One “bitch” that I have repeatedly expressed about the state
of our health care system is the practice which started with the HMOs of the Insurance carriers and which has now
been adopted by the Feds in Medicaid and Mediccare to rate doctors as good or
bad. There are in between levels, but if you are not “good” you must be “bad”.
The ratings are determined by a
set of standards that only an egghead would find infallible. Among the factors
by which Doctors are rated are: by (1) the number of tests ordered, (2) the
number of hospital admissions (3) and readmissions within a month of discharge,
(4) the patients evaluation of the doctor, (5) the doctors following certain
specified routines, (6) mortality rate,
(7) use of EHRs, and more such as sending prescriptions to the pharmacy
by fax or internet.
On paper that may help find a
perfect practice; but (1&2, 3,&6) no account is taken about the nature
of the doctor’s practice. It may be one of elderly patients that have more frequent
health crisis requiring Hospitalization, (2&3) the old, the ones with other
medical problems or too poor to afford medications, those that purely subjective
never follow instructions, and a basic high risk patient base. (4) The Patient’s
evaluation of a doctor is strictly subjective and often is due to some
unrelated incident not the outcome of treatment. (7) EHRs are only as good as
the reliability of the doctor or assistant to check all the boxes; it doesn’t
assure that the question was asked.
However that is not the object of
this blog. Rather the newest goal of the theorists (not realists) in Washington
to improve the outcome of higher education by establishing criteria to rate
colleges and universities. According to the Times which I quote:
“TheThe rating system, which the
president called for in a speech last year and is under development, would
compare schools on factors like how many of their students graduate, how much
debt their students accumulate and how much money their students earn after
graduating. Ultimately, Mr. Obama wants Congress to agree to use the ratings to
allocate the billions in federal student loans and grants. Schools that earn a
high rating on the government’s list would be able to offer more student aid
than schools at the bottom.”
Many college presidents said a rating
system like the one being considered at the White House would elevate financial
concerns above academic ones and would punish schools with liberal arts
programs and large numbers of students who major in programs like theater arts,
social work or education, disciplines that do not typically lead to lucrative
jobs.
They also predicted that institutions
that serve minority and low-income students, many of whom come from underfunded
schools and have had less college preparation, would rank lowest in a new
rating system, hurting the very populations the president says he wants to
help.
**the
college presidents said no school can mandate that graduates supply the
statistics”
No differentiation is made that students have different
occupation goals in mind; not all are going to be executives, lawyers, doctors engineers, politicians or other high reward
occupations; many will be interested in the humanities, musical or visual arts,
teaching etc. which always are lower income
professions.
Are schools that focus on those latter subjects going to be
rated poorer than those that have connections to place graduates in the best
jobs? Should schools be penalized for admitting only superior students? Or due those social planners what one m old
for all under a ridiculous government mold?
Once again we are being forced in to a bigger socialist
state under government rule. There is a great danger here in that our government is trying to force us all to be faceless automatons under the false theory that Big Brother knows what is best for you.
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