terms of offering things like AP courses.
  • Related, you’d have to really carefully plan the teaching rotation schedule so kids could take courses in the right sequence and graduate on time.
  • Unless you had the capacity to add a lot of variety in courses, you could run into a scenario where a student had a year between, say, math courses, which would be even worse than summer learning loss. The sequencing of courses and semesters would have to be very carefully planned.

I would love to hear from anyone who has tried something similar and how it worked!

I’m sure there are a ton of things I haven’t yet considered, so please share thoughts and comments. A girl can dream!

Make America Debate Again

As early as 3rd grade, I had set my sights on a career in law. If you had straight-As before the dot-com boom, the binary career paths offered to you were doctor or lawyer and I didn’t like blood so I chose law. Throughout middle school and high school, I prepared for my future career as a prosecutor with our mock trial teams. This exposed me to hours of exercising critical thinking, writing, and debate skills on topics such as DNA-based discrimination and vehicular manslaughter. I barely remember most concepts from high school math, but I have a deep understanding of vector analysis because it was a critical (and dramatic) component of my cross-examination.

 

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St. Leo’s 8th-grade mock trial team at the NJ Law Center

 

Yesterday, I read this heartwrenching article from the Miami Herald detailing how the survivors of America’s latest school shooting have been relying on notes and research from last year’s class debate topic on gun control. I was gutted with emotion reading the teens’ accounts of debate class and competition, remembering the ferocity and fervor my friends and I brought to debate practice as teens. It was some of the most academically rigorous work of my life – we did exhaustive research on the topics and diligently poked holes in each other’s arguments over countless pizza dinners until they were airtight. With this context, I am not at all surprised how thorough, biting, and compelling the Florida teens’ case has been on the national stage. Their performance is the quintessential assessment of their preparation through the cruelest test.

Their articulation of the issues at hand is turning heads in part because they are, well… articulate. And rational. And supported by facts. And utterly devoid of the rampant logical fallacies and sensationalism that have dominated public debates, social media, town halls, and media coverage of politicians in recent years. They are driving a well-reasoned and level-headed debate about one of the country’s most emotional and divisive issues with charm, poise, and humor.

This is public education at its best. This is America at its best. This is the kind of heated yet rigorous debate on which this country was founded. They are young, scrappy, and hungry and they are not throwing away their shot (I was also a theatre kid).

 

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Red Bank Catholic High School mock trial team

 

The teens’ exemplary display of rhetoric skills is a sharp juxtaposition to the fanaticism around STEM in public education, often at the expense of humanities courses and programs. After my first year of teaching as a middle school social studies teacher, the school cut the social studies program in order to extend English language arts classes and I had to find a new school. Social studies is not a state-tested subject, so it often falls by the wayside of education programming, although history, public policy, and economics are some of the most relevant and requisite topics for active citizenship and preservation of our democratic ideals. They are also some of the most fun, memorable, and defining experiences of schooling for many kids.

After watching a night of mock trial rehearsal, the teacher who coached our school’s Future Business Leaders of America chapter recruited me for the public speaking category. I initially rebuffed the idea, wholeheartedly and exclusively committed to the legal profession at the ripe age of 15, but she talked me into it (probably because of the free overnight trip with my friends, to be honest). It was 2001 and I crafted and delivered a speech about corporate responsibility in the wake of the Enron scandal, which won 1st place in the state and 10th place nationally. I remember scoffing that the experience was wasted on this future lawyer. Indeed, one can never predict when an opportunity will meet preparation.

The Lynchpin of Suspension

This week, The Baltimore Sun’s education reporter, Erica Green, ran a story on a controversial Baltimore City Public Schools incentive program: teachers and principals are eligible for monetary rewards up to $9,500 for successfully reducing suspension rates.

Great, right? Educators can be compensated for reducing suspensions:  improving school culture and decreasing disciplinary issues to keep kids in school and safe environments.
Oh, logical fallacies are so sneaky!

Logical fallacy: A reduced number of suspensions are necessarily the result of improved school culture and/or a decrease in serious misbehavior.

Likely reality: A reduced number of suspensions are the result of assigning fewer suspensions.

