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Health

The Government Bans Doctors Who Can’t Repay Their Student Loans From Treating Medicare Patients

By Sy Mukherjee on May 20, 2013 at 4:10 pm

Over ten percent of all doctors and nurses on the government’s Medicare and Medicaid blacklist end up on it because they defaulted on government-backed student loans. Medical workers on the blacklist are barred from treating Medicare and Medicaid patients or receiving federal reimbursements for a predesignated time period.

According to a Modern Healthcare analysis of federal records, more than 5,400 of the 51,729 people on the government health entitlement blacklist were placed on it after failing to pay an HHS-backed medical student loan. Given a still-shaky economy, some in the health care sector expect that trend to continue:

[Government data] show that one of the most common reasons for getting barred is failure to repay HHS-backed student loans: 5,417 people are currently kicked out of Medicare for that.

The number of annual exclusions related to student loans has grown steadily in the past decade, peaking at 517 in 2011 before declining again. “That is tied to the economy, and I would expect that to continue to rise,” [said Lynn Gordon, a Chicago-area hospital group partner].

The increasing frequency of default-related blacklisting could prove problematic as the Obama Administration tries to entice more medical students to become primary care and family doctors. Primary care providers and nurse practitioners will be crucial to effective Obamacare implementation, since the health law is expected to drive up demand for medical services as millions of previously uninsured Americans gain coverage.

But the ballooning cost of a medical education could end up being a major barrier to the Administration’s recruitment efforts. According to the Association of American Medical Colleges’ (AAMC) 2012 report on medical school debt, “86 percent of medical school graduates had education debt, with a median amount of $162,000″ in 2011 — a number that has been rising steadily over the years:

AAMC estimates that a borrower with the median $162,000 debt “would have monthly payments ranging from $1,500 to $2,100 after residency.”

That disproportionately affects the very primary care doctors that are integral to health care reform and the U.S. medical system at large. In a 2012 report, consulting firm Merritt Hawkins & Associates found that family practitioners, pediatricians, and psychiatrists are the lowest-paid physician groups in the U.S. with a base pay of $189,000.

While that’s still a lavish salary compared to average U.S. compensation, it pales in comparison to specialist pay — and as the entitlement blacklist numbers underscore, that contributes to a system in which care providers are banned from treating certain patients for purely financial, rather than medical or criminal, reasons.

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Economy

‘We May Have To Close Schools’: Five Districts That Are Grappling With Sequestration’s Budget Cuts

By Bryce Covert on May 20, 2013 at 2:30 pm

While many public schools will be able to stave off some of the harshest impacts of sequestration with other sources of revenue, those that serve military families and Native American communities are in a much more difficult situation. That’s because they rely heavily on federal Impact Aid. That money goes to schools on or near military bases and Native American reservations that don’t collect as much in tax revenues as other public schools to help fill the gap.

Sequestration will reduce the $1.2 billion these schools normally receive by more than $60 million. According to analysis by the Center for American Progress, there are nearly 150 schools in the country relying on more than $1 million in aid. Some could see cuts in the millions of dollars.

The National Association of Federally Impacted Schools, which works closely with these communities, is conducting a survey of school districts grappling with this reduction in funding. While the full results won’t be ready for another month, the preliminary report, shared with ThinkProgress, shows that many are already facing drastic choices. One school warned that “we may have to close schools” and another cautioned that “closure is always a possibility.” Six of the nine schools it talked to will have to consider closing schools if sequestration continues past next year.

