Misplaced Incentives Drive Health Care Cost

Posted by & filed under CGR Staff, Rochester Business Journal.

If you read this column regularly, you’ve heard about my mother’s bad back. The pain can be debilitating. She worries that she’ll be confined to a wheelchair if it gets worse and lose her independence. Mom gets along quite nicely on her own for the moment, however. I was pleased to see that she was still eager to play Scrabble when we visited at Christmas. She lost—but only by two points to my son, a grad student in Physics. I didn’t play, figuring I’d avoid the indignity of being whipped by one or the other.

She’s rejected spine surgery before, but revisited the issue with a different surgeon. She emailed his conclusion that “because I am in such good physical condition at the age of 85, I will probably live until I am 100 – so don’t spend your inheritance yet! Surgery would involve two rods, 14 screws, and a steel plate. I would have about four days of pain and then feel better the rest of my life.” Read more »

Doing the Retirement Math

Posted by & filed under CGR Staff, Rochester Business Journal.

Kent GardnerI was transfixed by the recent riots in France over raising the retirement age from 60 to 62. All the more striking was the participation of high school students in the riots. That, more than anything else, convinced me that France was in trouble.

My suspicions about the French were confirmed after I consulted the OECD PISA scores (that’s the Program for International Student Assessment from the Organization for Economic Cooperation and Development). In the percentage of students performing at an advanced level in mathematics, France ranked 20th, barely ahead of Estonia and way behind educational powerhouses like, oh, the Czech Republic and Liechtenstein. Clearly, these poor young people can’t do the simple math of retirement. If their parents and grandparents are going to continue to retire at the cushy age of 60, the younger generation’s taxes are going to go through the roof.

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Good Choice, NYS Regents

Posted by & filed under CGR Staff, Rochester Business Journal.

Hail, Regents! The most important task of the NYS Board of Regents is the selection of the NYS Education Commissioner. It is hard to imagine that they could have done better than David Steiner (see GothamSchools.org profile) .

Keynote at CGR’s teacher preparation symposium last week, Commissioner Steiner just kept talking sense all morning. From his formal address to each question response, he was ever gracious but direct, balanced and uncompromising.

Picking Steiner was certainly controversial. While a professor at Boston University in 2003, he authored a study of 16 teacher education programs across the nation that criticized them as ideologically driven and lacking rigor, a finding that hardly endeared him to the education elite. A pragmatist, one of the facts that he found disturbing was the lack of emphasis on skill development, noting that only 3 of the schools used video or audio tape to train teachers. As Dean of Hunter College’s School of Education, he put these lessons to work in Hunter’s program. He also teamed up with three successful charter school operators, Teach for America and the NYC Department of Education to form Teacher U, a new approach to teacher training emphasizing teaching as a craft, not an academic discipline. Steiner reinforced that view last week, noting that schools of education are organized more like liberal arts programs than as professional schools. With his charter school partners, Steiner emphasizes that teaching is a skill that can be taught and must be practiced.

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The Medicare ATM

Posted by & filed under CGR Staff, Rochester Business Journal.

I’ve written before about my mother’s back pain. Despite many different attempts by a pain specialist, she’s experienced no relief. Despite more daily meds, her quality of life has taken a turn for the worse. Last month she made a pilgrimage to a respected neurosurgeon at Loyola University Medical Center in Chicago. Pointing to her MRI, he sadly told her that her problem was very serious and that major spinal fusion surgery might help—but that the procedure is ill advised for an 85 year old patient.

Depressed about the pain and the prospect of being confined to a wheelchair, she’s willing to try anything. A presentation at her retirement community offered bioelectric therapy—“in the comfort of your own home at no cost to you—we will bill Medicare and your insurance. Any copayments are our responsibility.” She signed up and was scheduled for an appointment within a week. The good doctor and his friendly team rolled up to her townhouse, set up a table in her living room and proceeded to inject her back with—well, she’s not sure, he’s the doc—and ran an electric device over her spine. They scheduled her for twice-weekly treatments. A few days later the same group sent another doctor with a portable ultrasound and conducted a complete physical exam (he declared her healthy).

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Smart Regulation Cuts Airport Congestion

Posted by & filed under CGR Staff, Rochester Business Journal.

Kent Gardner

Score a hit and a miss for federal regulators.

Nearly three years ago I wrote a piece for the now-defunct New York Sun complaining about delays from New York’s Kennedy International Airport (JFK). In August 2007, nearly a third of scheduled departures were late. The average delay was an hour and many planes waited far longer. But why would a plane leave the gate only to get in a big line? As it happens, at most major U.S. airports the FAA grants permission to take off on a “first come, first served” basis—and “first come” is defined by pushing off from the gate, even if this means queuing up behind 40 or 50 other planes, burning fuel to keep the plane’s cabin temperature tolerable and roll the plane forward a few feet every couple of minutes. Thus the FAA rule guarantees a level of tarmac congestion that can spiral out of control when other factors—like weather—intervene.

