Monday, April 22, 2013

Common Core - Dangerous for America!

 Nebraska Taxpayers for Freedom Issue Paper: commoncore1.doc.  4-13.

BACKGROUND.  Conservatives are legitimately alarmed about the Obama Administration Common Core curriculum pressed onto our public schools.  The regime heavily pushes this curricula through its $4.35 billion 2009 Race to the Top education grant competition bribery.  Many states have embraced Common Core to grab these massive grants.  States that accepted its precepts received bonus points in their applications.  This plan awards points to states that adopt this common set of K-12 standards that are mostly identical all over America. Obama’s Education Dept. has awarded over $360 million to 2 liberal groups to create student assessments in Common Core.  Obama herded states into adopting these standards without time to deliberate on their adequacy, requiring adoption approved by state education dept. officials, if states want to obtain federal waivers from the 2002 No Child Left Behind law.  If Obama succeeds, states like NE will lose federal funds by adhering to their own standards, denied access to Race to the Top federal dollars for refusing Common Core.
VALID CRITICISM.  Common Core eradicates local school board control over the K-12 math and English curricula, substituting a lone, federally-imposed curricula that applies to public, private, parochial, and home schools.  Proponents advise that national standards will improve academic performance; however, these new standards evidence no proof that they are better than current NE standards.  No district has tested these standards, which use unproved instructional methods. These standards base on unproved ideas and questionable assumptions.  The job of teaching our kids is too important to depend on untested, common methods pushed by companies that have financial interests in selling textbooks, technology, and academic assessment but not accountable to parents or taxpayers. Several private corporations will make huge profits, with less money reaching classrooms.  Our children will become guinea pigs.  In Massachusetts, adopting Common Core meant dumping academic standards regarded as the best in the nation.  In many states, Common Core standards are inferior to state standards.  There exists no evidence that a federal curriculum brings high academic achievement.  France and Denmark boast national curricula that do not reflect high achievement on international testing.  Contrarily, both Canada and Australia use many regional curricula and show better results.[1]  A Brookings Institution study found that common state standards do little to equalize academic achievement among states.[2]   Instruction is confusing.  Common Core requires pupils to explain a math problem before doing the calculation, complicating the teaching of basic math.  Teachers become confused with the unfamiliarity of teaching this product.  Students do not learn traditional math, like multiplication, until a grade or two later. In Common Core math, kids abandon concrete skills for abstract confusing methodology.  Elementary kids who got “A” grades struggle to explain how they find answers after using mental math in Common Core and get lower grades.  These math standards delay development of key concepts and skills, instructions written at a level confusing to teachers, students, parents, and administrators.  Math standards not well-organized at the high school level, several important topics insufficiently covered, and standards not divided into defined courses. To avoid attention, proponents have focused only on math and English, aiming to eventually extend Common Core to all subjects.  Math standards are inferior.  A math professor, the only mathematician on the validation committee, refused to sign off on the math standards, declaring that they would drop many pupils 2 yrs. behind those in many other nations.  One most tragic change for English classes is the requirement that 50% or more of readings in Grades 6-12 come from informational instead of cultural texts.  Such means that curricula will not include many classic works in American and other literature.  Popular treatises like Common Sense, the Gettysburg Address, and To Kill A Mockingbird are not present, only on a list of reading suggestions.  No research tells that college readiness comes from reading informational items in high school classes.[3]  Conservatives around the country are angry about the secretive process by which Common Core standards became adopted, allowing for few or no public hearings, blocked from the legislative process.  The conservative Cato Institute noted that state lawmakers are surprised when academic curricula become snatched from their prerogatives.  Common Core defines contents for all U.S. K-12 math and English texts and defines what our kids will learn and not learn.  No empirical validation of standards or metric to monitor intended or unintended consequences.  No early childhood teachers or child development experts were included in the K-3 standards formulation process, because Common Core shocked these professionals.  Standard writers had no background in child development or early childhood education.  The Joint Statement of Early Childhood Health & Education Professionals statement criticizing Common Core garnered signatures from over 500 prominent early childhood professionals, like educators, pediatricians, developmental psychologists, and researchers.  The statement read that Common Core conflicts with new research in cognitive science, neuroscience, child development, and early childhood education about how young kids learn, what content they should learn, and the best methods to teach them in kiddiegarden and early grades.  Common Core pilots are disappointing.  One principal told of his school piloting the assessment, whereby the failure rate rose dramatically, particularly among slow learners. 