  • The Window Rock Unified School District in Arizona gets just under 60 percent of its funding from federal aid. This year it eliminated about 65 staff positions through attrition and cut down its buildings from seven to four. If sequestration continues, it will have to close schools, many of which are in areas of high unemployment and poverty.
  • The Harlem Elementary School District didn’t rehire for some positions and asked 100 employees to cut $100 from their operational budgets to deal with a 47 percent cut to the budget this year. It also canceled Kindergarten for a day, but one five-year-old still came to school because he was hungry and needed his state-subsidized breakfast. Next year it will have to dip into reserves or hold fundraisers. After that it will have to cut staff, go over the state class size limit, and look at closing schools.
  • Heart Butte in Montana, which gets over half of its funding from the federal government, cuts have forced the district to hold off on all repairs this school year. That means that there are leaks, no hot water, roofs that need patching, buses in neglect, and a playground that doesn’t comply with regulations. The school needs to install new doors and safety gates, but that is also on hold. If things don’t improve it may have to lay off teachers.
  • The Hays/Lodge Pole school district in Montana, which is losing more than half of its budget, is unable to fill a counseling spot even as youth suicides are on the rise. It also had to cut paraprofessionals, all secretaries but one, and cooks’ helpers. After next year, school officials say there will be nothing left to cut.
  • The McLaughlin Independent School District in South Dakota, which gets two-thirds of its budget from federal funding, has already implemented changes for the current school year: reducing staff to one teacher per classroom for grades three through five and cuts to the music program, P.E., and administrative positions. If Congress doesn’t end sequestration, it will have to close schools.

Justice

Columbia University Tries To Alter Scholarship Fund For Students ‘Of The Caucasian Race’

By Ian Millhiser on May 20, 2013 at 9:00 am

(Credit: AP)

Columbia University asked a Manhattan judge to allow them to change the requirements of a scholarship fund which limits recipients to members “of the Caucasian race.” The Lydia C. Roberts fellowship was created in 1920 when a woman donated her $500,000 estate to create the racially exclusive fund. Beyond limiting recipients to white people, the fellowship’s terms also require it to go to an Iowa resident, and it cannot be given to students who study “law, medicine, dentistry, veterinary surgery or theology.”

Columbia’s court filing argues that the terms of the fellowship should be altered because it is impossible to comply with its terms and also comply with laws banning race discrimination. The fellowship has not been awarded since 1997.

Alyssa

Michelle Obama Encourages African-American Students To Stop Aspiring To Be ‘A Baller Or A Rapper’

By Alyssa Rosenberg on May 17, 2013 at 3:36 pm

Because this is apparently a week that involves a lot of me lowering my head slowly and deliberately to my desk a la Peggy Olson, First Lady Michelle Obama decided to trot out some very old talking points in her commencement address to the 2013 graduating class at Bowie State University:

“Today, instead of walking miles every day to school, they’re sitting on couches for hours, playing video games, watching TV. Instead of dreaming of being a teacher or a lawyer or a business leader, they’re fantasizing about being a baller or a rapper,” Obama continued. “Right now, one in three African American students are dropping out of high school, only one in five African Americans between the ages of 25 and 29 has gotten a college degree.”

But priorities should change, she said, because “getting an education is as important if not more important than it was back when this university was founded.”

While those statistics are absolutely worrisome, I’m pretty sure that the challenges of preparing a competitive resume, getting equal access to standardized test prep, navigating the admissions process, and managing the cost of financial aid are also relevant issues to this conversation. Some of those barriers have been priorities for her husband’s administration. Mrs. Obama acknowledged the odds that a number of the graduates faced to get to and complete their educations Bowie State, though she focused on the cost of tuition and difficult family situations more than other structural issues that might affect students’ abilities to get access to a college education. And she framed their success as a matter of personal will and determination. I can also see why she might have wanted to continue a conversation of long standing within African-American communities given the setting, and as part of her larger, and important historical lesson about the obstacles that black students have faced to get educated in America.

But this particular talking point, which both Mrs. Obama and the President use relatively frequently, could do more to address the structural elements that prop up a culture that values athletics over academics. Personal motivations may be a problem, but the massive public investment in college athletic facilities, the fact that coaches are some states highest-paid public employees, and the allocation of both scholarship money and admissions spots to athletes who are unlikely to complete their academic degrees before entering professional drafts. There’s nothing wrong with wanting to dismantle “the slander that a black child with a book is trying to act white,” but I’m not sure the fantasy career aspirations of black children are the only, or even the main thing, at issue here.