If Destiny and Jaqueline get into a physical fight in class, the suggested disciplinary action in the Code of Conduct is a suspension, but the actual disciplinary action comes down to administrative discretion. If the principal is eligible for a monetary reward for reducing the number of suspensions, on which side of the disciplinary action spectrum do you suppose that discretion will fall? It doesn’t take a doctorate in behavioral psychology to imagine the negative consequences of this policy.

Unfortunately, the attention to the flaws of this initiative obscures the crux of the matter: suspensions don’t work. Suspensions have almost nothing to do with school and everything to do with home and parenting.

In 13 years of rigid Catholic schooling – where you could get detention for the wrong-colored socks, being one minute late, or wearing a flagrant hair accessory – I never got a single detention. Why? Well, because I was a goody-goody. But ALSO, because I did not want to even fathom the sort of wrath I would incur from my parents for receiving disciplinary action. Because I was terrified of even a single indiscretion on my “permanent record,” which I believed was very important because my parents told me so since forever. Because I knew the disciplinary action I received from school would pale in comparison to whatever my father deemed a suitable punishment. I did not worry about school infractions. I worried about what my father would say when he found out. I still shudder to imagine.

So what happens if this sort of disciplinary support doesn’t follow through at home? Nearly all of the punishing effect of detentions and suspensions are predicated on parents reinforcing the seriousness, legitimacy, and severity of these consequences at home.

In reality, many of my students viewed suspensions as a mental health day: a day of video games, Cocoa-Puffs, and Facebook.  At worst, they were bored. At best – vaaaaacation!

As a teacher, I had many students with incredibly supportive parents – we chatted frequently on the phone, via email, and at conferences. They checked homework, helped with studying, and monitored grades. Not so coincidentally, these students were never in danger of being suspended.
For fairly obvious (yet complex) reasons, it is the students who do not receive adequate support and attention at home who are usually the repeat offenders for misbehavior, violent conduct, and truancy. Suspensions won’t work, because the lynchpin of the punishment is missing. Unfortunately, sending a message that extreme or violent misbehavior will be ignored or downplayed is a recipe for school chaos – that message travels fast.

What to do? These students do need some form of disciplinary action to send a clear message that certain behaviors will not be tolerated. However, they are also likely in desperate need of additional support services. Unless you have an intensely Hobbesian view of human nature, it’s fair to say that students don’t generally go around cursing, punching, and threatening people without an underlying cause.

Without digging deeper to unearth and address the root causes of the misbehavior, those students (and their schools) will be caught in a vicious cycle of crime and punishment. Maybe they need therapy and counseling services, maybe they need a positive outlet for aggression (like joining a sports team), maybe they need a personal tutor… but one thing’s for sure: a mental health day won’t fix the problem, and neither will sending them back to class.

Show Them the Money? Why Merit Pay Doesn’t Work

Last week, Newark school district revived the debate on merit pay for teachers when the union passed a new teacher contract that awards $5,000 bonuses to highly effective teachers and up to $10,000 bonuses for highly effective teachers in low-performing schools and high-need subject areas like math and science. Proponents of merit pay argue for incentivizing effective teachers, while opponents of the measure claim that it will pit teachers against each other to the detriment of students. Merit pay doesn’t work, but not for the reasons cited by the opposition.
Schools are not businesses and school districts are not corporations, but like businesses and corporations, schools and school districts are operated by humans, which means that basic laws of human nature apply. Educational leaders would do well to explore some of the literature and research on motivation and leadership that has been so heavily marketed to the corporate world. Almost all of the business and social science research from the last decade on motivation, drive, leadership, management, retention, and job satisfaction agrees: it’s not about the money.
Again and again, research shows that the carrot/stick approach fails to motivate people. Daniel Pink, the author of Drive: The Surprising Truth about What Motivates Us, draws on 50 years of behavioral science research to argue that external rewards like money are not motivators for high performance. Instead, Pink’s research shows that the best motivators are intrinsic: autonomy, mastery, and purpose. When implemented strategically, these motivators lead to increased job satisfaction, higher retention rates, and stronger organizations.
One of the most famous case studies illustrating this point is Tony Hsieh’s turnaround of Zappos. When Hsieh became CEO of Zappos in 2000, the company was worth $1.6 million and floundering. By 2009, Zappos was worth over $1 billion and cited as a world class example of corporate culture and growth.  Zappos achieved success by empowering every employee, down to call center representatives, to make whatever decisions necessary to make the customer happy.  Hsieh instilled a culture of delivering happiness (the purpose) and then gave every single employee the autonomy to achieve that purpose. He didn’t build a company of devoted employees on bonus checks.
In spite of overwhelming research to the contrary, education “reformers” still think waving a fat check in front of teachers will somehow lead to higher test scores. This is insulting. It indirectly suggests that teachers are not already doing everything in their power to teach students successfully. It implies that by sweetening the deal with a few grand, teachers will magically whip out a secret arsenal of teacher tools they’d been holding out on until the district ponied up the cash. Oh, there’s a check at the end of the line? Well, I guess I’ll teach Johnny to subtract, after all! Sound ridiculous? It is.
No, school districts aren’t selling shoes, and they’re not looking to make a profit, but there is (or should be) a uniting purpose to educate students and grow their academic success. That won’t be accomplished with a carrot/stick approach. It will be accomplished by giving teachers the autonomy to make decisions about how to teach their students and increase their own teaching mastery.
If you want a dog and pony show, then offer ribbons and prizes. Real, systemic growth and change can’t be bought.

