A Simple Government Part 3

While prevention is always the goal, better management of chronic conditions is also essential. Right now we have a system that happily pays for a diabetic to have his foot amputated for about thirty thousand dollars but won't pay for visits to a nutritionist or podiatrist to keep that foot healthy. That's insane.

Tipping the Scale One-third of American adults are now obese-almost three times as many as in 1960. If we don't drop the Twinkies and pick up the carrot sticks, that number is expected to rise to almost one-half by 2020. Obesity rates are 50 percent higher for African Americans than for whites, and 20 percent higher for Hispanics, which explains why these groups suffer from an epidemic of diabetes.

Obesity-related health-care costs in 1998 were $74 billion. They are now $147 billion.

A Duke University study found that medical costs claimed from on-the-job injuries were seven times higher for obese workers.

In addition to diabetes, obesity has been linked to other chronic and degenerative diseases, like Alzheimer's. A 2010 study from Boston University School of Medicine found a link between stomach fat and a higher risk of Alzheimer's disease. Dr. Susanne Sorensen, who is in charge of research for the Alzheimer's Society, responded, "This is not really surprising as a large stomach is a.s.sociated with high blood pressure, cholesterol and diabetes-all major risk factors for dementia." Is it so much of a sacrifice to go for a jog or eat a salad if it means being able to stay lucid and vital in your old age?

An Inherited Problem Obesity is especially dangerous for pregnant women. About one in five women is obese (which means she has a body ma.s.s index, or BMI, of at least 30) when she becomes pregnant.

These mothers have much higher rates of Cesarean births, with all the risks of surgery. As BMI rises, women become two (BMI of 30-35), three (BMI of 35-40), and even four (BMI over 40) times more likely to have a Cesarean than a woman of normal weight, for whom the Cesarean rate is 11 percent.

The babies of obese mothers have double the risk of being stillborn and three times the risk of dying in their first month. They are 11 percent more likely to be born with a defective heart, and that gap jumps to 33 percent when the mother is one hundred pounds or more over a healthy weight.

These babies are less likely to be carried to term and thus more likely to need intensive (and expensive) neonatal care. A New York Times New York Times story about an obese woman who had a stroke and gave birth to her baby prematurely found that while a normal delivery would have cost about thirteen thousand dollars, the costs for this woman and her child were over two hundred thousand dollars! story about an obese woman who had a stroke and gave birth to her baby prematurely found that while a normal delivery would have cost about thirteen thousand dollars, the costs for this woman and her child were over two hundred thousand dollars!

And this problem doesn't stop with mothers. One of the most publicized interviews I've conducted for my Fox News weekend show was with First Lady Mich.e.l.le Obama. Shortly after a.s.suming the role of First Lady, she announced that she would make childhood obesity one of her major areas of focus. I was thrilled to hear it. I have taken a lot of heat from fellow conservatives who would demonize the Obamas for anything and everything, but that's absurd and as appalling as it was for yahoos like Keith Olbermann to do the same thing to President George W. Bush. We do have a serious crisis with childhood obesity in this country, and if you doubt it, here's an experiment for you. Go through your personal belongings and dig out your cla.s.s photo from the third grade. The following day, pay a visit to a third-grade cla.s.s somewhere in America-doesn't matter what part of the country, doesn't matter if it's a private or a public school. Walk into that cla.s.s and take a look at the kids and compare them to the look of your your third-grade cla.s.s. I promise if you do this, you will never again doubt that there have been dramatic changes in the health of children in this country. third-grade cla.s.s. I promise if you do this, you will never again doubt that there have been dramatic changes in the health of children in this country.

Since 1980, the number of obese children in the United States has tripled, to about 17 percent. We are seeing children as young as seven with type 2 diabetes (which used to be called adult-onset diabetes) and preteens taking medication for high blood pressure along with their grandparents. It is very sad and very scary to think that our children may have a shorter life expectancy than we do and that they will age with much illness and suffering.

A survey by C.S. Mott Children's Hospital in Ann Arbor, Michigan, found that over 40 percent of parents with obese children thought that their children were a healthy weight! We can't solve the problem if we don't recognize it.

There are more obese children in the southeastern part of the country, the so-called stroke belt. In 2010 the Archives of Pediatrics and Adolescent Medicine Archives of Pediatrics and Adolescent Medicine reported that Oregon has the lowest percentage of obese children and Mississippi has the highest. States where children watch more TV and are less physically active have higher obesity rates, just as you would expect. reported that Oregon has the lowest percentage of obese children and Mississippi has the highest. States where children watch more TV and are less physically active have higher obesity rates, just as you would expect.

A 2010 study from the University of Michigan found that obese children are 63 percent more likely to be bullied than thin children. Their obesity wasn't just a threat to their physical health-they also had higher rates of depression and loneliness. Even though childhood obesity has become all too common, it is still not accepted.