And if we’re going to talk personal motivations, wanting to be “a baller or a rapper” is not a dream that’s solely the property of African-Americans. America has three major televised singing competitions right now, American Idol, The Voice, and X-Factor, all of which promise that it’s possible to rise from anonymity to remarkable fame and a career in music, and the first of which actually became notorious for airing auditions of people who had neither the skills to realistically pursue their aspirations, nor the self-knowledge to recognize the gap between their abilities and their ambitions. Participation is hardly limited to African-American singers by design or choice. There are plenty of white folks who hope to make it big in the manner of Taylor Swift in the same way African-American boys might be dreaming of growing up to become Jay-Z.

The same is more true for sports than Mrs. Obama’s remarks would suggest. In Division I men’s basketball, 1,443, or 27 percent, of the 5,265 players who participated in the 2011-2012 season were white, while 3,158, or 59 percent were African-American. During that same season, in Division I baseball, the figures were most striking. 8,304, or 82 percent of the 10,093 players, were white that season. Clearly, in the college athletic programs that feed into careers in professional sports, there’s a great deal of white interest and participation, even if it isn’t evenly distributed by sport. Miami Heat star LeBron James may be an argument for skipping college in pursuit of a professional athletic career right out of high school, but so is Washington Nationals left-fielder Bryce Harper, who earned a GED and didn’t even finish high school in a classroom setting, all so he could focus on baseball instead, even though the idea that any ordinary person could emulate either of their paths is equally improbable.
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Justice

Kansas Elected Official Stands By Using Racial Slur ’100 Percent’

By Josh Israel on May 16, 2013 at 12:00 pm

Kansas Board of Education member Steve Roberts (R)

Kansas Board of Education member Steve Roberts (R)

Kansas Board of Education member Steve Roberts (R), an elected official representing one-tenth of the state, defended on Tuesday his use of a racial epithet at a previous board meeting to “push the frontiers of political correctness.” After a former Topeka NAACP president advocated for more African American history in state curriculum standards, Roberts had brought up an unrelated non-binding 2007 New York City resolution discouraging the use of the “N-word” and other offensive language.

Roberts, a former math tutor who was first elected to the board last November, had delivered a monologue to the Rev. Ben Scott at the April board meeting during a discussion on history, government, and social studies standards. Roberts complained that New York City had banned the same racial slur that Dr. Martin Luther King Jr. had used (in quoting racist police forces and other segregationists) in his famous 1963 “Letter from Birmingham Jail,” saying:

We have to push the frontiers of political correctness and do what’s right. And so, if I were to use it clinically, I would almost use a test to see what the effect on Twitter would be. You know, ‘That Roberts guy said nigger at the state school board meeting, and he said it as, it’s probably the ugliest word in our vocabulary.’ It’s an ugly repugnant absolutely horrific word that we should rise above. But I did get it out there and I appreciate the opportunity to do it in a politically correct setting.

Watch the video:

According to Topeka Capital-Journal reports, when Scott and other civil rights leaders expressed their concern about those comments at Tuesday’s board meeting, Roberts stood by his remarks.

“I did my best to say the ‘N-word’ clinically,” he noted, adding “I’m willing to be considered politically incorrect … I don’t think that’s a bad thing.” Roberts then accused those criticizing his comments as only wanting media attention.

Alyssa

Call To Ban ‘Anne Frank: The Diary of a Young Girl’ Prompts Sensible Response From Michigan School

By Alyssa Rosenberg on May 14, 2013 at 9:03 am

In an impressive expansion of the term “pornographic,” a Northville, Michigan woman, Gail Horalek asked that Anne Frank: The Diary Of A Young Girl (The Definitive Edition) be removed from the school’s curriculum because: “It’s pretty graphic, and it’s pretty pornographic for seventh-grade boys and girls to be reading. It’s inappropriate for a teacher to be giving this material out to the kids when its really the parents’ job to give the students this information.” The passages that she’s dubbed “pornographic” are actually more anatomical, given that they discuss Frank attempting to learn more about her own body, than they are “designed to arouse lust,” the conventional meaning of pornographic.