COMMON CORE TESTING.  After adoption of Common Core curricula, its standardized testing is approaching fast.  No national standardized test can effectively measure what teachers teach in each public school system.  Common Core demands a great increase in testing, much more than the already excessive amount required by No Child Left Behind.  NYC will spend over a half billion on technology, so that its students can take electronically federal tests.  Research proves that increasing testing does not increase achievement.  NE school districts suffer funding squeezes, but Common Core costs billions for new textbooks, infrastructure like high speed networks, new software for additional computers, training, consultants, and tests. 

COST TO TAXPAYERS.  Adoption is expensive, and states adopting Common Core jump into an assessment quagmire without estimates on costs.  Local school administrators complain that Obama grants do not cover the requirements, costing much more to implement all the mandates.  The education establishment likewise complained for years about the unexpected costs of No Child Left Behind.  Common Core will repeat this expensive lesson in forcing another underfunded ed mandate on states.  NE probably would not qualify for federal funding now, leaving NE taxpayers to pay the entire bill. 

LEFTIST CURRICULA.  One lesson features a video titled China Rises, that praises the virtues of Chinese communism over capitalism.  The leftist New York Times co-produced this propaganda piece.  Another lesson regrets children inability to vote, as they understand global warming and war better than adults who make world problems worse.  Common Core uses UN programs to institute international curricula. Materials promote “alternative lifestyles,” criticize capitalism, praise labor unions, redistribution of wealth, radical environmentalism, and social justice, and debase of Judeo-Christianity. The liberal progressive school-to-work plan will allow the Obama Regime to put everything in place to plan for future labor markets.  Common Core promotes a model of a command economy and unlimited federal governance.  Proponents want to control our schools, so that our children will become conditioned to accept that the federal government has the right to order them to serve its economic commands.  Government will be the master, not the servant. 

ITS FUNDING.  Common Core has received funding from the Bill & Melinda Gates Foundation and other leftwing sources. 

ITS SUPPORTERS.  The leftwing American Federation of Teachers (AFT) endorses Common Core. Several creators of  Common Core standards have accepted employment with testing companies that will accrue millions of dollars developing tests based on the standards they created.

HOME SCHOOLS UNSAFE.  Saxon Math and Math U See both declared that they will align their curriculum, popular among home schools, with Common Core.

INVASIVENESS.  Conservative parents object to violation of student privacy by data mining through assessment means. Common Core creates a student database including test scores, hobbies, family income, voting status, and health records, a violation of individual rights and limited government. [4]  Data mining includes using cameras to evaluate kid facial expressions, electronic seat that judges postures, a pressure-sensitive computer mouse, and a biometric wrap on wrists.

STATE BOARD OF EDUCATION.  Board members voted 7-1 (John Sieler voted with taxpayers) to pay a consultant company $47,000 to compare NE standards alignment to Common Core, due in October, 2013, a hint that the board majority will embrace the latter curricula.  The State Board of Education must give final approval of state curriculum standards and assessments. School districts should not use Common Core yet, as the state board has not adopted it yet.  We urge taxpayers to contact their state board of education member to pass the following resolution:
Notwithstanding any other statute, the state board of education shall not adopt, and the NE Dept. of Education shall not implement, Common Core standards developed by the Common Core Standards Initiative.  Actions pursued to adopt or implement the Common Core State Standards are void.  Common Core State Standards shall not be adopted or implemented without the approval of the NE Legislature.