A study from Ohio State University in 2010 had three recommendations for reducing childhood obesity: eating dinner as a family, cutting back on TV to no more than two hours a day, and making sure that children get enough sleep.

We also need more playgrounds and walking trails, more unstructured outdoor play, more recess and physical education at school (which many schools have cut back or eliminated since No Child Left Behind), and healthier school meals, with a special emphasis on eliminating high-calorie beverages. Children should exercise for at least an hour a day, at least five days a week.

This is an issue that I've personally invested in. To be clear, I don't want the government to become "sugar sheriffs" and tell us what to eat or tax us for eating what they don't think we should eat. I do believe individuals should arm themselves with the facts and then make rational, adult decisions about their health and future. But the cost of ignoring the epidemic of childhood obesity is a staggering financial burden to taxpayers in the form of increased health-care costs for those on taxpayer-funded programs like Medicaid, as well as a body blow to the human capital that will be lost by a generation whose lives will be cut short by chronic diseases that will plague them until they die a premature death.

It's even having an impact on the military: Revelations made public in April 2010 by a panel of retired military officers showed that three out of four youths between the ages of seventeen and twenty-four were unfit for military service, primarily because of obesity!

It is crucial that we keep our children at a healthy weight, because those who are overweight or obese when they're young tend to remain so. We are setting our children up for a lifelong battle. And it's a battle that we're losing.

Take Care of Yourself Our society suffers from a double whammy when it comes to our health. We have become more sedentary by watching TV and sitting at our computers, activities that have a symbiotic relationship with sugary and salty snacks. It's very difficult to eat a bag of chips when you're swimming or playing basketball.

An old Chinese proverb certainly applies to becoming physically fit: A journey of a thousand miles really does begin-literally and figuratively-with a single step. People say they hate exercise. But think back to when you were a child-what did you enjoy? Bike riding? Skating? Just as people who say they hate vegetables can come up with at least one they like if they think hard enough, everyone can find a physical activity that is not a ch.o.r.e. Start small in both time and energy expended. Take the stairs instead of the elevator; park at the opposite end of the mall from the store you're going to. Ideally, you should exercise for at least thirty minutes a day, at least five days a week.

As for losing weight, don't say, "I have to lose fifty pounds"; say, "I am going to gain my health," and when you do, take the steps to get healthy-good nutrition and realistic exercise. We all know the drill: eat smaller portions; limit high-calorie foods (those that are high in fat and refined sugar); eat more fruits, vegetables, and whole grains. But as I pointed out in my book about my own health journey, most of us need to spend a couple of weeks in "detox" from the fatty and sugary foods that we are literally addicted to.

I think it's a big mistake to set a weight-loss goal. First, to be healthy, we need to change our lifestyles, not just our waistlines. Second, Americans by nature don't want to lose lose but to but to win win. If the goal is to lose lose weight, it goes against our instincts. Set a goal to weight, it goes against our instincts. Set a goal to win win health, and when you take the steps to do it, weight will take care of itself. health, and when you take the steps to do it, weight will take care of itself.

Any amount of weight you get rid of in the process of getting healthy and keep off does you good. Your goal is to be healthier, not to be America's next top model.

A Sensible Approach to Health Care Of course, no matter how well you take care of your body, things happen and you need to go to the doctor. And in order to stay truly healthy, you need to engage in preventive medicine as well. It is essential that we go for regular health screenings, such as mammograms and Pap tests for women, PSA tests for men, and colonoscopies and cholesterol tests for everyone. When detected early, breast, prostate, and colon cancer have survival rates of more than 90 percent. But a test can't save your life if you don't take it. Less than 40 percent of colorectal cancers are caught early, simply because people don't get tested. Aside from saving your life, early detection often leads to treatments that are much less grueling, debilitating, and expensive.

To do all this, we need doctors, and we need hospitals, but we need a sensible approach, and nationalized medicine is not the answer. In devising ObamaCare, the president got his priorities reversed. Rather than emphasize gaining control of spiraling health-care costs, he concentrated on getting more people into the already flawed system. It might have had a chance to work, if he had taken the other way around. Here's how: If costs are brought under control first, then more people would be able to afford health care in the private system. Also, this approach would slow the unsustainable rise we've seen in Medicare and Medicaid. Now, of the thirty million people slated to enter ObamaCare, about twenty million are coming in through an expansion of Medicaid.

Let's look at it another way. What you and I will be paying to subsidize other people's health care under ObamaCare could have instead been covered by cost reductions brought about by a truly free market. Instead, we get higher spending. The country is already well on the road to economic ruin (if you've been paying attention), and Medicare is on the way to rationing. ObamaCare, a huge mistake moving in the wrong direction, is foisted upon us at a critical time when eighty million baby boomers are about to enter Medicare and, in most cases, subsequently face most of their lifetime medical costs.