But rather than quibble over the definition, in rendering a verdict on Horalek’s complaint, Robert Behnke, the assistant superintendent for Instructional Services in Northville, stood by the inclusion of the edition of the book in the seventh-grade curriculum on the grounds of its relevance to the unit on courage in which it was taught. And he reminded Horalek that existing school regulations mean she can get pretty much what she wanted. The full email he sent to parents, posted by one of them on a message board, reminds the community:

The committee also suggested the district take steps to further communicate information about the units of study within the middle school literature courses, and where possible, provide booklists to parents with the notation that reading selections can always be reviewed by parents prior to making a literature selection. As always, in the event that a concern surfaces during a unit and is brought to the teacher’s attention, adjustments can be made to move the student to another literature selection and/or an alternative assignments can be discussed.

A communication regarding the seventh grade English Language Arts units of study and booklists is being created and will be shared with parents in the near future. Communication on units of study and booklists from other grades also will be forthcoming.

At Northville Public Schools we are proud of the partnerships we have forged with parents in the best interest of all students. Keeping in mind that families within the Northville community have varying perspectives, and that our students have varying levels of sensitivity and maturity — which are often best accommodated by their parents — the district strives to provide choices for parents and students where appropriate and possible when it comes to programming and courses. As a school district, we also encourage parents to use supplemental learning activities and books that reflect their own family’s values and perspectives to support reading and literature analysis taking place in the classroom.

If Horalek wants to be the person responsible for introducing her daughter to issues of sexuality, the Northville Public Schools give her every right to do so. If she’d Googled the book when her daughter’s syllabus came out, she would have found references to the removal of the Definitive Edition from the curriculum in the Culpeper County, Virginia school system on some of the same grounds she complained about. If she’d searched the text of the diary on either Google Books or through Amazon, she would have seen the passages that made her uncomfortable before her daughter even started reading the book. Maybe Horalek couldn’t have predicted what might have made her daughter uncomfortable in a classroom setting, but if she thinks there are certain subjects that should be reserved for parental instruction, there were any number of ways Horalek could have checked the book to see if it threw up red flags for her.

I’m not opposed to the idea that parents should play a role in their children’s education, or that parents have some sense of what makes their children comfortable or uncomfortable—though I don’t think that knowledge is complete. But it seems to serve the interests of the most people to give those parents and those children appropriate exits from the mainstream curriculum, and resources to help them supplement the curriculum they want to opt out of.

Economy

Sequestration Batters Schools On Military Bases And Native American Reservations

By Bryce Covert on May 13, 2013 at 2:40 pm

Credit: The Associated Press

As sequestration went into effect in March, some lawmakers argued that the impact of the cuts would not be as immediate as had been claimed, as they would take place over a matter of years. But there are some areas that felt the impact immediately. One of those is schools on military bases or Native American reservations. Because schools on or near federal lands don’t collect as much in property and sales tax revenues as other public schools, Impact Aid from the federal government helps close that gap. Yet sequestration will reduce the $1.2 billion the government sends to these communities by more than $60 million.

Different schools have different funding structures, but some are dealing with the impact of reduced spending right now, according to the latest report from the Center for American Progress:

This past month we discussed sequestration’s effect on schoolchildren living on Naval Air Station Lemoore in California. Schools in that district rely on Impact Aid for 30 percent of their entire budget. As Heiko Sweeney, principal of the base’s Akers Elementary School, explained, “For us, Impact Aid is critical.” The students and staff of Akers Elementary School are not alone in this regard: Federal Impact Aid accounts for more than half the budget for the Dulce Independent School District in New Mexico. In Mascoutah, Illinois, Superintendent Todd Koehl is expecting a 20 percent reduction in Impact Aid this year. “State and federal dollars are some of our biggest revenues,” said Koehl. And according to Dawn Kirby, vice president of the Travis Unified School District in California, Impact Aid provides them with “a lot of money. … That money has to come from somewhere. A lot of our students come from military families.”

