Tuesday, August 31, 2010

Demographics: A Number of Interesting Observations

I would have thought that population dynamics would be such a slowly evolving field that interesting developments would be few and far between. Apparently that is not the case. There seems to be plenty going on and it will be important to keep paying attention.

This essay is based on an article by Martin Walker entitled The World’s New Numbers in the Spring 2009 issue of The Wilson Quarterly. Every two years the United Nations produces new estimates of population trends for all countries. The author presumably based his article on the 2008 data base. If one is interested, one can find a widget here that will give you population history and projections for any country over any period of time.

Walker’s purpose is to highlight interesting trends and debunk common misperceptions arising from the misuse of demographic projections.
"The human habit is simply to project current trends into the future. Demographic realities are seldom kind to the predictions that result. The decision to have a child depends on innumerable personal considerations and larger, unaccountable societal factors that are in constant flux. Yet even knowing this, demographers themselves are often flummoxed. Projections of birthrates and population totals are often embarrassingly at odds with eventual reality."As examples of the danger in trusting long-term projections, the author provides this quick overview.
"Something dramatic has happened to the world’s birthrates. Defying predictions of demographic decline, northern Europeans have started having more babies. Britain and France are now projecting steady population growth through the middle of the century. In North America, the trends are similar. In 2050, according to United Nations projections, it is possible that nearly as many babies will be born in the United States as in China. Indeed, the population of the world’s current demographic colossus will be shrinking. And China is but one particularly sharp example of a widespread fall in birthrates that is occurring across most of the developing world, including much of Asia, Latin America, and the Middle East. The one glaring exception to this trend is sub-Saharan Africa, which by the end of this century may be home to one-third of the human race."Wilson identifies three "accepted" demographic scenarios that appear to be highly suspect given the current data.
"....three deeply misleading assumptions about demographic trends have become lodged in the public mind. The first is that mass migration into Europe, legal and illegal, combined with an eroding native population base, is transforming the ethnic, cultural, and religious identity of the continent. The second assumption, which is related to the first, is that Europe’s native population is in steady and serious decline from a falling birthrate, and that the aging population will place intolerable demands on governments to maintain public pension and health systems. The third is that population growth in the developing world will continue at a high rate. Allowing for the uncertainty of all population projections, the most recent data indicate that all of these assumptions are highly questionable and that they are not a reliable basis for serious policy decisions."Walker has already mentioned the European resurgence in fertility. He also points out that an immigrant does not necessarily maintain the same birth rate in the new culture.
"One fact that gets lost among distractions.... is that the birthrates of Muslim women in Europe—and around the world—have been falling significantly for some time. Data on birthrates among different religious groups in Europe are scarce, but they point in a clear direction. Between 1990 and 2005, for example, the fertility rate in the Netherlands for Moroccan-born women fell from 4.9 to 2.9, and for Turkish-born women from 3.2 to 1.9. In 1970, Turkish-born women in Germany had on average two children more than German-born women. By 1996, the difference had fallen to one child, and it has now dropped to half that number."

"These sharp reductions in fertility among Muslim immigrants reflect important cultural shifts, which include universal female education, rising living standards, the inculcation of local mores, and widespread availability of contraception. Broadly speaking, birthrates among immigrants tend to rise or fall to the local statistical norm within two generations."
Most of the Muslim countries fall into the "developing" category, at best. Yet earlier population growth projections have proved untrustworthy.
"The decline of Muslim birthrates is a global phenomenon. Most analysts have focused on the remarkably high proportion of people under age 25 in the Arab countries, which has inspired some crude forecasts about what this implies for the future. Yet recent UN data suggest that Arab birthrates are falling fast, and that the number of births among women under the age of 20 is dropping even more sharply. Only two Arab countries still have high fertility rates: Yemen and the Palestinian territories."

"In some Muslim countries—Tunisia, the United Arab Emirates, Bahrain, Kuwait, and Lebanon—fertility rates have already fallen to near-European levels. Algeria and Morocco, each with a fertility rate of 2.4, are both dropping fast toward such levels. Turkey is experiencing a similar trend."

"Revisions made in the 2008 version of the UN’s World Population Prospects Report make it clear that this decline is not simply a Middle Eastern phenomenon. The report suggests that in Indonesia, the country with the world’s largest Muslim population, the fertility rate for the years 2010–15 will drop to 2.02, a shade below replacement level. The same UN assessment sees declines in Bangladesh (to 2.2) and Malaysia (2.35) in the same period. By 2050, even Pakistan is expected to reach a replacement-level fertility rate."
The author mentions two countries, Iran and Russia, where population trends could have serious geopolitical ramifications.
"Iran is experiencing what may be one of the most dramatic demographic shifts in human history. Thirty years ago, after the shah had been driven into exile and the Islamic Republic was being established, the fertility rate was 6.5. By the turn of the century, it had dropped to 2.2. Today, at 1.7, it has collapsed to European levels. The implications are profound for the politics and power games of the Middle East and the Persian Gulf, putting into doubt Iran’s dreams of being the regional superpower and altering the tense dynamics between the Sunni and Shiite wings of Islam. Equally important are the implications for the economic future of Iran, which by midcentury may have consumed all of its oil and will confront the challenge of organizing a society with few people of working age and many pensioners."

"In Russia, the effects of declining fertility are amplified by a phenomenon so extreme that it has given rise to an ominous new term—hypermortality. As a result of the rampant spread of maladies such as HIV/AIDS and alcoholism and the deterioration of the Russian health care system, says a 2008 report by the UN Development Program, "mortality in Russia is 3–5 times higher for men and twice as high for women" than in other countries at a comparable stage of development. The report—which echoes earlier findings by demographers such as the Woodrow Wilson Center’s Murray Feshbach—predicts that within little more than a decade the working-age population will be shrinking by up to one million people annually. Russia is suffering a demographic decline on a scale that is normally associated with the effects of a major war."
Finally, Walker provides an intriguing perspective on the issues associated with the aging populations of the developed countries. The major concern arises from the growing number of pensioners who will have to be supported by a relatively smaller work force. He points out that in many European countries the work force participation rate is quite low. Coupling a slightly higher retirement age with incentives to get more women into the work force will alleviate much of the problem.
"....the work force participation rate in Germany (and much of continental Europe) is relatively low. Not only do Germans retire on the early side, but the generous social welfare system allows others to withdraw from work earlier in life. An increase in employment would boost the revenues flowing into the social security system. For example, only 67 percent of women in Germany were in the work force in 2005, compared with 76 percent in Denmark and 78 percent in Switzerland. (The average rate for the 15 "core" EU states is 64 percent; for the United States, 70 percent.)"

"David Coleman, a demographer at Oxford University, has suggested that the EU’s work force could be increased by nearly a third if both sexes were to match Denmark’s participation rates. The EU itself has set a target participation rate of 70 percent for both sexes. Reaching this goal would significantly alleviate the fiscal challenge of maintaining Europe’s welfare system, which has been aptly described as "more of a labor-market challenge than a demographic crisis."
 
He also points out that one should consider the fact that a society and its workers must support all the non-workers, a category that also includes children too young to work.
"....the total dependency ratios of the 21st century are going to look remarkably similar to those of the 1960s. In the United States, the most onerous year for dependency was 1965, when there were 95 dependents for every 100 adults between the ages of 20 and 64. That occurred because "dependents" includes people both younger and older than working age. By 2002, there were only 49 dependents for every 100 working-age Americans. By 2025 there are projected to be 80, still well below the peak of 1965. The difference is that while most dependents in the 1960s were young, with their working and saving and contributing lives ahead of them, most of the dependents of 2009 are older, with more dependency still to come. But the point is clear: There is nothing outlandish about having almost as many dependents as working adults."Walker seems to be implying that as our population ages and a greater fraction of our income must go towards supporting pensioners, there can be a compensating effect from having relatively fewer children to support. Does the raising of a child cost society more than the support of a retiree? My guess is yes. Of course, that does not mean funds needing to be extracted from the workforce will not go up, it just means they will go to a level we have dealt with before. I have not heard the aging issue addressed in this context before. It is certainly something to think about.

