Health Care and Education

When thinking about Higher Education, I find thinking about health care as a parallel instructive.

Consumers don’t know always know what’s best for them in health care — studies show that they’ll rate inept doctors who are nice to them and give them what they ask for much better than doctors who actually cure them.

To the extent that health care gives consumers what they want and “acts like a business” prices skyrocket. The cure for high prices is actually anti-market solutions (e.g. single payer medicine) where the government only reimburses evidence-based practice.

So to some extent, I think the people that say “Why can’t you act more like a business?” to Higher Ed players are paddling the wrong direction. It’s acting like a business that *got* us here, via the system of subsidization that killed direct funding to public institutions and put consumers in control.

We have to compete in small class size, though we can’t discern the benefit in many cases, because that’s what consumers are asking for. We have difficulty pitching blended learning to some populations because parents see it as subpar. Take almost anything we do that is questionably expensive, and you’ll find a consumer-facing decision behind it. Consumers want education to look like it did for them as kids, and that’s what they get. They also want the most expensive-looking education their voucher can give them. And so it continues.

So follow the conservatives, and lower the voucher, right? Cut the subsidy and education will become cheaper, right? Not quite. You can lower the voucher amount that parents are walking around with, but that doesn’t change the main problem: that the patients are writing the prescription.

And it doesn’t change the even more dismal problem — we, the professionals, don’t always use evidence-based practice either, so it’s very difficult to ask for the prescription pad back.

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