JUST OUT: New "Chart of the Century" with data through December 2023. Increases in College Tuition and Fees continue to far outpace increases in Average Wages and the Overall CPI. If College Tuition had increased at the rate of the Overall CPI since 2000, it would be 28% LESS… pic.twitter.com/kWlo1nP7I6

— Mark J. Perry (@Mark_J_Perry) January 18, 2024

Jill Barshay:

In a Department of Education survey released in October 2023 of more than 1,300 public schools, 60 percent said they were partnering with community organizations to provide non-educational services. That’s up from 45 percent a year earlier in 2022, the first time the department surveyed schools about their involvement in these services. They include access to medical, dental, and mental health providers as well as social workers. Adult education is also often part of the package; the extras are not just for kids. 

“It is a shift,” said Marguerite Roza, director of the Edunomics Lab at Georgetown University, where she tracks school spending. “We’ve seen partnering with the YMCA and with health groups for medical services and psychological evaluations.”

Deeper involvement in the community started as an emergency response to the coronavirus pandemic. As schools shuttered their classrooms, many became hubs where families obtained food or internet access. Months later, many schools opened their doors to become vaccine centers. 

New community alliances were further fueled by more than $200 billion in federal pandemic recovery funds that have flowed to schools. “Schools have a lot of money now and they’re trying to spend it down,” said Roza. Federal regulations encourage schools to spend recovery funds on nonprofit community services, and unspent funds will eventually be forfeited.

ObamaCare was sold to Americans as something that would increase options, and allow people to keep plans they liked. Like most government programs, this has since been proven a lie. https://t.co/8YInTRGBbQ

— Will Flanders (@WillFlandersWI) June 26, 2023

Josh Anderson:

In 2024, eligibility will increase to include people whose only underlying condition is mental illness. By the way, in 2021, Mental Health Research Canada concluded that they’d found a correlation “between vaccine hesitancy and mental illness.” Not even COVID-19 vaccine hesitancy specifically, just vaccine hesitancy broadly speaking, because surely there are no legitimate reasons anyone might reasonably regard pubic health institutions with skepticism! That same year, New York City psychiatrist Dr. Aruna Khilanani was invited to none other than the Yale School of Medicine’s Child Study Center to give a talk entitled “The Psychopathic Problem of the White Mind.” The Yale School of Medicine eventually distanced themselves from Khilanani, but only after she indicated that perhaps she was the psychopathic one. Among other things, she told her audience that she “had fantasies of unloading a revolver into the head of any white person that got in my way, burying their body and wiping my bloody hands as I walked away relatively guiltless with a bounce in my step.” Apparently the title of the talk wasn’t enough of a red flag. (Writing about the incident, the Washington Post included several defenses of Khilanani, including, “Her comments and the negative feedback she’s received are more revealing about white supremacist thoughts than about Khilanani’s view on racism, said Nikki Coleman, a psychologist and consultant on diversity, equity and inclusion.”) I bring up this incident because if this is the sort of mental health “expert” invited to speak to students of a… *checks notes* 📔🧐 … Child Study Center at one of the most highly regarded universities in the world – if hers is the sort of speech to readily find defenders in the media and academia… then let’s just say I… hesitate… when the government officially enshrines into law the stance that death is preferable to however the “experts” of the day define “mental illness.”

Indeed, that stance – the stance that death is preferable to disability – has been the thrust behind the pushback towards this bill. Three disability rights advocates associated with the United Nations wrote futilely in a letter to the federal government before they expanded MAID in 2021:

Scott Girard:

After the district’s insurance consultant, M3, received word from GHC in February about its premium increase, district officials and M3 worked with Quartz to see if there was a better solution. They were left with two options, according to the letter, neither of which raises the amount staff will pay for premiums this year:

• Continue to provide employees with GHC-SCW health insurance, with no rate increase for employees in the 2023-2024 school year, but a 16.2% increase to the district, effective July 1, 2023, for an extra $5.6 million in the budget

• Change insurance carriers to Quartz, effective July 1, 2023, with no rate increase for employees in the 2023-2024 school year, but a 13.1% increase to the district, effective July 1, 2023, for an extra $4.1 million in the budget

Interesting letters section re: the NYT puberty blockers investigation. Three are tut-tutting NYT for playing into right-wing tropes and putting trans kids at risk, fourth is this, from one of the lead investigators behind the FDA approval of Lupron pic.twitter.com/wjFt3ejjfX

— Park MacDougald (@hpmacd) November 29, 2022

Terrence Jeffrey:

Americans spent more on taxes in 2020 than they did on food, clothing, healthcare and entertainment combined, according to newly released data from the Bureau of Labor Statistics.

American “consumer units,” as BLS calls them, spent a net total of $17,211.12 on taxes last year while spending only $16,839.89 on food, clothing, healthcare and entertainment combined, according to Table R-1 of the BLS Consumer Expenditures Survey.

“Consumer units,” BLS explains, “include families, single persons living alone or sharing a household with others but who are financially independent, or two or more persons living together who share major expenses.”

Logan Wroge:

Madison’s taxpayer supported K-12 school district, despite spending far more than most, has long tolerated disastrous reading results.

Health insurance costs have long been an issue in the Madison School District.

Administrators warned that benefits were unsustainable in 2014.

Kyso:

Globally, health expenditure as a percentage of GDP has increased in recent years, so evaluating the health care systems used in different countries is an important tool for identifying best practices and improving inefficient health care systems.

Total health expenditure is the sum of public and private health expenditures as a ratio of total population. It covers the provision of health services (preventive and curative), family planning activities, nutrition activities, and emergency aid designated for health but does not include provision of water and sanitation. Data are in international dollars converted using 2011 purchasing power parity (PPP) rates.

Chad Aldeman:

Consider the graph below, using data from the Census Bureau’s Public Education Finances reports. From 2001 to 2016, LAUSD increased overall spending by 55.5 percent, but its spending on salaries and wages increased just 24.4 percent. Meanwhile, employee benefit costs soared 138 percent.

LAUSD is an extreme example, but this situation is playing out across the country. More and more of our nation’s education spending is going toward benefit costs, due to significant increases in pension and healthcare costs.

Another way to slice the same data is to look at the percentage of our education budgets that are being spent on the salaries and wages of teachers who work in instructional roles. Again, the national trend is not positive, and LAUSD is no exception. In 2001, L.A. devoted 44 percent of its budget to teacher salaries and wages; by 2016, that figure had fallen to 33.5 percent.

On Teacher Compensation (Madison Spent 25% of its budget on benefits in 2014-2015).

Robert Hart::

The consequences of this oversight are pernicious. Women are far more likely to suffer the deleterious side effects of medication than men. Pregnant women get sick, but the consequences of taking many medications when pregnant are chronically understudied, or worse yet, unknown entirely. Women are far less likely to receive the correct treatment for heart attacks because their symptoms do not match “typical” (read: male) symptoms.
If evidence-based medicine is already far less evidence-based for anybody who is not a white male, how can the use of this unmodified data do anything other than unwittingly perpetuate this inequality? If we want to use AI to facilitate a more personalized medicine for all, it would help if we could first provide medicine that works for half the population.

The effects of this data can be even more insidious. AI systems often function as black boxes, which means technologists are unaware of how an AI came to its conclusion. This can make it particularly hard to identify any inequality, bias, or discrimination feeding into a particular decision. The inability to access the medical data upon which a system was trained—for reasons of protecting patients’ privacy or the data not being in the public domain—exacerbates this. Even if you had access to that data, the often proprietary nature of AI systems means interrogation would likely be impossible. By masking these sources of bias, an AI system could consolidate and deepen the already systemic inequalities in healthcare, all while making them harder to notice and challenge. Invariably, the result of this will be a system of medicine that is unfairly stacked against certain members of society.

Tap for a larger version.

March, 2017 School Board Presentation (PDF).

Notes and links: health insurance.

2015: Health Insurance premiums account for 16% of the Madison School District budget

MMSD will spend $61 million on health insurance this year.

One of Every Six Dollars is Spent on Health Insurance in the MMSD budget.

Health Insurance premiums account for 16% of the MMSD budget.

Over 3,900 employees are enrolled in the MMSD plan

Julia Powles:

Data-driven tools and techniques, particularly machine learning methods that underpin artificial intelligence, offer promise in improving healthcare systems and services. One of the companies aspiring to pioneer these advances is DeepMind Technologies Limited, a wholly-owned subsidiary of the Google conglomerate, Alphabet Inc. In 2016, DeepMind announced its first major health project: a collaboration with the Royal Free London NHS Foundation Trust, to assist in the management of acute kidney injury. Initially received with great enthusiasm, the collaboration has suffered from a lack of clarity and openness, with issues of privacy and power emerging as potent challenges as the project has unfolded. Taking the DeepMind-Royal Free case study as its pivot, this article draws a number of lessons on the transfer of population-derived datasets to large private prospectors, identifying critical questions f

NBC:

Oral arguments are set to begin Thursday for the lawsuit of a Minnesota woman who is suing her transgender teen daughter along with a variety of local school and health agencies.

Anmarie Calgaro’s lawsuit alleges that healthcare providers treated her 17-year-old as an emancipated minor without her consent when the teen began receiving transgender medical and mental health services.

While the lawsuit centers largely on the state’s lack of a clearly defined legal process for emancipation, Calgaro’s unnamed teen daughter earlier told Mid-Minnesota Legal Aid attorneys that her mother had “made it known to him [sic] that she no longer wishes to have any contact with him,” according to cou

Tap for a larger version.

Madison School District Administration Slides (PDF):

Compensation:

Prior Years Strategy
– Funded step advancement, lane movement, & base wage increase (varies), offset by multiple reductions in personnel / non-personnel areas

For 2017-18:
– With referendum resources, provide for step advancement, lane movement, and base wage increase (TBD), without multiple offsetting reductions

– Additionally, looking for a win-win on health insurance design which could provide additional employee compensation

Madison Schools’ budget priority items (PDF).

David Barnes:

ObamaCare won’t work without young Americans like me, and the Obama administration knows it. That’s why the president is holding a Millennial Outreach and Engagement Summit focused on the Affordable Care Act at the White House on Tuesday. But no matter what the president says, many young Americans simply aren’t buying what he’s selling—mainly because we can’t afford it.

The administration has targeted my generation to sign up for ObamaCare for one reason: We’re healthy. The health-insurance companies selling plans on the law’s exchanges need us to pay a pretty penny in premiums without using much medical care. We’re supposed to subsidize the system so that it stays afloat. That was the plan, anyway. It fell apart when we didn’t sign up in droves like the White House expected.

James Wigderson:

Despite the administration’s plan to make sure no employee experienced a net loss in pay in the coming year, Loumos wanted the district to cover the cost of the employee contributions for the first year so every employee could have the full amount of their raises.

“What would it be if we held, if we gave everybody the true raise and added their co-payment on top? That’s what I want,” Loumos said.

However, the other board members balked at the idea of finding another $1.3 million in the budget to cover the employee health-insurance premium contributions.

“My goal was no one takes a net pay cut and I’m happy that we can find $300,000, which achieves that goal,” said board member Ed Hughes.

The Lincoln Project (PDF):

Measured in inflation-adjusted dollars per full-time equiv- alent (fte) student, states have been cutting this support for well over a decade, and spending cuts accelerated in response to the Great Recession. Between 2008 and 2013, states cut appropriation support per fte student in the median public research university by more than 26 percent (overall, support per fte student at the median public institution was cut by more than 20 percent).

The decline in support in part reflects difficult choices states have made in response to manda- tory spending programs like Medicaid, rising pension contributions, and a desire to preserve k–12 education.3
Today, public research universities still rely on state appropriations for approximately 51 percent of their educational revenue, although the percentage fluctuates widely by institution—ucla, for example, receives only 7 percent of its funding from the state. For most public institutions, further cuts could be devastating.

Via Richard Askey.

Wisconsin K-12 Spending Dominates Local Transfers and Wisconsin State Tax Based K-12 Spending Growth Far Exceeds University Funding
.

Guy Boulton:

The average premium for single coverage is $6,251 this year, with workers on average paying $1,071 of the cost. The average premium for family coverage is $17,545, with workers on average paying $4,955 of the cost.

Premiums have increased an average of 5% a year since 2005, compared with 11% a year between 1999 and 2005, according to the survey by Kaiser Family Foundation, a health policy research organization, and the Health Research & Educational Trust, an affiliate of the American Hospital Association.

However, premiums still have increased at a much faster pace than inflation and wages.

The relatively modest increase in premiums over the past decade also stems partly from an increase in deductibles for most health plans.

The annual survey found that 81% of workers who have health benefits this year are in plans with a deductible, compared with 55% in 2006.

Pat Schneider:

“I will consider contributions to health care, depending on what we see in terms of costs and the budget,” Burke said. “But we need to look at compensation in its entirety to make sure we remain competitive while we are accountable to the taxpayers.”

The school district is in the process of preparing to hire a consultant to conduct a study of employee compensation, she said.

Representatives of Madison Teachers Inc. say the fully paid health care premiums are a benefit bought with concessions on salary increases over the years.

That’s exactly why it’s so important to look at the district’s compensation as a whole, Burke said.

“We want to make sure the school district is a place that can attract quality people. That’s why the survey will not only compare us to other school districts, but also to other professions,” she said.