We should be doing several different things. We must allow health insurance to be sold across state lines-now prohibited-in order for the insured to shop around for the most reasonable policies. We need to implement legal liability reform so that personal injury lawyers can't treat the health-care system as a grab bag. But most of all, we need health insurance that is consumer based, not employer based. It's simple: You can't have a functioning free market when the person paying for the service and the person using the service are not the same. Up to now, when it comes to costs, no one has been minding the store. Because the increased costs are just taken out of wages, employers don't care. Because the employer is handling the payments, workers don't care. In fact, they may think that health care is free, but it's actually about as free as the proverbial free lunch. No such thing under the sun. Instead, it's to health care that their wage increases have gone for the last decade. Wages have not stagnated because employers aren't spending more on health care per employee; they've stagnated because those increases are going directly to the insurers, not into workers' pockets.

Right now, the working consumer-whether under a private or a government plan-pays only twelve cents on the dollar for health care. The other eighty-eight cents come from the employer. If you had to pay only twelve dollars for every $120 in groceries you bought because your boss would pay the difference, you wouldn't be reaching for the Hamburger Helper; you'd be stocking up on lobster and prime rib. Because of the present system, in other words, workers don't really have incentives to compare the relative cost and quality of physicians and hospitals or to refrain from overuse. Not every situation is an emergency. When people don't question whether or not they really need a test or procedure, it's probably because they have too little skin in the game.

Not only is ObamaCare cost prohibitive, it's already been shown to not work! In chapter 2, I mentioned how the federal government ignored the negative results of the health-care "experiment" known as RomneyCare. It could be argued that if RomneyCare were a patient, the prognosis would be dismal. "No one but Mr. Romney disagrees," quipped Joseph Rago, senior editorial writer for the Wall Street Journal Wall Street Journal, in a piece ent.i.tled "The Ma.s.sachusetts Health-Care Train Wreck."

Governor Romney himself wrote a piece in the Wall Street Journal Wall Street Journal shortly after signing the bill, promising that everyone in Ma.s.sachusetts "will soon have affordable health insurance and the cost of health care will be reduced." A n.o.ble goal, indeed, but when the Ma.s.sachusetts Taxpayers Foundation stepped into the lab to examine this experiment-in-progress, they found that health care, which was 16 percent of the state budget in 1990, had jumped to 35 percent in 2010. (That's not a typo; health care is consuming over a third of the entire state budget!) Ma.s.sachusetts spends about twenty thousand dollars to insure a family of four, while an employer-based policy costs about thirteen thousand. shortly after signing the bill, promising that everyone in Ma.s.sachusetts "will soon have affordable health insurance and the cost of health care will be reduced." A n.o.ble goal, indeed, but when the Ma.s.sachusetts Taxpayers Foundation stepped into the lab to examine this experiment-in-progress, they found that health care, which was 16 percent of the state budget in 1990, had jumped to 35 percent in 2010. (That's not a typo; health care is consuming over a third of the entire state budget!) Ma.s.sachusetts spends about twenty thousand dollars to insure a family of four, while an employer-based policy costs about thirteen thousand.

You get one guess as to who now has the highest average health-insurance premiums in the country. Yep, it's Ma.s.sachusetts! We hear so much flak from the administration about "unsustainable" increases nationwide in health-care costs, but according to the Boston Globe Boston Globe, premiums in Ma.s.sachusetts under RomneyCare are rising 21 percent to 46 percent faster than the national average. Rather than costs being reduced, as Romney promised, everyone-government, businesses, and consumers-is paying more.

If everyone in Ma.s.sachusetts is paying more, it must mean patients are receiving better care, right? In fact, just the opposite is happening. By almost three to one, Ma.s.sachusetts's residents believe that the quality of their care has been reduced. The people of Ma.s.sachusetts partic.i.p.ated in an experiment that blew up in their faces, and now they have to stand in line at the burn clinic.

If our goal in health-care reform is better care at lower cost, then we should take a lesson from RomneyCare, which shows that socialized medicine does not work does not work. Period. It astounds me that those on the left, claiming to advocate for those less fortunate, would push for a program that will, no doubt, put everyone in danger.

I recognize it's a tough world out there. It's scary to hear that people have lost their houses because they lacked health insurance or got dropped when they became seriously ill. I don't deny that these can be problems. But it has been less well publicized that some people lose homes indirectly indirectly as a result of rising health-care costs, even when they aren't dealing with a catastrophic illness. These tend to be folks who tried to make up for the stagnation in their wages by refinancing their homes on what they thought was their equity-equity that proved to be illusory and vanished in the downturn. Because what would have been their wage increases got diverted into "employer-paid" health insurance, they relied on the borrowed money to buy cars and take vacations and pay college tuition. If they had stuck with their original mortgages, which had lower balances and payments, they wouldn't have lost their homes. I think we can understand why these choices were made, even if we can agree that they did not turn out to be sensible. as a result of rising health-care costs, even when they aren't dealing with a catastrophic illness. These tend to be folks who tried to make up for the stagnation in their wages by refinancing their homes on what they thought was their equity-equity that proved to be illusory and vanished in the downturn. Because what would have been their wage increases got diverted into "employer-paid" health insurance, they relied on the borrowed money to buy cars and take vacations and pay college tuition. If they had stuck with their original mortgages, which had lower balances and payments, they wouldn't have lost their homes. I think we can understand why these choices were made, even if we can agree that they did not turn out to be sensible.

