Much of the speculation around Obama's health care reform centers around a single payer government monstrosity resembling either a larger bankrupt Medicare platform or the discredited national health schemes in Canada or the UK. Yet it's just as likely Obama's inspiration is the failed public school model.
The government school monopoly, compulsory with mediocre results, unaffordable and ungovernable with beleaguered local taxpayers hopelessly unable to force accountability from teachers' unions co-dependent with democrat party legislators, is a perfect model for Obama to finance and ration health care for the masses.
Who can argue against the noble objectives of universal healthcare? Horace Mann's education reform exhortations in the late 1830's and 40's were eerily parallel to the pitch for Obama today: full inclusion, mandatory attendance, standardized pedagogy, along with coerced community participation by virtue of local taxes providing funding. It promised to eradicate illiteracy, violence and vice. For decades, the payoff was impressive.
But one hundred years later, Mann's idealism would be corrupted by John Dewey's progressive advocacy of self esteem replacing subject matter mastery. Finally, any hope for high performance pedagogy was thoroughly crushed by President John F. Kennedy's executive order enabling collective bargaining and unionization of public school teachers. It is safe to expect none of Mann's idealism but all of today's public school abominations will shape Obama's health care system.
In a seductive overture to private health plan stalwarts, Obama says the government health care system will not be a mandatory substitute for private health care preferences, only an option. Of course those who remain in a private system will face double jeopardy -- covering their own private medical costs while suffering higher federal taxes to pay for somebody else's -- in the same manner that private school parents, opting out of horrible local public schools for far better independent alternatives, must pay private school tuition while still shouldering ever escalating property and state income taxes to educate those poor wretches who cannot escape the government's incompetence.
Those who cannot afford private health care, whose employers would rather pay higher taxes instead of underwriting actual medical claims, will also be victimized just as parents with no choice have to send their children to lousy government schools. Want to see what demotivated clock watchers -- doctors and nurses alike -I n a government run clinic would look like? Just spend a few hours in a typical public high school faculty lounge. Want to see what government hospital administrators consumed by micro-management of trivialities would look like? Just spend a few hours at a typical Public School Board or School Committee meeting.
And who would thwart the temptations for the government health care bureaucrats to regulate medical care provided by private institutions who accept federal grants for medical research? Check out the hostility towards home schoolers these days from State Boards of Education . And given the enthusiasm shown by Congressman Barney Frank and Treasury Secretary Tim Geithner alike for government control over compensation of executives running government financed private companies, why wouldn't they have an equally big appetite to regulate pay and benefits for doctors wherever they practice? Tenure for marginal practitioners and those twelve step compensation tables embedded in nearly all teachers' contracts wouldn't be far behind.
Well at least one group of health care professionals might vote for the Obama health care public school model -- medical residents. Imagine trading off those legendary 36 hour shifts for three months vacation every summer. But such relief would be short lived as civil service exams, just like state mandated teacher certifications, would soon be more important than Medical Board exams. After all, isn't government run enterprise all about proving mediocrity can be delivered consistently to everybody while pretending to actually know something about anything.
Obama showed his hand in yanking the school vouchers in the DC school system. When private choice threatened to disinfect the stubborn bacteria in DC's public schools, choice was flushed. Expect more of the same under Obama's public school system look-alike for health care.