In Response to “The Imaginary Teacher Shortage”

On Tuesday, The Wall Street Journal ran an opinion editorial by Jay Greene, “The Imaginary Teacher Shortage,” which posited that while the United States has added a million teachers to the rolls since 1970, student performance has remained unchanged. Greene challenged the presidential candidates’ plans to add more teachers, imploring state and local officials to instead shrink the teaching force.  Mr. Greene proceeded to make an argument based around exactly the kind of flawed, simplistic logic that is so damning to contemporary “reform” efforts. 
Scapegoating teachers for being unsuccessful and overpaid is not only lazy critique, it is irresponsible. Finger-pointing draws energy and attention away from the far more nuanced dysfunctions of the education system, but furthermore, reveals a shallow and narrow interpretation of educational progress during the past 40 years. This article is link-bait, at best, and I am disappointed by the lack of integrity of The Journal for running a piece based on such tired logic and misplaced criticism with grossly misrepresented statistics. 
The editorial features an image of a smiling young teacher with pin curls from some idyllic day of yore. She sits at a sturdy wooden desk with an apple atop, with a stack of papers in one hand and reading glasses in the other, in front of a blackboard with white chalky cursive. (A closer look at the blackboard suggests that on the day of the photo shoot, students were memorizing metric conversations and causes of the Revolutionary War, while also learning to multiply fractions and add with decimals. Must have been a busy day!) The caption states: “How did she do it? Less money for education, larger classes—and plenty of success.”  Mr. Greene, kudos to you for undermining so many basic facts of American history, economics, education, technology, politics, and data in one cheeky caption. 
How did she do it? Less money for education, larger classes—and plenty of success.
“For decades we have tried to boost academic outcomes by hiring more teachers, and we have essentially nothing to show for it. In 1970, public schools employed 2.06 million teachers, or one for every 22.3 students, according to the U.S. Department of Education’s Digest of Education Statistics. In 2012, we have 3.27 million teachers, one for every 15.2 students.”
Come on, teachers! We took 7.1 kids out of your classrooms – why haven’t the test scores budged? Firstly, I’m curious to know by which metrics of achievement Mr. Greene is measuring student stagnation. To date, our best measure of national student achievement is the National Assessment for Education Progress (NAEP), which did not begin testing in reading and math until 1983, at which time, special needs students wereexempt from testing. The other standard indicators of national student achievement at this time were the SAT and ACT, whose scores only represented the averages of college-bound seniors, not the entire student population. 
Metrics aside, Mr. Greene’s statement that the United States has “nothing to show for it” is patently false in that it not only assumes that all other factors have remained consistent in the classroom (including the very purpose of schooling), but also completely fails to acknowledge educational progress by any measures other than test scores and class size, (which are nearly useless in aggregate, anyway).
In 1970, just 12.5 percent of 3 and 4 year olds were in pre-school. Research has consistently shown the importance of pre-school in terms of later academic success. 40 years ago, pre-school education was reserved primarily for children of affluence, which disproportionately put low-income children at an academic disadvantage at the ripe age of 3, which partially explains the socio-economic achievement gap from very young ages. Thanks to federal and state funding for programs like Head Start, nearly half of 3 and 4 year olds receive a pre-school education today. We still have a long way to go towards ensuring early child hood education for every child, but the United States has quadrupled the percentage of 3 and 4 year olds receiving early childhood education during the past 40 years. 
What about the other end of the education pipeline? In 1970, just 6.7 percent of males and 3.8 percent of females over the age of 25 completed four years of college and the median number of years of school completed was 12 – the equivalent of a high school degree. Between 2007-2009, 38.8 percent of 25-34 year olds had completed an associate’s degree or higher. 
What do these numbers mean for the K-12 teaching force? Comparing teachers in 1970 to teachers in 2012 is futile, because the nature and purpose of schooling has transformed so fundamentally during the past 40 years that the modern demands of the profession bear little resemblance to job description of teachers in 1970. Unfortunately for teachers in 2012, the United States now pays attention to educating every child, not just the healthy rich white kids, (which is a real bummer because teachers were so successful with those students).
If the goal of schooling is to prepare young people for careers and citizenship, then the turn of the 21st century has necessitated the most dynamic shift of educational outcomes in American history. Globalization and the digital age have had an unprecedented impact on our workforce economy. The number of manufacturing jobs in the United States during the 1970s exceeded the job numbers from the World War II era manufacturing boom. Those jobs remained at fairly steady levels until 2000, at which point they began to steadily and rapidly decline. 
 