When Government Plays G.o.d When we conservatives warned that ObamaCare did not bode well for Grandma's life expectancy, we were accused of fearmongering. But nothing is more frightening than the words of President Obama's choice to head Medicare, Donald Berwick: "The decision is not whether or not we will ration care-the decision is whether we will ration with our eyes open." Funny, I never heard this among the administration's talking points when they were rounding up health-care votes in Congress. Dr. Berwick looks to Britain's socialized medicine for his inspiration: "I am romantic about the National Health Service. I love it." Uh-oh.

But we were in trouble even before ObamaCare pa.s.sed. Tucked away in the $787 billion stimulus was the establishment of the Federal Coordinating Council for Comparative Effectiveness, which will become our version of Britain's National Inst.i.tute for Health and Clinical Excellence, the ironically and Orwellian-named NICE. NICE decides who lives and who dies based on age and the cost of treatment. So the stimulus didn't just waste your money; it planted the seeds from which the poisonous tree of death panels will grow.

Dr. Berwick warns: "Limited resources require decisions about who will have access to care and the extent of their coverage." Yet if we were healthier, our resources would be sufficient to care for everyone.

Who will get rationed? Well, the very old and the very young, obviously, the most helpless and vulnerable among us. But it will also be those who don't live politically correct lives-those who have too many cigarettes or c.o.c.ktails or cans of soda. "Death by Chocolate" won't just be a cute name on the dessert menu.

I fully realize that all health care is somewhat rationed, from the triage of the paramedics at the accident scene to the emergency room, where the most critical patients are given priority. But it's one thing for your own doctor to tell you you shouldn't have a procedure and quite another for it to be a government worker. I think I need a trip to the doctor just from thinking about giving the government that much power!

Dr. Berwick's belief system is fundamentally un-American: "The complexity and cost of healthcare delivery systems may set up a tension between what is good for the society as a whole and what is best for an individual patient." That's what happens under socialism. Individuals-your child, your parent, you-don't matter and may have to be sacrificed. By contrast, we have always believed that every life is precious; we have built the freest and most prosperous society in human history precisely by championing the individual. Americans believe that society exists to serve the individual, not the other way around.

CHAPTER SIX.

If You Don't Hear the School Bell Ring, Cla.s.s Never Starts We Need an Education System That Values All Students

I love rock'n' roll just as much as, if not more, than the next guy. One of my favorite tunes is the Pink Floyd megahit "Another Brick in the Wall": "We don't need no ed-u-cay-shun . . . Hey! Teacher! Leave those kids alone!" But as catchy as that song is, I don't think it should serve as a motto for our education system. Unfortunately, if you look around, that seems to be the case. love rock'n' roll just as much as, if not more, than the next guy. One of my favorite tunes is the Pink Floyd megahit "Another Brick in the Wall": "We don't need no ed-u-cay-shun . . . Hey! Teacher! Leave those kids alone!" But as catchy as that song is, I don't think it should serve as a motto for our education system. Unfortunately, if you look around, that seems to be the case.

Case in point: A friend of mine owns a printing business, and as part of the job-application process he gives a prospective employee a ruler and a piece of paper. He tells the wannabe employee to mark one-eighth of an inch, one-sixteenth of an inch, and a few other simple measurements. He tells me that only about one in ten actually know what he's talking about!

If we are going to regain and retain our prosperity and keep America compet.i.tive in the twenty-first century, our children must get properly educated. Not only does a lack of education make children less compet.i.tive among their peers-often confining them to a life of low-paying, dead-end jobs (not to mention government handouts), but, as Americans grow up to be less educated than their counterparts in other countries-like China and India-our nation becomes less compet.i.tive as whole.

Already we see this trend taking a toll on American jobs as large companies seek talent from abroad to fill the s.p.a.ces Americans aren't skilled enough to fill. High-tech companies such as Microsoft, Google, Apple, and Cisco have had to recruit top talent from other countries such as India, Taiwan, Israel, and j.a.pan, which have held students to higher standards in math and science while our students continue to fall behind in these areas. Our children are growing up without the basic skills they need to stay compet.i.tive in the job market. We're pushing them through a broken system and setting them up for failure on the other end.

Our children are our most valuable natural resource. The children we're educating (or not educating) today will grow up to be the presidents, business leaders, doctors, and scientists, not to mention teachers, of tomorrow. But you'd never know we were grooming such important people by the haphazard way in which we structure their education. "Book learning" needs to go a long way toward a focus on the student and not just the school. We need to ignite the innate curiosity in the minds of young people and inspire them to be lifelong learners with an insatiable appet.i.te for knowledge and wisdom.

