The heart of NYU Wagner's programs is our faculty. An amalgam of full-time, clinical/research/visiting, and adjunct professors, they are outstanding teachers, expert researchers and committed practitioners.
The House vote to repeal what critics call "Obamacare" (the Patient Protection and Affordable Care Act - ACA -- signed by President Obama on March 23, 2010) was a key part of the GOP campaign to win back the House of Representatives in the November elections. It worked as an effective mobilizing call to arms.
HR2 (Repeal of the Job-Killing Health Care Act) passed the House by a vote of 245 to 189 on January 19, 2011. The Senate, however, killed the bill February 2, and the issue receded to a background murmur. Republicans and Democrats have drawn their swords over the President's budget, instead.
Still, repealing the health care act is likely to return to the political agenda. House Speaker John Boehner (R-Ohio) states that "The Congress can do better in terms of replacing Obamacare with common sense reforms that will bring down the cost of health insurance and expand access for Americans."
To assess such a proposition, one would have to know more details about his party's solutions. But proposals so far are conspicuously absent.
After Congress passed the ACA, Boehner called it a "dangerous experiment." Texas Gov. Rick Perry called it "socialism on American soil." Many of their Republican colleagues have reread the script used by the American Medical Association (AMA) in opposing extensions of health insurance coverage propounded by President Franklin Roosevelt, Harry Truman, Lyndon Johnson and Bill Clinton. They suggest that the ACA will result in a "government take-over" of American medicine, at worst, and "government-run" health care, at best.
But such attacks are dangerously misleading because they distort present realities and generate ill-founded fears.
We already have a massive government role in American health care; and for good reasons. We have socialized expenditures for our highest-risk populations - the elderly and severely handicapped (Medicare) and for the very poor (Medicaid) -- and we have a system of socialized medicine for our military veterans, which delivers health care of higher quality than what is received by the average American.
At the same time, most health care in the U.S. is provided by private non-profit hospitals and private doctors reimbursed on a fee-for-service basis. Clinical decisions remain largely in the hands of our physicians and to the extent that there has been increasing intervention and regulation of these decisions, it has come most forcefully from private insurance companies. Meanwhile, we have more government expenditure of biomedical research (NIH) and public health (CDC) than any nation in the world. And the system produces staggering rates of innovation in pharmaceutical research, medical devices and medicine.
The ACA is largely a bipartisan, half-way reform strategy inspired more by former Republican Governor Mitt Romney of Massachusetts than by left-leaning advocates of single-payer health insurance reform. It does not nationalize the health insurance industry. It does not increase the share of public hospitals. It does not set uniform prices for hospital and physician payment across all payers. And it does not assure universal coverage.
At best, the ACA, if implemented in 2014, will begin to increase coverage to 32 million of the more than 50 million Americans who are currently uninsured. It will achieve this objective through Medicaid expansion and the creation of health insurance exchanges that will strengthen federal regulation of the private health insurance industry through the prohibition of risk selection by insurance companies (the ban on refusals to cover pre-existing conditions and to set annual and life-time limits on coverage).
Finally, the ACA, passed before the extension of the Bush tax cuts for the wealthiest Americans, begins to reverse the post-Reagan policies of increasing income inequalities. It does so by increasing the existing Medicare payroll tax on all those earning over $200,000 ($250,000 for couples).
These are significant, but modest, steps toward what political scientist Jo White calls the "international standard" among health systems in wealthy capitalist democracies - Japan, Germany, France, United Kingdom, Canada, Switzerland, Australia, Netherlands, and many more.
This standard, met by all governments in such nations, either imposes taxes on its citizens or enforces a health insurance mandate to provide access to a minimum level of health care services. Without taxes or a mandate, there can be no universal health insurance coverage. Without universal health insurance coverage, we cannot meet the international standard.
Amy Ellen Schwartz writes:
Cathie Black's appointment as New York City Schools Chancellor came at a difficult period. While her predecessor, Joel Klein, enjoyed swelling public coffers and large increases in per-pupil spending, Chancellor Black takes office at a time when the budget is shrinking, certainly significantly and maybe substantially.
At the same time, while Chancellor Klein claimed standardized test results "proved" his reforms were working, the recent adjustments in those metrics have fueled doubt about whether - and to what extent - his hallmark strategies such as replacing large comprehensive high schools with new, small schools and increasing school autonomy "worked." Even more, the turmoil created by opening and closing schools - and the attendant expense - raises questions about the sustainability of these reforms.
Bottom line: Cathie Black faces considerable challenges in the months ahead and it behooves us to help her succeed. In that spirit, I offer the following suggestions.
Beyond "What Works": While education officials and policy makers tout the importance of finding out "what works," we need more than that. We need to figure out "what's worth the money" or what gives the biggest bang for the public buck. Is the high cost of new small schools worth the money, or would we do better to invest in mid-size schools or schools-within-schools? Unfortunately, relatively little attention has been paid to the costs of interventions and reforms and so the evidence base is thinner than it should be. This is a gap that needs to be filled.
