Health and Education: A Tale of Two Crises

Iglehart John K. , “Health Policy Report: The American Health Care System: Medicare,” New England Journal of Medicine, 327, no. 20 (1992): 1462–72; and Iglehart John K. , “Health Policy Report: The American Health Care System: Medicaid,” New England Journal of Medicine, 328, no. 12 (1993): 896–900.

United States Bureau of the Census, Statistical Abstract of the United States: 1992 (Washington, D.C.: U.S. Government Printing Office, 1992), p. 321 (No. 497).

Emergency Medical Treatment and Active Labor Act, 42 U.S.C. § 1395dd.

Starr Paul , The Social Transformation of American Medicine (New York: Basic Books, 1982), pp. 379–449.

See Thro William E. , Note: “To Render Them Safe: The Analysis of State Constitutional Provisions in Public School Finance Reform Litigation,” Virginia Law Review, 75 (1989): 1639–79.

See Statistical Abstract of the United States, supra note 2, at 141 (No. 215).

Id. at 141 (No. 214).

President Clinton's Address to Joint Session of Congress, Sept. 22, 1993.

Pear Robert , “Fewer Are Insured for Medical Care,” The New York Times, Dec. 15, 1993, sec. A24.

Editorial, “Shrinking Health Coverage,” The Washington Post, Oct. 11, 1993, sec. A30.

In fact, education may be the key determinant to health status. Adler Nancy , “Socioeconomic Inequalities in Health,” Journal of the American Medical Association, 269, no. 24 (1993): 3140–45; and Pear Robert , “Big Health Gap Tied to Income Is Found in U.S.,” The New York Times, July 8, 1993, sec. A1.

Celis William , “Study Says Half of Adults in U.S. Lack Reading and Math Abilities,” The New York Times, Sept. 9, 1993, sec. A1.

Testimony of Laura D'Andrea Tyson, Hearing of the Health Subcommittee of the House Ways and Means Committee, Nov. 4, 1993.

Rosenbaum Susan , “Programs Combating Increase in Illiteracy,” The New York Times, Jan. 14, 1990, sec. 12 (N.J.) at 1.

White House Domestic Policy Council, Health Security: The President's Report to The American People (New York: Simon & Schuster, 1993), pp. 7–11.

Id. at 7.

Hilts Philip J. , “Doctors' Pay Underestimated But Resented Just the Same,” The New York Times, Mar. 31, 1993, sec. A21.

National Center for Education Statistics (U.S. Department of Education), The Condition of Education 1992 (Washington, D.C.: U.S. Government Printing Office, 1992), p. 335.

Id. at 338.

See Statistical Abstract of the United States, supra note 2, at 151 (No. 233) (citing National Education Association, Estimates of School Statistics).

Id. at 151 (No. 234).

Elam Stanley M. Ross Lowell C. Gallup Alec M. , “The 23rd Annual Poll of the Public's Attitudes Toward the Public Schools,” Phi Delta Kappan, 73, no. 1 (Sept. 1991): 41–56; and Elam Stanley M. , “The 22nd Annual Gallup Poll of the Public Attitudes Toward the Public Schools,” Phi Delta Kappan, 72, no. 1 (Sept. 1990): 41–55.

Woolhandler Steffie Himmelstein David U. Lewontin James P. , “Administrative Costs in U.S. Hospitals,” New England Journal of Medicine, 329, no. 6 (1993): 400–03.

See Hubbard Catherine , “Study Finds Health and Education Largest State Costs in 1992,” State Tax Notes, 4, no. 18 (May 3, 1993): 1036.

See Morain Dan Banks Sandy , “State Voters Reject School Vouchers,” The Los Angeles Times, Nov. 3, 1993, sec. A1; and “School Voucher Movement Survives California Massacre,” St. Louis Post-Dispatch, Nov. 5, 1993, at 1C.

H.R. 3222, 103d Congress, 1st Sess. (1993).

S. 1757, 103d Congress, 1st Sess. (1993).

Congressional Budget Office, Estimates of Health Care Proposals from the 102nd Congress (Washington, D.C.: U.S. Government Printing Office, 1993), p. 18.

Kronick Richard Goodman David C. Wennberg John , “The Marketplace in Health Care Reform,” New England Journal of Medicine, 328, no. 2 (1993): 148–52.

Consumer sovereignty may be further reduced because open enrollment periods only will occur annually. They will seldom occur at the precise moment, in the course of treatment, that a patient is dissatisfied with the care received.

Rice Thomas Richard Brown E. Wyn Robert , “Holes in the Jackson Hole Approach to Health Care Reform,” Journal of the American Medical Association, 270, no. 11 (1993): 1357–62.

See Reinhardt Uwe E. , “Managed Competition in American Health Care Reform: Just Another American Dream, or the Perfect Solution?,” Paper Delivered at the 1993 Annual Meeting of the American Society of Law, Medicine & Ethics, Arlington, Virginia, Oct. 22, 1993. While the plan will require health alliances to prohibit discrimination on the basis of race, geography, or employment status, in fact there are many ways in which insurer networks can fashion the market they desire. For example, by not including leading infectious disease specialists in their physician panels, networks can deter HIV patients from joining.

See, e.g., Smetanka Mary Jane , “Most Minnesota Reforms Met with Opposition at First,” Minneapolis Star Tribune, April 25, 1993, sec. A18 (discussing structural reforms in Minnesota); Skeen v. State, 505 N.W.2d 299, 319, and note 12 (Minn. 1993) (discussing fiscal reforms in Minnesota); and Howe Peter , “Questions on Extent of School Reform,” The Boston Globe, June 7, 1993, p. 1 (discussing fiscal and structural reforms in the 1993 Massachusetts Education Reform Act, 1993 Mass. Acts c.71).

Some reform efforts have failed to appreciate the importance of equalizing resources before permitting parental choice, and some have structured the choice systems in ways that significantly favor wealthier parents over poorer ones (especially by failing to cover the costs of interdistrict transportation). These failings raise the threat of the same sorts of invidious segmentation posed by voucher systems.