Browsing the blog archivesfor the day Thursday, November 19th, 2009.

Health Care Quicktakes

Economics

The Senate bill was released today and I have a few thoughts about how politicians on both sides are being dishonest about the bill.

Let’s start with the Republicans. The CBO’s estimate of the effects of the bill are that the cost for the government option health insurance plan will likely be higher than private plans. On Fox News, Carl Cameron reported that this confirmed what Republicans have been saying for months — that government-run health care will be more expensive. Really? That’s not how I remember it at all. I remember Lindsay Graham (R-SC) saying that the government option would be cheaper than private plans. And because it is cheaper, companies will ditch their private health insurance plans. Private health insurance companies won’t be able to compete and they’ll be driven from the market. the government option was supposed to destroy private health insurance. Now we discover that it won’t, and that’s somehow bad too? Republicans are trying to take both sides of this issue. If the government option is less expensive, it will ruin private industry. If it’s more expensive, it’s a sign that the government is inefficient and can’t do anything right. You can’t have it both ways, guys.

Speaking of having it both ways, let’s move on to the Democrats. In trying to keep this bill deficit-neutral, they are forced to raise about a half trillion dollars in taxes. $28 billion of this is taxes is expected to come from employers that do not provide government-approved health insurance plans for their employees, so they get fined. So what happens if these companies shape up and put their employees on the government option? The government now has to pay for the health care of these individuals, and the government does not collect the tax revenue. Seems to me the Democrats are counting on money that, if their bill is successful, they won’t get. It’s just like the SCHIP bill passed a few years ago. In order to help pay for an expansion in the State Childrens Health Insurance Program, the Democrats in Congress increased cigarette taxes. If people stop smoking (as we want them to do), the government doesn’t get its money and the kids don’t get health care. As I tell my students, next time you’re smoking, just tell yourself, “I’m doing it for the kids.”

The Democrats say the bill costs $848 billion and will reduce the deficit by $130 billion. That means they’re increasing revenues by 848+130 = $978 billion. Some of this is assuming new efficiencies in Medicare that the CBO says are questionable. And the rest of it is on taxes. The goal wasn’t to reduce the deficit by increasing taxes (especially in a recession) — it was to provide affordable health care for all. If you only need $848 billion, why not increase taxes enough so that you get $848 billion in revenue. If you ask me, this extra $130 billion is because they know those Medicare cuts won’t happen.

And last but not least is the difference in timeline between costs and revenues. The Democrats start collecting taxes next year, so the $978 billion in revenues comes over 10 years. But the benefits people get in the health care bill don’t start for 5 years. So they’re actually saying that we’ll collect money for 10 years and only pay it out for 5, and somehow this is a deficit reduction. That’s like me saying that I’m only going to pay half of my bills this year and then, at the end of the year being proud of all of the cash that I have in my checking account. It’s ridiculous. And the CBO says that in the second 10-year period of the bill (2019-2029), health care costs will TRIPLE.

And politians wonder why we’re sick of their games and want to throw them out of office. They can’t be honest about the numbers. They play a shell game with our money. And they talk out of both sides of their mouths. My suggestion for 2010: vote out every single incumbent. Maybe they’ll get the message.

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Technological Frustrations

Random

I like to consider myself a relatively tech-savvy person.

When my colleagues have a question about D2L (our course management system, similar to WebCT or Blackboard), they ask me. When a colleague gets a new iPhone, he asks me how to set up his mail. When I visit my parents every year, they have a list of things I need to show them how to do (and write instructions they can refer to after I’m gone) — how do I rip a CD into iTunes and then burn a copy of it? How do I format something in Excel. How do I set up the wireless network? Usually I feel like I have a good idea of what’s going on, know what questions to ask and know where to find the answers.

Then I started working on my online courses. The goal originally was to have everything in D2L. Each week’s material (a “module”) would be a folder in the Content area and students would click on their different assignments. A Word document with an introduction to the chapter and a set of learning objectives. A link to a lecture presentation or two on video. All of these things would be housed on a media server at SCSU (since taking up space on D2L is, shall we say, frowned upon).

At first I just used PowerPoint and recorded audio. That file would be sent to the tech people on campus and they would convert it using Adobe Presenter into a flash video that students could watch in a web browser. It looked great and worked well. The problem was that it was just me reading a slide. It couldn’t do screen capture. I have colleagues at other schools that have used a software called Camtasia. It captures what’s on your screen so that when you’re talking through your presentation, students can see your cursor. You can highlight things and draw graphs on the screen in real time. And you can open up a web browser to show them an article, or where to go to get a piece of data. It looked cool. Of course, it costs money — $180 or so for educational purposes.

I then learned about Camstudio — a free version that has most of the same features. The only problem is that the flash conversion done by Camstudio has an interface that does not include FF or RW buttons on it. The whole upside to video is that students can rewind a section if they don’t understand it and watch it again.

So I learned about something called Flowplayer, which has a nicer interface — basically, you watch videos in much the same way you would watch a YouTube clip someone put on a blog. You can rewind, fast forward, go to specific points in the video using the slider bar, and expand to full screen. But then I need another software to convert the Camtasia AVI output file into FLV format. Okay, I got that. I also got a video editing program so I can clip out the beginning and ending parts of a presentation if they’re rocky, and I can split up a long video or splice together short ones. And now I don’t have to send every video (which is too big to send in e-mail of course) to the tech people to have them converted to a Flash file.

The question is then: how the heck do I get my students to watch this? I spend hours playing around with some HTML code that would enable Flowplayer but it wouldn’t work. The tech people gave me a workaround but the flash video they created did not include the ability to make the video full-screen, which will be crucial for my students to look at all the graphs.

Then yesterday I finally realized the best solution to my problem. I decided to put the online courses up as two new blogs hosted on my own personal web site. (You’ll see them as the top two links on the right side of the page.) I don’t know how anybody would do what I’m doing using the school’s resources. It’s just too complicated — too many moving parts going on and what ends up getting sacrificed is the experience for students. So instead I’ll have a blog and each post will be a module. I’ll add all the text I need, include video clips they can watch full-screen, and include links to other articles. All in all, I think it’s a great solution. I can password-protect each post and give students the password each week, and other people can’t steal my content. It also means I can give the password to colleagues from other universities who want to see what I’ve done — something I can’t do if the course is all on D2L. In the end, I found a great solution that meets all of my needs and will hopefully provide a quality educational experience to my students.

But I think it’s a little sad that the only way to have an online course set up the way I need it to be set up, so my students can learn what I need them to learn in the way that I think is most effective — and in a way that is not that technologically fancy at all — is to completely bypass the university technology system that is supposed to make everything happen for us. I honestly don’t blame the tech people — I think they’re doing the best they can. They were extremely helpful in helping me realize what exactly it was that I wanted to be able to do in the online course, providing a headset and microphone so I could make my recordings, and answering all my questions in a way that was understandable. I know they’re dealing with restrictions imposed on them by others, security issues, licensing issues, etc. I post this not to complain about the work they have done (because, frankly, without them I would have been even more lost), but to point out that right now we have a system where technology dictates pedagogy. You are told what is possible and you try to mold your course around that — and if you don’t like it, you have to find a way to work around the system. That’s not right. Pedagogy should drive technology, not the other way around

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