Special Education is Critical: Between 2002 and 2008, full-time special education students increased by 20 percent, from just over 82,000 to over 98,000. (That's an increase from 7.5 to 9.5 percent of total enrollment.) At the same time, direct per pupil expenditures for special education increased 31 percent. Together, this means that Special Education eats up a larger and larger share of the budget, threatening to crowd out spending and services for general education students. (My forthcoming paper with Leanna Stiefel provides more detail.) While federal and state rules and regulations place significant restrictions on classification, services, and so on, the school district can and must find ways to deliver required services in the most cost effective way possible.
Don't overestimate the value of value-added: Although evaluating the efficacy of teachers and schools using test score based value-added measures has undeniable intuitive appeal, the usefulness of these measures in improving schools now is much more limited than the publicity might suggest. For one thing, value-added measures can only be calculated for a fraction of teachers in NYC public schools. (Currently, only about one in five.). More importantly, however, it seems unlikely that value-added scores will identify significant numbers of previously unidentified "bad teachers" that can then be dismissed to make way for (or save the jobs of) otherwise-hidden "great teachers." I am certain that value-added analyses have an important role to play in education policy and practice in the long run - and equally confident that the short-run returns will be fairly small.
Moving Matters: Chancellor Klein was fond of saying that much of his reform efforts were guided by a desire to create a system of good schools and not a good school system. In practice this meant that accountability fell to individual schools for the students currently enrolled. Who, then, is responsible for making sure that students enroll in schools that can provide the services they need? That they choose "well"? In a different vein, a growing body of research shows that student mobility between schools - prompted, say, by family dissolution, foreclosure, or behavioral or academic problems - harms their performance and, potentially, affects their peers. Helping students navigate between schools, adjust to new environments, and succeed will mean attention and accountability for the school system and not just a collection of good schools.
One of my colleagues once claimed that every home in New York City was within walking distance of one of the best public schools in the country...and one of the worst. As a parent and alum of the New York City public schools, I wish Cathie Black the best of luck in her effort to make all of our schools better.
Stiefel, L., Schwartz, A. E. (2011). "Financing K-12 Education in the Bloomberg Years, 2002-2008" in Jennifer A. O'Day, Catherine S. Bitter and Louis M. Gomez (Eds.), Education Reform in New York City: Ambitious Change in the Nation's Most Complex School System (pp. 55-84). Cambridge MA: Harvard Education Press.
Stiefel, L., Schwartz, A. E., Conger, D. (2010). "Age of Entry and the High School Performance of Immigrant Youth." Journal of Urban Economics, 67:303-314.
The MacArthur Foundation has announced support for a multi-disciplinary, cross-university set of researchers, including three from NYU Wagner, to study the enormous instability in the housing arrangements of many American families over the last decade, and the impact of this instability on children.
According to the researchers, "policymakers know surprisingly little about how such instability affects children, and therefore are hampered in their ability to craft responses." The project approved for Foundation support aims to fill these gaps and provide better guidance to federal, state, and local housing and education officials, community organizations, and elected officials about the benefits of housing stability.
The three Robert F. Wagner Graduate School of Public Service professors working on the project are:
• Ingrid Gould Ellen, professor of public policy and urban planning, and faculty co-director of the Furman Center for Real Estate and Urban Policy, a joint initiative of NYU Wagner and the School of Law.
• Amy Ellen Schwartz, professor of public policy, education, and economics, and director of the Institute for Education and Social Policy at NYU. She also teaches at NYU Steinhardt.
• Leanna Stiefel, professor of economics, and associate director of Institute for Education and Social Policy, who also teaches at Steinhardt.
The trio's co-PI's include:
Vicki Been, Boxer Family Professor of Law, New York University, and faculty director of the Furman Center, and the principal investigator on this project; David Figlio, professor of education and social policy at Northwestern University; Ashlyn Aiko Nelson, assistant professor at Indiana University's School of Public and Environmental Affairs; and Stephen L. Ross, professor of economics at the University of Connecticut.
The co-investigators note that, to date, some research has examined how residential moves affect children's educational outcomes, but the research has been limited by concerns that effects attributed to moves cannot be separated from those of unobserved characteristics of the families that move and of the neighborhoods to which they move.
Further, existing research does not adequately distinguish between types of housing moves: those that the family plans versus those that are more involuntary; those that involve only a change in housing versus those that take the child to a new neighborhood or school; or those that place the child in better neighborhoods or schools versus those that do not.
Using longitudinal data linking foreclosures and other kinds of housing upheavals to individual public school student records in four major markets that are suffering from unusual housing instability-New York City, and the counties of San Diego and Fresno in California and Pinellas County in Florida - Professors Ellen, Schwartz, Stiefel and their co-investigators will test the hypothesis that housing instability negatively affects students' educational outcomes.
In addition, they we will assess whether any effect that housing instability has on children differs by the child's race or the predominant race of the neighborhood in which the child lives or to which the child moves, and if so, what explains those differences.
The research grant was announced as part of a group of nine new MacArthur Foundation grants totaling $5.6 million for explorations of the role that housing plays in the long-term health and well-being of children, families, and communities.
Over the past 15 years, the Furman Center has been committed to the highest standards of interdisciplinary empirical and legal research about housing, land use, real estate, and urban affairs. This report looks back at the Furman Center’s past research, events and reports in four focus areas: Housing Finance and Foreclosures, Affordable Housing, Land Use Regulation, and Neighborhood Change.