Yet about one-third of our students are dropping out of high school. For minorities, it's closer to 50 percent. That's more than a million students a year, or six thousand every school day. We must especially target the 12 percent of our high schools that currently produce 50 percent of our dropouts. It's hard for the student to succeed when he or she is in a school that is a dismal failure.

This is a tragedy not just for those directly involved but for our society as a whole. Considering how much we spend to put kids in school, it's a tragedy that there is such an economic impact when it simply doesn't work. A dropout can expect to earn a quarter of a million dollars less than a high school graduate, to be in worse health by the age of forty-five than a graduate at the age of sixty-five, and to die nine years younger than a graduate. Dropouts are far more likely to become involved with drugs and crime. Economists estimate that for each 1 percent rise in high school graduation rates, we'd have one hundred thousand fewer crimes every year. Considering the average cost of an inmate to be about fifty thousand dollars a year, ignorance gets very very expensive! expensive!

Even for those who finish high school, that diploma is not what it used to be. Are the taxes you pay going to provide a high school education or a high school diploma? In too many of our schools, the two are not the same. Recognizing that a high school diploma is not what it used to be, more than half of our states have adopted exit exams designed to ensure that those receiving diplomas really deserve them. They are responding to growing evidence that our high school graduates are not adequately prepared for higher education, since one-third of those going on to four-year colleges and one-half of those going on to two-year colleges need remedial cla.s.ses. This means taking high school cla.s.ses at college prices, and it's costing us more than two billion dollars a year. At City College of San Francisco, a community college with one hundred thousand students, 90 percent aren't prepared for college-level English, while 70 percent aren't prepared for math.

While college enrollment keeps rising, graduation rates keep falling. Fewer than one in three students who enter a community college with the intent of getting a degree actually do so. Lack of adequate preparation is the major reason for dropping out of both two- and four-year programs.

Students who drop out of college are giving up tremendous earning potential. In 2008, the median income for workers with college degrees was almost $45,000, almost twice as much as the $25,000 median income of those with only high school diplomas.

Besides the lack of preparation for higher education, states are also facing the fact that many high school graduates can't do jobs that employers traditionally considered appropriate for them. Companies that have been burned by low-performing high school graduates are increasing their entry-level requirements to insist on a two- or four-year degree. Young people who have studied hard and done well through high school are denied opportunities where they could thrive because of the wide disparity among high school graduates.

Exit exams are a great idea for restoring the integrity of a high school diploma. Unfortunately, when the states started doing practice tests, they found that significant numbers of students failed them. You would think the states would take this as a sign that they need to smarten up their students. Instead, they are dumbing down the tests to avoid a high failure rate or putting off the testing altogether. This is not a solution; it is a sin. It's the equivalent of a basketball coach deciding that the way to help his losing team is to lower the basket from ten feet (rim to floor) down to seven feet so that every player can slamdunk the ball. Problem is, the teams they face will be playing to the higher standard. The students from the rest of the world will increasingly be playing to a higher standard. So must we.

Lowering graduation standards is a disservice not only to our young people but also to our country. Those who receive diplomas they haven't earned may get a job, but many get fired or don't get promoted. They lack the reading comprehension and math skills they need to understand apartment leases and home mortgages; health, auto, and life insurance; and credit-card fees and terms. Besides being less equipped to care for themselves and their families, they are less able to be fully partic.i.p.ating citizens.

I spend a lot of time at airports, and our education system reminds me of the people movers that take us between terminals. Our children get on in kindergarten and get moved along through high school. When they stumble, no one stops the conveyor belt. They just keep moving forward from one grade to the next, falling further and further behind in the knowledge and skills they need for success. It's time that our states. .h.i.t the emergency b.u.t.ton and give those who fall the practical help they need, not a phony diploma to commemorate a wasted trip.

Let's Not Flee Our Public Schools, Let's Fix Them In Washington DC the initial group of students who won a voucher lottery to attend private school are reading two grade levels higher than those who entered the lottery but didn't win. This is a telling comparison because it shows how even the most highly motivated students and parents can't bridge the education gap without the necessary resources from our schools.

There's no doubt that the right of every citizen to a free public education is one of the things that makes America great, but our schools are still failing us. Despite the years and money spent so far on No Child Left Behind, the results of national reading tests released in May 2010 showed that inner cities are still way below the national average at both the fourth- and eighth-grade reading levels. This National a.s.sessment of Educational Progress, nicknamed the "nation's report card," revealed that our children are severely lagging in reading comprehension skills as they enter middle school. This affects their ability to do well in just about every subject, since you can't succeed in history or science without solid reading comprehension skills.