The Madison Metropolitan School District’s three major health insurance providers — Group Health Cooperative, Dean Health Plan and Unity Health Insurance — each agreed to hold the line on premiums next year. That helped the school district hold the line on a major expense — more than $61 million annually — in a budget round that saw operating expenses up nearly 11 percent as state aid dropped.

Madison’s 2015-2016 budget and its long term disastrous reading results, here. Note that Madison has long spent more than double the national average per student.

David Wahlberg:

Madison Teachers Inc. and five other Madison-based unions are so concerned about significant financial losses at Group Health Cooperative of South Central Wisconsin, they’re urging members to vote for particular candidates in Group Health’s board election Thursday.

“MTI cannot stand idly by and watch GHC disappear,” John Matthews, the teacher union’s executive director, wrote in a letter last month to members.

Group Health lost $18.7 million last year after losing $15.7 million in 2013 and $5.5 million in 2012, according to financial statements filed with the National Association of Insurance Commissioners.

Kevin Hayden, Group Health’s CEO, is on leave for reasons the HMO won’t explain.

Group Health made $364,000 the first quarter of this year and expects a “substantial improvement over 2014,” a statement by board president Ken Machtan said.

The losses were covered by “substantial reserves so no debt was accumulated,” Machtan said. Group Health “continues to maintain a healthy reserve,” he said.

Details.

Healthcare costs have long been a significant issue in the Madison School District’s budget.

John Torinus:

One small governmental entity has shown the way. The West Bend School District went self-insured years ago, then bid out its network needs, then went CDHP and now is putting in its own on-site clinic. It’s in the vanguard in learning from the private sector payers about what works and being a fast-follower.
Result? It is delivering first class health care for less than $10,000 per employee. That’s half of what many districts are playing for fully insured plans.
Think about the numbers. At a savings of $10,000 per employee and about 1000 employees, it is saving the taxpayers $10 million per year.
The district is giving raises; it has found funds for deferred maintenance; it found $5 million in reserves to put against a $25 million bond program for school construction.

Smart, anti-orthodoxy thinking.

Erica Breunlin:

The Greendale School District’s high-deductible plan has been in place for the past four years but was not available to teachers until last year. When the district first offered the plan, nonunion employees agreed to try it out but teachers declined, Green said. Once Act 10 came into effect, the district offered the high-deductible plan to teachers again. The district allowed teachers to choose between the high-deductible plan and the traditional plan this school year, and 70% decided to go the high-deductible route after seeing how it was working for other staff members, Green said.
The district runs the plan in conjunction with a health reimbursement account.
In addition to a wellness plan, the Greendale district provides an on-site nurse practitioner from Aurora Health Care.
Green said the high-deductible plan significantly reduces the price of health insurance plans for school districts. When factoring in the cost of the high-deductible plan each year plus what the district is putting into the health reimbursement account, the total is about $1,000 less per family plan per year than the traditional plan.

Related: The Madison School District recently ended their longtime support of a costly WPS healthcare plan.

WILL:

In May, RAND released the fifth iteration of their hospital price study which ranked Wisconsin as having the 5th highest hospital prices, and the most expensive professional fees in the nation. The RAND report is an important tool for employers to better understand their costs and make the best financial decisions possible for their employees’ health coverage. It also highlights the importance of strengthening healthcare price transparency in Wisconsin, a measure that would empower patients to make the best healthcare decisions for them, ultimately increasing competition and reducing healthcare costs in the state.  

 However, the Wisconsin Hospital Association (WHA) immediately took issue with the study as they have with the previous versions due to its “inherently flawed methodology and skewed data.” But do these claims hold water? While this and every study has flaws and limitations, their claims are an over exaggeration at best, and an attempt to undermine the importance of price transparency at worst. Let’s dive into their claims.  

Madeleine Rowley

According to a letter written by Haim’s lawyers, Assistant U.S. Attorney Tina Ansari admitted that she hadn’t reviewed the purported evidence against Haim and was instead relying on what FBI agents told her. In the same discussion, Ansari insisted that the documents Haim sent to Rufo included children’s names, but nothing in the documents Rufo saw identified any individuals. All were redacted. The prosecutor then asked Haim to admit wrongdoing, telling him that he should apologize to the families of the children who received transgender medical interventions at TCH if he wanted her to help him avoid a felony prosecution. When this tactic failed, Ansari intimated that the families would sue if she didn’t bring criminal charges.

Roger Severino, vice president of domestic policy for the Heritage Foundation and a former HIPAA regulator at the Department of Health and Human Services, called Haim’s prosecution “outrageous.” As Severino notes, Haim blew the whistle in good faith in a state “where it’s illegal to do these experimental surgeries on minors.” (In September 2023, Texas attorney general Ken Paxton announced that SB 14, a new law banning gender-transition procedures for minors in Texas, had gone into effect.)

Ansari’s zeal to prosecute Haim is especially strange, given her lack of knowledge of HIPAA law, as noted in a letter from Haim’s lawyers. In the past, Ansari has prosecuted cases involving doctors who falsified patient-care documents to receive higher insurance payouts, a health-center owner who scammed Medicare out of millions based on fraudulent claims, and a pharmacist who submitted false claims to Tricare and other federal insurance programs while pocketing $22 million. Yet she moved to indict Haim in this case, despite his having no profit motive, and despite the Texas Attorney General’s Office declining to act on the case for six months.

Dan Epstein, vice president of America First Legal, a conservative public-interest law group, calls the Haim indictment an overreach of epic proportions. “The fact that Texas state attorneys decided not to bring action on this case says that there wasn’t much public concern over it,” Epstein said. “This is a policy matter, and as a prosecutor if you’re enforcing legal policy and statute, you have to exercise some level of discretion.”

Paragraph 19 of the indictment alleges that Haim’s disclosures to Rufo resulted in “financial loss” to TCH, and that Haim blew the whistle out of “malicious intent.” Haim, for his part, observes that he swore an oath to “do no harm” and believed he had a duty to disclose alleged TCH’s secret gender clinic to prevent further harm to children undergoing procedures for which there is a lack of long-term evidence of efficacy (or safety).

By Niall Ferguson

But it only recently struck me that in this new Cold War, we—and not the Chinese—might be the Soviets. It’s a bit like that moment when the British comedians David Mitchell and Robert Webb, playing Waffen-SS officers toward the end of World War II, ask the immortal question: “Are we the baddies?”

I imagine two American sailors asking themselves one day—perhaps as their aircraft carrier is sinking beneath their feet somewhere near the Taiwan Strait: Are we the Soviets?

Yes, I know what you are going to say. 

There is a world of difference between the dysfunctional planned economy that Stalin built and bequeathed his heirs, which collapsed as soon as Mikhail Gorbachev tried to reform it, and the dynamic market economy that we Americans take pride in. 

The Soviet system squandered resources and all but guaranteed shortages of consumer goods. The Soviet healthcare system was crippled by dilapidated hospitals and chronic shortages of equipment. There was grinding poverty, hunger, and child labor. 

——

Total public cynicism about nearly all institutions.

Shannon Najmabadi:

Last summer, a rural hospital on the Kansas plains began filing dozens of lawsuits against patients who hadn’t paid their medical bills.

In July and August 2023, four of every five sheriff-delivered court summonses in Pratt County were from Pratt Regional Medical Center. In September, 95% of civil cases set to be heard in Magistrate Judge Ronald Sylvester’s Pratt courtroom were brought by the hospital. By December, it had sued some 400 people in a county of 9,000—more than it had in the past five years combined.

“If it makes you feel any better,” Cynthia Mehlhorn recalls an officer telling her when she got her court summons for $5,619 in outstanding hospital bills last year, “you’re not the only one.”

The debt-collection spree is an example of how some hospitals in recent years have become more aggressive in recouping bills from the estimated more than 15 million Americans who have medical debt. The issue can be particularly acute in rural areas like Pratt, where residents are more likely to be older and uninsured, and hospitals are under financial stress.

Jill Barshay:

Schools spend billions of dollars a year on products and services, including everything from staplers and textbooks to teacher coaching and training. Does any of it help students learn more? Some educational materials end up mothballed in closets. Much software goes unused. Yet central-office bureaucrats frequently renew their contracts with outside vendors regardless of usage or efficacy.

One idea for smarter education spending is for schools to sign smarter contracts, where part of the payment is contingent upon whether students use the services and learn more. It’s called outcomes-based contracting and is a way of sharing risk between buyer (the school) and seller (the vendor). Outcomes-based contracting is most common in healthcare. For example, a health insurer might pay a pharmaceutical company more for a drug if it actually improves people’s health, and less if it doesn’t. 

Although the idea is relatively new in education, many schools tried a different version of it – evaluating and paying teachers based on how much their students’ test scores improved – in the 2010s. Teachers didn’t like it, and enthusiasm for these teacher accountability schemes waned. Then, in 2020, Harvard University’s Center for Education Policy Research announced that it was going to test the feasibility of paying tutoring companies by how much students’ test scores improved. 

Freddie DeBoer:

In 1963, JFK signed the Community Mental Health Act. Its order to close the state psychiatric hospitals was followed, and hundreds were shuttered; the community mental health centers that were meant to replace them were never built. With far fewer beds for a growing patient population it should not have surprised anyone that the streets gradually filled with the severely ill. But somehow, we were surprised. The state governments were mostly just grateful to save money that had once gone to mental healthcare. The passage of Medicaid two years later deepened the problem. Medicaid’s funding structure presented states with an opportunity to further offload costs, this time onto the federal government. Unfortunately, the private institutions that filled with Medicaid patients were no better than the state facilities that had been closed; often they were worse. And maintaining access to Medicaid funding for such care, in practice, was more complicated and less certain than staying in a state institution. In 1975, the Supreme Court’s O’Connor v. Donaldson decision established a national standard that the mentally ill could only be involuntarily treated if they represented an immediate threat to themselves or others. This completely removed actual medical necessity from the equation, and the standard directly incentivized hospitals to discharge very ill patients, many of whom leave these useless emergency room visits and immediately abuse drugs, self-harm, commit crimes, attack others, or commit suicide. In 1990 the passage of the Americans with Disabilities Act further empowered treatment-resistant patients and created legal incentives that led hospitals to release severely ill people rather than face the burden of litigation. Various state reforms in recent decades have almost uniformly pushed the severely ill out of treatment rather than into it, under the banner of “autonomy.” For sixty years we’ve done everything in our power to make it harder to treat people who badly need care. And here we are.

Will Flanders:

Among the key findings of this report:

• Student-teacher ratios have not been negatively affected by Act 10. The number of students per teacher in Wisconsin has stayed relatively constant at about 13.2 students per teacher.
• The decrease of public sector unions has stabilized. While there was a substantial decline in the number of unions in the immediate aftermath of the passage of the law, recent declines have been far more moderate.
• Restoring collective bargaining for teacher salaries could cost districts and the state nearly $650 million annually. This number is based on the difference in the rate of growth in teacher salaries observed from 2001-2011 compared to 2011-2021.
• Eliminating employee contributions to retirement would cost districts and the state about $422 million annually. Based on inflation-adjusted comparison of retirement spending in 2009 versus 2022.
• Eliminating employee contributions to healthcare would cost districts and the state about $560 million annually. Based on inflation-adjusted comparison of healthcare spending in 2009 versus 2022.
• Numbers are conservative estimates of the total cost. This study does not take into account the costs to municipalities from repeal, nor the salary costs for non-teachers.
• An end to Act 10 would likely lead to tough decisions for districts. One Superintendent we spoke with said that ending Act 10 would likely lead to a need for larger class sizes, cuts to popular programs, and an inability to offer higher compensation for high-demand teaching positions.

Few single pieces of state-level legislation have garnered as much attention and controversy in the 21st Century as Wisconsin’s Act 10. Passed by Republican Governor Scott Walker over the strong objections of Democrats, 3 the legislation introduced several important reforms to public sector unions around the state. Twelve years later, the legislation remains controversial. Supreme Court Justice Janet Protasiewiczelected to the Court in 2023—has said that she believes the legislation may be unconstitutional, 4 giving new hope to those who would like to see the law off the books. In November, seven unions representing teachers and other public sector workers filed a lawsuit with that goal. 5 But what would an overturn of the legislation mean for Wisconsin and its taxpayers?

In the last decade, WILL and others have conducted extensive research that helps to answer that question. In this paper, we review the existing work on what Act 10 has meant to the state and provide updated data in some of the areas we’ve examined previously. In the end, we find that overturning Act 10 could have a devastating effect on Wisconsin taxpayers, as well as the budgets of local school districts.

——

Wisconsin’s Act 10, Flexible Pay, and the Impact on Teacher Labor Markets: Student test scores rise in flexible-pay districts. So does a gender gap for teacher compensation.

Leon Sapor:

Imagine if American doctors told parents the following truths. The mental health benefits of puberty blockers are highly uncertain, according to multiple systematic reviews of the evidence, the bedrock of evidence-based medicine. The World Health Organization says the evidence is “limited and variable.” There is no research into long-term harms, but some evidence suggests decreased IQand brittle bones. Permanent sterility is guaranteed for minors who go through full hormonal “transition.” Sexual dysfunction appears to be extremely common as well. Over 93 percentof kids who take these drugs go on to cross-sex hormones, which lead to permanent physical changes including excruciating genital growth, vaginal atrophy and tearing and much higher risk for cancer and cardiovascular disease.