LEGISLATURE.  Sen. Jim Scheer from Norfolk introduced LB 512, to order the state to accept Common Core national assessments and allow the state board of education to proceed with this curricula. We must lobby our state senators to kill LB 512, then co-sponsor and support legislation to ban NE from adopting and spending money on all activities relating to Common Core, like training teachers or buying materials.  Also, press them to pass a bill to forbid sharing of private student information without parental consent.   

CONSTITUTIONAL ISSUE.  As awareness of this federal education power grab increases, opposition mounts.  States now realize that accepting Common Core means transferring control of school curriculum to the Obama Regime.  Only Texas, Alaska, Nebraska, and a few other states are steadfastly resisting, and others have withdrawn participation or are considering such.  Common Core violates the U.S. Constitution and several federal statutes that prohibit federal direction, control, or supervision of curricula, instruction, and materials in K-12 schools.  This plan is a serious assault on state sovereignty, a power grab by which the Obama Regime will directly target school districts.  This federal intervention will cripple state, local, and parental authority over curricula and cost states $16 billion in new spending.[5] 

TAKE ACTION NOW.  We still can stop this dangerous scheme to nationalize education and indoctrinate our children.  Do not permit nameless, faceless, unelected and unaccountable bureaucrats to seize control of NE public education.  Contact your state board of education member and state senator today to stop the progress of Common Core in Nebraska.  Email for their contact information. 
Research, analysis, and documentation for this issue paper done by Nebraska Taxpayers for Freedom, with prior permission granted for its use by other groups in the NE Conservative Coalition Network.  4-13.   C

[1] Closing the Door on Innovation: Why One National Curriculum is Bad for America. Available at:
[2] “The 2012 Brown Center Report on American Education: HOW WELL ARE AMERICAN STUDENTS LEARNING?
[3] Common Core Standards, Devastating Impact on Literary Study and Analytical Thinking, Sandra Stotsky, Heritage Issue Brief, Heritage Foundation, December 2012.
[4] Joy Pullmann, managing editor of School Reform News and an education research fellow at the Heartland Institute.
[5] Heritage Foundation. 

Thursday, April 11, 2013

Medicaid Patients Have Worse Access and Outcomes than the Privately Insured

Abstract: Academic literature has consistently illustrated that Medicaid patients—adults and children—have inferior access to health care, and notably poorer health outcomes, than privately insured patients. Due to the program's low reimbursement rates, more and more doctors are refusing to even accept Medicaid. As a result, it is becoming increasingly difficult for Medicaid patients to find access to primary and specialty care physicians. When Medicaid patients are admitted to hospitals, they are often admitted with more serious conditions than those with private insurance. By further expanding this broken program, Obamacare will only exacerbate the situation, continuing to harm many low-income Americans who have no option other than Medicaid. Policymakers should reform Medicaid to allow Medicaid patients access to private insurance in a consumer-driven market.

Established as a fundamental component of President Lyndon Johnson's Great Society, Medicaid is a jointly funded federal and state program that pays for health care for low-income individuals. The academic literature has consistently illustrated that Medicaid patients have poorer access to care, and poorer health outcomes, than privately insured patients. By further expanding this broken program, the Patient Protection and Affordable Care Act - Obamacare - only exacerbates the situation. Policymakers should reform Medicaid to provide consumers with greater access to private insurance in a consumer-driven market.

Medicaid typically pays physicians 56 percent of the amount that private insurers pay.[1] Given these low reimbursement rates, more and more doctors are refusing to accept Medicaid.[2] As a result, it is becoming increasingly difficult for Medicaid patients to find primary care doctors and specialists. When Medicaid patients are admitted to hospitals, they are often admitted with more serious conditions, and in some cases, with a higher level of co-morbidity, than privately insured patients. The peer-reviewed academic literature clearly illustrates Medicaid's problems for children as well as for adults.

