Joseph Cramer, M.D.: Improving our schools by reforming our health care
Editor's note: First in a two-part series on education and health care.
Recently, I had the privilege to sit at a round table of experts on K-12 education in the state of Utah. There were educators from teachers to principals to academics and parents to PTA members. There were advocates for children, refugees and the under-served populations.
Deseret News sponsored the event with dozens of good, smart people. I suspect they needed a token individual who was neither smart nor good — my qualification is I have done thousands of school physicals. My place at the table, and more importantly in the food line, may have also been because I had been the Medical Director for Utah Medicaid.
Some of the items stressed were the overwhelming number of students with various needs, anticipated growth and having the lowest dollar per student in the nation. While Utah has done much with little, there was this ever-present tension that if we want to educate our children, we will have to make some major changes and commitments.
Many agreed that we have to shift from the lofty chatter of "children are our future" and how we treasure our little ones, to some cold, hard facts about money.
There was a touching story about a school teacher standing in line to purchase school supplies with her own money. The person behind her asked about all the educational necessities, and the teacher answered they were for her class this school year. The fellow shopper stepped forward and insisted on paying for the goods.
It is a model of someone increasing their own personal taxes on behalf of children and the teachers who sacrifice for their students. This is an example of the one serving the many. Perhaps it has a political note to anyone who is reading — we are more ready as a population to give to the future than our elected officials might think. It is the people leading the way.
As an outsider to the closer circle of educators, I had the sad duty to remind everyone that unless we can control the growing costs of health care in this state and nation, there will be even less money for education. Medicaid is in direct competition for state taxes with education.
People in medicine have failed to stop the rise of health care costs that exceed the rate of inflation. There are understandable reasons for this: We are growing older as a population, technology is expanding with the benefit of new options — but with a large price tag, and lastly, we have administrative and for-profit costs that exceed international norms. We do not control ourselves.
Therefore, maybe the people in education could help come to the rescue so we have a win-win-win. Education wins, Medicaid wins and we all win.
Why not combine education and health care reform together? Both have endpoints to improve the health and well-being of all. With improved education we have a better-prepared workforce, lives enriched by the fruits of civilization and we have a better-informed public to bolster a lagging democracy.
With better health care, we have a healthier, more productive workforce. Lives are enriched and prolonged with the advances of science and technology, and we can save our struggling economy from medical bankruptcy.
One possible combined initiative could be to promote more school-based clinics. One of the speakers said when a child enrolls into his charter school, the whole family is matriculated. The entire family could also receive necessary health care at the school.
Schools are the smallest geopolitical areas to which we have any affinity. We don’t emotionally bond with our census tract or have any particular loyalty to our voting precincts. Therefore, to create a new healthy community we should define it by schools.
To afford health care, we need to reform how and where it is delivered. This time, ask the teachers.
Joseph Cramer, M.D., is a fellow of the American Academy of Pediatrics, practicing pediatrician for 30 years, and an adjunct professor of pediatrics at the University of Utah. Email: firstname.lastname@example.org
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