Kristof and WuDunn: Slavery Today

It is very easy to begin thinking of slavery as something to look up in history books. Kristof and WuDunn, in their book Half the Sky, point out that it is an industry that is large—almost beyond comprehension. They do not give a very specific definition of slavery, but, based on their discussion, it would include physical confinement, being forced to perform services against your will, and being subject to physical punishment or to being killed, while having no access to legal assistance.

In terms of numbers of people subjected to these conditions, the authors quote our State Department.
"Technically, trafficking is often defined as taking someone (by force or deception) across an international border. The U.S. State Department has estimated that between 600,000 and 800,000 people are trafficked across international borders each year, 80 percent of them women and girls for sexual exploitation....As the State Department notes, its estimate doesn’t include ‘millions of victims around the world who are trafficked within their own national borders’."Kristof and WuDunn are concerned with the treatment of women. Consequently, they focus on the sex trade. It is not possible to determine a precise number of girls who could properly be called "enslaved" by the definition given above. Much of this activity occurs in Asian countries where girls are either purchased outright or lured away from their homes with promises of jobs in other locations. They are then sold to brothels where they are then either beaten or drugged (or both) into submission. Once they have been tainted by the shame of prostitution, they have little recourse from society and often resign themselves to their fate. Many have developed drug addictions that keep them from leaving. If the girls become pregnant, the brothel owners will keep the child captive in order to inhibit the mother from trying to run away. Often girl babies are raised as a cash crop to feed into the business. Unless one knows something about the girl’s history it is hard for a casual observer to distinguish between voluntary participation and enslavement.
"Our own estimate is that there are 3 million women and girls (and a very small number of boys) worldwide who can fairly be termed enslaved in the sex trade. That is a conservative estimate that does not include many others who were manipulated and intimidated into prostitution....We are talking about 3 million people who in effect are the property of another person and in many cases could be killed by the owner with impunity."The authors put into perspective the scale of modern slavery by noting some historical data.
"In contrast, in the peak decade of the transatlantic slave trade, the 1780s, an average of just under eighty thousand slaves were shipped annually across the Atlantic from Africa to the New World. The average then dropped to a bit more than fifty thousand between 1811 and 1850. In other words, far more women and girls are shipped into brothels each year in the early twenty-first century than African slaves were shipped into slave plantations each year in the eighteenth or nineteenth centuries...."The authors also point out that this is one of the humanitarian or human rights issues that is actually getting worse. They also emphasize that while by numbers the most instances occur in Asia, this sort of activity goes on all over the world, even in the U.S. Not only are the absolute numbers growing, but the targets are becoming younger, and all the girls risk an early death.
"...reason for the worsening situation is AIDS. Being sold to a brothel was always a hideous fate, but not usually a death sentence. Now it often is. And because of the fear of AIDS, customers prefer younger girls whom they believe are less likely to be infected. In both Asia and Africa, there is also a legend that AIDS can be cured by sex with a virgin, and that has nurtured demand for young girls kidnapped from their villages."So—if you feel that the world is going to hell in a hand basket—you are probably correct.

Thursday, August 26, 2010

Kristof and WuDunn: The Axis of Equality: China—Rwanda

Kristof and WuDunn have a consistent message throughout their book, Half the Sky. They strain to point out that no matter how horrible are the horrors, no matter how terrible the terrors, something can always be done. They present numerous stories to illustrate how individual women have managed, after incredibly difficult and apparently hopeless situations, to not only survive, but to thrive. One purpose of this chapter of the book, The Axis of Equality, is to demonstrate that even countries, no matter how disgraceful their history, can change and acquire more enlightened ideas with respect to the treatment of women; the second is to point out the benefits of this enlightenment.
"We sometimes hear people voice doubts about opposition to sex trafficking, genital cutting, or honor killings because of their supposed inevitability. What can our good intentions achieve against thousands of years of tradition?"

"One response is China. A century ago, China was arguably the worst place in the world to be born female. Foot binding, child marriage, concubinage, and female infanticide were imbedded in traditional Chinese culture. Rural Chinese girls in the early twentieth century sometimes didn’t even get real names, just the equivalent of ‘No. 2 sister’ or ‘No. 4 sister’.....Girls were rarely educated, often sold, and vast numbers ended up in the brothels of Shanghai."
And who was the leader who ushered in the revolution that brought these practices to an end? It was none other than the "benevolent" Chairman Mao.
"Communism after the 1949 revolution was brutal in China, leading to tens of millions of deaths by famine or repression, but its single most positive legacy was the emancipation of women. After taking power, Mao brought women into the workforce and the Central Committee of the Communist Party, and he used his political capital to abolish child marriage, prostitution, and concubinage. It was Mao who proclaimed: ‘Women hold up half the sky’."This is not to say that Chinese men have completely shed their chauvinist heritage, but Mao did provide women with an opportunity to have political influence, and, perhaps most importantly, economic influence.

The authors provide an anecdote that is worth our while to remember concerning our own country and the importance of political influence.
"As late as 1920, America had a maternal mortality rate equivalent to poor parts of Africa today. But then deaths from pregnancy began to plunge. One reason was antibiotics and blood transfusions, but another was women’s suffrage. A society that gave women the right to vote also gave their lives more weight and directed more resources to women’s health. When women could vote, suddenly their lives became more important, and enfranchising women ended up providing a huge and unanticipated boost to women’s health."Having a say in the world of politics is important, but it is more important to be able to participate in the economy. Allow a woman to leave the house and earn money and old attitudes are quickly brought up to date. This works on a national level as well as on an individual level. In fact, it is not clear that a nation that subjugates its women can ever lift itself from poverty.
"China is an important model because it was precisely its emancipation of girls that preceded and enabled its economic takeoff. The same is true of other rapidly growing Asian economies. As Homi Kharas, an economist who has worked on these issues for the World Bank and the Brookings Institution, advised us:

‘Engineering an economic takeoff is really about using a nation’s resources most efficiently. Many East Asian economies enjoyed a sustained boom by moving young peasant women from farms to factories, after giving them a basic education for free. In Malaysia, Thailand, and China, export-oriented industries like garments and semi-conductors predominately employed young women who had previously been working in less productive family farms or doing household work. The economies got multiple benefits from this transition. By improving the labor productivity of the young women, growth was raised. By employing them in export industries, the countries got foreign exchange which could be used to buy needed capital equipment. The young women saved much of their money or sent it back to relatives in the village, raising national savings rates. Because they had good jobs and income earning opportunities, they also delayed marriage and childbearing, lowering fertility and population growth rates’."
 
The authors then present us with another example, far away from China, where a necessary move towards gender equality has proven beneficial. Rwanda was a typical poor African nation with a patriarchal society. Its "revolution" arose from the genocide of 1994. So many men were killed that in the aftermath it possessed a population that was 70% female. If the country was going to get back on its feet it would have to make use of its women. Assistance from western nations would be needed and Paul Kagame, the president, probably figured it would not hurt to be viewed as a country with an equal opportunity policy. The constitution ended up with a requirement that women make up 30% of the parliament.
"Rwanda is consciously implementing policies that empower and promote women....Kagame has regularly appointed strong women to cabinet posts and other top positions. Women now hold the positions of president of the supreme court, minister of education, mayor of Kigali and director of Rwanda television....in September 2008, a new election left Rwanda the first country with a majority of female legislators—55 percent in the lower house...Rwanda is also one of the least corrupt, fastest-growing, and best governed countries in Africa."Good things happen when countries empower their women. That issue was discussed at length in a broader context here. The question that arises is: "Could you ever foresee Pakistan and Afghanistan turning their women loose in their economies?" Not tomorrow, but in a few years, who knows? Stranger things have happened.