There is no credible evidence that puberty blockers function as suicide-prevention measures. Finland’s top gender clinician has called the suicide narrative “purposeful disinformation” and “dangerous.” For all these reasons, health authorities in a growing number of countries, including some of the most LGBT-friendly, are now prioritizing talk therapy.

Matt Barnum:

Nationally, average teacher pay has barely budged since 1990, despite states pumping more funding into public schools. Across the country, new education dollars have instead gone toward additional staff, rising healthcare costs and pension obligations.

Now, some lawmakers are championing new pay mandates to force the issue, amid elevated teacher-turnover rates and a decline in people training to become teachers.

In South Dakota earlier this month, Gov. Kristi Noem signed into law a minimum teacher salary of $45,000, which will rise with inflation.

“If you want to have quality teachers enter the workforce and stay in the workforce, you have to pay them,” state representative Tony Venhuizen said at the bill’s signing ceremony. “When the state puts money into the schools, we want to see that money get into the teachers’ pockets.”

Last year, Arkansas set starting teacher pay at $50,000, a five-figure increase in many districts. The legislation also guaranteed every teacher at least a $2,000 raise. In 2026, $50,000 and $60,000 minimums will go into effect in Tennessee and Maryland, respectively.

Claire Jones:

Swagel, who served in the US Treasury under Republican president George W Bush, acknowledged that next year would be important “for fiscal policy in particular”, given debate over extending the tax cuts and Obama-era healthcare subsidies that are also due to expire.

The CBO projections issued this week showed debt-to-GDP levels surpassing their second world war high of 116 per cent in 2029 — a trajectory that Swagel described as “unprecedented”.

“The debt that was run up during World War Two, was largely paid back within the generation of the people who fought the war,” Swagel said.

“The fiscal burdens being generated today are not ones the current generation is going to bear the burden of.” The dollar’s role as the world’s reserve currency would not always insulate the US from market pressures as debt interest payments increased, Swagel warned.

——

US Debt Clock.

Sarah Shaffer:

Coming together around the question ​“What could we win together?” this broad cross section of Minnesota’s working class decided to go on the offensive, developing a set of guiding principles over months, made possible in turn by years of relationship building through street uprisings and overlapping crises.

Shortly after we spoke that day, Villanueva and her colleagues felt that collective power manifest: reaching a tentative agreement with their employers after months of bargaining. The strike they’d authorized to begin March 4 would not be necessary: they won a 17% increase in base pay, an improved healthcare plan, more paid time off, and their first-ever paid holidays on Thanksgiving and Christmas. 

The next day, the building security workers who were negotiating nearby on the same property, also reached an agreement, one that included pay raises of up to 27%, employer-paid 401Ks, and a Juneteenth paid holiday. 

This broad cross section of Minnesota’s working class decided to go on the offensive, developing a set of guiding principles over months, made possible in turn by years of relationship building through street uprisings and overlapping crises.

What is happening in the Twin Cities could be a powerful model for the working class everywhere: a movement ecosystem whose members show up in deep solidarity across differences, that thinks strategically and builds for the long term while maximizing its current power. That understands workers are also renters, neighbors, people who want a livable city and climate — and that they can exponentially amplify their power by acting together. 

“We have learned over and over again,” Local 26President Greg Nammacher explained, “when we try and push for justice in each of our own separate lanes, we are not as successful as if we push for justice together across our different organizations.” 

——-

Act 10.

The Milwaukee pension scandal and political implications.

WEAC: $1.57 million for Four Wisconsin Senators

Brianna Abbott::

Stacy Hernandez always had irregular periods. But when the bleeding wouldn’t stop, she got scared.

She said she visited her general practitioner and urgent care at least six times. Doctors changed her birth-control medications, blamed her excess weight and suggested the bleeding would eventually subside.

It didn’t. After more than a year, a doctor ordered an ultrasound followed by a test that finally identified the problem: uterine cancer.

“It was surreal,” said Hernandez, 31, who is undergoing treatment near her home in Utah. “It’s not OK for them to dismiss it like that.”

Uterine is the only cancer for which survival has fallen in the past four decades, the American Cancer Society said. The disease will kill some 13,250 women in the U.S. this year, the group estimates, surpassing ovarian cancer to become the deadliest gynecologic cancer.

Wall Street Journal:

The University of California Los Angeles School of Medicine requires that first year students take a class called “Structural Racism and Health Equity” as part of the standard curriculum. In one exercise for the course, students divide by racial group and retreat to different areas to discuss antiracist prompts.

This is known as racial caucusing, a teaching device that UCLA describes as an “anti-racist pedagogical tool” to “provide a reflective space for us to explore how our positionality—particularly our racial identities as perceived within clinical spaces—influence our interaction with patients, colleagues and other staff.”

It’s also illegal. According to Do No Harm, a group that describes its mission as “eliminating racial discrimination in healthcare,” the practice violates the 1964 Civil Rights Act. In a letter to the San Francisco Office for Civil Rights, Do No Harm wrote this week that the school’s racial caucusing groups “illegally segregate and separate its first year medical students based on their race, color and/or national origin” in violation of Title VI.

Medical students in the class are asked to choose which of three racial categories they will identify with. They can select among “white student caucus group,” “Non-Black People of Color (NBPOC) student caucus group” or “Black student caucus group.”

Julie Wernau:

Braxton is among thousands of teenagers and young adults who have developed delusions and paranoia after using cannabis. Legalization efforts have made cannabis more readily available in much of the country. More frequent use of marijuana that is many times as potent as strains common three decades ago is leading to more psychotic episodes, according to doctors and recent research. 

“This isn’t the cannabis of 20, 30 years ago,” said Dr. Deepali Gershan, an addiction psychiatrist at Compass Health Center in Northbrook, Ill. Up to 20% of her caseload is patients for whom she suspects cannabis use triggered a psychotic episode.

Rates of diagnoses for cannabis-induced disorders were more than 50% higher at the end of November than in 2019, healthcare-analytics company Truveta said this week. The trend is contributing to the broader burden of caring for people who developed mental health and addiction problems during the pandemic.

Julie Wernau:

Braxton is among thousands of teenagers and young adults who have developed delusions and paranoia after using cannabis. Legalization efforts have made cannabis more readily available in much of the country. More frequent use of marijuana that is many times as potent as strains common three decades ago is leading to more psychotic episodes, according to doctors and recent research. 

“This isn’t the cannabis of 20, 30 years ago,” said Dr. Deepali Gershan, an addiction psychiatrist at Compass Health Center in Northbrook, Ill. Up to 20% of her caseload is patients for whom she suspects cannabis use triggered a psychotic episode.

Rates of diagnoses for cannabis-induced disorders were more than 50% higher at the end of November than in 2019, healthcare-analytics company Truveta said this week. The trend is contributing to the broader burden of caring for people who developed mental health and addiction problems during the pandemic.

Kelly Meyerhofer:

Alex Mancilla graduated last month from Marquette University, an electrical engineering degree in hand and a job lined up at GE HealthCare.

Behind the educational milestone is the story of a young south side Milwaukee man whose parents immigrated from Mexico and were unable to help him financially. College wasn’t even on Mancilla’s radar until his seventh-grade English teacher pulled him out of class and asked about his plans.

“Was college the dream?” Mancilla asked “I don’t think so. The teachers that we had in elementary school had good intentions but college wasn’t something talked about. They would tell us to go to college but didn’t say how. There was no robust path to get there.”

Paving a path for Mancilla, 22, and hundreds of others was All-In Milwaukee, a nonprofit supporting diverse, low-income Milwaukee students through college and into their careers. Corporate and individual donors cover their college costs, so most graduate without any debt. Equally important is the advising support students receive throughout their time on campus.

Ling Xin:

After more than a decade of research and teaching in the United States, Chinese-born maths star Sun Song has joined a university in eastern China as a full-time professor.

The 36-year-old geometer started his role as a permanent faculty member at the Institute for Advanced Study in Mathematics (IASM) at Zhejiang University earlier this month, according to the university’s official WeChat account.

Liz Essley Whyte:

Jessica Harris’s 15-year-old daughter was walking to her school bus in London, Ky., last month when a classmate offered her a piece of red candy.

The square-shaped sweet seemed harmless at the time to Harris’s daughter. But it turned out it contained a form of tetrahydrocannabinol, or THC, the intoxicating ingredient in cannabis plants, and it sent her to the hospital.

An explosion of products containing THC and similar chemicals—some of them in kid-enticing forms such as candy or gummy bears—is sending children to emergency rooms across the country and has federal and state regulators grappling with how to contain it. Many of these products face little to no restrictions, because their creators obtain their intoxicating compounds not from marijuana but from hemp, which Congress legalized in 2018.

Calls to poison-control centers concerning these newly popular hemp-derived cannabinoids boomed over the past several years, from four in January 2021 to hundreds every month of 2022 and 2023 for which there is data, according to America’s Poison Centers. More than half of those calls concerned children. Reports of adverse events from these products to the Food and Drug Administration have also increased.

WILL:

The News: The Wisconsin Institute for Law & Liberty (WILL) has filed a lawsuit against the State Bar of Wisconsin for promoting discriminatory DEI practices including its “Diversity Clerkship Program,” which offers premier internship opportunities based primarily on race.

WILL’s client must pay mandatory and annual State Bar dues, which not only fund this internship program, but also other programs and communications that discriminate against him and thousands of other Wisconsin attorneys.

The Quotes: WILL Associate Counsel, Skylar Croy, stated, “When the government discriminates based on race, it sows more division in our country and violates the Constitution in the process. WILL is standing up against discrimination and holding the State Bar accountable to the rights of its due-paying members.”

Wisconsin employers using state DEI internship program to "engage in illegal affirmative action," new lawsuit alleges. Prominent participants in State Bar program include @Fiserv, @GEHealthCare, @NM_Financial, @Kohler, @Froedtert.
More here: https://t.co/MiZxRIZ1pC

— Dan Lennington (@DanLennington) December 20, 2023

Wisconsin Legislative Audit Bureau

The Department of Safety and Professional Services (DSPS) is statutorily responsible for ensuring the safe and competent practice of credentialed professionals in Wisconsin. In August 2023, DSPS administered more than 200 types of credentials for individuals who work in healthcare professions, business professions, and the trades.

DSPS is funded primarily by program revenue, including from the fees individuals pay when applying for initial credentials and renewing their credentials. In fiscal year (FY) 2022-23, DSPS spent $11.2 million on credentialing activities.

Commentary.

Scott Girard:

“Wisconsin’s Teacher Pay Predicament,” published today by the nonpartisan Wisconsin Policy Forum, says it’s likely to get more challenging for districts to match the rising cost of living, even as many of the largest school systems gave out record wage increases ahead of the 2023-24 school year.

That includes the Madison Metropolitan School District, which gave staff an 8% increase in base wages — the largest allowed by the Wisconsin Employment Relations Commission. School Board members and Madison Teachers Inc. said it was necessary to keep employees amid an ongoing teacher shortage.

“After years of declines in real wages, teachers and public school advocates may welcome the recent raises for school staff, but the increases also leave a difficult path ahead for district finances,” the Policy Forum report notes.

The nonprofit’s report finds that in 2009, the median gross teacher pay was at $51,069. In 2023, that had risen to $59,250 — but that was over $8,000 less than what it would have been if tied to inflation.

The Forum suggests there are a mix of factors at play, including the exodus of experienced teachers in 2012 after the Legislature and then-Gov. Scott Walker passed Act 10, which limited union collective bargaining rights. Teachers who left their jobs were largely replaced by younger, lower-paid teachers, which reduced the median salaries.

“With Wisconsin teachers leaving the public school classroom at an average annual rate of 8% from 2009 to 2023, this factor has likely held down salaries,” the report states, and adds that “constraints in district spending and in actual increases in teacher salary also clearly impacted these numbers.”

Wisconsin Policy Forum

Other factors either cushioned or exacerbated this impact. Act 10 required teachers to pay greater health care and pension contributions, which limited staff compensation but helped balance school budgets. Starting in 2016, school districts increasingly turned to referenda asking voters to increase local property taxes beyond their revenue limits.

Declining student enrollment, however, has further tightened the limits for districts over these years. In particular, the decrease in student enrollment (-5.8% from 2009 to 2023) occurred without a decrease in the number of teachers (+0.3% over the same time period), leaving some districts stretching fewer overall dollars than they would otherwise have across largely static personnel

———

Teachers should be well paid and address things like the Foundations of Reading. Massachusetts increased compensation when implementing MTEL.

Madison K-12 healthcare $pending.

Also, union fees are not mentioned.

Related:

The world’s third-richest person, worth roughly $161 billion according to Forbes, will also ditch Washington State’s hefty taxes, likely saving him billions of dollars over the long term, according to securities filings, tax lawyers and accounting experts.

People will use this to argue for more public-school spending. But the reality is we spend more on schools in real dollars than we did in 2000. What has happened to teacher pay is what has happened to all of us-massive inflation under @JoeBiden https://t.co/3otkibbXz0

— Will Flanders (@WillFlandersWI) November 30, 2023

Wall Street Journal:

We’ve all heard children say things like “Look at me, I’m a robot” or “When I grow up, I’m going to be Captain America.” We smile when children say these things, because we know that children live in a world of imagination unhindered by reality. Why then does the medical community and culture at large think it is acceptable for children to make irreversible health decisions?