As much as I believe education is a national problem, I want to be clear that I don't think it's best solved on the national level. As I said in chapter 2, I believe that our state and local governments are best suited to know the needs of our citizens-and that goes for our kids too. There's been a lot of talk lately about national education standards, but I do not endorse letting the federal government take over education and would oppose having it set the curriculum, standards, cla.s.s sizes, or teacher pay for our public schools.

So what to do? Lately charter schools have been all the rage. A charter school differs from a public school in that, even though it receives public money and is free for students to attend, it does not operate within the normal rules and regulations of traditional public schools. Instead, each charter school draws up its own mission, or "charter," for producing results and is held accountable for achieving these results by its sponsor (e.g., a school board or state agency). Any student can apply to attend a charter school but, due to their popularity, spots are often limited and must be allocated by a random lottery system.

There are more than five thousand charter schools in the United States, with about 3 percent of our children, over 1.7 million, attending them. In some cities, that percentage is much higher, such as 57 percent in New Orleans and 36 percent in Washington DC. Much of the success of these schools depends on how much supervision they have. Charter schools in New York City have a lot of oversight and have been very successful. By contrast, in places where there is little accountability, such as Texas, Arizona, and Ohio, the charters tend not to perform very well. A 2009 study by Margaret Raymond, a fellow at Stanford University's Hoover Inst.i.tution, found that 83 percent of charters did not outperform their local public schools. In fact, almost 40 percent were worse than those schools.

I support charter schools and other methods of empowering parents with choices for their students and providing compet.i.tion for the existing establishment government schools. Getting more children into private schools through vouchers and scholarships and supporting high-performing charter schools are good things. But the truth is that the overwhelming majority of our children are going to go to their local public school. We have to provide solutions for them.

Our public schools have historically been outstanding, and they can be again. Instead of fleeing our public schools, let's fix them. Our schools aren't failing for lack of money. Among developed countries, we are at the top in per-pupil spending but score in the bottom third in achievement. I am a product of public schools. All three of my adult children spent their entire primary and secondary education in public schools. As much as I support and appreciate Christian schools, home-schooling, private academies, and charter schools, I doubt they will be able to replace public schools for many of America's students.

A gifted teacher can provide both the encouragement to overcome obstacles and the excitement about learning that our children need to stay in school and excel. We must attract the best possible talent to teaching. But for about the last forty years, we have been drawing from a shallower pool. We no longer have a captive, abundant supply of bright, ambitious men and women who lack other career paths. They're no longer in our cla.s.srooms-they're in our courtrooms, our operating rooms, our boardrooms. We must reestablish teaching as a respected profession, as a desirable, compet.i.tive career path, and that means abolishing tenure and providing merit pay.

The Problems with Tenure and the Promise of Merit Pay In June 2010, Timothy Knowles, director of the University of Chicago Urban Education Inst.i.tute, wrote an op-ed in the Wall Street Journal Wall Street Journal arguing that we must eliminate tenure for teachers: arguing that we must eliminate tenure for teachers: As a former teacher, princ.i.p.al and district leader . . . there are two things I've learned for certain. First, teachers have a greater impact on student learning than any other school-based factor. Second, we will not produce excellent schools without eliminating laws and practices that guarantee teachers-regardless of their performance-jobs for life.

Most school systems follow a first-hired-last-fired rule when they have to cut back on staff. In fact, fifteen states, including large states like New York and California, have laws requiring that layoffs be based on seniority. Firings ought to be based on performance. It's a shame to keep a bad teacher because he's been there boring his students to death for twenty years and fire a gifted, inspiring teacher just because he or she arrived a year ago. Cuts should be an opportunity to get rid of deadwood, not those bearing the most fruit.

Mich.e.l.le Rhee, the former chancellor of public schools for the District of Columbia, said, "When I first came here, all the adults [teachers] were fine; they all had satisfactory ratings. But only 8 percent of eighth graders were on grade level for math. How's that for an accountable system that puts the children first?"

While more than half the states offer some form of merit pay in theory, it's usually a reality in just a few districts or schools. In their 2010 paper "Blocking, Diluting, and Co-Opting Merit Pay," Stuart Buck and Jay Greene of the University of Arkansas found that of the 15,200 school districts in the United States, only 528 were using merit pay, which is 3.5 percent of districts. They discovered that where merit pay was enacted, "it often ends up being blocked, co-opted, or diluted by established interests." For example, it is enacted temporarily and then expires, or it is repealed under the excuse of budget constraints, or unions keep local districts from partic.i.p.ating. Buck and Greene reported that of the 360 school districts in Iowa, only three applied for a merit-pay plan that was pa.s.sed in 2007.

Buck and Greene wrote that merit-pay plans are foiled when pay is determined based on resume builders like graduate degrees rather than on actual results like test scores or graduation rates. Likewise, they are ineffective when they require a very low standard of actual improvement and when they are used for what is effectively an acrossthe-board raise in which bonuses small and are given to most teachers.