Wednesday, August 25, 2010

McKinsey Quarterly: Reforming Hospitals with IT Investment

Most of the stories I have heard about the impact of electronic health records have been negative, with claims of software bugs, development costs that will never be recovered, and the general contention that there is not much money to be saved anyway. This article (free registration required to view), Reforming Hospitals with IT Investment, finally provides some good news.

Let’s start with the bad news first. The stimulus and the health care bills together make a transfer to electronic medical records and computerized-physician-order-entry (CPOE) systems mandatory and set standards for the systems to be implemented. This report quotes a figure of $120 billion to bring hospitals into compliance. Only a small portion of this is subsidized by the government. The report points out that the implementation must be done carefully if it is to be successful and affordable.

The good news is that there are examples in place which indicate that this expense can be quickly recovered in lower operating costs. The authors also point out that their estimates of cost savings are conservative and the actual savings could be considerably higher.
"The productivity and resource savings often pay back the initial IT investment within two to four years while also producing better health outcomes for patients. We estimate that total savings across the US provider landscape could be on the order of $40 billion annually. (By comparison, about $1.3 trillion a year is spent on inpatient and outpatient services across the United States and about $80 billion on health care IT.) Achieving such a positive return on investment (ROI), however, requires distinctive change-management skills among hospital leaders, better governance, and sustained engagement from key clinicians."There are multiple areas in which the IT investment will contribute to cost reduction.
"Optimizing the use of labor

Many hospitals continue to rely on manual charting, paper records, and outdated software to manage bed counts, schedule staff, and reserve key resources, such as operating rooms and imaging machines. Electronic health records and computerized physician order entry bring these elements together online, automating charts, records, and medical information about patients and directing medical staff toward protocols clinically proven to be more effective in treating illnesses.

When these technologies are linked to bed-management and equipment-scheduling software, doctors, nurses, and administrators can assess current and projected bed counts and optimize the scheduling of key equipment (for instance, x-ray systems) and the level of staffing. This approach reduces not only administrative waste (such as time spent tracking down medical information or calling to secure needed services) but also the level of overbooking, simultaneously improving bed turnover. The results can save upward of $20,000 per bed in labor utilization alone.

Reducing the number of adverse drug events

Electronic health records and computerized-physician-order-entry systems can sharply reduce the risk of prescription error and negative drug interactions by mapping patient histories with information from drug manufacturers to highlight the risks of prescribing a particular product. Problems with drugs cost hospitals $8,000 to $15,000 per bed each year, or between $1.6 million and $3 million for an average 200-bed hospital. Access to medical information allows physicians to adjust prescriptions or dosages to prevent complications, improve the quality of care, and reduce the human impact of adverse drug events.

Managing the revenue cycle

Every year, roughly 0.4 percent of hospital services go unbilled, at a cost per bed of just over $4,000. Some of the billing issues result from coding errors or eligibility questions. Coupled with data standards such as ICD-10, computerized-physician-order-entry systems promote the consistent naming, coding, and classification of treatments, allowing hospitals to improve the oversight of all procedures and to increase the first-time pass-through of claims.

Reducing the number of duplicate tests

When all health records are stored in electronic format and providers gain access to them through health information exchanges, they become more widely accessible to doctors, insurers, hospital administrators, and patients, regardless of location. This kind of visibility gives clinicians a more complete sense of a patient’s history and reduces the need for duplicate tests that can affect the quality, cost, and speed of care.

An average hospital can pay back its initial (and usually onetime) investment in two to four years; cost savings accrue year on year. Health care providers with better-integrated systems often realize even higher ROI."
 
Paying for a significant technology implementation in two to four years is an impressive return on investment. Presumably at least $40 billion will then be saved each year in the future.

Let us now think really positive. The report gives as an example of the potential of the IT-driven approach, of a group of Canadian hospitals who invested $100 million (Canadian) in a new system over a period of four years. They observed annual savings equal to the cost of the entire four-year implementation.

Tuesday, August 24, 2010

More on For-Profit Schools

For those of you who were aghast to learn that a few of the for-profit colleges were offering cash to homeless people if they would apply for student loans and attend class, you will be happy to learn that the pressure is gradually being turned up against these people. An article in Businessweek entitled "What’s This Degree Worth?" shines a spotlight on Education Management Corp. (EDMC), 38% owned by beloved Goldman Sachs. The main theme is that the schools run by EDMC have been known to charge exorbitant fees for essentially worthless degrees.

The lead story is about a young woman who wished to have a career designing video games. She enrolled in the Art Institute of Fort Lauderdale. Tuition and fees for a degree in game art and design added up to $70,000. The best she could do after graduating was a $12 an hour job recruiting employees for video game companies. She was soon laid off and now makes a living as a stripper in a night club. She has thought of going to another college, but she would have to start from the beginning because none of the credits from the "Art Institute" would be acceptable at a traditional school. She was sold an expensive degree in a field that perhaps does not even exist, or, at least, can not provide a salary commensurate with the debt accrued.

A second story involves a woman who attended Argosy University in Dallas. She acquired a doctorate in clinical psychology at the cost of $130,000 in student loans and $150,000 in private loans for living expenses. When she enrolled she was told the school would be accredited by the American Psychological Assn. (APA). When she graduated she discovered that positions with a decent salary were not available to her because she had a degree from an unaccredited institution. Argosy is still "preparing" for the accreditation process. A group of students is suing Argosy for having provided them with false information.

I want to add a personal observation. Within the past week I heard one of these schools advertising on the radio a program in "Construction Supervision." Whoever heard of such a field?

There are two aspects of the situations described above. One involves the greed for easy money on the part of the schools. That is a well-understood phenomena that can be dealt with whenever an outbreak is detected. The second involves the apparent gullibility of the students. Why would one plan to spend more money at an unaccredited college than it would cost to get an equivalent degree at a traditional school? As the article points out for-profit schools are offering culinary degrees for $40,000 to $50,000, but a beginning cook only makes about $18,000 a year. If the person is lucky, it will only take a lifetime to pay off that debt. Part of what is happening must involve preying on students who either could not gain entry to a traditional school for some reason, or who are unable to defend themselves against the onslaught of misleading claims and promises that school recruiters are providing. This only makes the behavior of the schools more despicable.

