This week is National School Choice Week, a week when education reformers stress the importance of individual choice in education. While the official effort is focused on education issues, the underlying principle – choice – is critical to a host of current policy issues, especially health care.
The parallels between education and healthcare policy are instructive. In both areas, the national debate centers around what role the government and individuals should each play in making decisions and controlling resources in these service industries. The policy solutions that will maximize choice, abundance, and favorable outcomes are also similar for both issue areas.
In many parts of America, families do not enjoy much educational choice. They are assigned a public school based on where they live. Unless they can afford to move, pay tuition for private school or homeschooling, they have to use that local school. Similarly, more and more Americans face limits on what healthcare providers they can access, due to the narrow and ultra-narrow networks offered in their Affordable Care Act health insurance plans. Even worse, many Americans don’t even get to choose their health insurance plan; it’s simply assigned to them based on where they work.
These inputs – addresses and places of work – are arbitrary and tell us little about the needs of students and patients. We aren’t assigned a grocery store, auto-body shop, or shopping mall based on where we live or work. Rather, we are free to participate in a marketplace of offerings that compete with one another for our business. Why – in arguably the two most important service markets – would Americans be assigned limited options?
In education, some believe that public school assignments create more equitable outcomes. The thinking goes: If every child in the neighborhood is forced to attend the same school, and every parent is equally invested in seeing the school succeed, then all children will get a quality education.
However, reality is very different. Public schools vary greatly from place to place, with some having far more resources, both in terms of dollars and in engaged, supportive parents, than others. Furthermore, wealthier families, regardless of where they live, always have the option of sending their children to private schools. It’s low- and middle-class children who are trapped when the local public school fails to deliver a quality education.
Similarly, our healthcare system is inequitable. American tax laws encourage employers to provide, and workers to obtain, health insurance through their businesses. Especially today, when so many workers do not have traditional full-time jobs that they keep for many years at a time, this makes little sense. Employees have only the insurance options selected by their bosses, and Americans without workplace health benefits are at a big disadvantage.
The solution to giving people more and better access to health care is the same kind of policy fix we need to improve the education services that are available: We have to return choice to the individual level. This means two changes: First, real choice means control of resources. Families have to be entrusted with their own healthcare and education dollars. Secondly, government should deregulate and de-standardize these areas to allow maximum experimentation, innovation, and competition.
In education, here’s what this looks like: Allow families to choose the school that is right for their child, and then allow state education dollars to follow the child. This would spur competition among schools for students, the greatest accountability mechanism of all.
In healthcare, dollars must similarly follow patients. Policymakers should replace the tax advantage enjoyed by employer-based plans with a universal tax deduction or credit that all consumers could use to purchase the health plan of their choice. Again, competition would reign and consumers would benefit from more choices, higher quality, and more affordability.
In both issue areas, government regulation must be scaled back. Just as each child has unique and personal educational needs, each patient needs individualized care. Our governments – both state and federal – seek to put in place basic standards for what is acceptable. Government regulates school curriculums, just as it regulates insurance policies. But it has gone far too far.
Not every child benefits from the same curriculum or teaching methods. Not every patient needs the same insurance coverage. Attempts to over-standardize have limited “competition” to a meaningless choice. Only when education and healthcare providers are free to creatively explore new ways to provide what consumers want will we see meaningful, innovative, diverse options in a robust market.
As we celebrate National School Choice Week, let’s also consider how the concept of choice can be applied in other issue areas. This includes healthcare, a similarly important service industry, which sorely needs greater competition and real choice.
Manning is the director of health policy at the Independent Women’s Forum.