“Gender-affirming” healthcare is the only area of medicine where patients make their own diagnosis and prescribe their own remedy. Meanwhile, physicians frighten parents with warnings of their child’s suicide while convincing parents that there are no long-term effects to puberty blockers and hormone treatments. The tragic fact is that puberty blockers and gender procedures effectively sterilize children and cannot be reversed. Not only are the medical principles of informed consent and parental involvement for minor patients often ignored, but gender transition for children rejects alternate causes and remedies. Since most cases of juvenile gender dysphoria are resolved by the time of puberty, physicians should stop pushing gender transition on minor patients as the only solution.

Mohar Chatterjee and Rebecca Kern:

The White House is poised to make an all-hands effort to impose national rules on a fast-moving technology, according to a draft executive order.

President Joe Biden will deploy numerous federal agencies to monitor the risks of artificial intelligence and develop new uses for the technology while attempting to protect workers, according to a draft executive order obtained by POLITICO.

The order, expected to be issued as soon as Monday, would streamline high-skilled immigration, create a raft of new government offices and task forces and pave the way for the use of more AI in nearly every facet of life touched by the federal government, from health care to education, trade to housing, and more.

At the same time, the Oct. 23 draft order calls for extensive new checks on the technology, directing agencies to set standards to ensure data privacy and cybersecurity, prevent discrimination, enforce fairness and also closely monitor the competitive landscape of a fast-growing industry. The draft order was verified by multiple people who have seen or been consulted on draft copies of the document.

The White House did not reply to a request to confirm the draft.

Though the order does not have the force of law and previous White House AI efforts have been criticized for lacking enforcement teeth, the new guidelines will give federal agencies influence in the US market through their buying power and their enforcement tools. Biden’s order specifically directs the Federal Trade Commission, for instance, to focus on anti-competitive behavior and consumer harms in the AI industry — a mission that Chair Lina Khan has already publicly embraced.

———

President Biden has signed an executive order that will require AI companies to “address algorithmic discrimination” and “ensure that AI advances equity.” They want to embed the principles of CRT and DEI into every aspect of AI.

Permissionless Innovation: The Continuing Case for Comprehensive Technological Freedom, and.

“Fiscal indulgences”

Imagine a computer code Ibram Kendi installed directly into your operating system, forever.

This is a terrible tech policy document. The noise made by some closed AI companies around simple word calculators taking over the world has now led to a regulatory regime which functionally makes it tougher for newer entrants, in both closed and open source AI worlds. This is the textbook definition of regulatory capture playing out (cc @bgurley). Some red flags:

It mostly demands a lot of reports, almost entirely from within the government.

1. A lot of government employees will be writing a lot of reports.
2. After they get those reports, others will then write additional reports.
3. There will also be a lot of government meetings.
4. These reports will propose paths forward to deal with a variety of AI issues.
5. These reports indicate which agencies may get jurisdiction on various AI issues.
6. Which reports are requested indicates what concerns are most prominent now.
   1. A major goal is to get AI experts into government, and get government in a place where it can implement the use of AI, and AI talent into the USA.
   2. Another major goal is ensuring the safety of cutting-edge foundation (or ‘dual use’) models, starting with knowing which ones are being trained and what safety precautions are being taken.
   3. Other ultimate goals include: Protecting vital infrastructure and cybersecurity, safeguarding privacy, preventing discrimination in many domains, protecting workers, guarding against misuse, guarding against fraud, ensuring identification of AI content, integrating AI into education and healthcare and promoting AI research and American global leadership.

US Fifth Circuit:

For the last few years—at least since the 2020 presidential transition—a group of federal officials has been in regular contact with nearly every major American social-media company about the spread of “misinformation” on their platforms. In their concern, those officialshailing from the White House, the CDC, the FBI, and a few other agenciesurged the platforms to remove disfavored content and accounts from their sites. And, the platforms seemingly complied. They gave the officials access to an expedited reporting system, downgraded or removed flagged posts, and deplatformed users. The platforms also changed their internal policies to capture more flagged content and sent steady reports on their moderation activities to the officials. That went on through the COVID-19 pandemic, the 2022 congressional election, and continues to this day.

Enter this lawsuit. The Plaintiffs—three doctors, a news website, a healthcare activist, and two states1 —had posts and stories removed or downgraded by the platforms. Their content touched on a host of divisive topics like the COVID-19 lab-leak theory, pandemic lockdowns, vaccine sideeffects, election fraud, and the Hunter Biden laptop story. The Plaintiffs maintain that although the platforms stifled their speech, the government officials were the ones pulling the strings—they “coerced, threatened, and pressured [the] social-media platforms to censor [them]” through private

Anna Wilde Mathews:

Health-insurance costs are climbing at the steepest rate in years, with some projecting the biggest increase in more than a decade will wallop businesses and their workers in 2024.

Costs for employer coverage are expected to surge around 6.5% for 2024, according to major benefits consulting firms Mercer and Willis Towers Watson, which provided their survey results exclusively to The Wall Street Journal.

Such a boost could add significantly to the price tag for employer plans that already average more than $14,600 a year per employee, driving up health-insurance costs that are among the biggest expenses for many American companies and a drain on families’ finances.

Employers worry the hike might signal a new trajectory, with health costs resuming the rapid upward march of the early 2000s. Now, though, big increases would come on top of a total annual cost per covered family that is often equivalent to the purchase price of a small car. These increases come at a time when employers are reluctant to add to out-of-pocket charges that have left some of their workers in debt or unable to get care they needed.

“It’s much worse than we’ve seen over the last decade,” said Elizabeth Mitchell, chief executive of the Purchaser Business Group on Health. “It comes out of wages and core business.”

Holman Jenkins:

Our steps did not significantly impede its spread even as our efforts miraculously quashed the annual flu. In year two, despite vaccination, as many Americans died as in year one. Yet further healthcare meltdowns were avoided. Vaccines clearly saved lives; if lockdowns and masking mandates contributed by keeping people alive until they could be vaccinated, though, the effect is hard to sort out from the voluntary measures an informed public would have taken anyway.

Meanwhile, bans on elective medical procedures, forced unemployment, school closures and other extreme measures produced their own toll. Among the 1.1 million Americans who died of Covid, their average age was 74 and they lost 12 years of life. Nobody yet knows the total years lost to younger people due to “excess deaths” from substance abuse, suicide, homicide, accidents, lack of cancer screening and other non-Covid causes. Only with the arrival of the Biden administration did it become expedient to acknowledge a truth known from the start: The virus was something we would have to “live with,” not defeat with indiscriminate social and economic curbs.

This is where the decision of U.S. District Judge Terry Doughty sheds light. His detailed recounting shows a Washington energetic in protecting Americans from Covid opinions, expertise and claims that conflicted with its own, at a time when it served politicians to show they were trying to save Americans from encountering a virus that couldn’t be avoided. When government has a message to deliver, especially when the political stakes are high, it won’t be content just to push its own message, it will try to silence others. Fighting back will always be necessary. The only surprise in our age is how thoroughly the “liberal” position has become the pro-censorship position.

Related: Taxpayer funded Dane County Madison Public Health mandates

Anna Mutoh:

Jaclyn Ohmer couldn’t wait to have a baby. Before she was pregnant, she bought onesies and beagle-shaped booties. She and her husband, her high-school sweetheart, found out they were having a son and prepared a Star Wars-themed baby room. The 26-year-old from Parma, Ohio, was ready for his arrival.

Things got harder after he was born in June of last year. Ohmer loved him but she often felt sad. She grew anxious waiting for his next cry. She wasn’t sure she was fit to be a mom.

When he was shrieking one day, Ohmer had a terrifying thought: “If I put my hand over his mouth, he will be gone. He wouldn’t have to live with me, or go through this.”

She became increasingly fearful of hurting her baby—and more convinced that her family would be better off without her. Ohmer tried to seek help, but help was hard to find.

Researchers estimate that one in five new mothers in the U.S. suffers from mood and anxiety disorders during pregnancy and up to a year after giving birth—about 800,000 mothers every year. Yet studies show that a large majority of women who suffer from maternal mental-health disorders aren’t able to get help.

A major cause is the piecemeal nature of the U.S. healthcare system, where no one medical professional takes responsibility for new mothers and their mental health. Obstetricians, usually the first medical point of contact for new mothers, often don’t specialize in it. Pediatricians focus on the children. Many women seeking help go from doctor to doctor, who struggle to find care amid a shortage of mental-health specialists.

Maya Bodnick:

Every year, hundreds of thousands of students around the U.S. participate in competitive debate. Most start competing at a young age (early high school or even middle school), eager to learn about politics. At its best, the activity teaches students how to think critically about the government and the trade-offs that policymakers face. They are assigned to argue for different positions that they may not agree with and engage with their peers’ diverse perspectives. 

I started competing in Parliamentary debate at 12 years old. Growing up in Silicon Valley—a place full of scorn for politics—and attending a STEM-focused high school, debate was how I learned about public policy and economics. Often, the activity broadened and enriched how I thought about politics. But debate has strayed from these goals. Instead of expanding students’ worldviews, debate has increasingly narrowed to become a microcosm of critical theory.

The rise of critical theory in high school debate

In a traditional debate round, students argue over a topic assigned by the tournament — for example, “The U.S. should adopt universal healthcare.” One side is expected to argue in favor of the motion (the affirmation side), and one against (the negation side). However, in recent years, many debaters have decided to flat-out ignore the assigned topic and instead hijack the round by proposing brand new (i.e., wholly unrelated to the original topic), debater-created resolutions that advocate complex social criticisms based on various theories — Marxism, anti-militarism, feminist international relations theory, neocolonialism, securitization, anthropocentrism, orientalism, racial positionality, Afro-Pessimism, disablism, queer ecology, and transfeminism. (To be clear, traditional feminism is out of fashion and seen as too essentialist.)

These critical theory arguments, known as kritiks, are usually wielded by the negation side to criticize the fundamental assumptions of their affirmation side opponents. Kritik advocates argue that the world is so systematically broken that discussing public policy proposals and reforms misses what really matters: the need to fundamentally revolutionize society in some way. For example, if the topic was “The U.S. should increase the federal minimum wage,” the affirmation side might provide some arguments supporting this policy. But then the negation side, instead of arguing that the government shouldn’t raise the minimum wage, might reject spending any time on the original resolution and counter-propose a Marxist kritik. Here’s an example of how the negation might introduce this kritik:

Hayden Dublois

But in 2022, a Foundation for Government Accountability (FGA) review of more than 6,400 hospitals found that nearly two-thirds were not complying with price transparency requirements.³ More recent records suggest that most hospitals are still not compliant today.⁴Other organizations have suggested as many as 75 percent of hospitals are ignoring the price transparency rule.⁵ The Biden administration has come under fire from lawmakers for failing to enforce the rule with publicly accessible information, with one member of Congress noting that, “we can get more information about a local restaurant from Yelp than you can get about your local hospital from CMS.”⁶

Thousands of pages of new records obtained by FGA have shined a light on precisely why so few hospitals are compliant with price transparency requirements. These CMS records—which include detailed warnings, notices of violations, corrective action plan requests, and monetary penalties—span more than 250 hospitals in 46 states and Washington, D.C. The conclusion drawn from the records is clear: CMS simply does not take price transparency seriously.

CMS is providing substantial deference to hospitals on price transparency requirements

Despite the price transparency rule taking effect in January 2021, the Biden administration waited four months before CMS began taking any action, with the first batch of warnings issued in mid-April 2021.⁷ Even so, only a handful of hospitals received warnings in this first month of action—a lackluster start to price transparency enforcement.

Healthcare costs have long been an issue in K-12 budgets.

Christopher Rufo

Following the French Revolution, the British philosopher Edmund Burke signaled a note of caution, warning that the desire for progress, uninhibited by convention, can lead to disaster. Revolutions in the name of lofty ideals—liberty, equality, science—can yield their opposites. A revolution in our time merits similar consideration: the transformation of human sexuality and, in particular, the rise of so-called transgender medicine.

The gender surgery program at Oregon Health & Science University, a public teaching hospital in downtown Portland, provides a productive tableau for analysis. The program is led by Blair Peters, a self-described “queer surgeon” who sports neon-pink hair, uses “he/they” pronouns, and specializes in vaginoplasty (the creation of an artificial vagina), phalloplasty (the creation of an artificial penis), and “non-binary” surgeries, which nullify the genitals altogether. Peters and his colleagues have pioneered the use of a vaginoplasty robot, which helps efficiently castrate male patients and turn their flesh into a “neo-vagina.”

Business is booming. According to Peters, OHSU’s gender surgery clinic has “the highest volume on the West Coast,” and his robot-assisted vaginoplasty program can accommodate two patients per day. His colleague Jens Berli, who specializes in phalloplasty, boasts a 12- to-18-month waiting list for a consultation and an additional three- to six-month waiting list for a surgical appointment.

This openness marks a revolution in manners and morals. In the past, transgender theorists acknowledged that their surgical transformations were disturbing and anti-normative. “I find a deep affinity between myself as a transsexual woman and the monster in Mary Shelley’s Frankenstein,” wrote the male-to-female transgender theorist Susan Stryker in 1994. “I will say this as bluntly as I know how: I am a transsexual, and therefore I am a monster.”

Leor Sapir:

A growing number of countries, including some of the most progressive in Europe, are rejecting the U.S. “gender-affirming” model of care for transgender-identified youth. These countries have adopted a far more restrictive and cautious approach, one that prioritizes psychotherapy and reserves hormonal interventions for extreme cases.  