These practices have not escaped the notice of Congress. The GAO was tasked to send undercover agents to several schools posing as prospective students. The results of the report are available from the GAO. Here is the meat from the Executive Summary.
"Undercover tests at 15 for-profit colleges found that 4 colleges encouraged fraudulent practices and that all 15 made deceptive or otherwise questionable statements to GAO's undercover applicants. Four undercover applicants were encouraged by college personnel to falsify their financial aid forms to qualify for federal aid--for example, one admissions representative told an applicant to fraudulently remove $250,000 in savings. Other college representatives exaggerated undercover applicants' potential salary after graduation and failed to provide clear information about the college's program duration, costs, or graduation rate despite federal regulations requiring them to do so. For example, staff commonly told GAO's applicants they would attend classes for 12 months a year, but stated the annual cost of attendance for 9 months of classes, misleading applicants about the total cost of tuition. Admissions staff used other deceptive practices, such as pressuring applicants to sign a contract for enrollment before allowing them to speak to a financial advisor about program cost and financing options. However, in some instances, undercover applicants were provided accurate and helpful information by college personnel, such as not to borrow more money than necessary. In addition, GAO's four fictitious prospective students received numerous, repetitive calls from for-profit colleges attempting to recruit the students when they registered with Web sites designed to link for-profit colleges with prospective students. Once registered, GAO's prospective students began receiving calls within 5 minutes. One fictitious prospective student received more than 180 phone calls in a month. Calls were received at all hours of the day, as late as 11 p.m.....Programs at the for-profit colleges GAO tested cost substantially more for associate's degrees and certificates than comparable degrees and certificates at public colleges nearby. A student interested in a massage therapy certificate costing $14,000 at a for-profit college was told that the program was a good value. However the same certificate from a local community college cost $520. Costs at private nonprofit colleges were more comparable when similar degrees were offered."There is an article here describing the Administration’s response.
"The proposed rules released today by the U.S. Department of Education would link U.S. student aid eligibility at Apollo Group Inc., ITT Educational Services Inc., Career Education Corp. and other education companies to former students’ salaries and debt repayment rates. The rules may cut off access to federal student grants and loans at about 5 percent of all for- profit education programs, Secretary Arne Duncan said in a telephone call with reporters yesterday."

"Students earning two-year associates’ degrees at for-profit colleges had an average student-loan debt of $14,000 in 2007- 2008, about twice that of students at nonprofit colleges, the department said in a statement."


"If the rules were in effect today, programs enrolling about 8 percent of the students at for-profit colleges nationwide would lose eligibility, the Education Department said."

"Under the proposed rules, the Education Department would monitor loan repayments and starting salaries among graduates of for-profit colleges. To remain fully eligible for student loans, education companies would have to show the agency that at least 45 percent of their former students are paying off their student loans, or that graduates pay less than 8 percent of their total income or less than a fifth of their "discretionary income" on student loan payments."
Critics of the Administrations plan state that his is a step in the right direction and is a good approach, but they believe the restrictions proposed are not severe enough. In my current state of outrage I would tend to agree.

Let us finish on a pleasant, harmonious, perhaps-all-will-be-well-with-the-world note.
"Near their peak in April, Goldman’s shares in EDMC were worth $1.39 billion. Since then they have fallen by 42 percent, to about $800 million."

Friday, August 20, 2010

Unemployment: Do the Germans Have a Better Way?

A recent article in Businessweek points out that Germany has a different approach than us on how to respond to an economic slowdown. In our country if there is not enough work to sustain a particular position fulltime the employer has the option of cutting work hours or wages, or of dismissing the worker. The worker is then eligible for about 36% of the former wages from unemployment insurance for up to 26 weeks unless extended. Germany has a policy referred to as "short-work." German companies can choose to keep workers on at a reduced schedule and the government will compensate up to 67% of the workers wages for the work hours eliminated. Does this policy work? According to the article:
"While the worst recession since World War II pushed up unemployment in the U.S. to 10.1 percent, a 27-year high, in Germany the rate fell well below 8 percent, a 17-year low....Almost half a million jobs were saved, a feat Angela Merkel recently called a ‘minor miracle’."On that basis, the German policy seems like an excellent idea. But is there a down side to this approach? The Businessweek authors seem to think there is, saying that the Germans will now have to face a period of low job growth which will slow their rate of economic recovery. I do not understand that logic. The equivalent of job growth is getting more workers off of government support and working full time. The economy is growing and unemployment is low, at least by historical standards. They should be thrilled with the situation they are in.

I think the issues are more subtle. The German system puts pressure on companies to maintain jobs during a downturn and continue them in the future. The U.S. system encourages employers to eliminate jobs and encourages them to avoid bringing them back when business picks up. This arises both from the unemployment compensation model and stock-price rewards for cutting costs. Another way to look at our end result is to consider that a smart business will emerge from a slowdown with either fewer jobs or jobs that have been dumbed down so that they can handled by lower wage workers. This is a fundamental conflict between businesses who wish to minimize employment and workers’ earnings, and the government which has to try to maximize employment and earnings.

How is this different in the German model? A German company is under pressure to maintain positions for everyone they have hired. This probably makes them very careful about who they hire and what they hire them for. That could be a concern. On the other hand, once they create a position, it will be one that they think will have to have long-term value to the organization. Will there be a tendency to upgrade positions rather than "dumb them down?" My guess is yes, and if that is the case, then I would vote for the German model.

If you can create a system in which you have fewer jobs, but they all come with living wages—you can live and eat and raise children without a government dole—then you are way ahead of a system that only seems capable of creating ever more jobs tending downward toward the minimum wage. The latter situation is what we find ourselves in today—and it is not sustainable.

Thursday, August 19, 2010

Kristof and WuDunn: The Shame of “Honor”

Of all the justifications used by men as they torment women, the notion that women’s lives must be restricted in order to protect their honor is the most insidious. In many societies women are viewed as possessions. As possessions they need to be protected in the same way one would protect a cow or a vehicle. Women are guarded in the same way cars are guarded: they are stored in a garage until they can fulfill some need of the owner. There is no altruism here. Men are competing against men and the one with the greatest possessions wins. Women are merely chips in this age-old game. On one hand, this makes them assets to be protected; on the other hand it makes them assets to be targeted.

In their book, Half the Sky, Kristof and WuDunn describe some of the myriad ways in which the notion of "honor" is used to abuse and kill women.
"Of all the things people do in the name of God, killing a woman because she does not bleed on her wedding night is among the most cruel. Yet the hymen—fragile, rarely seen, and pretty pointless—remains an object of worship among many religions and societies around the world, the simulacrum of honor."

"The cult of virginity has been exceptionally widespread. Not only does the Bible advocate stoning girls to death when they fail to bleed on their wedding sheets, but Solon, the great lawgiver of ancient Athens, prescribed that no Athenian could be sold into slavery save a woman who lost her virginity before marriage. In China, a neo-Confucian saying from the Song dynasty declares: ‘For a woman to starve to death is a small matter, but for her to lose her chastity is a calamity’."

"This harsh view has dissipated in most of the world, but survives in the Middle East, and this emphasis on sexual honor is today a major reason for violence against women."
The more value you place on an asset the more likely it is that an enemy or rival will try to take that asset away from you. This represents a cycle in which the "protected" female is viewed as ever more valuable and thus becomes ever more vulnerable, and results in things like "honor" killings.

The most efficient way to humiliate a man is to rape his daughter. It is generally not a punishable crime if the rape occurs against a family of a lower class, and the victim is expected to disappear—either through suicide or being murdered by her own family. This supposedly eliminates the shame experienced by the remaining family members. Often the rape of a young woman is ordered by the community elders (men) as punishment for something someone else did—perhaps a relative. Why punish a man when there are plenty of women around for that purpose? The net result is supposed to be another dead woman.

There are many variations on this theme of a woman’s value being determined by her virginity. Kristof and WuDunn describe a common practice in Ethiopia. If a young man wants to marry a young woman but suspects that he does not have enough money to pay the bride price or that the parents will not approve of him, he gathers some friends and kidnaps and rapes the girl. This diminishes her value greatly and the girl’s family, acknowledging her now lack of value, usually feels that she might as well go ahead and marry the young thug. In Ethiopia rape is not a crime if you end up marrying the girl. If she refuses, the man is highly motivated to continue kidnapping and raping her until she changes her mind. The authors pointed out that a US advocacy group put so much pressure on Ethiopia that they eventually changed the law to make rape a crime even if the girl agreed to be married. Unfortunately, laws passed in capital cities often have little standing in the countryside where tradition is generally stronger.