In 1970, the majority of the student population was preparing to enter the manufacturing workforce, which required basic reading and math skills, but almost no high level critical thinking skills. Digital literacy was hardly a concern, since computers were still the stuff of science fiction for the average Joe. So, in 1970, it was wholly acceptable for less than 10 percent of students to be on the college track. Fast forward 40 years and politicians proclaim: everybody should go to college! No longer do we consider teachers a success for preparing 10 percent of students for higher education. Today, teachers are expected to have 100 percent of students on the road to college (never mind that it defies the law of averages and basic principles of economics). 
“The path to productivity increases in every industry comes through the substitution of capital for labor. We use better and cheaper technology so that we don’t need as many expensive people. But education has gone in the opposite direction, making little use of technology and hiring many more expensive people.”
I will be there first to admit that there are worthy parallels between business and education in terms of motivation, culture, financing, and leadership. However, let’s stop short of commoditizing children, please. We are not making iPods (if we were, that manufacturing jobs graph might not look so dire), we are educating human beings, who have a helluva lot more moving parts. Technology offers some wonderful innovations for education, but education technology should be designed to assist teachers, not replace them. I would like to see a computer break up a fight or mediate a conflict between angry adolescents. I would like to see an iPad dry a child’s tears or help him blow his nose or zip her jacket when it snags. I would like to see a SmartBoard smile or tie a tiny pair of shoes. 
Educators get a lot of flack for being too warm and fuzzy, but the fact of the matter is that teachers are working with little humans who sometimes need a little warm and fuzzy in their strange and scary lives. Education technology products like Common Curriculum and Class Dojo are wonderful in taking the nuisance out of teaching tasks like lesson planning and classroom management without undermining the role of the teacher. 
 