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What’s the Role for Charter Schools?

Posted by & filed under CGR Staff, Rochester Business Journal.

Kent GardnerWhen Eva Moskowitz chaired the Education Committee of the New York City Council, she demanded to know why Mayor Michael Bloomberg and NYC Schools Chancellor Joel Klein didn’t do a better job improving public education. Rochester Schools Superintendent Jean-Claude Brizard, then a regional superintendent in the NYC schools, remembers his own time on the Moskowitz hot seat. A New York Magazine profile describes her as having “grilled and filleted” administrators in a series of 100 hearings in 2002.

Bloomberg called her bluff. “If you think we’re doing such a bad job, why don’t you give it a try?” So in 2006 Moskowitz founded the Success Charter Network with the first Harlem Success Academy.  The network now runs four schools in Harlem with another three approved for the fall. Moskowitz plans to increase the network to forty schools.

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Local Development Corporations: Honest Graft?

Posted by & filed under CGR Staff, Rochester Business Journal.

Kent GardnerA story surfaced last week (in a rival publication) that brought local development corporations (LDCs) back into public view. CGR studied LDCs in 2008, and we were never able to find a “smoking gun” suggesting that an LDC had been used for evil deeds.

But we still wonder. As we recounted in our report (see http://goo.gl/IOKu), there is nothing inherently wrong with LDCs and they can be used for good. But they are expressly designed to circumnavigate the cumbersome rules we’ve established for public bodies, e.g. open meeting requirements, public bidding, etc. The simple fact that we were never able to compile a list of active LDCs should be enough to light a warning beacon.

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Making a Difference: Measuring Outcomes in the Human Services

Posted by & filed under CGR Staff, Rochester Business Journal.

Kent GardnerI’ve a dear friend who has been in poor health for many years. What, exactly, is wrong is unclear. Over the decades, diagnoses have come and gone, as have various treatments—and the value of some seems far-fetched. When a new treatment is particularly odd and I raise an eyebrow, she invariably informs me that the research supporting the intervention is quite sound. She’s a bright woman and is well educated—in fact, she’s a registered nurse. Yet I suspect that if I reviewed the “research,” I would find that the study linking, say, concentrated pomegranate tea to the cure of psoriasis relied on only five subjects, or was performed in a research laboratory no one has heard of before or since, or was conducted by the PGA (Pomegranate Growers Association—quit thinking about golf and read my column), or that the finding is based on 54 of 100 psoriasis sufferers having been cured (hardly persuasive), or that the result came from a massive statistical study correlating 250 conditions and 1,235 environmental/lifestyle factors (some of which will appear to be associated just by chance).

Or consider coffee. Ubiquitous in lists of lifestyle factors, it seems that coffee is found to be alternately bad for you, neutral, or good for you in each successive year. (The latest news being good, I choose to regard the matter as settled.)

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Mayoral Control: The conversation continues

Posted by & filed under CGR Staff, Rochester Business Journal.

Kent GardnerSchool Board President Malik Evans and CGR are portrayed as being on different sides of this “mayoral control” discussion. Yet we agree that community opinion matters. The response of CGR was to conduct a poll with our partner, Metrix Matrix. At a forum televised by WXXI last Thursday, Mr. Evans suggested a referendum. But it amounts to the same thing—what the community thinks about this issue is important.

We’ve had two helpful forums on the topic. After the City Administration postponed several planned public meetings, the Rochester Business Journal’s forum was the first. School Board Commissioner Van White and Rochester Teachers Association President Adam Urbanski spoke against the proposal. In addition to remarks from Mayor Duffy, panelists Margaret Raymond from Stanford, Kenneth Wong from Brown, and Dennis Walcott, NYC’s Deputy Mayor for Education, spoke in support.

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Mayoral Control Survey Informs the Community and Empowers Decisionmakers

Posted by & filed under CGR Staff, Democrat & Chronicles.

Kent GardnerReaction to CGR’s survey on mayoral control, conducted with partner Metrix Matrix Inc (MMI), has reinforced what the survey revealed: Our community cares deeply about this issue and the education of our city’s children. The only prior test of community sentiment was a relatively small telephone survey of parents. Yet parents-to-be, grandparents, resident property owners, renters, and resident business owners all have a stake in the effectiveness of the schools. And all can vote in Board of Education and mayoral elections.

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