Kristof and WuDunn use the phrase "honor rapes" to describe the most vicious and, numerically, the most prevalent application of rape. One hears of mass rapes in civil wars in Africa and forms an image of rampaging young men with guns and hormones seeing women as easy targets of opportunity. What is actually occurring is more complex and even more abhorrent.
"In recent genocides, rape has been used systematically to terrorize certain ethnic groups. Mass rape is as effective as slaughtering people, yet it doesn’t leave corpses that lead to human rights prosecutions. And rape tends to undermine the victim’s tribal structures, because leaders lose authority when they can’t protect the women. In short, rape becomes a tool of war in conservative societies precisely because female sexuality is so sacred. Codes of sexual honor, in which women are valued based on their chastity, ostensibly protect women, but in fact they create an environment in which women are systematically dishonored."

"In Darfur, it gradually became clear that the Sudanese-sponsored Janjaweed militias were seeking out and gang-raping women of three African tribes, then cutting off their ears or otherwise mutilating them to forever mark them as rape victims. To prevent the outside world from knowing, the Sudanese government punished women who reported rapes or sought medical treatment....[they were treated as criminals] The crime? Fornication, for by seeking treatment she was acknowledging that she had engaged in sex before marriage, and she did not provide the mandatory four adult male Muslim eyewitnesses to prove that it was rape."
Let us leave this subject with the authors’ chilling observation:
"In 2008, the United Nations formally declared rape a ‘weapon of war’.....Major General Patrick Cammaert, a former United Nations force commander, spoke of the spread of rape as a war tactic and said something haunting: ‘It has probably become more dangerous to be a woman than a soldier in an armed conflict’."

Tuesday, August 17, 2010

Diane Ravitch and the Performance of Charter Schools

Diane Ravitch is no fan of Charter schools. In her book, The Death and Life of the Great American School System, she makes several claims about Charters having unfair advantages over traditional public schools with no significant performance benefit as their justification.

Although she was once in favor of options for giving students a choice in selecting a school, she believes that the various plans have either not worked, or they have worked to the detriment of the regular public school systems. She sees Charter schools as being the vehicle of choice for those would wish to apply market-based principles to schools or those who wish to experiment with alternative educational approaches. I think it is important to recall that these are two different approaches to the vision of charter schools. Ravitch has a tendency to lump these two types together when evaluating the utility of charter schools. This can be misleading.

With respect to market-based initiatives, the author points out that:
"The basic strategy was the market model, which relied on two related assumptions: belief in the power of competition and belief in the value of deregulation. The market model worked in business, said the advocates, where competition led to better products, lower prices and leaner bureaucracies, so it would undoubtedly work in education as well."There are so many things that could go wrong with this type of approach that one need not take the time to explain why they would agree with Ravitch that this not the way to go. However she tends to paint all charter schools with the same brush, often forgetting the second class of charter school—those who wish to experiment with new techniques that might be more broadly applied.
"Charter schools represented, more than anything else, a concerted effort to deregulate public education, with few restrictions on pedagogy, curriculum, class size, discipline, or other details of their operation."

"They recalled that one of the original goals of the charter movement was to engage in experimentation to see what works best, but the repeated claim that charter schools were superior to regular schools suggests that ‘experimentation is not necessary because charter school operators already know what works’."
There is a recent study which presumably came out too late for inclusion in this volume, but she does refer to it in a recent article in The Nation magazine. That particular article was discussed here. The study was by the Center for Research on Education Outcomes at Stanford University (June, 2009). This study seems to support her claim that charter schools have not been successful—at least in general. This is a long report with much data. The most quoted outcome of the study was a chart which is referred to as a "Market Fixed-Effects Quality Curve." What this is intended to do is compare charter school performance to those of comparable traditional public schools (TPS) as fairly as possible. The summary results were that the performance of 37% of the charter schools was below the level of TPS, for 46% there was not significant difference with TPS performance, and 17% of the charter schools produced significantly better results than TPS.

Ravitch looks at this data and sees failure on the part of the charter movement. I look at it and see success. Given the sloppy approach to introducing charter schools in many states (well documented by the author), I would not expect many to outperform the traditional public schools. However, why not rejoice in the 17% who have succeeded. To support her thesis, the author has to argue away this success. She concludes that the successful charter schools are "gaming" the system in one way or another. The ways this is done are usually via student selection. Most of the successful charters seem to work with a lottery system for children in socially and economically challenged environments. Students who apply for charters (which generally promise increased demands on the students) are the most motivated of the students whose departure will leave the traditional school at a disadvantage. Charter schools are also claimed to enroll fewer special-needs students such as English learners and disabled children. She also claims that such schools have high attrition rates, which means that the lowest performers have to be reabsorbed by the traditional schools.

She points out that the KIPP schools tend to perform well.
"The charter schools with the most impressive record of success are the KIPP (Knowledge is Power Program) schools, which have been called culture changing schools, because they aim to teach students not just academics but also self-discipline and good behavior"She then proceeds to try and negate the KIPP success by the various student selectivity arguments given above. Then she makes the claim
"Thus while KIPP schools obtain impressive results for the students who remain enrolled for all four years, the high levels of student attrition and teacher turnover raise questions about the applicability of the KIPP model to the regular public schools."She then, curiously, couples that statement with the following observation.
"In the demands they make on students, teachers, and parents, the KIPP schools are reminiscent of the American public schools of the 1940s, or even the 1920s, before the onset of class-action lawsuits and union contracts. In those days, it was not unusual to encounter schools with strict disciplinary codes and long working hours (although not nine-and-a-half hour days."So, she says it can’t be done that way, and in the next breath says that was the way we used to do it in the good old days. I find that a bit perplexing. Does she not realize that by making comments like that she is playing into the hands of those who would claim that unions and regulations are the source of all problems?

Malcolm Gladwell wrote at length about the KIPP school approach in his book Outliers. What he emphasized is that the long hours at the school and the study requirements essentially created a new community for the children. Disadvantaged children were taken out of an environment in which they had little social capital in terms of parental guidance and positive peer pressure, and lacked of a sense of empowerment—a sense of personal worth. Within the KIPP community they begin to obtain the same social capital that children from more wealthy and successful communities obtain almost by birth right.

Needless to say, based on what I know, I am a fan of the KIPP approach. But what of the claims of unfair advantages that accrue to their schools. There is yet another study recently published. Several foundations (not the Gates Foundation) contributed funds to support a long term study of the performance of KIPP schools by Mathematica Policy Research (Princeton). Since this study is funded by a friendly audience one should look at it carefully. I will, for now, assume it to be accurate and unbiased. The first report was issued in June 2010. Its summary conclusions were:
KIPP does not attract more able students (as compared to neighboring public schools).

KIPP schools typically have a statistically significant impact on student achievement.

Academic gains at many KIPP schools are large enough to substantially reduce race and income-based achievement gaps.

Most KIPP schools do not have higher levels of attrition than nearby district schools.
The author’s claim of higher attrition rates that would leave only the high performers who bend the performance curve upward does not seem to be applicable here. While the claim that the most motivated students are being drawn to the KIPP schools might be true, it does not appear that the public schools are being left stripped of talent. Although KIPP can draw from private funds for development and expansion, its spending per student is comparable to ambient public schools. The report did indicate that the KIPP schools tend to have fewer "special needs" students. If the KIPP schools can do more with the students than the traditional schools, then more power to them. Isn’t that precisely the point of a charter school? How can Ravitch argue that it is wrong to take 2%, 5%, 10%, 20%, or whatever number of willing students there are, and put them on a path to success, when the alternative is to let them remain part of a failing population?

