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News item:



On the NPR show “Wait, Wait, Don’t Tell Me” when this item came up one of the panelist suggested that this was an evidence-based decision. Perhaps a study of homeless people had been done and they had all sung the “Crayon Song” one too many times. Big audience laugh…

As a parent, we want a lot for our children. We want them to have a good life, to work hard but not too hard, to enjoy beauty and the company of others, and to have a family of their own to torture them like they tortured us. To this end, schools function to provide content that our children need to learn but also contribute to the rest of this as well. By ignoring any outcomes but college acceptance, we diminish the other aspects of education.

The two pillars that predict community success are educational and health care infrastructure. Measuring both has been fraught with peril.  Like Justice Stewart said about pornography, we know good schools and good healthcare when we see it. Unfortunately, that metric, like pornography, is difficult to quantify. In the Mobile   public schools that my children attended, there was a metric of “total scholarship money offered.” This was a particularly weird metric that encouraged the students to apply to colleges they had no intention of attending so they could receive a reportable scholarship offer. The healthcare metric, “Providence Hospital is MY hospital” is likewise not a good metric. If you go to the government’s hospital compare website (found here) you’ll swhat are good metrics.

Commonwealth has just come out with the latest report on the state of our county’s health (found here). We as a community once again fared poorly. Out of 306 health regions, we are listed at number 270. Of the 43 metrics that are used to assess our health system’s performance, we were excellent in one and very poor in 13. We were rock bottom in 3. What are we best in? Nurse response to call lights and home health wound healing. We are rock bottom in preventable mortality (people dying early) and people who have lost 6 or more teeth.

Mostly, it turns out that good schools reflect a critical mass of motivated parents who are willing to pay extra to attract good teachers and work harder to help their children achieve. When that happens, the halo effect tends to help others to achieve as well. Health care quality, it turns out, also is dependent on insurance status, educational attainment, regional income, and engagement of people in their own health. To improve education or health care delivery, it takes a village.

People want to live in areas with quality education and healthcare. I can only hope we can find a metric other than early ABCs to measure kindergarten quality with.  I also hope that our doctor governor accepts the health care metrics and charges us to work together to improve them, rather than force us to live in denial and in a broken system.