Wednesday, May 3, 2017

Trust and Cost Disease

I have been wondering if loss of trust is a significant driver of our rapidly increasing spend for schooling and medical care. Spending is increasing rapidly and yet the teachers and MD's are less happy with their jobs and the patients are not happier with the service. See here.

We do not trust the teachers as much as we used to and so we test more and regiment them more. We don't trust MD's and so we build rules and bureaucracy to regiment them. Part of that is inevitable in a 3rd party payer system but it might be increased by this international competition. All the stories that tell us how poorly the USA does on PISA and life expectancy as compared to the other developed countries when there are many non schooling non health care things that effect PISA scores and life expectancy.

BTW As far as schooling goes, does PISA really test anything important? On PPP GDP per capita USA Ranked 6th, 44% more than Finland, maybe the Finns should change their schools to look more like ours? Maybe the PISA tests are too close to an IQ test tell us much about the quality of our schools.

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