Found here  is a short article summarizing the KIPP study findings. And here is another article describing a charter high school in Chicago that is located in a poor area and has managed to get 100% of the students (all male, all black) from their first graduating class accepted into four-year colleges, even though only 4% were reading at grade level as incoming freshmen. Like KIPP, this is not your average school. Like KIPP, the school tries to create a more nurturing community where the students can accumulate knowledge and the required social capital necessary to succeed.

There are ways to do things better. Rather than damning all because many are not exceptional, we should applaud those who have demonstrated methods that work, and try to take better advantage of what has been learned.
 

Friday, August 13, 2010

Hitchens and Archeologists Take on the Old Testament

Christopher Hitchens is one writer who is best enjoyed in small sips. He is witty, erudite and brutally honest to those who agree with him. He is arrogant, conceited and aggressively obnoxious to those who don’t. In his book, god is not Great, he devotes a chapter to debunking the Old Testament as a religious document. This is Hitchens in his prime. The ancient text itself, and recent archeological findings, provide plenty of low hanging fruit for Hitchens to take a whack at.

His task is to demonstrate that the "sacred" texts were written by men—with human intentions—and that god was created to suit man’s needs. He begins by pointing out that the main texts that define the Judaic religion were not written by Moses, but by a person or persons later than 700 BCE. The events surrounding Moses would have had to occur around 1300 BCE. Furthermore, many of the events described in those texts seem to never have happened. Hitchens hints that a likely explanation for the production, at that time, of a relatively coherent religious framework from a collection of myths and legends is that a ruler or high priest wanted to create a context in which the current kingdom would appear to be the culmination of an illustrious history. A ruler would further wish to define a God who would approve of whatever actions he might wish to take, and who would frighten his subjects into being obedient.

The presentation of the Ten Commandments, as described in the book of Exodus, receives the following treatment.
"It would be hard to find an easier proof that religion is manmade. There is, first, the monarchical growling about respect and fear, accompanied by a stern reminder of omnipotence and limitless revenge, of the sort with which a Babylonian or Assyrian emperor might have ordered the scribes to begin a proclamation. There is then a sharp reminder to keep working and only to relax when the absolutist says so. A few crisp, legalistic reminders follow…No society ever discovered has failed to protect itself from self-evident crimes like those supposedly stipulated at Mount Sinai. Finally, instead of the condemnation of evil actions, there is an oddly phrased condemnation of impure thoughts….One may be forcibly restrained from wicked actions, or barred from committing them, but to forbid people from contemplating them is too much."One can forgive the Judeans for not understanding brain function—but God?
"If god really wanted people to be free of such thoughts, he should have taken more care to invent a different species."Hitchens is the most persuasive when he describes the God that is presented by whoever wrote these Old Testament documents. Continuing with the discussion of the commandments:
"Then there is the very salient question of what the commandments do not say. Is it too modern to notice that there is nothing about the protection of children from cruelty, nothing about rape, nothing about slavery, and nothing about genocide? Or is it too exactingly ‘in context’ to notice that some of these very offenses are about to be positively recommended? In verse 2 of the immediately following chapter, god tells Moses to instruct his followers about the conditions under which they may buy or sell slaves (or bore their ears through with an awl) and the rules governing the sale of their daughters."The image Hitchens, and the Old Testament, presents is that of a god who approved of practices that were common around the seventh century BCE, but would be considered crimes against humanity today, thus supporting his thesis that man created God in its own image.
"Then we must come to those things which probably did not happen and which we must be glad did not. In Deuteronomy Moses gives orders for parents to have their children stoned to death for indiscipline (which seems to violate at least one of the commandments) and continually makes demented pronouncements (‘He that is wounded in the stones, or hath his privy member cut off, shall not enter into the congregation of the Lord’). In Numbers, he addresses his generals after a battle and rages at them for sparing so many civilians:

‘Now, therefore, kill every male among the little ones, and kill every woman that hath known a man by lying with him. But all the women-children that hath not known a man by lying with him, keep alive for yourselves.’

This is certainly not the worst of the genocidal incitements that occur in the Old Testament (Israeli rabbis solemnly debate to this day whether the demand to exterminate the Amelikites is a coded commandment to do away with the Palestinians), but it has an element of lasciviousness that makes it slightly too obvious what the rewards of a freebooting soldier could be."
And then there is God condemning half of his creation to lives of discrimination and servitude, if not outright slavery, where violence is always a threat.
"Thou shalt not suffer a witch to live."No one seemed concerned about wizards. This was the justification for centuries of Christian murder of women who chose to be, or were accused of being, "different." He contributed the following to the canonization of male-female inequality, and provided permission for several millennia of violence against women.
"If a man takes a wife and after lying with her, dislikes her and slanders her and gives her a bad name, saying, ‘I married this woman, but when I approached her, I did not find proof of her virginity,’ then the girl’s father and mother....shall display the cloth [that the couple slept on] before the elders of the town....If, however, the charge is true and no proof of the girl’s virginity can be found, she shall be brought to the door of her father’s house and there the men of her town shall stone her to death."In other words, God appeared to be a man of the times.

Now let us see what archeology tells us of the veracity of the Old Testament stories.

Hitchens uses a book by Israel Finkelstein and Neil Asher Silberman, The Bible Unearthed: Archeology’s New Vision of Ancient Israel and the Origin of Its Sacred Texts (2001). I have not read that book. What I will reference is a review of the subject, in general, and of the book, in particular, by Sarah Belle Dougherty, Fiat Lux: Archeology and the Old Testament (2003). Material in double quotes will be from Dougherty. Excerpts in single quotes will be Dougherty referencing text from the book.
"The Bible Unearthed.....shows why, although ‘no archeologist can deny that the Bible contains legends, characters, and story fragments that reach far back in time....archeology can show that the Torah and the Deuteronomistic History bear unmistakable hallmarks of their initial compilation in the seventh century BCE’."

"Archeologists, many of them churchmen, have searched intensely for evidence of the historical patriarchs because they felt that unless these people actually existed, their own religious faith would be erroneous. Although the Bible provides a great deal of specific information, the search has proved unsuccessful....Excavations of several sites mentioned as prominent in Genesis sometimes show that in the early Iron Age they were insignificant or nonexistent, but by the late eighth and seventh century BCE had become important."

‘It is now evident that the selection of Abraham, with his close connection to Hebron, Judah’s earliest royal city, and to Jerusalem....was meant also to emphasize the primacy of Judah even in the earliest eras of Israel’s history. It is almost as if an American scripture describing pre-Columbian history placed inordinate attention on Manhattan Island or on the tract of land that would later become Washington, D.C. The pointed political meaning of the inclusion of such a detail in a larger narrative at least calls into question its historical credibility.’

"Rather than a chronicle or history, evidence indicates that this part of Genesis was a national epic created in the seventh century BCE which successfully joined many regional legendary ancestors into one unified tradition."
 
The story of Moses leading 600,000 people and wandering forty years in the wilderness appears to never have happened. These events would have had to take place in the late thirteenth century BCE. The region in which this wandering was supposed to take place was closely observed by the Egyptians who kept detailed records of events. There is no mention of Israelites or any other ethnic group living or moving around in that area.
"Sites mentioned in the Exodus narrative are real. A few were well known and apparently occupied in much earlier periods and much later periods—after the kingdom of Judah was established, when the text of the biblical narrative was set down in writing for the first time. Unfortunately for those seeking an historical Exodus, they were unoccupied precisely at the time they reportedly played a role in the events of the wandering of the children of Israel in the wilderness."Existing Egyptian documents tell of Canaanite cities being small and unfortified, and of a Canaanite population that was probably less than 100,000. It was not clear that Jericho was populated at the time when Joshua supposedly captured the city.