Children Suffer Under Medicaid

Medicaid undermines care for millions of children. Consider, for example, children with asthma, one of the most common chronic diseases affecting children in the United States. A 2001 study published in the Journal of Health Care for the Poor and Underserved compares hospital care for children with asthma who are covered by Medicaid to children with asthma who are covered by private insurance in California, Georgia, and Michigan.[3] The authors found slightly longer length of stay and significantly poorer outpatient care for the children on Medicaid. In terms of outpatient care, the authors specifically found that pediatric Medicaid patients were more likely than privately insured patients to be discharged on subpar medication routines. The authors also found that Medicaid patients generally lacked a consistent source of outpatient care, unlike privately insured patients. These issues with outpatient care suggest that these children are more likely to be re-admitted for hospitalization at a subsequent time in the future.

Adequate access to care is also a serious problem for children on Medicaid. A 2004 study published in Pediatrics examined children’s access to specialty surgeons in Southern California.[4] The researchers surveyed specialty surgeons throughout southern California and found that the surgeons are generally less inclined to accept patients enrolled in Medi-Cal (California’s version of the Medicaid program). The surgeons cited difficult paperwork, administrative burdens, and poor reimbursement rates as reasons for not wanting to take on these patients. The authors consequently caution policymakers about expanding this program, noting that coverage through Medi-Cal does not necessarily signify meaningful access to health care. The authors also suggest that expanding Medi-Cal may in fact exacerbate the existing problems of limited access to care.

Another study published in 2005 in Urology found similar problems with boys’ access to urologic care.[5] The authors surveyed a simple random sample of urologic offices located throughout California in order to determine the offices’ attitudes toward Medi-Cal recipients. Of the offices they found that were willing to see pediatric patients, the authors found that 96 percent of these offices would accept privately insured patients. They also found that only 41 percent of these offices would accept Medi-Cal patients. Three-quarters of the offices that refused to accept Medi-Cal patients were unable to even recommend offices that would.

Furthermore, a recent study published in the New England Journal of Medicine examined pediatric access to specialty clinics in Cook County, Illinois.[6] Sending out research assistants posing as mothers and making phone calls to a random sample of specialty clinics, the study found a significant disparity between access to specialty care for privately insured children and children on Medicaid as well as the publicly funded Children’s Health Insurance Program (CHIP). Specifically, the researchers noted more denials of appointments as well as longer waiting times for Medicaid and CHIP patients than for privately insured patients.

These studies suggest that children on Medicaid lack access to the kind of care that privately insured patients enjoy. As long as the program in its current form remains in place, these problems will persist.

Adults Suffer Under Medicaid

Children are not the only ones Medicaid is failing. A number of academic studies have also pointed out the disparities in health outcomes between adult Medicaid recipients and those who are privately insured.

A 1993 study published in the New England Journal of Medicine found that breast cancer patients in New Jersey were often diagnosed with more advanced stages of the disease and had higher risks of death if they received their insurance coverage through Medicaid instead of private insurance.[7] These findings have been corroborated by a number of subsequent studies looking at a variety of serious illnesses:
  • A 2000 study published in Cancer examined health outcomes of breast cancer patients in Florida. The study found that, as a result of later diagnoses, Medicaid patients have higher mortality rates than patients who are covered by commercial fee-for-service insurance.[8]
  • A 2000 study published in the American Journal of Public Health that examines colorectal cancer treatments and outcomes found that Medicaid patients not only had higher mortality rates, but were also less likely to receive cancer-directed surgery, than patients using commercial fee-for-service insurance.[9]
  • A 2001 study published in Cancer compared health outcomes for a variety of cancers for patients in Michigan. The study found that Medicaid patients had significantly higher rates of occurrence as well as higher risks of death for breast, cervix, colon, and lung cancers compared to non-Medicaid patients. The study also found that Medicaid patients had a higher risk of being diagnosed with these cancers at later stages.[10]
  • A 2003 study published in the Archives of Internal Medicine that compares health outcomes for colorectal, lung, prostate, and breast cancer in Kentucky for a variety of insurance classifications also found similar results. For all four illnesses, the authors found that survival rates are markedly higher for privately insured patients than for Medicaid patients.[11]
Most recently, a 2010 study in the Journal of Hospital Medicine found similar results for non-cancer-related illness. In this study, the authors examine the relationship between insurance status and health outcomes for myocardial infarction, stroke, and pneumonia patients.[12] The authors statistically analyzed a nationally representative hospital database and noticed, even after adjusting for factors such as age, gender, income, other illnesses, and severity, higher in-hospital mortality rates for Medicaid patients than for privately insured patients. Additionally, even after adjusting for these factors, the study found that Medicaid patients hospitalized for strokes and pneumonia also ran up higher costs than the privately insured, as well as the uninsured.