While some school systems might be able to rely on reserves to make up some of the shortfall resulting from Impact Aid cuts, others such as the Tomah School District in Wisconsin are not as fortunate. “The only thing left is to reduce salaries and benefits or eliminate programs,” said Greg Gaarder, the district’s business manager. “There are no tools left in the toolbox.”

On the Wind River Indian Reservation in Ethete, Wyoming, a loss of $1.7 million in Impact Aid to School District 14 means a cut of 11 percent of the district’s overall budget. Such a drastic cut in Impact Aid will only serve to make a bad situation worse on reservations across the country. Native Americans have the lowest educational attainment of any racial or ethnic group in the United States. “We are at the mercy of the federal government,” said an unnamed District 14 school official. According to Michelle Hoffman, superintendent of District 14, Impact Aid is critical in addressing a host of problems: “Poverty, alcoholism, drug abuse.” She continued, “We have two full-time nurses in our district, which the state model does not cover. We pay for that through Impact Aid.”

The U.S. already ranked 44th in the world in the percentage of GDP spent on education in 2009. Sequestration will reduce that amount even further.

This is not the only way that it will impact spending on education and children, however. Low-income children are already being kicked out of Head Start programs. In total, 70,000 are expected to lose access to Head Start, while 1.2 million disadvantaged students will see funds eliminated for their schools. Special education programs will lose $633 million and $157 million will be cut from federal student financial aid. Low-income families will also lose $115 million in child care subsidies.

Congress acted swiftly to undo cuts to the Federal Aviation Administration that resulted in flight delays but has not moved to undo these cuts to education programs. While some lawmakers have proposed giving agencies flexibility in implementing the cuts, most agencies don’t have the reserves or funds to blunt the impact.

Update

According to the Center for American Progress’s Senior Fellow Scott Lilly, there are nearly 150 schools in the country that receive more than $1 million in Impact Aid. Some of them could see aid cut by millions of dollars, with the Gallup-McKinley County Public Schools in New Mexico anticipating a $3 million cut to its budget.

Immigration

Hispanic College Enrollment Rate Overtakes White Enrollment

By Rebecca Leber on May 10, 2013 at 1:35 pm

A Pew Research Center report released Thursday notes that Hispanic college enrollment reached a record high for the class of 2012, surpassing the rate of white enrollment for the first time. Pew shows that 69 percent of Hispanic high school graduates enrolled in college compared to 67 percent of whites, a jump from just under half of the graduating class in 2000. And there are other promising stats: The Hispanic high school dropout rate is at 14 percent, down from 28 percent a decade before. Still, Hispanic college students are less likely to enroll in a four-year, full-time college and are less likely to complete a bachelor’s degree.

Though the Pew report does not look closely at the reasons behind the increase, it suggests that declining employment opportunities for high school graduates may be part of the explanation:

It is possible that the rise in high school completion and college enrollment by Latino youths has been driven, at least in part, by their declining fortunes in the job market. Since the onset of the recession at the end of 2007, unemployment among Latinos ages 16 to 24 has gone up by seven percentage points, compared with a five percentage point rise among white youths. With jobs harder to find, more Latino youths may have chosen to stay in school longer.

Another factor, however, could be the importance that Latino families place on a college education. According to a 2009 Pew Hispanic Center survey, 88% of Latinos ages 16 and older agreed that a college degree is necessary to get ahead in life today (Pew Hispanic Center, 2009). By contrast, a separate 2009 survey of all Americans ages 16 and older found that fewer (74%) said the same (Pew Research Social & Demographic Trends, 2009).

