165,903 Missourians Report No Income but Food Stamps

Posted on by Christine Harbin

Over the weekend, the New York Times published an article about a growing subset of Americans: those whose sole source of income is food stamps.

This population extends into Missouri. According to data collected from food stamp programs, the number of food stamp recipients in Missouri with no other cash income rose from 139,418 in June 2007 to 165,903 in June 2009. This represents an increase of 19 percent.

Single-Sex Classrooms and Single-Age Classrooms

Posted on by Sarah Brodsky

Reading this article about an all-girl charter school, I appreciate the parallel Leonard Sax draws between single-sex schooling and single-age schooling (thanks to the Panama City Renaissance School for the link):

Sax understands that single-gender classrooms may not be for everyone, but he believes people should have a choice. He also questions why schools segregate classrooms based on age but not gender.

It’s assumed that students will attend class with others of the same age because it’s gone on for so long. We’re used to it, and almost nobody protests age segregation in schools. But when a few single-sex charters open, or when districts allow single-sex classes, the idea threatens established educational policy and prompts knee-jerk condemnation. For example, the ACLU says it opposes single-sex public schooling “because it deprives both girls and boys of the benefits of co-education,” a statement that means nothing unless you specify what those benefits are and explain why students have a right to them. One could just as well criticize coed classrooms for depriving students of the benefits of single-sex education.

Sax brings up the analogy in order to argue for single-sex education, but it can also be used to justify teaching students of different ages in class together. Grouping students by sex isn’t for everyone; neither is grouping students by age. Like the parents who would choose coed classrooms even when a single-sex option is available, there are parents who would prefer multi-age classrooms if they had a choice.

It would be great if more public schools offered multi-age education. An easy way to do this is by opening charter schools; parents who want multi-age classes could enroll their children in charters with this specialty. Or traditional public schools could start multi-age tracks, the same way that Parkway’s Carmen Trails Elementary offers elective single-sex classes.

How Did We Get Into This Health Care Mess?

Posted on by Stephen Feman

Many people would like the relationships in health care to follow a straightforward economic pattern. They imagine that the doctor-patient relationship should look like an Intro to Economics price to quantity graph, with physicians as suppliers and patients as demanders. If that were the case, simply adding more doctors could shift the supply curve and create a new equilibrium. They think that would produce a lower price for health care and resolve many of America’s health care concerns. The real world, however, is not quite like that.

The first, and most obvious, problem is that the physician supply has not kept up. That is one of the many reasons why the United States is being inundated with foreign-trained physicians. As another post showed, the number of U.S. physicians is inadequate for our country’s needs now. The most reliable resources indicate that there may be a shortfall of 150,000 by the year 2025. If the economics of health care followed the simple model described above, then the supply curve would shift in the undesired direction. In that case the price of health care would become even greater than the dollar figures mentioned in the current political debate.

But there is more. The demand for health care has increased much more than expected. A look at the Congressional Research Service’s demographic charts shows that there are many more older people in this country. The United States is in the midst of a profound demographic change, and has had an overall aging of its population; this has been characterized by the increased proportion of persons aged 65 and older in our population. In general, as people get older, they use more health care. The result may be a shift of both the supply and demand curves. Using that old economics diagram, the resulting equilibrium will be higher and much more costly.

However, some argue that physicians are more than just the suppliers of health care. Those people feel that physicians may be a part of the problem themselves and some physicians may stimulate overuse of the heath care system. In the recent past, President Barack Obama spoke to the American Medical Association about this issue, and implied that physician behavior may be one of the factors driving up costs. He suggested that some doctors create a demand for services, and their intervention has contributed to the problems of the health care market. The difficulty with that argument is in separating issues that relate to demand from the physician role as the gatekeeper to health care system. Physicians are often the means that patients use to initiate access the health care system. However, the health care demand exists in and of itself; it is an independent factor. All that physicians do is show they care for patients by responding to the existing demand.

If physicians are not the cause of the problem, is physician supply a factor of concern? It is important to be aware that some believe an increase in physician supply does not translate into better care. In fact, as counter-intuitive as it may seem, some recent reports indicate that patients’ satisfaction with care, and patients’ perceptions of access, are no better in high physician supply regions than in low physician supply regions. With that understanding, many argue that more physicians may not result in better care for patients. People who follow that argument believe that what we need is improved efficiency, not more doctors, to produce a more cost-effective result. (See: Skinner et al, “The Elusive Connection Between Health Care Spending and Quality.” Health Affairs 28, w119–w123, 2009.)

Could it be that what we need is both more doctors and more efficiency? In some countries with different health care systems, demographic predictions of this variety have resulted in significant changes in hospital design and physician education. The demographic details for our country present a pretty strong argument showing that there will not be enough physicians for your care when you get older. At the same time, every one could use more efficiency. How will the combined House and Senate bills respond to these issues?