Buck and Greene concluded that merit pay depends on school choice and compet.i.tion to succeed and defeat the "powers that be": The problem is that public schools are not primarily educational inst.i.tutions where policies are organized around maximizing student achievement. Instead, [they are] political organizations organized around the interests of their employees, their union representatives, and affiliated politicians and other interest groups-"school people instead of kid people!"

That's an interesting concept-school people versus kid people. Whom do we owe a responsibility to? Our schools or our students?

Buck and Greene went on to argue that schools should adopt merit-pay programs, which would make the teaching profession more compet.i.tive and thus attract better candidates.

Some say that merit pay wouldn't be fair, that some teachers would get more simply because the princ.i.p.al likes them. But isn't that how life works in the private sector? Don't some people get promoted because their boss thinks they do a good job? Merit pay at every school in the country would create a system superior overall to what we have now. We hear all this agonizing about the criteria for merit pay, about the difficulty of deciding who deserves more. The truth is that princ.i.p.als know who their best teachers are. Teachers themselves know who the best teachers in their school are, as do the children and their parents.

Of course, it is not easy to establish merit pay and abolish tenure. Take Florida, where the legislature pa.s.sed both reforms but they fell victim to Governor Charlie Crist's political ambitions. Having changed his party affiliation to Independent from Republican, he vetoed the bill as part of his strategy of moving leftward to try to win a Senate seat in 2010. But at the end of the day, we need to ask ourselves, who loses when we don't educate our children? Everyone.

Tough Choices for Education During my decade as governor, there were many situations that confronted me that were not of my own choosing, and the field of education was no exception. It was always easy for some expert from out of state based at a Washington think tank to evaluate the decisions I had to make on the ground. That is the reality of leadership: Every governor in the country has to navigate whatever situation arises.

In December 2002, the Supreme Court of Arkansas finally ruled in a nearly twenty-year-old ongoing lawsuit related to school funding. The justices decided that the state had failed in terms of both educational equity and educational adequacy. The court directed the state to ensure that all students, no matter what their geographical location, be granted access to essentially the same education as all other Arkansas students. This ruling would have several consequences. For one, there would have to be increased spending on a per-pupil basis to deal with the differences in spending between affluent and less well-off communities. For another, objective evaluators would be brought in to determine exactly what was adequate and what was equitable. Arkansas schools spent considerably less per pupil than most states-in some districts, pitifully below others-so there really was no way to argue the propriety of the decision.

This was a very challenging experience. I was confronted with the necessity of getting adequate revenue to comply with the court's orders and, more important, meet the very real needs of the children of our state. But this could only be achieved if I sailed through some very unfriendly legislative waters. Nor were many people pleased when I suggested that, rather than simply spend more money, we commit to spending it efficiently. Specifically, I argued that we should not raise revenue unless we made the politically tough decision to consolidate many school districts because their separate existence could not be justified financially. Only consolidation, I felt, would produce the economies of scale that needed to be achieved in order to operate an efficient system.

In many cases, my approach was unpopular and would later provide a great deal of political fodder to my opponents in the presidential campaign. They made simplistic charges against me without putting forth any context. Of course, this is one of the most painful realities of today's politics. If a person has no record at all or, if already in political office, has carefully avoided confrontations and difficult decision making, the voter has no way of knowing what the candidate's really made of. I have always believed that ultimately, people would rather elect those with the courage to make tough decisions than those who've governed so as to preserve their own political future at the expense of a better future for coming generations.

As I've recalled for you here, in my experience, educational issues are affected by all levels of government and by the beliefs and convictions of school officials, elected representatives, and outside "experts," as well as by the legal opinions issued by courts. As I said before, education is a function of state and local governments and was never intended, as evidenced by our Const.i.tution and the words of our Founding Fathers themselves, to be a federal concern. As we look directly into the cla.s.sroom now, please don't forget this context. It is complex and can be determinative.

Race to the Top Although I believe education should be left to the states, I fully endorse the new federal program Race to the Top, which has states compete for additional education funds, allowing them to decide what reforms to enact rather than having specific reforms imposed on them from above. Applications are evaluated under a five-hundred-point system, with points awarded based on criteria in several categories. The greatest number of points (138) is allocated to the category of reforms that address tenure and seniority.

It's a very clever way to prod states to embrace much-needed reform just out of the hope hope of getting federal money, without actually promising any particular state anything. The mere prospect of this money has motivated states to stand up to their teachers' unions or get unions to agree to reforms they've opposed in the past. It's like getting all five of your children to do a great job on their ch.o.r.es knowing that only the one who does best will get an allowance. For all the criticism of the Obama administration (and I've been the source of plenty), this is an area where I give them credit. If we're going to spend federal money on education and have a federal education department (even though it's not really a const.i.tutional function of the federal government), then we ought to at least make the money count. of getting federal money, without actually promising any particular state anything. The mere prospect of this money has motivated states to stand up to their teachers' unions or get unions to agree to reforms they've opposed in the past. It's like getting all five of your children to do a great job on their ch.o.r.es knowing that only the one who does best will get an allowance. For all the criticism of the Obama administration (and I've been the source of plenty), this is an area where I give them credit. If we're going to spend federal money on education and have a federal education department (even though it's not really a const.i.tutional function of the federal government), then we ought to at least make the money count.

