June 2008 Archives

The Wall Street Journal recently reported on a meeting of the world's top eight economists (five Nobel laureates) at the Copenhagen Consensus Center in Denmark.  The economists recommended, in priority order, the way to acheive the most good with finite resources, in this case $75 billion worldwide over four years. 

Their recommendations are enlightening and available here:

1. Micronutrient supplements for children (vitamin A and zinc) - Malnutrition - $60 million
2. The Doha development agenda - Trade - $0
3. Micronutrient fortification (iron and salt iodization) - Malnutrition - $286 million
4. Expanded immunization coverage for children - Diseases - $1 billion
5. Biofortification - Malnutrition - $60 million
6. Deworming and other nutrition programs at school - Malnutrition and Eduction - $27 million
7. Lowering the price of schooling - Education - $5.4 billion
8. Increase and improve girls' schooling - Education - $6 billion
9. Community based nutrition promotion - Nutrition - $798 million
10. Provide support for women's reproductive role - Women - $4 billion
11. Heart attack acute management - Disease - $200 million
12. Malaria prevention and treatment - Disease - $500 million
13. Tuberculosis case finding and treatment - Disease - $419 million

Total $18.75 billion a year

To quote the WSJ: "...providing vitamin A and zinc would help some 112 million children in sub-Saharan Africa and South Asia for merely $60 million a year. The minerals would help prevent blindness and stunted growth - increasing lifetime productivity by an estimated $1 billion. "

To put this in context, the world's top economists recommend the best way to improve health is to spend $60 million worldwide on vitamin supplements for 112 million kids.  Interesting, $60 million is about what Governor Baldacci wants to Maine taxpayers to spend on Dirigo Health in fiscal year 2009.

Where are our State's priorities?  What logic drives such foolish decisions?

After the first year of Massachusetts' RomneyCare health reform, the public is seeing the effectiveness of the plan that has an individual and employer mandate combined with a Medicaid expansion and new subsidized private health insurance plans, reports Boston.com. The results are interesting and point to the challenge facing anyone who wants to use government to require universal health care, even in a relatively high-income, low-uninsured state like Massachusetts. Key findings include:

• Overall uninsured rate dropped from 13% to 7%
• 355,000 newly insured
• 92,000 did not sign up for health insurance and face a $219 tax penalty that rises to over $900 in 2008
• 60,000 were exempt from the health insurance mandate for their low incomes
• The plan cost Bay State taxpayers $869 million this year, $150 million or 21% over the original budget

Massachusetts is suffering from Maine Dirigo Health's high cost overruns, but at least some of the uninsured are being covered.

Again, this is a preview of how expensive and difficult the easily-promised universal coverage really is.

The Bangor Daily News recently reported on a State of Maine program that lets patients mail in unused medication safely, rather than flushing the pills and potentially polluting the water supply.  The interesting thing is that only 35 envelopes have been mailed in, despite the availability of 1,800 postage-paid envelopes at 11 Maine pharmacies.  The State just received $150,000 EPA grant to expand to 7,200 envelopes at pharmacies statewide.  Now only if consumers would use them...

A Transparent, Open Government is a growing priority in the quest to preserve American individual liberties and economic freedom.  The ability to review the influences, interests, income sources and relationships of lawmakers is a way to confirm and re-confirm the trust the public has in our elected officials.  
 
In an ideal world, updated Transparency methods will not reveal anything new.  Just like cleaning your own front window with Windex, you hope to see no surprises in your yard.  Same trees, same sidewalk, same street, same neighbors. . .  nothing you didn't expect.
 
In the same way, as more information is available, Transparency should reveal nothing significantly new.  Hopefully, when we spray on this Windex, we will see no conflicts of interest involving relationships, supporters, personal income, campaign contributions or other reasons why representatives' decisions are not 100% based on what is best for their constituents.
 
It is particularly important in an Election Year that a focus on Transparency will help clarify that elected officials in Washington, Augusta and our hometowns are unburdened with obligations, favors owed and personal financial interests when they make decisions for the people who elected them.

An odd and somewhat confusing editorial from our friends at the Portland Press Herald today. The piece is focused around the issue of exclusive tuitioning contracts. Towns without their own high schools, for instance, are required to ensure that their high schoolers get a high school education somewhere. Such towns often allow students a choice of high school to attend, but others enter into "exclusive" contracts with a single school, agreeing to send their students to that school only.

As the editorial points out, the "sending" town benefits from doing this, in that they often negotiate a lower tuition rate in exchange for the contract. There are benefits for the "receiving" school as well, because they have a predictable number of students enrolling and can plan accordingly. The only mention of any benefit to the actual student is that the sending towns can "dovetail" their curriculum with that of the high school.

The success that school choice programs have had both here in Maine and elsewhere would seem to suggest that having a coordinated curriculum is not nearly as important as the level of accountability that comes from allowing families to choose the school their children attend. Is Bangor High School a good school because of a coordinated curriculum, or because John Bapst High School is across town in direct competition with them? Will Morse High School In Bath get better because students in the former Union 47(except for those in Georgetown) are now forced to go there as part of RSU 1? We'll see.

The paper's editorial seems to want to separate the choice issue from the contract issue, but they are intertwined because, as I pointed out in our recent report on choice, the presence of a contract has become one of the factors that will determine whether a town gets to keep school choice after it has joined an RSU. The Department of Education is saying that the presence of an "exclusive contract" means a town is NOT a choice community. You therefore cannot discuss choice in the current context without talking about contracts.

Of more interest to me is what appears to be something of an endorsement for school choice within the paper's editorial. It reads:

If one were to develop a school choice model with improved education as the goal, it likely would look quite different from the model employed by Maine's smaller communities. It would and should be available to all Maine students. It would have to be designed to work to the benefit of every student, not just those who could afford to commute to school or pay the balance on private school tuition.

Hmmm...."Should be available to all Maine students?" Sounds like the PPH might have some interest in the notion. I hope school choice advocates are paying attention...