Dave Roland Quoted on Charter Schools

Posted on by Christine Harbin

The Show-Me Institute’s Dave Roland was recently quoted in an article about charter schools in the Springfield News-Leader. He communicates some benefits:

“Part of the reason (traditional public) schools have gotten into the situation they are in — having quality problems — is they effectively have a captive audience. They don’t have to earn students,” said Dave Roland of the Show-Me Institute, a think tank that promotes free-market solutions to public policy.

“Wealthy parents already have the option of moving into the best school districts, or the best zoning within districts,” he said. “The idea of school choice is we make sure low-income parents have the same range of options.”

St. Louis Made the Right Call in Giving Vaccine to Retailers

Posted on by Sarah Brodsky

This Post-Dispatch article about the H1N1 vaccine mentions that St. Louis city sent most of its vaccine supply to hospitals and pharmacies. Some doses have been distributed for free in schools and existing public clinics, but the city didn’t open any new free vaccine clinics like the ones in other cities.

It was a smart move on the city’s part. Offering free vaccines is a recipe for shortages. Charging for the cost of administering the vaccine — as pharmacies do — prevents demand from skyrocketing and depleting the vaccine supply. And allowing people to buy the vaccine at their local retail pharmacies is better than forcing everyone to come to a few central clinics. People are used to going to those retailers for prescriptions or other vaccines, so they don’t have to go out of their way to find a clinic they’ve never been to before.

And, while it’s true that taxpayers paid for the H1N1 vaccine, as the people quoted in the article stated, that doesn’t mean that they should all receive it for free. Administering the vaccine would require the city to hire nurses. Taxpayers shouldn’t be made to incur yet another flu-related expense, especially considering that new H1N1 cases have been declining for weeks.

Innovations for Healthy Kids Game Challenge

Posted on by Sarah Brodsky

The USDA, always eager to tell kids what they should eat, wants to spread its message through a more effective medium than “Know Your Farmer” trading cards. The department is soliciting feedback for a contest to reward creators of online games that teach kids about nutrition.The games must be based on USDA data.

MyPyramid Blast Off Game is the only game I’ve found on the MyPyramid.gov website. It’s cute and colorful, albeit inflexible. Players are supposed to select a day’s menu from a list of foods. The game doesn’t take into account differences in nutritional needs, so every player is scored as an average American. A kid who is lactose intolerant has to choose dairy servings anyway, and a kid with Celiac disease has to add whole grains to the rocket ship’s “diet.” Players see a message that their rocket ship didn’t complete its mission if they go over the recommended calorie limit, even if they go just a few calories past the target with an extra serving of vegetables.

The contest will probably inspire new games that improve on MyPyramid Blast Off. Developers could start from the same premise but add complexity, allowing nutritional targets to vary. There would be no need to solicit personal health information from kids — players could be asked the design menus for hypothetical people. Changing targets would also make the game more fun to play repeatedly. In the current game, once players create menus for themselves, there’s nothing more to do.

I’m less confident that an online game can change a generation’s eating habits. Is it worthwhile for the government to sponsor a nutrition contest that may not have a large effect on public health? As usual, the USDA has lofty aspirations, and I’m left wondering whether we’re all really better off because of its actions.

Hoop House Dreams

Posted on by Sarah Brodsky

A video from the USDA shows the erection of hoop houses — also referred to less imaginatively as “high tunnels” — at the White House Garden. The USDA, through its “Know Your Farmer, Know Your Food” campaign, is launching a pilot study that will subsidize farmers’ hoop house purchases in the interest of increasing the availability of local produce. From the press release:

The 3-year, 38-state study will verify if high tunnels are effective in reducing pesticide use, keeping vital nutrients in the soil, extending the growing season, increasing yields, and providing other benefits to growers.

Missouri is among the states that will participate.

Farmers have sheltered plants in temporary greenhouse structures like these for decades. The practice wouldn’t have continued for so long if it weren’t advantageous, so I’m sure the study will find that hoop houses provide some benefits.

What is less certain is whether the USDA’s high expectations will be borne out. The press release states that the study will look into pushing back the end of the growing season. That seems like a reasonable — even cautious — goal, knowing that farmers already use hoop houses for that purpose. But, in the video, officials blithely assert that you can grow food year-round in a hoop house, in “pretty much any climate.”

Are hoop houses tools that can help some farmers grow crops a little longer? Or are they miracle implements that make plants grow anywhere, anytime? I suspect that if the latter were true, most farmers would buy hoop houses without the inducement of a subsidy. After all, hoop houses sell for anywhere from a few hundred to a few thousand dollars — not a big up-front expense. That would be a small price to pay for the ability to grow crops during several additional months of the year, no matter the weather.

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