The $4.3 billion allocated is less than 1 percent of the money spent annually on education by government at all levels. But small amounts of money-in fact, just the possibility of small amounts of money-can effect significant change. So far about half the states have pa.s.sed reforms in their effort to get a share of this money. Forty states and the District of Columbia competed in stage one, which concluded in March 2010 with grants to Delaware and Tennessee.

Personalized Learning Besides attracting and keeping better teachers, we have to help our teachers help our children. One of the major reasons for dropping out is simple boredom. I want to transform America's high schools by putting each student at the center of his education to make his learning personal, relevant, and respectful of his individual learning style. The New Hampshire Vision for Redesign has done impressive work on this concept of "personalized learning" that can serve as a model for our whole country. A close friend of mine, Fred Bramante, owns a chain of music stores along the East Coast and, after serving on the state board of education in New Hampshire, envisioned a different and revolutionary approach that would center on the interests of the student rather than those of the school inst.i.tution.

With the help of his parents, teachers, and community, each student drafts a learning plan. For part of each day, he studies the core curriculum. But beyond that, he is encouraged to integrate his personal pa.s.sions and career ambitions into credits toward his high school diploma. What has traditionally been considered extracurricular becomes a source of academic credit. A student who takes karate lessons gets gym credits. A student who plays in a rock band gets music credits. A student who interns for the local newspaper gets English credits. The opportunities are as limitless as our children's imaginations, dreams, and talents and our communities' willingness to help them. What's brilliant is that students are able to integrate what they are studying with real-world experience so that they understand that what they learn has authentic practical value. It exchanges the make-work of many schools for something vibrant. Fred's vision is catching on, and rightfully so.

Local businesses should partic.i.p.ate to ensure that they have homegrown talent to fill their jobs. Community colleges should get involved to encourage students who were at risk of dropping out to see themselves as college material and to ensure that their transition to higher education is seamless and won't require remedial cla.s.ses.

Students don't have to sit in the cla.s.sroom all day, staring out the window and watching the clock. Let's take the walls and roof off our cla.s.srooms and realize that they should encompa.s.s the entire community. In fact, in the age of the Internet, they should encompa.s.s the whole world.

We are a nation proud of our respect for the individual, yet for too long our high schools have been cookie cutter, one size fits all. Let's encourage the individuality of our children; let's acknowledge that each one has his special G.o.d-given gifts, his unique contribution to make to America. One can play the violin like an angel, and another does science experiments that will help us achieve energy independence. Transforming our schools with personalized learning won't just lift our graduation rates. It will lift our children into more successful and satisfying lives.

Art and Music Education The twenty-first century will belong to the creative; they will thrive and prosper, both as individuals and as societies. The creative ones will be the compet.i.tive ones. While you can't teach creativity the way you do state capitals and multiplication tables, you can nurture it by offering art and music to all of our students, all the way through school. I believe that the secret weapons for our remaining creative and compet.i.tive in the global economy are art and music, what I call our "weapons of ma.s.s instruction."

Studies have shown a direct correlation between music education and math scores. Music develops both sides of the brain and improves spatial reasoning and the capacity to think in the abstract. Music teaches students how to learn, and that skill is transferable to learning foreign languages, algebra, or history.

Art and music education levels the differences in academic performance among students from different socioeconomic backgrounds and reduces delinquent behavior. Art and music education results in what all parents and school districts are looking to brag about-higher SAT scores.

Some children decide early on that they're not good at school and they hate it. Art and music can save these children, can keep them in school. For them, biology may be broccoli and Spanish may be spinach, but when they get to art cla.s.s or band practice, that's a hot fudge sundae. If it weren't for these opportunities, where they feel successful and worthwhile, where they're enthusiastic and engaged, many students would drop out of school. According to research by the Education Commission of the States, there is an established correlation between art and music education and high school drop out rates.

It infuriates me when people, especially my fellow conservatives, dismiss art and music as extracurricular, extraneous, and expendable. To me, they're essential to a well-rounded education.

In reality, creativity doesn't really have to be "taught" because it is naturally "caught" by every child. Do you have to beg a three-year-old to sing or a four-year-old to draw pictures or a five-year-old to playact various roles when playing fireman, doctor, or parent? What happens between the naturally creative early years and the bored-to-death teenage years? Those years are spent in a cla.s.sroom in which students are told to sit down, be quiet, face forward, get your head in the book, and be still. Students today aren't dumb-the people who run the educational establishment, who want to create a conveyor belt that treats students like parts in a manufacturing plant (like the one in the Pink Floyd videos), are the dumb ones. And there's no reason to let it stay that way.