Governors see need to reform education, health care
Park City • Utah Gov. Gary Herbert asked western governors and guest experts the same question Saturday about public education and health care: how can states afford their increasing costs?
He received the same answer for both: Totally reform the systems, because business as usual is too expensive. Experts, by the way, said that could also improve quality.
"We can't be doing the same old, same old and expect different and better results," Herbert, the outgoing chairman of the Western Governors' Association, said in an interview after the group's convention held sessions on health care and education.
For example, he said, "A teacher could have gone to sleep 100 years ago, come back 100 years later and felt very comfortable in the classroom Â because nothing has changed."
But students have changed, with more not speaking English at home, or wanting to use computers and the Internet to learn. Also, millions of adults started college but never finished, and need help the current system lacks.
Herbert said reforms to consider include more competency-based testing to allow students to skip classes on what they already know, spend more time on what they need to learn and possibly graduate quicker. More use of the Internet and technology could cut need for extra buildings and stretch the reach of teachers, and allow instructors to offer more individualized coaching.
"We need to be more innovative," Herbert said.
Mike Leavitt, former U.S. Health and Human Services secretary and former Utah governor, gave governors the same message about health care as they try to figure out how to cover higher costs as the federal Affordable Care Act kicks in.
He likened their situation to a mythical city that had used taxis to provide transportation, but could no longer afford that as the population increased but tax revenues did not. "So it invented buses," to carry more people cheaper, if not necessarily as conveniently, he said.
Leavitt said states need to create the equivalent of that with their regulatory powers over insurance, health care standards and what they are willing to cover for employees and Medicaid recipients.
"States can have more influence than they think," he said. "Frankly, governors have the tools to accomplish that [reform], tools that the federal government pretends to have but simply does not."
Greg Poulsen, senior vice president of Intermountain Healthcare, suggested a reform states should seek: "Change the payment mechanism to reflect what we really want the health care system to do, which is keep us healthy."
He said incentives now give doctors more money if they provide more treatment, which may not be needed. When providers are also the insurer, he said, studies show costs decrease and health actually increases. He said states could move such reform forward by setting standards of care they will cover for employees and Medicaid recipients.
Several speakers similarly outlined reforms they would like to see states promote in education both to save money and improve quality.
Bob Mendenhall, president of Western Governors University, said its model of competency-based education can save money by avoiding classes for what people already know. He said its graduates take an average of three years to complete a degree, while it takes five at traditional schools. Its high use of technology also allows people to study from distant locations and avoids expensive campuses.
Neil Ashdown, president of iSchool, said another use of technology includes using online textbooks that tend to be cheaper and are updated constantly, and avoid the old problem of teaching from out-of-date books. He said by not using more such technology, "We are preparing for the past in some instances, rather than the future."
Daniel Greenstein, director of the Postsecondary Success Program of the Bill & Melinda Gates Foundation, said educators have long known that surrounding students with one-on-one tutorials vastly improves results. "We can't afford that," he said. While technology can help, "We're also going to need to think fundamentally differently about how we deliver the educational experience."