The flipped classroom model certainly has some benefits for some students in some classrooms. But before we go and replace all our teachers with Sal Khan, please remember a little something called the digital divide: not every student has the luxury of going home to watch Internet videos. In fact, only 78 percent of Americans have Internet access. I wonder if the 20 percent of children living in poverty in America fall into the 23 percent of people without Internet access? That sure would be a snafu for teachers trying to flip classrooms in areas of highly-concentrated poverty.
“There is also a trade-off between the number of teachers we have and the salary we can offer to attract better-quality people. As the teacher force has grown by almost 50% over the past four decades, average salaries for teachers (adjusted for inflation) have grown only 11%, the Department of Education reports. Imagine what kinds of teachers we might be able to recruit if those figures had been flipped and we were offering 50% more pay without having significantly changed student-teacher ratios.”
This sounds good in theory: recruit the best people and compensate them accordingly. It does not work. Teach for America has done a fine job of recruiting the top college-grads in the country by igniting their sense of injustice and passion for change. We do not have a recruitment problem in teaching – we have a retention problem. Nearly half of all teachers leave during their first five years because they are burned out, which is a problem that salary increases (while nice) will not fix. I have informally surveyed many teachers over the past several years and asked them: “Would you rather have a $50,000 raise or another co-teacher or aid in your classroom?” No one has taken the money. 
“Hiring hundreds of thousands of additional teachers won’t improve student achievement.”
On this point, I actually agree with Mr. Greene. One of every five children in America lives in poverty. Children living in poverty are disproportionately facing the added challenges of poor nutrition, incarcerated parents or siblings, single family homes, drug use, physical or sexual abuse, gang culture and neighborhood violence. These challenges are not insurmountable, but we are kidding ourselves and doing a disservice to students to continue ignoring the overwhelming evidence that these factors affect classroom performance.
As a nation, if we decide that schools should be the place to address all societal ills, we owe it to the students and faculty of our schools to provide them with the necessary resources. School equity means giving students what they need to succeed, not treating all students the same. Some students may thrive in a classroom of 30, while others need a small group setting limited to five students, and still others will need one on one attention. Some students may naturally develop socio-emotional skills in a 20 minute recess, while others will need years of counseling to overcome Post-Traumatic Stress Disorder or other mental health issues. 
Simply adding more bodies to the classroom will not improve student achievement nor will it increase teacher satisfaction. If we want our teachers and students to be successful, we must provide them adequate capital to provide resources at their discretion. Students will only be successful when we stop blaming teachers and start acknowledging that the true obstacles to education lie far beyond the classroom doors.
 

The Only Way Out Is Up

“Ever since I was a little girl, I wanted to teach teachers,” said no one, ever.
You may be surprised to know that being a teacher of teachers is a highly coveted position in education circles. After a few years in the classroom, many teachers discover that their passion lies not so much with teaching children, but, as it turns out, other teachers. With all the wisdom of two, three, or five years of professional teaching under their belts, they will earnestly tell you of their newly realized professional ambition: supporting teachers.
As social beings, humans seek order and hierarchy in complex systems. Not unlike other industries, education professionals are organized in a complex and hushed hierarchy of respect, authority, and salary.  But unlike other professions, the people most directly responsible for outcomes are at the bottom of the totem pole, scavenging for resources.
Teaching is a relatively static profession. There is no clear career ladder with universally accepted benchmarks of achievement. There are few, if any, promotions. In law, one might aim to someday be a judge or make partner at a prestigious firm. In business, young associates set their sights on the C-suite.  In medicine, there’s a strict progression from intern to resident to attending. But in teaching, a prolific career could blossom in the same classroom, with the same title, over the course of 30 or 40 years. The salary increments are marginal. The prestige is limited and local. The accolades are private. An enduring teaching career runs counter to almost every indicator of success in our culture. It’s less like a ladder and more like a Ferris wheel.
But Americans, particularly Millenials, are not conditioned for success in stagnation. Raised on titles and trophies, we’re looking for the next rung before we’ve even steadied our footing. In a commencement address at Harvard Business School, Sheryl Sandberg compared the 21st century career path to a jungle gym instead of a ladder. But a jungle gym still contains a variety of heights – encouraging risky jumps and maneuvers to become king or queen of the playground. Rather than allow for some professional gymnastics within the teaching profession, the education industry has outsourced the monkey bars to various “Offices Of.”
It pains me to admit that a certain Miley Cyrus song seems particularly prescient here: it’s the climb, and young education professionals seem to be always looking for the next mountain to conquer. Suddenly, dozens of new positions with fancy titles exist in schools and districts and Teach for America offices across the country. Instructional Support Teacher, Model Teacher, Lead Teacher, Program Director, Vice President of Leadership Development, Director of School Leadership, Director of School Design, Director of Teaching and Learning, etc. Surely, all of these roles are filled with passionate, well-intentioned, intelligent people working to improve the country’s education system and provide excellent learning experiences for children. But arguably, the easiest way to provide excellent learning experiences for children is to be an excellent teacher of children. Many of these newly invented roles are filled by former teachers, which begs the questions: are these new roles truly necessary for providing excellent education, or have they been created to make adults feel better?
Most of these positions are accompanied by salaries and benefits equal to or better than those of teachers. And instead of managing and catering to the unique needs of up to 150 young people every day, these other education professionals can retreat to comfortable climate controlled offices where they will engage with (mostly) rational adults all day.  What sane person wouldn’t view this as a step up in the world: equal or better pay for an easier job that still serves a higher purpose.  Certainly, these professionals make worthy contributions to education. However, I have to wonder if their contributions are absolutely essential to the education system, or if they are diverting the already scarce human capital and other resources away from the classrooms they aim to serve.
In its simplest form, education involves only a teacher and a student (think Socrates). What would happen if we streamlined all resources for the direct benefit of students and teachers? If instead of having PowerPoints and Curriculum Manuals and managers and managers of managers, every classroom had three certified teachers and one-to-one internet-ready technological devices? In which system would students thrive? In which system would adults thrive in their chosen professions? And might they be one and the same?