Egyptian history does tell of Canaanite immigrants who settled in Egypt and were expelled around 1570 BCE. This could provide an explanation, although an ironic one, for the origins of these myths.
"But if the Israelites did not flee Egypt and invade Canaan, who were they?....the discovery of the remains of a dense network of highland villages—all apparently established within the span of a few generations—indicated that a dramatic social transformation had taken place in the central hill country of Canaan around 1200 BCE. There was no sign of violent invasion or even the infiltration of a clearly defined ethnic group. Instead it seemed to be a revolution in lifestyle....far from the Canaanite cities that were in the process of collapse and disintegration, about two-hundred fifty hilltop communities suddenly sprang up. Here were the first Israelites."

‘The emergence of early Israel was an outcome of the collapse of the Canaanite culture, not its cause. And most of the Israelites did not come from outside Canaan—they emerged from within it. There was no mass exodus from Egypt. There was no violent conquest of Canaan....The early Israelites were—irony of ironies—themselves originally Canaanites!’

"As far as we can see on the basis of archeological surveys, Judah remained relatively empty of permanent population, quite isolated, and very marginal right up to and past the presumed time of David and Solomon, with no major urban centers and no pronounced hierarchy of hamlets, villages and towns."

"There is no trace of written documents or inscriptions, nor of the Temple or palace of Solomon, and buildings once identified with Solomon have been shown to date from other periods. Current evidence refutes the existence of a unified kingdom: ‘The glorious epic of a united monarchy was—like the stories of the patriarchs and the sagas of the Exodus and conquest—a brilliant composition that wove together ancient heroic tales and legends into a coherent and persuasive prophecy for the people of Israel in the seventh century BCE’."
People will make of this information what they wish, but the data is consistent with Hitchens’ claims. Since we started with him, let us give him the last word.
"Mediocre individuals engage in single combat or one-on-one argument with god or his emissaries, raising afresh the whole question of divine omnipotence or even divine common sense, and the ground is forever soaked with the blood of the innocent. Moreover, the context is oppressively confined and local. None of these provincials, or their deity, seems to have any idea of a world beyond the desert, the flocks and herds, and the imperatives of nomadic subsistence. This is forgivable on the part of the provincial yokels, obviously, but then what of their supreme guide and wrathful tyrant? Perhaps he was made in their image, even if not graven?"

Monday, August 9, 2010

Diane Ravitch Versus Bill Gates

Diane Ravitch has a lot to say about Bill Gates and his foundation in her book The Death and Life of the Great American School System. Essentially every reference to the foundation’s work in education is criticism. Some of her assessments seem justified, others are clearly arguable, but others appear to be based on misinformation. I felt it would be appropriate and useful to present Gates’ side of the story, through his own words where possible, with me as the devil’s advocate where appropriate.

Ravitch begins by declaring the Gates foundation to be frighteningly large and powerful.
"The foundation’s decision-making process…’was a closed internal process, and as far as can be seen, accountable to none other than itself.’ In a statement that had implications for the foundation’s educational initiatives, the scientist said that the powerful influence of the foundation ‘could have implicitly dangerous consequences on the policy-making process in world health.’ In other words, the Gates Foundation was setting the international agenda, because of its unrivaled wealth, and intentionally shutting out competing views."I do not see that the Gates Foundation is behaving any differently than other funding agency. Essentially all research in the US in the field of health goes through the NIH. They have a process of reviewing proposals that selects the most promising and eliminates the least promising. You can refer to that process as "intentionally shutting out competing views" if you wish, but it is hard to see that as anything but the inevitable nature of the world of research. It is valid to point out that financial power can, in the wrong hands, be dangerous, but to cast aspersion on billions of dollars worth of effort in many areas with the comment of one unhappy scientist in one area seems a bit unprofessional.

Most of the author’s discussion of the foundation’s work involves the small school initiative that was supported for several years. Data seemed to indicate that smaller-sized high schools were more successful in preparing students for college. A few billion dollars were invested in investigating this notion over a period of several years. The results were mixed and it was not clear that this was a viable approach to pursue further. Ravitch presented some valid reasons why scaling schools down in size would create difficulties that should have been foreseen. The Gates’ people admitted that there appeared to be better ways to spend the foundation’s money. In retrospect, this approach does appear to be a bit loopy, but it probably was no more poorly based than any of the other attempts to improve education that the author describes.

It is in the characterization of the Gates Foundation’s current and planned activities in education that the author is unfair and inaccurate. The fact that her discussion is in a chapter titled The Billionaire Boys’ Club is a clue that he is not going to get any respect. She begins with
"Bill and Melinda Gates invited the leading educators to their home in Seattle and told them that they planned to invest millions in performance-based teacher pay programs; creating data systems; supporting advocacy work; promoting national standards and tests; and finding ways for school districts to measure teacher effectiveness and to fire ineffective teachers."While I have no doubt that Bill gates believes that teachers who are deemed irreparably ineffective should be fired, I really doubt that he said he wanted to help find ways to fire ineffective teachers. The author sounds a bit like someone who was not invited to the Gates’ home with the big kids. In fact, Gates is funding initiatives to help teachers become more effective. He criticizes traditional educators, a group that includes Ravitch, for providing an environment in which teachers are given essentially no help in improving their skills. In his annual letter about his foundation’s activities he includes this comment.
"One job where the worker is provided almost no feedback is the teacher at the front of the class. In a teacher’s personnel file there is rarely anything specific about where the teacher is strong or weak. Often there is just a checklist of basic things like showing up on time and keeping the classroom clean. In places where there is a rating system at all, 99 percent of teachers are rated satisfactory. Although this personnel system has the benefit of low overhead and predictability, it doesn’t identify best practices and drive improvement."
"An alternative is a system where time and money are invested in evaluation with the goal of helping teachers improve. Making this work requires both resources and trust. A new system needs to be predictable and help teachers identify weaknesses and give them ways to improve, and it should not make capable teachers afraid of capricious results."
Ravitch then goes on to claim that
"It was clear that the richest foundation in the world planned to put its considerable resources into the proliferation of charter schools and into the issue of teacher effectiveness: how to improve it and how to terminate ineffective teachers."The author provides an ambivalent and inconsistent discussion of charter schools. This is a topic worthy of an extended discussion. For present purposes it is sufficient to point out that Bill Gates does not mention charter schools in his annual report. If you go to the Gates Foundation web site and do a search on charter schools you will find little evidence of recent funding activities. Once again, Ravitch has chosen to be snarky rather than precise.

