Matthew S. Holland: The collision between education and Medicaid

By Matthew S. Holland

Published: Sunday, Feb. 27 2011 12:01 a.m. MST

Editor's note: Dr. Matthew S. Holland is president of Utah Valley University and a member of the Deseret News Editorial Advisory Board.

Just a few days ago, a devastated president of University of Nevada Las Vegas, who has had his budget cut by 50 million dollars in last four years, announced that his school appears to be facing its worst cuts yet: another 50 million over the next year and a half.

Faculty openly wept as he explained that UNLV will have to become a much, much "smaller and more expensive" institution. In an era of global competition and technological transformation — when a college education is more critical than ever for raw economic survival — fewer kids in Nevada will enjoy a great education.

While higher education in Utah has not been spared significant, mission-jeopardizing cuts the last few years, we have not faced anything like our immediate neighbor to the west or many other states around the country.

Our legislators and executive officers have toiled to promote a robust and diversified economy and maintain a fiscal responsibility rare among the states and utterly non-existent at the federal level. As a result, when the rainy days finally came, we have been able to weather them without the truly devastating measures pursued by other states. For this, educators across Utah should applaud the overall efforts our political leaders.

With that said, and even with the pleasing revenue reports that came in this last week betokening a possible end to the education budget ax, education still faces a very precarious situation.

Utah is growing rapidly. So are the demands of citizenship and the workplace as the world around us becomes more technologically complex and globally interconnected. Simply avoiding further cuts to education will be a profoundly insufficient strategy to provide current and future generations with what they need to navigate the world around them. While we must not abandon our sound and distinctive commitment to fiscal responsibility, we must find a way to make more positive investments in education as we move forward.

One of the biggest obstacles to our ability to do that, now and in the years ahead, comes from the culture of entitlements that grips our political system. Chief among those entitlements that threaten education is health care spending. In the last decade, Medicaid spending in this state has basically doubled — now a roughly 400 million dollar state expense each year. Unless some changes are made to the system, this obligation is expected to balloon to 800 million dollars a year by 2020.

A highly reputed Georgetown University study has recently shown that by that same year Utah will need 66% of its adults to have some form of college or university training in order to remain economically competitive. Currently, only 39 percent of our adults have a higher education certificate or degree.

Education and health care are on a collision course. If Medicaid costs continue as projected, we will not have anything close to the resources needed to sustain an adequate network of accessible and quality institutions of higher learning in this state.

The threat here, however, is not just an economic one.

In perhaps the best book ever written about American democracy, Alexis de Toqueville warned that if this nation was ever to succumb to despotism, it would not be the familiar variety of a ruthless dictator. Rather, he warned of a steadily creeping "soft despotism" where a large, sprawling and seemingly "gentle" system of bureaucrats comes into existence to provide, in great detail, for every physical and social need, thus relieving the individual citizen of needing to think for themselves at all.

As Toqueville puts it, such a system "gladly works for (its citizens') happiness but wants to be the sole agent and judge of it. It provides for their security, foresees and supplies their necessitates, facilitates their pleasures, manages their principle concerns, (and) directs their industry. . . . Why should it not entirely relieve them from the trouble of thinking and all the cares of living."

We are shrinking investments in education — the single best public program we have for raising generations who can think and act for themselves. At the same time we are exploding investments in Medicaid — an increasingly byzantine web of bureaucratic controls to care for every aspect of our physical heath.

It all sounds, alarming, like Tocqueville's nightmare coming true. Yes, I hope that that in the coming weeks the legislature will consider spending every available dollar it has to avoid any further cuts to education. Perhaps more importantly, though, I hope they will prepare themselves for future investments in education. An excellent place to begin will be to do whatever can be done on the state level to reform Medicaid.

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