Doctors for America

“Are you having trouble finding a doctor who will see you? If not, give it another year and a half. A doctor shortage is on its way,” warns John C. Goodman is his Wall Street Journal op-ed. He’s wrong. According to Businessweek, there’s already a shortage of 15,000 doctors, with projections of a 130,000 shortage of doctors by 2025. So why not increase the supply of doctors to meet the demand of the 30 million new patients ushered into the US health care system with the Affordable Care Act? Currently, doctors are trained through a rigorous residency program, lasting three to seven years, costing $145,000 per year per resident. “The residency programs to train new doctors are largely paid for by the federal government, and the number of students accepted into such programs has been capped at the same level for 15 years. Medical schools are holding back on further expansion because the number of applicants for residencies already exceeds the available positions.”

Wait, isn’t this supposed to be an education column?
Internet trolls love to snipe in comment threads about Teach for America, “Imagine if we had Doctors for America – would you want someone performing brain surgery on you after five weeks of training?” Frankly, this is blissfully ignorant First World snark. Partners in Health, founded by the brilliant Paul Farmer, trains community members as public health workers in impoverished settings like Haiti, Rwanda, Peru, and Malawi because they have a severe shortage of doctors. The only reason the United States doesn’t have Doctors for America is because America is not facing a severe shortage of doctors… yet.
Goodman’s op-ed dances around some very important ethical and economic questions, but unfortunately, he abandons them for low hanging fruit like “wait time” at the doctor’s office, which will be probably be the least of the US health care system’s problems in the next decade. Universal healthcare will inevitably create some of the same supply and demand issues that plague the public education system. That’s basic economics. And as doctors increasingly feel overwhelmed and underpaid, they too will burn out and leave the profession for private pastures.
I wonder if the internet trolls will gripe how lazy doctors have become, as public health professionals across the nation try in vain to address the ailments of 30 patients at a time?
As a moral, socially conscious citizen, it is a popular liberal opinion to agree that healthcare and education are basic human rights that should be provided by the government. But as a society, are we willing to make the commitment (and sacrifices) required to actually provide those rights? Or do we just want to feel better about ourselves by nodding our heads and passing laws without footing the bill for the financial capital and human resources required to make those lofty provisions a logistical reality?
The two-tiered healthcare system that Goodman prophecies is essentially the education system we already have – wealthy people evade the system by paying for high-end education through private schools, while poor/middle class people are stuck with a resource depleted public system. Does America have the capacity to provide high-quality social goods and services to everyone? Or is a two-tiered system inevitable? Is a two-tiered system acceptable as long as the lower-tier provision isadequate? These are uncomfortable questions to ask, especially when politically palatable answers are not always economically feasible. Of course, it does not help matters that our nation’s political “leaders” are busy quibbling over the technicalities of rape instead of solving actual political and economic problems.
If you need immediate cardiac care, would you rather take your chances and wait a year for a top notch doc, or go under the knife with a 22-year old-who learned how to wield a scalpel last week (but was, like, so good at Operation)?
And if neither of these options is acceptable for our bodies, why is it the fate for so many of our nation’s young minds?