Health care conundrums

February 17, 2017

As I advance in age, I am exposed more and more to the health care industry, despite having enjoyed relatively good health until recently.  As a retired New York State employee, I am blessed with excellent health insurance that covers most doctor visits, medical tests and procedures, as well as prescription drugs, with only a relatively modest co-pay. Here are a few observations:

First, it appears that many of our health problems are what a friend of mine calls “diseases of affluence.”  More appropriately, they should be called “diseases of lifestyle,” since they affect people of all socioeconomic strata.  A lot of these are directly influenced by government policies.  For instance, our auto-centric physical infrastructure minimizes the opportunities for and pleasures of walking and cycling, and cannot help but contribute to obesity and other problems based on lack of physical activity.  Our government subsidies to cane sugar and corn (the main ingredient of high fructose corn syrup) help make junk food and sugared soft drinks attractively priced.  This is especially so for the poor, since the SNAP program (formerly known as Food Stamps) allows their purchase with SNAP benefits.  If we collectively spent more on complete streets that were friendly to pedestrians and cyclists, as well as cars, how much could we save on health care (not to mention on school transportation)?  How about if we stopped subsidizing sugar?  I think it would be worth a try.

For all the criticism leveled against it, the Affordable Care Act (“Obamacare”) has achieved something great — it has shifted the dialog from whether health care insurance should be extended to many of those who don’t have it to how the present system should be replaced or improved.  Neither Trump nor his minions are suggesting that those who obtained health insurance through Obamacare should lose it, meaning that they recognize that there is no going back on government’s commitment to growing numbers of its citizens.  Whether things actually get better or worse remains to be seen, but at least no one is talking a bout a pre-Obamacare “reset.”  To me, that is yuge.


Traffic management

January 21, 2017

The delays occasioned by traffic jams, red lights and other things that slow our automotive travel are a major source of frustration to most of us.  As individuals, we can mitigate this frustration by choosing our home and work locations, and the times at which we work.  We may be able to telecommute, walk or bike, or take public transit (which has its own frustrations).  But in today’s automobile-dominated society, most of us have to use the private automobile for most of our travel, much of which must be done on a rigid schedule.

We deal with this frustration with fancy sound systems, luxury seating and blue tooth connections that allow us to use some of our automotive downtime productively.  However, those measures do not address the tremendous waste of oil-based fuel and its concomitant pollution. Government, on behalf of us all, can do more to manage traffic and its related delays, but in our geographic area it has largely failed to act.

While I was driving down Washington Avenue in Albany recently, hitting red light after red light, my frustration triggered some early memories — from the 1960s — of driving up and down avenues in Manhattan with my father, watching each light turn green as we approached it.  My dad explained to me that the lights were timed so that you would rarely have to stop, if you maintained a steady speed at or around the limit.  I am aware of nowhere in our area that employs this proven (and by now, probably more affordable), technology.

Another local failure, on the part of the Thruway Authority, is its lagging behind the Mass Pike in eliminating toll plazas at exits and entries to its highways, with all tolls being tallied by gantries over the road that read E-Z Pass transponders without the need for cars to slow down (a few such gantries do exist on the Thruway, most notably near the Harriman exit, but they have not replaced the toll plazas at the entries and exits).  Although the demolition of the toll plazas and barriers on the Mass Pike is not complete, travel time savings already have been noted.

While we now do have electronic signs on many of our primary roads advising of travel time to various points, these signs do not offer alternatives when delays are indicated, and in most cases no alternatives exist.  While information may reduce frustration during times of congestion, expenditures aimed at reducing congestion would be a better use of taxpayer funds.

Money spent on reducing traffic congestion, as well as on things like bike paths and libraries, benefits everyone by making the area a more attractive one in which to live.  Unfortunately, in New York, “everyone” is not a special interest, which may be why government under-spends in many of these areas.


More on charter schools

November 6, 2016

This recent column in the New York Times summarizes some studies on charters, and sheds some interesting light.  Apparently, the charters that do the best (and not all even do well) are those that stress the basics — longer days, more support for teachers and students and imposition of high standards.

Aside from reflecting what appears to me to be common sense, these values contrast with those present in many conventional public schools, where shorter work days and more insulation from accountability are the goals of the teachers, as expressed through collective bargaining and political action (many individual teachers put in extra time and strive for excellence, even after achieving tenure).  While I understand teachers’ perceived need for some job protections, and while I believe most tenure “abuses” are caused by management that does not terminate probationary teachers who are unlikely to be successful, there still is a disconnect between the positions of advocates of traditional education and those of the best, successful charters.