In stark contrast to groups like the American Academy of Pediatrics (AAP), which urges clinicians to “affirm” their patient’s identity irrespective of circumstance and regards alternatives to an affirm-early/affirm-only approach “conversion therapy,” European health authorities are recommending exploratory therapy to discern why teens are rejecting their bodies and whether less invasive treatments may help.  

If implemented in American clinics, the European approach would effectively deny puberty blockers and cross-sex hormones to most adolescents who are receiving these drugs today. Unlike in the U.S., in Europe surgeries are generally off the table before adulthood.  

Why are more countries turning their backs on what American medical associations, most Democrats and the American Civil Liberties Union call “medically necessary” and “life-saving” care? The answer is that Europeans are following principles of evidence-based medicine (EBM), while Americans are not.

Harold Robertson:

At a casual glance, the recent cascades of American disasters might seem unrelated. In a span of fewer than six months in 2017, three U.S. Naval warships experienced three separate collisions resulting in 17 deaths. A year later, powerlines owned by PG&E started a wildfire that killed 85 people. The pipeline carrying almost half of the East Coast’s gasoline shut down due to a ransomware attack. Almost half a million intermodal containers sat on cargo ships unable to dock at Los Angeles ports. A train carrying thousands of tons of hazardous and flammable chemicals derailed near East Palestine, Ohio. Air Traffic Control cleared a FedEx plane to land on a runway occupied by a Southwest plane preparing to take off. Eye drops contaminated with antibiotic-resistant bacteria killed four and blinded fourteen. 

While disasters like these are often front-page news, the broader connection between the disasters barely elicits any mention. America must be understood as a system of interwoven systems; the healthcare system sends a bill to a patient using the postal system, and that patient uses the mobile phone system to pay the bill with a credit card issued by the banking system. All these systems must be assumed to work for anyone to make even simple decisions. But the failure of one system has cascading consequences for all of the adjacent systems. As a consequence of escalating rates of failure, America’s complex systems are slowly collapsing.

The core issue is that changing political mores have established the systematic promotion of the unqualified and sidelining of the competent. This has continually weakened our society’s ability to manage modern systems. At its inception, it represented a break from the trend of the 1920s to the 1960s, when the direct meritocratic evaluation of competence became the norm across vast swaths of American society. 

In the first decades of the twentieth century, the idea that individuals should be systematically evaluated and selected based on their ability rather than wealth, class, or political connections, led to significant changes in selection techniques at all levels of American society. The Scholastic Aptitude Test (SAT) revolutionized college admissions by allowing elite universities to find and recruit talented students from beyond the boarding schools of New England. Following the adoption of the SAT, aptitude tests such as Wonderlic (1936), Graduate Record Examination (1936), Army General Classification Test (1941), and Law School Admission Test (1948) swept the United States. Spurred on by the demands of two world wars, this system of institutional management electrified the Tennessee Valley, created the first atom bomb, invented the transistor, and put a man on the moon.

Why is Norway failing?#Norway (pop. 5.475.240)
vs. #Finland. (pop. 5.569.431)

Norwegian Public Sector 885.419
Finnish Public Sector 647.000

Finland – less tax, better school system and healthcare. Norwegian politicians are mismanaging the country!
1/5 pic.twitter.com/wqy1nzwzmy

— Alexander Ellefsen⚡️ (@4lexEllefsen) June 9, 2023

The Generalist:

The great business theorist Peter Drucker didn’t think all that much of ideas. “Ideas are cheap and abundant,” the management expert said, “What is of value is the effective placement of those ideas into situations that develop into action.” 

Drucker’s position is a common one. Across academia and industry, plenty of fine thinkers have made equivalent statements, arguing that real value resides in effective implementation, not ideation. The prolific executive brings most value to the world, this thesis goes, rather than the unproductive theorist. 

Though there’s wisdom in Drucker’s words, he is wrong in his assessment of ideas. Ideas are not cheap, not the valueless things the Austro-American characterizes them as. Certainly, ideas cannot impact society without “effective placement,” but there would be nothing to “place” without them. They are the seed of all progress, the beginning of every great invention. The fibers of our clothing, refrigeration of our food, design of our medicines, and architecture of our computer chips all began as ideas, or more accurately, a series of ideas stacked on top of each other, finely balanced. 

Nor are ideas abundant. Indeed, there is evidence they are growing rarer by the year. A Stanford University study titled “Are Ideas Getting Harder to Find?” detailed how “research effort is rising substantially while research productivity is declining sharply.” For example, maintaining Moore’s Law – which predicts the doubling of transistors on a computer chip every two years – has required massive increases in research efforts. Compared to the 1970s, 18x more researchers are needed to continue its trajectory, with productivity slipping. The study documents similar slumps in other industries like agriculture and healthcare. 

The decrement of ideas makes their study all the more important. Rather than diminishing them, we should seek to understand better how, where, and by who they are created. What incentives encourage originality? Who should you hire to boost an organization’s innovation? And how do you harness the abilities of a collective?

David Blaska:

The UW-Madison branch of Workers Strike Back met here late last month and plastered the campus with their signage. Their pitch is a “demand” for a yearly salary of $50,000.

These are graduate degree students who help their professors grade papers, lead classes, and work at the lab. UW-Madison’s 5,400 graduate research and teaching assistants already make between $21,115 and $28,388 a year. That doesn’t count the $12,000 we pay toward their graduate school tuition, and $7,500 worth of health insurance. Plus a free bus pass, on-campus parking, access to the university health clinic, child care, no heavy lifting, yadda yadda. 

You wanna make a college degree even more unaffordable, go for it! The Werkes thinks graduate students should suffer for their art. A teaching assistantship is not a career, it’s a rung on a ladder!

Workers Strike Back is Kshama Sawant

Ms. Sawant announced that “Workers Strike Back will be launched in early March in cities around the country.” Sawant offers the usual grab bag of grievances: “Fight racism, sexism & all oppression! Quality affordable housing & free healthcare for all! No more sellouts! We need a new party.” Oh, and “Free abortions!”

A rapacious and parasitic capitalist class has amassed untold fortunes off the labor of billions of workers. But their system is in deep crisis, and it cannot sustain itself. Capitalism needs to be overthrown. We need a socialist world.— Kshama Sawant

Dick Bauer:

During the pandemic, this same university chose not to send its foreign students to their native homes during the two-year period of the COVID pandemic. The reason: The F2F tuition the school was charging the students (and this school was in the top 100 in Forbes magazine for their graduate school) was three times the in-state or U.S. citizen tuition. Sending foreign students home would eliminate a very lucrative revenue source. 

Additionally, such foreign nationals were required, according to the school’s pandemic-era policies, to attend at least three classes in-person each semester to maintain matriculation status and keep their student visas. That meant that there needed to be instructors on campus to teach these classes, but of course the full-time faculty could not be forced to endanger themselves by breaking COVID lockdown rules. So it was left to adjuncts like myself, who did not receive any medical insurance from the school, to drive to campus to hold in-person classes for these high-revenue students.

Despite teaching as many as eight courses in one term, I was never offered any of the benefits that are customarily associated with a full-time academic salary in America. Some schools have elected to restrict the hours adjunct faculty are allowed to work in order to avoid the Affordable Care Act requirement that would otherwise require them to provide health insurance to their employees. According to AdjunctNation, more than 200 schools set limits on adjunct working hours. Adjuncts typically earn between $20,000 and $25,000 annually, while the average salary for full-time instructors is $84,300, according to the American Association of University Professors.

Some adjuncts cobble together a full-time teaching schedule by offering classes at more than one university—as many as three or four. However, professors who “moonlight” at multiple colleges rarely earn the same salary or benefits as full-time instructors.

Stanley Goldfarb:

For better or worse, I have had a front-row seat to the meltdown of twenty-first-century medicine. Many colleagues and I are alarmed at how the DEI agenda—which promotes people and policies based on race, ethnicity, gender, religion, and sexual orientation rather than merit—is undermining healthcare for all patients regardless of their status.

Five years ago I was associate dean of curriculum at the University of Pennsylvania’s Perelman School of Medicine, and prior to that, codirector of its highly regarded kidney division. Around that time, Penn’s vice dean for education started to advocate that we train medical students to be activists for “social justice.” The university also implemented a new “pipeline program,” allowing ten students a year from HBCUs (historically black colleges or universities) to attend its med school after maintaining a 3.6 GPA but no other academic requirement, including not taking the MCAT (Medical College Admission Test). And the university has also created a project called Penn Medicine and the Afterlives of Slavery Project(PMAS) in order to “reshape medical education. . . by creating social justice-informed medical curricula that use race critically and in an evidence-based way to train the next generation of race-conscious physicians.” Finally, twenty clinical departments at the medical school now have vice chairs for diversity and inclusion.

Do No Harm Medicine

The bill’s findings clearly state that “public medical institutions of higher education best serve the state when providing meritorious education and training that positions future healthcare professionals to serve all patients adequately and to the best of their ability.” Do No Harm could not agree more.

To ensure that happens, the bill includes several key provisions:

• No DEI Statements: Applicants for employment and admission cannot be required to submit DEI Statements, which medical schools increasingly use to weed out candidates who don’t toe the woke party line. This helps ensure that students and faculty are chosen by merit, not politics. And getting rid of these statements will create a more intellectually diverse campus environment where students and their teachers are open to exploring new research ideas.
• No DEI Spending: Medical schools are prohibited from using state funds for fees, dues, subscriptions, or travel relating to an organization that requires an individual to endorse or promote a divisive concept – i.e., that a certain race or sex is inherently superior to another or that the United States is fundamentally racist or sexist. This ban covers essentially every medical association. This puts pressure on groups like the AMA and AAMC to drop their increasingly discriminatory demands. Most taxpayers don’t realize their hard-earned dollars fund woke national organizations that focus on progressive activism over patient outcomes.

There are even more victories in the bill, including welcoming campus speakers with differing views, banning discrimination against student groups based on their ideologies, requiring DEI officers to focus on workforce training and promote intellectual diversity, and notifying students and teachers of their rights, among others.

Gustavo Arellano:

He joined his father in El Salvador after graduating from high school in Florida, teaching English as a second language classes while studying engineering. But the pay wasn’t good, so Arias returned to Florida, where he worked at a Radio Shack for four years while waiting for a chance “to go back to El Salvador and keep the fight going.”

A fellow Salvadoran exile suggested that he intern for an SEIU campaign in Michigan. 

“They actually pay people to do that?” Arias remembers responding.

He soon got hired as an organizer in Chicago, then moved to California to work as an assistant director for collective bargaining for SEIU-United Healthcare Workers West’s hospital division. In Oakland, he led what was until this week the biggest strike of his career. 

At two nursing homes in 2010, about 80 caregivers — janitors, nursing assistants and other lower-rung employees — went on a five-day strike over working conditions. Afterward, 38 workers were fired.

“They lost heart, but we kept organizing and pressuring and reminding people, ‘The struggle is long,’” Arias said. The workers eventually got their jobs back, along with lost wages, after the National Labor Relations Board ruled in 2016 that their firing was illegal.

By then, Arias was Local 99’s executive director, with a more existential challenge.

Kevin Bardosh, Alex de Figueiredo, Rachel Gur-Arie, Euzebiusz Jamrozik, James Doidge, Trudo Lemmens, Salmaan Keshavjee, Janice E Graham, Stefan Baral

Vaccination policies have shifted dramatically during COVID-19 with the rapid emergence of population-wide vaccine mandates, domestic vaccine passports and differential restrictions based on vaccination status. While these policies have prompted ethical, scientific, practical, legal and political debate, there has been limited evaluation of their potential unintended consequences. Here, we outline a comprehensive set of hypotheses for why these policies may ultimately be counterproductive and harmful. Our framework considers four domains: (1) behavioural psychology, (2) politics and law, (3) socioeconomics, and (4) the integrity of science and public health. While current vaccines appear to have had a significant impact on decreasing COVID-19-related morbidity and mortality burdens, we argue that current mandatory vaccine policies are scientifically questionable and are likely to cause more societal harm than good. Restricting people’s access to work, education, public transport and social life based on COVID-19 vaccination status impinges on human rights, promotes stigma and social polarisation, and adversely affects health and well-being. Current policies may lead to a widening of health and economic inequalities, detrimental long-term impacts on trust in government and scientific institutions, and reduce the uptake of future public health measures, including COVID-19 vaccines as well as routine immunisations. Mandating vaccination is one of the most powerful interventions in public health and should be used sparingly and carefully to uphold ethical norms and trust in institutions. We argue that current COVID-19 vaccine policies should be re-evaluated in light of the negative consequences that we outline. Leveraging empowering strategies based on trust and public consultation, and improving healthcare services and infrastructure, represent a more sustainable approach to optimising COVID-19 vaccination programmes and, more broadly, the health and well-being of the public.

William Galston:

For most of my life, I rejected the assertion that America is a “sick society.” This judgment seemed too broad and lacking in nuance. Yes, there was regress in some areas, such as the surge of gun-related crimes in the 1980s. But there was progress on other fronts. Life expectancy increased steadily, and a rising share of Americans had access to healthcare. The rate of smoking among young people declined sharply, as did teen pregnancy. Many gaps among racial and ethnic groups were narrowing.