Medicaid: Hinders Access to Care, Fails to Meet Patients’ Needs

A number of academic studies over the years have illustrated that Medicaid patients have consistently had poor access to care and that Medicaid fails to meet important needs:
  • A 1992 study in the Journal of the American Medical Association examined hospitalizations in Massachusetts and Maryland.[13] The study found that Medicaid and uninsured patients were statistically more likely than privately insured patients to be hospitalized for avoidable conditions such as pneumonia and diabetes.
  • A 2007 study in Health Affairs examined access to specialty services for patients who receive primary care from community health centers.[14] The study found that Medicaid recipients have significantly more difficulty accessing specialty care than privately insured patients.
  • A 2012 study in Health Affairs examined physicians’ willingness to accept new patients. Using survey data from a nationally representative sample, the study found that nearly one-third of physicians nationwide will not accept new Medicaid patients. Doctors in smaller practices, as well as doctors in metropolitan areas, are among the least inclined to accept new Medicaid patients.[15] The authors’ results suggest that this reluctance may largely be a consequence of Medicaid’s poor payment rates to doctors.
Given these findings in the peer-reviewed literature, it is not surprising that Medicaid patients often arrive at emergency rooms in poor, and in many cases, untreatable condition. In fact, research has shown that Medicaid and CHIP patients end up in emergency rooms even more frequently than uninsured patients.[16]


As the academic research has consistently suggested, Medicaid’s so-called safety net cripples the very people it is designed to help. To fix the broken safety net, Congress should consider the following.[17]
  • Repeal Obamacare and its Medicaid expansion. One of Obamacare’s greatest pretenses is that it improves access to health care. The new law attempts to achieve this goal by dumping millions more patients into the broken Medicaid system. Recent Heritage Foundation research has statistically illustrated the debilitating effect that Medicaid expansion will impose on state governments.[18]
Some proponents will likely argue that Obamacare addresses access issues by providing additional federal funding to increase physician reimbursement to Medicare levels. However, this additional federal reimbursement is only temporary and solely applies to primary care physicians. As a result, it is only a matter of time until state budgets become more burdened and a lack of access to meaningful health care becomes even more of a problem nationwide.[19]
  • Maximize access to private health insurance for Medicaid beneficiaries. The best approach to improving access and outcomes would be to integrate the success of private health insurance into the Medicaid system. Some states, such as Florida, have pursued reforms in the past decade by giving Medicaid patients a choice of private managed care plans. A five-county pilot version of the program flattened Medicaid costs and had been saving the state slightly under $120 million annually. Additionally, the program overall noted greater access to care, higher degrees of patient satisfaction, and a marked improvement in health outcomes.[20]
The Heritage Foundation’s Saving the American Dream proposal goes further. It recommends transitioning non-disabled Medicaid beneficiaries out of the failing Medicaid program and into private health insurance and integrating private, patient-centered models into Medicaid to better serve the disabled and frail elderly.[21]


Medicaid is a prime example of government’s inability to outperform—or even keep up with—the private sector. Academic research has consistently illustrated that the program is associated with poorer access to care and poorer health outcomes than private insurance. With the right reforms, however, lawmakers can significantly expand Medicaid patients’ access to private health insurance and put low-cost, high-quality care back in the hands of those truly in need.

—Kevin D. Dayaratna is Graduate Fellow in the Center for Health Care Policy Studies at The Heritage Foundation.