Genealogy & Local History in Buffalo, NY

If HMOs Ran Our Education System

By Cynthia Van Ness, © 2008
Originally published in Artvoice, v. 7, no. 11, March 13-19, 2008, p. 5

As the folk song goes, last night I had the strangest dream.  I dreamt I visited a proud, capitalist nation who had roundly rejected "socialized education."  It was an article of faith in this nation that the market could and should efficiently supply education at a profit.  Those who questioned this premise were denounced as traitors to their nation's ideals.  Here's how it worked.

Employers were responsible for providing families with education insurance, which would be administered by a handful of highly profitable, privately owned Education Maintenance Organizations.  Unfortunately, EMO insurance was so costly that many employers had to provide skimpy insurance or none at all.  Legislators, of course, had very good educational insurance and their children got art and music classes, field trips, and individual tutors.

In this proud nation, 40 million adults and children had no education insurance.  Some tried to teach themselves to read and write and add and subtract but generally failed standardized tests.   Part-time and minimum-wage employees rarely qualified for education insurance.  Workers who lost their jobs eventually lost their education insurance and had to pull their kids out of school.

Lucky workers got to pick from a few private insurance packages.  Often they didn't know what was actually covered until their kids went to school.  Some plans covered algebra but not calculus.  Some covered band but not chorus.  Some covered spelling bees but not team sports.  Some covered grades K-8 but not 9-12.   Some covered military schools but not Montessori.  Textbooks came with deductibles ranging from $10 to $100.  LeShawn's plan gave him 150 school days a year but Lisa's plan funded only 100.  Computers had widely varying levels of co-pays.  Lisa's keyboard use cost $5 an hour but LeShawn's use cost $50 an hour.  If Lisa needed classes that weren't covered by her plan, the bills might eat up half of her household income.

Principals checked insurance cards at the door and uninsured students were sent home.  Every time LeShawn enrolled in a class, a billing clerk would submit claims to his family's EMO and reviewers would decide if he had a genuine educational need for Earth science or sixth grade math.  Kids with evidence of pre-existing ignorance routinely had their policies canceled.  Reprints and copyright-expired books were usually covered by the EMO textbook formulary; new books and software were considered experimental and were not covered.  Teachers earned more by working as EMO reviewers and denying education than by working for schools and supplying it.

For less fortunate families, neighborhood fundraisers to send bright but uninsured kids for remedial education were common.  Some poor families qualified for Educare, but they had to sell their houses and cars and usually got rejected several times before they were accepted into the program.  Waiting rooms for Educare-funded clinics were crowded and ill-maintained and kids might sit for 10 hours before seeing a teacher.

Meanwhile, corporate EMOs were huge campaign donors, so legislators had every incentive to dismiss all alternatives to their free market educational system.  Oh, they made the occasional gesture, like their complicated Educare Textbook Benefit, but this program was actually designed to protect publisher profits.  Most qualifying families saw their textbook and software expenses eat up more, not less, of their take-home pay. 

Literacy and numeracy levels in this wealthy nation were among the worst in the industrialized world but at least the government could boast that it had protected its citizens from the scourge of socialized education.  I woke up grateful to live in a country foresighted enough to invest in universal free public education for all.  Damn shame about American health care, though.

Updated 18 March 2010