It’s no secret that life expectancy in the U.S. is much lower than it should be. In 2019, before the Covid-19 pandemic struck, we ranked 29th among the 38 member nations of the Organization for Economic Cooperation and Development. U.S. life expectancy trailed Germany’s by 2.5 years, Canada’s by 3.2 years, and France’s by four years.

Some of this disparity reflects the U.S.’s terrible performance in infant mortality. It ranked 33rd, behind every European and Asian country in the OECD. Some of it reflects huge geographical disparities within the U.S. The life expectancy gap in 2019 between America’s best state (Hawaii) and its worst was about seven years. Still, even Hawaii trailed 25 OECD countries. (West Virginia would have placed dead last, behind Mexico.)

Christopher Snowdon:

Since back then Big Tech’s fact-checkers were still describing claims about SARS-CoV-2 being airborne and face masks preventing infection as ‘misleading’, a fake-news flag was something of a badge of honour. And, as with those claims, the ‘disputed’ information in my article has been borne out by the evidence.

After a brief burst of incredulous coverage in the spring of 2020, the media soon lost interest in the hypothesis that smokers are less likely to get Covid-19, but dozens of studies have been quietly published in the past two-and-a-half years which confirm it. I have been listing them on my blog and last week added the hundredth study. It seems a good time to stop. By any reasonable standard, the jury is in.

Of the 100 studies from around the world, 87 of them show a statistically significant reduction in SARS-CoV-2 infection risk among current smokers as compared to non-smokers. Seven of them found no statistically significant association either way. Two of them found mixed results. Four of them found a positive association between smoking and infection, although three of these looked at people with a genetic propensity to smoke rather than at smokers themselves. 

The studies used a range of methodologies. Very few of them set out to look at the effect of smoking specifically, but epidemiologists tend to ask people if they smoke as a matter of course and so the association kept popping up. Some of the studies looked at specific outbreaks of Covid-19, such as on a French aircraft carrier. Several of them looked at healthcare workers, such as this one from Germany and this one from Chile. Others looked at groups of hospital patients, such as psychiatric patients in New York or HIV patients in South Africa. A large number of them used seroprevalence surveys to see who had antibodies and, therefore, who had been infected in the past (prior to the vaccines).

Robert F. Graboyes:

“Be skeptical of everything you hear, including this sentence.” That was the central message of the 48 semester-long classes I taught to medical professionals—doctors, nurses, therapists, administrators, etc. over 19 years. Officially, my courses were on the economics of healthcare, but they also encompassed ethics and a much broader look at epistemology and the philosophy of science.

While my students’ knowledge of science and medicine was vastly greater than my own, it was my point to teach them how dangerous their knowledge could be when when unleashed with inadequate skepticism and introspection. My greatest tool in this effort was to devote a couple of weeks of our course to the history of eugenics—the now-discredited but once-transcendent science of being well-born. The logo of the Second International Eugenics Congress in 1921, pictured above, declared that “Eugenics is the self direction of human evolution,” with the goal being “an harmonious entity.” Self-direction was essential, they thought because, as Alexander Graham Bell had written in 1883, “natural selection no longer influences mankind to any great extent.” (Bell was honorary president of the 1921 conference. More on him in an essay coming soon.)

In the past month, I’ve participated in one webinar and two podcasts on the topic of eugenics. I opened the webinar by arguing three things:

It is a grave error to refer to eugenics, as many do, as a “pseudoscience.” Eugenics was hard science run amok, untempered by skepticism and profoundly intolerant of dissenting viewpoints. In a recent essay, “The Briar and the Rose,” I noted that the field of mathematical statistics—the core of modern science—was to a significant degree an outgrowth of eugenics.

It is equally erroneous to assume that eugenicists were ideological troglodytes—Ku Klux Klansmen in tuxedos,so to speak. Support for eugenics spanned the ideological spectrum, but the movement was at its heart a progressive endeavor. They were profoundly optimistic that eugenics could produce a stronger, happier, healthier human species—with the caveat that some unfortunates would be swept aside in the process.

It is exceedingly dangerous to presume that eugenics is a quaint historical topic of little consequence in our far-more-enlightened era. As we discussed in these recordings, eugenics remains very much with us in spirit, if not in name, and new medical technologies offer “self-directed evolution” to a degree unimaginable to the original eugenicists. And the eugenicists’ lack of skepticism and intolerance for dissent is very much with us in science and policy discussions today

summarised via Tyler Cowen:

But going forward, I think the old metrics that showed large advantages for single payer are going to continue to slide. Unions (formal or otherwise) are going to militate for higher pay. Governments are going to have to deal with one side of the political spectrum going into hoc to the health employees and the other polarizing to the folks in the disfavored region(s) who are lower priority for healthcare and pay more in taxes for the “giveaways”. And all of it is going to run into the trouble that the developing world is going to have fewer kids and hence fewer physicians while the relative advantage of immigrating is going to continue to fall.

Single payer was overwhelmingly built on the post-World Wars consensus and environment. It operates as a monopsony. What on earth would make us think that it would be stable into the future?

That is from “Sure.”

TC again: There is a natural tendency on the internet to think that all universal coverage systems are single payer, but they are not. There is also a natural tendency to contrast single payer systems with freer market alternatives, but that is also an option not a necessity. You also can contrast single payer systems with mixed systems where both the government and the private sector have a major role, such as in Switzerland.

The data clearly indicate that being able to read is not a requirement for graduation at (Madison) East, especially if you are black or Hispanic”

2017: West High Reading Interventionist Teacher’s Remarks to the School Board on Madison’s Disastrous Reading Results 

Madison’s taxpayer supported K-12 school district, despite spending far more than most, has long tolerated disastrous reading results.

My Question to Wisconsin Governor Tony Evers on Teacher Mulligans and our Disastrous Reading Results

“An emphasis on adult employment”

Wisconsin Public Policy Forum Madison School District Report[PDF]

WEAC: $1.57 million for Four Wisconsin Senators

Friday Afternoon Veto: Governor Evers Rejects AB446/SB454; an effort to address our long term, disastrous reading results

Booked, but can’t read (Madison): functional literacy, National citizenship and the new face of Dred Scott in the age of mass incarceration.

No When A Stands for Average: Students at the UW-Madison School of Education Receive Sky-High Grades. How Smart is That?

10news:

“At this time, Knox County Schools will not be reporting cases or sending notifications,” spokesperson Carly Harrington said. “We do encourage students and staff to stay home if they are sick and to follow the advice of their healthcare provider.”

On Monday, the Knox County Board of Education talked about reports and possible new policies during its monthly work session. One of the discussions was whether to re-implement Knox County Schools’ COVID-19 isolation leave policy.

Eugene Volokh:

The student government president’s executive orderprovides, among other things,

That it shall be prohibited for the Undergraduate Student Government Executive Branch to contract or expend funds to any individual, business, or organization which actively advocates to further limit by law access to reproductive healthcare, including, though not limited to, contraception and induced abortions.

This seems to me a clear violation of the First Amendment:

1. Under Board of Regents v. Southworth (2000), public university student government are generally subject to the same First Amendment limits imposed on public entities more generally.
2. When it comes to generally available student group funding, Southworth and Rosenberger v. Rector (1995) make clear that the government can’t discriminate based on the student group’s viewpoint.
3. And when it comes to contracting, Board of Comm’rs v. Umbehr (1996) holds that the government generally can’t discriminate based on contractors’ ideological expression, either.

Of course the same would be true of a public university’s cutting off generally available student funding or contracting to “individual[s], business[es], or organization[s]” that express pro-abortion-rights views or pro-Israel views or anti-Israel views or what have you. The Free Speech Clause generally doesn’t stop government actors from conditioning funding on groups’ nonspeech conduct, such as on the groups not refusing to do business with Israel or not excluding military recruiters (Rumsfeld v. FAIR (2006)) or providing funding for abortions or contraception for their employees. But the government may not condition funding on groups’ refraining from expressing anti-Israel, anti-military, or anti-abortion views.

Anna Wilde Mathews, Tom McGinty and Melanie Evans:

Nonprofit hospitals get billions of dollars in tax breaks in exchange for providing support to their communities. A Wall Street Journal analysis shows they are often not particularly generous.

These charitable organizations, which comprise the majority of hospitals in the U.S., wrote off in aggregate 2.3% of their patient revenue on financial aid for patients’ medical bills. Their for-profit competitors, a category including publicly traded giants such as HCA Healthcare Inc., wrote off 3.4%, the Journal found in an analysis of the most-recent annual reports hospitals file with the federal government.

Jeff Klausner:

Moving forward, we must improve our sentinel hospital surveillance to include only those cases likely to be a true COVID-19 hospitalization. Many experts suggest that can be easily done by counting those cases that required oxygen therapy or specific COVID-19 treatment. Population-based surveys would be very useful, albeit expensive and time-consuming, but conducted in an ongoing statistically meaningful fashion could be very informative.

The bottom line is that we must understand and accept the limitations of current COVID-19 numbers. We should not be responding out of proportion to the severity of the epidemic. We should be focused on making sure vulnerable people have easy and timely access to effective treatment and investing in new vaccines that can truly prevent future infections.

David Perry:

Tech is just a tool or a plaything for him like any other. But we were promised more than that — we were promised a future in which technology would mediate between my disabled son and an ableist world. Instead, what is available to my son is driven more by arbitrary systems than by his needs and his personality. 

My son’s most significant needs relate to speech. By the time he was three, it was clear he was not going to predominantly use verbal speech, though he was learning to communicate in a wide variety of ways. His speech therapist at the time quickly sent us to a world-class facility to assess the best way for him to use tech to talk. At the time, Nico’s healthcare and education costs were covered by the “early intervention” programs in Illinois — statewide systems funded by federal, state, and local dollars intended to help children under three years of age meet “developmental milestones.” 

We tried a wide variety of devices, but because he had the manual dexterity to operate the simplest one, that’s the one the state would pay for. Within a few weeks after having it prescribed, we had a plastic box where you could literally cut and paste pieces of paper with words and pictures on it, and then use your voice to record sounds that then my son could press to play out loud. It was over a foot long. It cost over $3,000. 

There were much better, and much more expensive, dedicated speech devices on the market, many of which are in fact a marvel of engineering, and do not require exhausted parents to do arts and crafts. But what we needed, we thought, was a speech app; they were just becoming available on mobile platforms like iPads. We wanted Proloquo2go, one of a number of programs that can reproduce words or phrases by selecting from an infinitely customizable menu. It cost $250, which we didn’t have, and needed to be on an iPad, which we also couldn’t afford. The price would have been much lower than our state-funded arts and crafts box, but at the time the system wouldn’t pay for medical programs on non-medical devices. We ultimately got both the tablet and the app thanks to a donor.

Chang Che:

Until 2022, Shanghai was called “the enchanted city.” It was a land of Gucci bags and French wine and weekend jogs along the Bund. It was a land of restless nights spent in the company of eclectic strangers. It was a land of coffee and convenience, of cloud-kissing skylines and flash-delivery bubble tea. There is an old cliché that the Shanghainese are an especially proud bunch, but it’s easy to see why: in a country with a xenophobic past and a revanchist nationalism, the cosmopolitan pleasures of the city bordered on the magical.

It was this pride that broke the magic spell. In March, when the Omicron variant penetrated China’s iron walls, other cities such as Shenzhen and Changchun locked down under a policy known as “dynamic zero-Covid,” which seeks to snuff out all virus transmissions. When cases began to rise in Shanghai, however, officials hesitated, believing China’s main financial hub too vital for a wholesale closure. They chose a retail approach, shuttering neighborhoods one by one as cases emerged. But by the end of March, it was clear the improvised plan had failed. As cases spilled into neighboring provinces, Beijing authorities took matters into their own hands. They ousted Shanghai’s more outspoken officials the way nature sent Icarus—wax-winged and recalcitrant—tumbling back to earth.

Twenty-five million residents—over twice the population of Greece—have paid the price ever since. For nearly two months, the city has been a ghost town. Shop front doors are bolted shut, and windows are strewn with black tarp. Sidewalks are hemmed by white tape, and neighborhood doors are patrolled by security guards. For an older generation who had witnessed the excesses of the Cultural Revolution, this was all too familiar. Food had to be rationed. Door-knocks became the stuff of nightmares. The Red Guards had returned—this time adorning white.

Peter Sullivan

“Right before the election, people would get notices of big premium increases, and that will certainly not reflect well on Democrats,” said Larry Levitt, a health policy expert at the Kaiser Family Foundation. 

Vulnerable Democratic lawmakers are trying to sound the alarm. A group of 26 House Democrats from swing districts, led by Rep. Lauren Underwood (D-Ill.), sent a letter to leadership last week urging the extra subsidies to be extended.  

“I’m worried that we’re running up on a cliff,” said Rep. Susan Wild (D-Pa.), one of the signers of the letter, who compared it to the expanded child tax credit that was allowed to expire at the start of this year. “We’re suddenly going to lose that ability. It’s similar to the child tax credit, which, you know, just kind of came and went, the expiration of it. I just don’t want to see that happen. I think it is absolutely game-changing.”

Given Republican opposition to any increased spending on ObamaCare, an extension of the subsidies would have to be included in a party-line package using the reconciliation process to bypass a GOP filibuster in the Senate.  

The problem for Democrats is that negotiations over that broader package with Sen. Joe Manchin (D-W.Va.), the key swing vote, have shown few signs of progress for months.   