It is clear from his writing and speeches that Gates has bought into the notion that the best way to improve educational results is by improving the quality of the teachers.
"In last year’s letter I wrote about the evidence that helping teachers teach more effectively is the best way to improve high schools. It is incredible how much the top quartile of teachers can improve the skills of even students who are quite far behind."Notice how Gates always refers to raising the quality of teachers by helping existing teachers learn how to improve their teaching while Ravitch refers to the same process as firing lowly-ranked teachers. It is appropriate to be suspicious of people who come in wishing to change things, but she may have a tendency to overreact. Gates is aware of this attitude.
"A key point of contention about an evaluation system is how much it will identify teachers who are not good and do not improve. A better system would certainly identify the small minority who do not belong in teaching, but its key benefit is that it will help most teachers improve."The author repeats over and over that ranking teachers on the basis of test scores is one of the greatest evils to ever befall our nation. She has this to say with regard to Gates’ initiatives.
"Given the foundation’s significant investment in advocacy, it was improbable that anyone would challenge bill Gates and tell him his new goals were likely to be as ill advised as the $2 billion he had poured into restructuring of our nation’s high schools….Who would caution him of the dangers of judging teacher effectiveness solely by the ups and downs of scores on standardized tests of basic skills? "The author invariably states that teachers will be ranked "solely" on the basis of test scores. She does appear to allow that test scores have a role to play in evaluation.
"A good accountability system must include professional judgment, not simply a test score, and other measures of students’ achievement, such as grades, teachers’ evaluations, student work, attendance, and graduation rates. It should also report what the school and district are providing in terms of resources, class sizes, space, well-educated teachers, and a well-rounded curriculum."Here is a quote from Gates on accountability systems.
"A new system requires more than just taking the test scores of the students and seeing how they improve after a year with a teacher. It involves things like feedback from students, parents and peer teachers and an investment of time in reviewing actual teaching. Tools like video can be used so that a teacher can send peers a video showing him trying to do something hard, like keeping a class focused, and ask for advice. Instead of people coming into the classroom, which is quite invasive, a webcam can be used to gather samples for evaluation."Does it really look like Ravitch and Gates are headed in different directions? My guess is that Gates would be in total agreement with Ravitch’s description of an ideal accountability system.

The author recognizes the fact that our educational system is not doing the job that is required. Many people have struggled with figuring out how to fix the problem. The author seems to believe, arguably, that all attempts have failed. Yet, she has no solution of her own. She seems to think that if only we would move to a situation where funding was plentiful, and excellent teachers were attracted by good salaries and great working conditions, and the necessary number of classes to cover the broad curriculum she favors were available to properly motivated students, all would be well again. She can sit around and wait for that to happen if she wishes, but I, for one, appreciate people like Bill Gates devoting not only his money, but his life to the service of humanity. And if he and the Obama administration want to seed some education experiments in hopes that better and more successful practices will emerge and propagate through the system, then I chose to applaud them—not mock them.

Friday, August 6, 2010

Sullenberger Lectures Hospital Administrators on Safety

The American Hospital Association apparently invited Captain Sullenberger to give them a talk in July on how lessons learned in enhancing aircraft safety could be used to improve the quality of hospital care. He gave them an earful. It must have been an impressive performance. Here are some quotes attributed to him in an article posted by Healthleaders Media.
 
"Thirty plus years ago, before CRM (cockpit resource management), captains could be alternately Gods or cowboys, ruling their cockpits by preference or whim with insufficient consideration of best practices or procedural standardization…And first officers trying to do the right thing would never quite know what to expect. Some captains did not bother with check lists (and it was unclear who was responsible for what)."

"We worked to build a culture of safety that allows us to face an unanticipated dire emergency, suddenly, one for which we had never specifically trained, and saved every life on board…"
He nails them good with this passage comparing the horrendous consequences of the infrequent aircraft disaster with the unnoticed daily disasters taking place in hospitals.
"But medical mishaps, on the other hand, happen one by one. But as everyone in this room knows, all too well, the mortality in America’s hospitals from accidents and hospital acquired infections is nearly 200,000 people per year in the U.S., or 548 lives a day, the equivalent of two large passenger jets crashing daily with no survivors….(if that happened in aviation) the airline industry would come to a screeching halt; airplanes would be grounded and airports shut down. There would be Congressional inquiries and companies would go out of business."Then he points out that most medical errors are the result of system failures. Just as in the aviation industry, safety required the development of a culture where all participants were viewed as members of a team. A comparison is implied between the cowboy pilots of yesteryear and the doctors of today who choose not to bother with checklists, then he goes on to decry the current medical situation where it is assumed that when something goes wrong it is the result of an individual’s error.
"Conventional wisdom often has it that if a nurse makes a mistake, he or she should be terminated, but the vast majority of harmful events are due to system failures not practitioner error. The (health care) leaders are responsible for the maintenance of these support systems, not the caregivers. And the current punitive culture only drives problems underground where they can never be examined or solved."

"Federal legislation is about to link health care payments to the quality of service. I believe in ten years, when this is integrated throughout the system, we’ll look back at where we are today and will know that we were flying blind."
It was said the Sullenberger was accorded a standing ovation at the end of his presentation. He deserved one! Hopefully these hospital administrators will take to heart what he told them.

Tuesday, August 3, 2010

Another Perspective on Peace Talks: Is the Onus Now on the Palestinians?

We are used to considering the Israeli –Palestinian conflict in various big picture scenarios such as: this conflict destabilizes the entire middle east, precludes any unified action by nations in the area, and it continues to breed generations of terrorists outraged at the treatment of Arabs. Efraim Karsh, a professor at Kings College London brings a different perspective in his article The Palestinians, Alone.
"What then are we to make of a recent survey for the Al Arabiya television network finding that a staggering 71 percent of the Arabic respondents have no interest in the Palestinian-Israeli peace talks?"

"While the ‘Palestine question’ has long been central to inter-Arab politics, Arab states have shown far less concern for the well-being of the Palestinians than for their own interests....it was common knowledge that the May 1948 pan-Arab invasion of the nascent state of Israel was more a scramble for Palestinian territory than a fight for Palestinian national rights."
Karsh describes how Jordan, Egypt, Syria and Lebanon had intended to divide up Palestine between them if the Israelis had been defeated. He then sets up his final point by listing a number of instances where an Arab state’s self-interest caused them to act, often brutally, counter to the interests of the Palestinians. Consider this example.
"Shortly after the Persian Gulf War, Kuwaitis then set about punishing the P.L.O. for its support of Hussein—cutting off financial sponsorship, expelling hundreds of thousands of Palestinian workers and slaughtering thousands. Their retribution was so severe that Arafat was forced to acknowledge that ‘what Kuwait did to the Palestinian people is worse than what has been done by Israel to Palestinians in the occupied territories’."Finally Karsh comes to his conclusion.
"Against this backdrop, it is a positive sign that so many Arabs have apparently grown so apathetic about the Palestinian-Israeli conflict. For if the Arab regimes’ self-serving interventionism has denied Palestinians the right to determine their own fate, then the best, indeed only, hope of peace between Arabs and Israelis lies in rejecting the spurious link between this particular issue and other regional and global problems."

"The sooner the Palestinians recognize that their cause is theirs alone, the sooner they are likely to make peace with the existence of the state of Israel and to understand the need for a negotiated settlement."
Most of the press coverage has dealt with the actions and attitudes of the Israelis. Of late Netanyahu has been going around saying he is ready for direct talks right now, let’s get to it. What that enthusiasm actually translates to is arguable, but it is certainly better than having him refuse to participate. There was an article in the Washington Post describing pressure that Obama is putting on Abbas to agree to begin these direct negotiations. The partial contents of a letter from Obama to Abbas were provided anonymously by a PLO official. Obama was quoted as asking:
"[Abbas] to go to direct negotiations and [writing] that he can’t help the Palestinians unless they go to direct negotiations....he expects [Abbas] to agree to this demand, and that not accepting it would affect the relations between the Palestinians and the Americans."That seems quite clear. If there are no direct negotiations there can be no progress and it will all be the Palestinians fault. If Abbas agrees he will face the wrath of many of his people. If he refuses to participate he risks losing his greatest ally, the growing world-wide sympathy for his cause. The Arab foreign ministers have endorsed the notion of direct talks, but left the issue of timing up to Abbas. That appears to contribute additional pressure on Abbas to accede to Obama’s request.

It would appear that Obama thinks there is a path forward that he, at least, thinks is reasonable. We shall see.
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