If competition produces better results for all, and if charters are to fulfill their original mission as laboratories in which successful teaching methods can be developed and tested, both systems need support.


Charter school success?

August 3, 2016

This New York Post story suggests that NYC charters have worked a miracle — closing the heretofore intractable racial achievement gap, and outperforming even affluent conventional public schools.  If this is true, why haven’t other news outlets picked up the story?  If it’s not true, in whole or in part, why hasn’t anyone refuted it?

I don’t think charters are miracle workers, and I am somewhat skeptical of reports of huge successes.  But I also think they do a lot of things better than conventional public schools (which are adapting to meet the competition), such as providing greater support and a longer school day and year.  Charter students are also more likely to come from more supportive homes, since parents need to take many affirmative actions to have their children attend charter schools.

So where does the truth lie?

 


What goes around . . .

August 3, 2016

This little item in the Albany Times Union (the longer story linked to in the item is behind the paper’s pay wall) about the burden of rising pension costs is unusual only because of the employer — NYSUT, the teachers’ union.   NYSUT’s own management is clearly aware of the burdensome costs of benefits for its own employees, and its officers appear to be willing to take a cut while they negotiate similar cuts with their employees’ union.

Of course, NYSUT’s role as bargaining representative for its members is different from its role as an employer, and it is charged by law to represent its members’ interests.  In playing that role in contract negotiations, I don’t think NYSUT would be receptive to the concept of givebacks by its members.

What I suspect I won’t see is any of the school districts asking for the kind of givebacks NYSUT appears to believe warranted with respect to its employees (and leading the way by imposing them on their own staff).  One reason for public employee unions’ great success has been the lack of aggressive counter parties representing the taxpayers in contract negotiations, though I am sure the School Boards’ Association would argue to the contrary.  There are many reasons for this: the understandable urge (especially when spending other peoples’ money) to show appreciation for the good work teachers do, the large financial and political clout of the unions, and the fact that the better the deal for teachers, the better the deal for management, who must of course, be paid more than the rank and file in the trenches. Of course, in a competitive market for teachers, salary and benefits must be competitive, but smart management would make sure they were regardless of union pressure.

Recently, a caller to one of our local public broadcasting stations expressed the dilemma of wanting to support local public education but wanting to remain in his house, which was becoming increasingly  less affordable due to rising school taxes, among other things.  The moderator pooh-poohed him with the usual response — “nothing’s too good for our kids.”

Like that caller, I see both sides, and I certainly don’t want to return to the days of exploitation of teachers.  However, I wonder who is representing this taxpayer, and how strongly.  Only when both sides have equal bargaining power can a reasonable balance of interests be struck.

 

 

 

 

 

 

 

 

 

 

 

 

 


All that’s wrong with New York’s government

May 23, 2016

This startling story in yesterday’s New York Daily News shows an almost criminal disregard by our Legislature for the taxpayers’ dollar.  It’s another example of how wastefulness or ineptitude by government can turn liberals into conservatives.  Those who would like government to do more ultimately decide that our government should not do more, because it either won’t do the job well or will do it at an unreasonably high cost (some of the overage going to the “corruption tax”).

Consequences of governmental inefficiency are unmet needs, or privatization of traditional government functions. Traditional public education in New York is threatened by charters and alternatives because of its high cost and mediocre results, accountability for which proves elusive.  People vote with their feet and leave the State for places with lower taxes and services that are not appreciably worse than they get here (for example, I can’t think of anywhere, including the deep South, that has roads in worse condition than those in our area).

While people with differing ideologies can and do differ as to the scope of government’s role in our lives, there should be absolutely no disagreement among honest citizens that what government is called upon to do should be done as efficiently and effectively as possible, for the benefit of all, not special interests.  Maybe that is an idea that all citizens can support, putting aside their ideological differences until after it is achieved.


Opposing view

May 21, 2015

Today’s Daily News letters section contained the following rebuttal to Mulgrew’s piece:

Manhattan: It is astonishing that in a single sentence, United Federation of Teachers President Michael Mulgrew can disparage New York’s Common Core-aligned state exams as a farce, and praise the National Assessment of Educational Progress as reliable (“The better tests N.Y. kids deserve,” Op-Ed, May 18). In reality, both tests tell the same dismal story about the proficiency of our schoolchildren. On the most recent NAEP exams, given in 2013, just 37% of New York State fourth-graders scored proficient in reading, 40% in math. Among eighth-graders, 35% tested as proficient in reading and 32% in math. In New York City, where Mulgrew’s union holds sway, the results were even worse. Can he truly believe those are acceptable numbers — even if city kids have, in his words, shown “modest but generally consistent gains”?

Eva Moskowitz, Success Academy Charter Schools