But the health care cliff is adding increased urgency for Democrats to find a way forward on the package.

Alex Gutentag:

The collapse of educational pathways and structures has had a particularly brutal effect on the poorest students, who can least afford to have their schooling disrupted. High-poverty schools had the lowest levels of in-person instruction, causing low-income students to fall even further behind their more affluent peers. The entirely foreseeable ways in which bad COVID-19 policy choices exacerbated inequality perversely led many public school systems to try to hide their mistakes by dismantling programs for gifted and talented students along with entrance tests and other standardized testing regimens—piling on more bad policy choices that deprive economically disadvantaged students of opportunity.

The available numbers tell a worrying story of educational slippage that is likely to keep large numbers of kids from acquiring the basic skills, both intellectual and social, that they will need to hold decent jobs. Recent test scores have dramatically declined, with one report finding that in districts offering distance learning, the decline in passing rates for math was 10.1 percentage points greater than in districts that offered in-person instruction. In Maryland, 85% of students now are not proficient in math, and in Baltimore the figure is 93%. Michigan, Washington, and other states have found dramatic declines in their test scores. In Los Angeles, the decline has been worse for younger students, with 60% of third and fourth graders not meeting English standards compared to 40% of 11th graders. Overall, the youngest children were most profoundly impacted by lockdowns and school disruptions, and some of them now lack basic life skills.

As the severity of these repercussions comes to light, some outlets—notably those that most aggressively advocated for lockdowns and masking—have been eager to suggest that we are now aware of the overwhelmingly negative consequences of these policies thanks to “new research” that has only just become available to fair-minded people, who can therefore be forgiven for having adopted the course they did. But to many doctors and scientists, the damage to kids caused by COVID-19 panic was neither inevitable nor surprising. Rather, it was the result of the public health establishment’s conscious choice to eschew rational cost-benefit analysis in favor of pet cultural theories and political gamesmanship. For those who applied the scientific method to the available evidence, the consequences were already clear just a few weeks into the pandemic. “It was not at all true that people in healthcare and public health were unaware of what was going on with children,” Dr. Noble told me. “They were not ignorant.”

Mandates, closed schools and Dane County Madison Public Health.

The data clearly indicate that being able to read is not a requirement for graduation at (Madison) East, especially if you are black or Hispanic”

2017: West High Reading Interventionist Teacher’s Remarks to the School Board on Madison’s Disastrous Reading Results 

Madison’s taxpayer supported K-12 school district, despite spending far more than most, has long tolerated disastrous reading results.

My Question to Wisconsin Governor Tony Evers on Teacher Mulligans and our Disastrous Reading Results

“An emphasis on adult employment”

Wisconsin Public Policy Forum Madison School District Report[PDF]

WEAC: $1.57 million for Four Wisconsin Senators

Friday Afternoon Veto: Governor Evers Rejects AB446/SB454; an effort to address our long term, disastrous reading results

Booked, but can’t read (Madison): functional literacy, National citizenship and the new face of Dred Scott in the age of mass incarceration.

No When A Stands for Average: Students at the UW-Madison School of Education Receive Sky-High Grades. How Smart is That?

Aaron Kheriaty

Japan’s ministry of health is taking a sensible, ethical approach to Covid vaccines. They recently labeled the vaccines with a warning about myocarditis and other risks. They also reaffirmed their commitment to adverse event reporting to document potential side-effects.

Japan’s ministry of health states: “Although we encourage all citizens to receive the COVID-19 vaccination, it is not compulsory or mandatory. Vaccination will be given only with the consent of the person to be vaccinated after the information provided.”

Furthermore, they state: “Please get vaccinated of your own decision, understanding both the effectiveness in preventing infectious diseases and the risk of side effects. No vaccination will be given without consent.”

Finally, they clearly state: “Please do not force anyone in your workplace or those who around you to be vaccinated, and do not discriminate against those who have not been vaccinated.”

They also link to a “Human Rights Advice” page that includes instructions for handling any complaints if individuals face vaccine discrimination at work. 

Other nations would do well to follow Japan’s lead with this balanced and ethical approach.

This policy appropriately places the responsibility for this healthcare decision with the individual or family. 

We can contrast this with the vaccine mandate approach adopted in many other Western nations. The U.S. provides a case study in the anatomy of medical coercion exercised by a faceless bureaucratic network.

Helen Dale

America’s dysfunctional airports are instances of widespread low state capacity. And this is bigger than airports. Low state capacity can only be used to describe a country when it is true of multiple big-ticket items, not just one.

State capacity is a term drawn from economic history and development economics. It refers to a government’s ability to achieve policy goals in reference to specific aims, collect taxes, uphold law and order, and provide public goods. Its absence at the extremes is terrifying, and often used to illustrate things like “fragile states” or “failed states.” However, denoting calamitous governance in the developing world is not its only value. State capacity allows one to draw distinctions at varying levels of granularity between developed countries, and is especially salient when it comes to healthcare, policing, and immigration. It has a knock-on effect in the private sector, too, as business responds to government in administrative kind.

Think, for example, of Covid-19. The most reliable metric—if you wish to compare different countries’ responses to the pandemic—is excess deaths per 100,000 people over the relevant period. That is, count how many extra people died beyond the pre-pandemic mortality rate on a country-by-country basis. For the sake of argument, drop the five countries leading this grim pack. Four of them are developing countries, and the fifth is Russia, which while developed, is both an autocracy and suffers from chronic low state capacity.

At the other end of the scale, ignore China, too. It may be lying about its success or, more plausibly, may have achieved it by dint of being an authoritarian state with high state capacity(notably, the latest round of draconian lockdowns in Shanghai commenced after the WHO collated that data).

Mandates, closed schools and Dane County Madison Public Health.

The data clearly indicate that being able to read is not a requirement for graduation at (Madison) East, especially if you are black or Hispanic”

2017: West High Reading Interventionist Teacher’s Remarks to the School Board on Madison’s Disastrous Reading Results 

Madison’s taxpayer supported K-12 school district, despite spending far more than most, has long tolerated disastrous reading results.

My Question to Wisconsin Governor Tony Evers on Teacher Mulligans and our Disastrous Reading Results

“An emphasis on adult employment”

Wisconsin Public Policy Forum Madison School District Report[PDF]

WEAC: $1.57 million for Four Wisconsin Senators

Friday Afternoon Veto: Governor Evers Rejects AB446/SB454; an effort to address our long term, disastrous reading results

Booked, but can’t read (Madison): functional literacy, National citizenship and the new face of Dred Scott in the age of mass incarceration.

No When A Stands for Average: Students at the UW-Madison School of Education Receive Sky-High Grades. How Smart is That?

Johan Anderberg;

When the epidemiologist Johan Giesecke read the paper, it left him a little puzzled. On any normal day, 275 people die in Sweden, he thought. He’d spent a large part of his life studying just that: where, when, and how people die. The way the world currently thought about death was, to him, completely alien. When he’d taken part in an online conference in Johannesburg, one participant had pointed out that, in that year alone, more than 2 million people had died of hunger in the world. During the same period, Covid-19 had claimed between 200,000 and 300,000 lives.

Giesecke felt as though the world was going through a self-inflicted global disaster. If things had simply been left to run their course, it would have been over by now. Instead, millions of children were being deprived of their education. In some countries, they weren’t even allowed to go to playgrounds. From Spain came stories of parents sneaking down into parking garages with their children to let them run around.

Tens of thousands of surgeries had been postponed by healthcare services. Screenings for everything from cervical to prostate cancer were put on ice. This wasn’t just happening in other countries. Sweden had seen its fair share of peculiar decisions, too. The Swedish police hadn’t tested drivers for insobriety for months, out of fear of the virus. This year, it didn’t seem quite as serious if someone were to get killed by a drunk driver.

Vanessa Fuhrmans and Kathryn Dill:

As the labor market reorders, more Americans are making the leap from blue-collar jobs and hourly work to “new collar” roles that often involve tech skills and come with better pay and schedules.

More than a tenth of Americans in low-paying roles in warehouses, manufacturing, hospitality and other hourly positions made such a switch during the past two years, according to new research from Oliver Wyman, a management consulting firm that surveyed 80,000 workers world-wide between August 2020 and March 2022. Many of the new jobs are in software and information technology, as well as tech-related roles in logistics, finance and healthcare. New data from the Current Population Survey and LinkedIn also suggest the pandemic has helped catapult more workers into more upwardly mobile careers.

Tech job postings have boomed over the past two years as work, shopping and other aspects of daily life have gone more digital. At the same time, millions of Americans quit their jobs, with some sitting on the sidelines and others finding new ones with higher salaries. Companies have struggled to hire all the talent they need, so many have dropped prequalifications like prior work experience or a four-year college degree.

Those pandemic shifts kicked in as broader macroeconomic forces were already creating new job-market opportunities and pressures. The percentage of retirees in the U.S. population has climbed sharply over the past decade and ticked even higher in the Covid-19 era, with millions of baby boomers leaving the workforce. Declining immigration has added to shortages, particularly in tech, healthcare and other fields that depend heavily on foreign-born employees. Thousands of businesses are in the thick of a digital revolution that is requiring them to fill new roles and adapt existing ones to integrate more data and automation.

WILL

In recent years, WILL has represented several public-school parents after their local school established policies and procedures that undermined fundamental parental rights to make decisions about their child’s education, healthcare, and overall welfare. AB 963/SB 962 is a response to this common experience for Wisconsin’s public-school parents.

• Right to review educational materials and access to learning materials: This legislation empowers parents to have access to learning materials used in the education of their child. This is vital as parents continue to engage with their child’s teachers and school administrators.
• Right to determine the names and pronouns used for the child while at school: WILL has two active lawsuits, representing public-school parents, against the Madison Metropolitan School District and Kettle Moraine School District regarding the districts’ policy on gender pronouns and student nicknames. The legislation ensures that parents are not in the dark about serious and important medical decisions regarding their child.
• Right to opt out and be notified about educational topics: This legislation provides parents with options to decide their own child’s educational experience and learning materials based on whether the material violates the parent’s religious or personal convictions.
• Right to be notified about surveys to students: Federal law protects students from being required to participate in any sort of “survey, analysis, or evaluation” that divulges information concerning, among other things, political affiliations or beliefs of the student or the student’s parent; legally recognized privileged relationships, such as that between a physician and a patient; and religious practices, affiliations, or beliefs of the student or student’s parent.”
• Right to be notified about student safety and incidents of violence: The legislation requires a school to notify parents about security updates, disciplinary actions taken against their child and if crimes or acts of violence occur on school campus.
• Establishes a legal right to direct the education of their child: This legislation creates a legal standard for state infringement on fundamental rights of parents and guardians through specific items enumerated in the bill. It also gives parents and guardians a way to hold the district accountable for their actions by suing the district who fails to comply with this bill.

THURSDAY: Assembly Committee on Education will be hearing testimony on a Parent Bill of Rights. pic.twitter.com/2zPwBJmbwu

— WILL (@WILawLiberty) February 9, 2022

Notes:

Parent Bill of Rights: In recent years, WILL has represented several public-school parents after their local public schools established policies and procedures that undermined the parent’s rights to make decisions about their child’s education, healthcare and overall welfare. AB 963 is a response to this common experience for Wisconsin’s public-school parents.

• Right to review educational materials and access to learning materials: This legislation empowers parents to have access to learning materials used in the education of their child. This is vital as parents continue to engage with their child’s teachers and school administrators.

• Right to determine the names and pronouns used for the child while at school: WILL has two active lawsuits, representing public-school parents, against the Madison Metropolitan School District and Kettle Moraine School District regarding the districts’ policy on gender pronouns and student nicknames. The legislation ensures that parents are not in the dark about serious and important medical decisions regarding their child.

• Right to opt out and be notified about educational topics: This legislation provides parents with options to decide their own child’s educational experience and learning materials based on whether the material violates the parent’s religious or personal convictions.

• Right to be notified about surveys to students: Federal law protects students from being required to participate in any sort of “survey, analysis, or evaluation” that divulges information concerning, among other things, political affiliations or beliefs of the student or the student’s parent; legally recognized privileged relationships, such as that between a physician and a patient; and religious practices, affiliations, or beliefs of the student or student’s parent.”

• Right to be notified about student safety and incidents of violence: The legislation requires a school to notify parents about security updates, disciplinary actions taken against their child and if crimes or acts of violence occur on school campus.

• Establishes a legal right to direct the education of their child: This legislation creates a legal standard for state infringement on fundamental rights of parents and guardians through specific items enumerated in the bill. It also gives parents and guardians a way to hold the district accountable for their actions by suing the district who fails to comply with this bill.

Mandates, closed schools and Dane County Madison Public Health.

The data clearly indicate that being able to read is not a requirement for graduation at (Madison) East, especially if you are black or Hispanic”

2017: West High Reading Interventionist Teacher’s Remarks to the School Board on Madison’s Disastrous Reading Results 

Madison’s taxpayer supported K-12 school district, despite spending far more than most, has long tolerated disastrous reading results.

My Question to Wisconsin Governor Tony Evers on Teacher Mulligans and our Disastrous Reading Results

“An emphasis on adult employment”

Wisconsin Public Policy Forum Madison School District Report[PDF]

WEAC: $1.57 million for Four Wisconsin Senators

Friday Afternoon Veto: Governor Evers Rejects AB446/SB454; an effort to address our long term, disastrous reading results

Booked, but can’t read (Madison): functional literacy, National citizenship and the new face of Dred Scott in the age of mass incarceration.