The following graphs show the dramatic change:

This should catch the attention of Heritage Foundation’s Jason Richwine, who coauthored a debunked immigration study that argues reform is too costly. Richwine argued in his dissertation that immigrants naturally possess a lower IQ, a pseudoscience point linked to anti-immigration groups actively working against reform.

Anti-immigrant advocates don’t note this, of course, but legalization and state-level reform would help more undocumented immigrants pursue a college education. But right now many states still do not provide in-state tuition to deferred action students.

Justice

School Suspends Senior Class President For Tweeting Jokes About School Sports Teams

By Andrea Peterson on May 8, 2013 at 12:00 pm

(Credit: Wichita Eagle)

Kansas high school student Wesley Teague is the president of Heights High’s senior class and a varsity track athlete. He was also suspended for the rest of the school year and banned from most graduation activities, including a speaking opportunity at a senior breakfast and convocation ceremony Friday, for tweets joking about his high school’s sports program.

On Thursday, Teague tweeted “‘Heights U’ is equivalent to WSU’s football team.” “Heights U” refers to a term some in the school community use to express pride in their sports teams. “WSU” refers to Wichita State University, which has not had a football team since the 1980s. He followed up this tweet with quips about Heights sports teams’ trouble winning games, and with comments about how he feels comfortable making these comments because he is about to graduate.

In a letter to Teague and his parents explaining the decision to suspend the senior class president, the school claimed Teague “acted to incite a disturbance” and that he “posted some very inappropriate tweets about the Heights athletic teams, aggressively disrespecting many athletes [...] After reading the tweets and taking statements from other students it was found that Wesley acted to incite the majority of our Heights athletes.” A school spokesperson later claimed that “there was a negative reaction from many students, including threats of fights in the school.”

In a conversation with ThinkProgress, Teague flatly denied that his comments were intended to be disruptive and said both his peers and the administration over-reacted to his routine use of social media:

“The school labeled it as cyberbullying, saying I tried to incite the students and I caused a disruption, but at the same time what the students were saying back to me about the comment was actually the cyberbullying [...] I was just like, “Wow, it’s my opinion, and freedom of speech,” but I’m not mad at the kids who were talking trash on me, I’m upset that my school and our school district won’t let me participate in my senior activities that I’ve waited four years to take part in.”

As a matter of First Amendment law, a school may target student speech if school officials “reasonably conclude that it will ‘materially and substantially disrupt the work and discipline of the school.’” Even if Teague’s tweets actually did result in sufficient disruptiveness to permit the school to take action, however, it hardly follows that suspending Teague was the appropriate response.

For his part, Teague is trying to find peace with the school’s actions. “I’m trying to let it go,” he told ThinkProgress. “If the school wants to suspend me because of my opinion, I honestly don’t want to go there anymore.”

Health

On Nurses Week, Public Schools Face Serious Nursing Shortage

By Annie-Rose Strasser on May 7, 2013 at 2:50 pm

(Credit: Pam Panchak/Post-Gazette)

On Tuesday, to celebrate Nurses Week, Rep. Carolyn McCarthy (D-NY) will introduce legislation for a startling problem in America’s public schools: A serious shortage of access to school nurses.

A 2007 study (PDF) by the National Association of School Nurses found that “45 percent of public schools have a school nurse all day, every day, with another 30 percent working part time in one or more schools.” It’s likely those numbers have only worsened as schools deal with drastic budget cuts, though no newer studies are available.

In total, one quarter of schools completely lack a school nurse. At the local level, such a lack of access to care can have dangerous consequences: In Michigan — where it’s estimated that there are 180 public school nurses for 1.5 million children from K-12 — other teachers become responsible for giving insulin shots or even “rectal anti-seizure medicines.”

McCarthy’s bill, the Student to School Nurse Ratio Improvement Act of 2013, would create new funding for public school nurses. But it might also help to shed light on why it’s so important to have nurses in the first place; it would also require the Department of Education to study how access to nurse care impacts students’ academic performance.

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