When A Stands for Average: Students at the UW-Madison School of Education Receive Sky-High Grades. How Smart is That?

Ariana Garcia:

Gov. Greg Abbott announced Thursday evening plans to amend the Texas Constitution with a Parent Bill of Rights if he is re-elected. The proposal follows Abbott’s introduction of a Taxpayer Bill of Rights this week. 

Abbott publicly signed the bill at an event hosted by the Founders Classical Academy of Lewisville, where he criticized schools shutting down during the pandemic and issuing mask mandates. He said the bill will help restore parents as the primary decision-makers of their child’s education and healthcare decisions.

“No government program can replace the role that parents play in the education of their children,” Abbott told the audience. “Our focal point is to ensure that parents are put at the forefront, both of education of their children as well as the decision-making for their child’s healthcare.”

Abbott continued to impart that the government often intrudes on parental decision-making and threatens the role guardians have in their child’s wellbeing. “Many parents are growing increasingly powerless about what to do to regain that control,” Abbott said. “That must end.”

Dana Goldstein and Noam Scheiber:

Few American cities have labor politics as fraught as Chicago’s, where the nation’s third-largest school system shut down this week after teachers’ union members refused to work in person, arguing that classrooms were unsafe amid the Omicron surge.

But in a number of other places, the tenuous labor peace that has allowed most schools to operate normally this year is in danger of collapsing.

While not yet threatening to walk off the job, unions are back at negotiating tables, pushing in some cases for a return to remote learning. They frequently cite understaffing because of illness, and shortages of rapid tests and medical-grade masks. Some teachers, in a rear-guard action, have staged sick outs.

In Milwaukee, schools are remote until Jan. 18, because of staffing issues. But the teachers’ union president, Amy Mizialko, doubts that the situation will significantly improve  and worries that the school board will resist extending online classes.

“I anticipate it’ll be a fight,” Ms. Mizialko said.

She credited the district for at least delaying in-person schooling to start the year but criticized Democratic officials for placing unrealistic pressure on teachers and schools.

“I think that Joe Biden and Miguel Cardona and the newly elected mayor of New York City and Lori Lightfoot — they can all declare that schools will be open,” Ms. Mizialko added, referring to the U.S. education secretary and the mayor of Chicago. “But unless they have hundreds of thousands of people to step in for educators who are sick in this uncontrolled surge, they won’t be.”

The view from Madison, via David Blaska:

Madison Teachers Inc. claims that two-thirds of its members surveyed “either did not support a return to school buildings on January 10 or would only do so if COVID-19 infection rates were stabilizing or decreasing.”

“Not only have we started this school year short-staffed, but we are losing an extraordinary number or staff due to burnout and disrespect from leadership and community stakeholders.”

Disrespect from “community stakeholders?” Whom might that be? Parents? Taxpayers? At least, they have the support of the Madison-area Democratic Socialists. The Far Left group today blamed Covid on capitalism:

Hello comrades,

I am sure you are all thinking about Omnicron and how it yet again illustrates the blatant failings of capitalism, the state, the U.S. healthcare system, and so many other oppressive institutions. … (MTI) is calling on MMSD leadership to make basic commitments to staff members. Please read their statement, sign their petition, and share it.

Mandates, closed schools and Dane County Madison Public Health.

The data clearly indicate that being able to read is not a requirement for graduation at (Madison) East, especially if you are black or Hispanic”

2017: West High Reading Interventionist Teacher’s Remarks to the School Board on Madison’s Disastrous Reading Results 

Madison’s taxpayer supported K-12 school district, despite spending far more than most, has long tolerated disastrous reading results.

My Question to Wisconsin Governor Tony Evers on Teacher Mulligans and our Disastrous Reading Results

“An emphasis on adult employment”

Wisconsin Public Policy Forum Madison School District Report[PDF]

WEAC: $1.57 million for Four Wisconsin Senators

Friday Afternoon Veto: Governor Evers Rejects AB446/SB454; an effort to address our long term, disastrous reading results

Booked, but can’t read (Madison): functional literacy, National citizenship and the new face of Dred Scott in the age of mass incarceration.

When A Stands for Average: Students at the UW-Madison School of Education Receive Sky-High Grades. How Smart is That?

Dr. Amesh Adalja:

It was evident almost from day 1 that COVID-19, caused by an efficiently spreading respiratory virus with an animal host, was with us for good. The goal of the public health campaign was not to somehow return the virus magically to bats but to tame the virus and shift its spectrum of illness to the mild side — all the while acknowledging that there would always be a baseline number of cases, hospitalizations and deaths.

Biden faces series of minefields in coming year
Massive sewage spill closes beaches around Los Angeles
By repeatedly counseling the public with these facts early on and coupling it to actionable ways for people to learn how to develop the ability to COVID-19 risk calculate (e.g. get vaccinated, wear masks in high-risk situations, outdoors are safer than indoors, surface transmission is not common) the rise of omicron and the looming ubiquity of infections would not seem so startling.

Taylor Nicole Rogers and Gary Silverman:

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https://www.ft.com/content/51ece9ca-750b-49ef-aacb-834b8e691eea

When US civil rights campaigners of the last century took to the streets, they dreamt of a day when black Americans would enjoy the same educational opportunities as everyone else in the country. Sabrina Cannon has lived that dream — and it has landed her deep in debt.

Cannon, 33, was the first member of her African-American family in Buffalo, New York, to go to college, using $100,000 in federal student loans to obtain a marketing degree in 2010 from Niagara University, a nearby private institution.

But she struggled to find work in her field during the tough times that followed the financial crisis, and only earned enough from other jobs to make minimum payments on her borrowings, leaving the principal untouched.

So, Cannon switched gears. She decided her future was in healthcare — specifically, mastering the alphanumeric code doctors use to keep track of patients — and she went back to school part-time to obtain a second degree in 2017 from State University of New York Polytechnic Institute. Resuming her studies allowed her to put payments on her first student loan on hold while she was in school, but it also required her to take on more debt to obtain new credentials.

Michelle Fulcher:

The emergency is over,’ according to Governor Jared Polis, who explained on Colorado Matters on Friday that vaccines have changed the COVID-19 landscape, rendering masks useful but not required in the state’s fight against the pandemic. 

Meanwhile, Colorado continues to see a rise in hospitalizations and deaths among unvaccinated patients. With the state’s healthcare system overwhelmed by COVID-19 patients and staffing shortages, public health officials are worried another surge of infections may overwhelm already overworked hospitals and medical staff. And the emergence of the omicron variant in the state has introduced more uncertainty into the fight against the pandemic.

The Governor spoke about why he favors vaccination over mask mandates, despite many metro counties having implemented their own mandates to help control the spread of the virus. “Public health [officials] don’t get to tell people what to wear; that’s just not their job,” the Governor said.

Meanwhile, Dane County / Madison continues to operate under “mandates” that have not been voted on by elected officials.

Gunter Kampf:

High COVID-19 vaccination rates were expected to reduce transmission of SARS-CoV-2 in populations by reducing the number of possible sources for transmission and thereby to reduce the burden of COVID-19 disease. Recent data, however, indicate that the epidemiological relevance of COVID-19 vaccinated individuals is increasing. In the UK it was described that secondary attack rates among household contacts exposed to fully vaccinated index cases was similar to household contacts exposed to unvaccinated index cases (25% for vaccinated vs 23% for unvaccinated). 12 of 31 infections in fully vaccinated household contacts (39%) arose from fully vaccinated epidemiologically linked index cases. Peak viral load did not differ by vaccination status or variant type [[1]]. In Germany, the rate of symptomatic COVID-19 cases among the fully vaccinated (“breakthrough infections”) is reported weekly since 21. July 2021 and was 16.9% at that time among patients of 60 years and older [[2]]. This proportion is increasing week by week and was 58.9% on 27. October 2021 (Figure 1) providing clear evidence of the increasing relevance of the fully vaccinated as a possible source of transmission. A similar situation was described for the UK. Between week 39 and 42, a total of 100.160 COVID-19 cases were reported among citizens of 60 years or older. 89.821 occurred among the fully vaccinated (89.7%), 3.395 among the unvaccinated (3.4%) [[3]]. One week before, the COVID-19 case rate per 100.000 was higher among the subgroup of the vaccinated compared to the subgroup of the unvaccinated in all age groups of 30 years or more. In Israel a nosocomial outbreak was reported involving 16 healthcare workers, 23 exposed patients and two family members. The source was a fully vaccinated COVID-19 patient.

A SoCal school board is way overpaying for its superintendent. More than $600K cash/year plus lots benefits.

Even after supe &board are long gone, this shrinking district will continue to pay LIFETIME healthcare for supe &family.

That will come from $ meant for tomorrow’s kids. https://t.co/9O91y0ccPS

— Marguerite Roza (@MargueriteRoza) November 15, 2021

The lengthy 2020-2021 remote experience that Madison’s K-12 students endured made me wonder how the taxpayer funded school district is performing with online services.

I was part of a group that reviewed the District’s acquisition of “Infinite Campus” software in the 2000’s. Having been through many software implementations, I asked the District’s then IT/Chief Information Officer if teachers and staff would be required to use this system, as part of their day to day jobs?

“No”.

I asked how they planned to successfully implement the system?

“with great care”.

I then suggested that they forego the purchase and not spend the money (million$ over time) if the system was not made part of everyone’s job.

How did it go?

2010 Madison School District Usage Report. More.

2012 Infinite Campus Usage Referendum.

2012 Madison Teachers, Inc:

As the District contemplates consequences for those teachers who are not using Infinite Campus, MTI has heard from several members about the difficulty in meeting this District expectation.

2013: Infinite Campus To Cover Wisconsin? DPI Intends to Proceed

Fast forward to 2020. I sent an open records request to the Madison School District on 28 July 2020 requesting the following:

Number of distinct teachers who login daily, weekly and monthly

Number of assignments created weekly

Number of report cards created and updated weekly

Number of distinct parents who login daily, weekly and monthly

Number of distinct students who login daily, weekly and monthly

Total Infinite Campus license, hosting and maintenance costs (2019-2020)

I received the following on 14 September 2021, from Mankah Mitchell:

Number of distinct teachers who login daily, weekly and monthly

• On average, 1,558 unique staff members logged in to Infinite Campus each day in the 2019-20 school year in MMSD.
• On average, 2,885 unique staff members logged in to Infinite Campus each week in the 2019-20 school year in MMSD.
• On average, 3,527 unique staff members logged in to Infinite Campus each month in the 2019-20 school year in MMSD.

Number of assignments created weekly

MMSD teachers created a total of 236,650 assignments in Infinite Campus during the 2019-20 school year. MMSD teachers created an average of 6,396 assignments per week in Infinite Campus.

Number of report cards created and updated weekly

• (In the 2019-20 school year…)13,502 elementary (4K-5th grade) students received 2 report cards each, for an estimated total of 27,004 Elementary report cards.
• 5,486 middle school students received 2 report cards each, for an estimated total of 10,972 report cards. In some cases, students also received quarterly progress reports, totaling a maximum possible count of 21,944 quarterly progress reports and report cards combined.
• 7,891 high school students received 2 report cards each, for an estimated total of 15,782 report cards. In some cases, students also received quarterly progress reports, totaling a maximum possible count of 31,564 quarterly progress reports and report cards combined.

Number of distinct parents who login daily, weekly and monthly

• On average, 42 unique parents logged in to Infinite Campus each day in the 2019-20 school year.
• On average, 133 unique parents logged in to Infinite Campus each week in the 2019-20 school year.
• On average, 256 unique parents logged in to Infinite Campus each month in the 2019-20 school year.

Number of distinct students who login daily, weekly and monthly

• On average, 2,671 unique students logged in to Infinite Campus each day in the 2019-20 school year.
• On average, 6,608 unique students logged in to Infinite Campus each week in the 2019-20 school year.
• On average, 9,295 unique students logged in to Infinite Campus each month in the 2019-20 school year.

Total Infinite Campus license, hosting and maintenance costs (2019-2020)

MMSD spent a total of $149,140.92 on Infinite Campus in the 2019-2020 school year.

## The linked pdf report, includes some interesting notes, as well.

I remain interested in this topic for several reasons:

• I was part of the original review group, and had implementation experience.
• I was and am very concerned about the lack of (consistent) pervasive online learning experiences in our very well taxpayer funded K-12 system, amidst long term, disastrous reading results.
• The inability to do this, effectively, while spending millions reflects much larger organizational challenges.
• The imposition of remote learning on our student population – while many other districts managed to stay in person – has long term consequences for all of us.
• A “successful” implementation of a system such as Infinite Campus would have placed everyone in a much better position for the events of 2020-2021.
• ** I do not mean to suggest that Infinite Campus is the be all/end all. Rather, it is the system we have spent millions on….
• ***** I spoke recently with someone familiar with large scale healthcare software implementations. One of the largest vendors conducts a review with clients on the tools they use, sort of use and don’t use along with the costs thereof (and any 3rd party services that may or may not be useful). With respect to Madison, perhaps it is time to rethink many things….

Related (2011): On the 5-2 Madison School Board No (Cole, Hughes, Moss, Passman, Silveira) Madison Preparatory Academy IB Charter School Vote (Howard, Mathiak voted Yes) [rejected].

And, my 2012 conversation with Henry Tyson.