Re: Rationing Education

[Jennifer Booher-Jennings <jlj2102@columbia.edu>]

Art makes the troubling assertion that educators? adoption of triage
practices proves that ?we need better people in public education,
not that there are problems with NCLB.? But can we eliminate
educational triage by replacing ?unscrupulous and unprofessional?
public educators with ?ethically upstanding? ones? This argument
not only ignores many years of evidence demonstrating that diverse
actors ? doctors, lawyers, business people, engineers, and
university administrators ? respond to perverse organizational
incentives in similar ways. It dangerously distracts attention from
the need for policymakers to change NCLB?s incentive structure to
encourage educators to improve the academic performance of all
kids.

Are teachers less ethical than their counterparts in other
professions? In ?Rationing Education,? I used the medical metaphor
of triage to describe what is currently happening in schools. But
the practice of turning away the sickest patients has been
happening in medicine for the last fifteen years. In response to
state-mandated cardiac surgery report cards that rate doctors based
on mortality rates, cardiac surgeons have been avoiding ?hopeless
cases? in order to protect their ratings.  In New York, 67% of
cardiac surgeons refused to operate on at least one patient who was
perceived as ?high risk.? When two-thirds of cardiac surgeons are
responding this way, it is difficult to believe that the problem
resides in the ethics of doctors. Rather, this finding suggests
that poorly designed accountability systems have pernicious
unintended consequences.

This brings us to Art?s claim that triage responses are not a
consequence of NCLB. Imagine that NCLB evaluated schools based on
their students? growth rather than the percentage of students
passing. While gaming would surely occur, teachers would have no
reason to focus narrowly on bubble kids.* If we believe that
altering NCLB?s measurement strategy would also alter teachers?
responses, NCLB?s focus on proficiency is, in fact, the cause of
teachers? current behavior. Unless we believe that all triaging
teachers (or the doctors discussed above) are moral degenerates,
then we can conclude that high-stakes incentives can trump almost
any individual?s moral compass.

Of course, there are organizations that have taken Art?s advice. In
response to organizational failure, they have offloaded blame onto
the ethics of individuals and cleaned house.  NASA?s response to
the Challenger disaster is one such case.  In the wake of this
tragedy, the Presidential Commission placed much of the blame on
unethical middle managers. This did not address NASA?s deeper
structural problems: that NASA?s accountability pressures (an
unachievable production schedule and an emphasis on launching on
time) resulted in engineers gradually redefining what constituted
an ?acceptable risk.? Perhaps unsurprisingly, the Columbia shuttle
disaster resulted from the same normalized, yet dysfunctional,
organizational processes. Only then did NASA acknowledge that the
problem was much larger than a few bad apples:  ?You can?t change
the behavior unless you change the organization. You can change the
people, but you?re going to get the same outcome if the organization
doesn?t change? (Columbia Accident Investigation Board public
hearing transcript, April 23, 2003, p. 48, cited in Vaughan 2006).

The point of drawing attention to the NASA and cardiac surgery
examples is to emphasize that teachers engaged in triage are in no
way unique. In each of these cases, poorly designed accountability
systems have induced regrettable behaviors that none of us is happy
to witness. However, policymakers, not teachers, are the appropriate
targets for reform.

An ?individual ethics? approach to ending educational triage is
likely to be as ineffective in averting further disasters as NASA?s
post-Challenger finger-pointing.  If we truly want to stop rationing
education, we must stop blaming individual teachers and seriously
reexamine NCLB?s incentives.

Best wishes,
Jennifer


* This is not to say that growth models, particularly as they are
currently conceived by the Department of Education, do not have
numerous shortcomings.

Burack, J.H., P. Impellizzeri, P. Homel, and J.N. Cunningham, Jr.
1999.  ?Public reporting of surgical mortality: A survey of New
York cardiothoracic surgeons.? Annals of Thoracic Surgery 68(4):
1195-1202.

Dranove, D., D. Kessler, M. McClellan, and M. Satterthwaite. 2003.
?Is more information better? The effects of ?report cards? on
health care providers.? Journal of Political Economy 111(3):
555-88.

Vaughan, Diane. 1996. The Challenger Launch Decision: Risky
Technology, Culture, and Deviance at NASA. Chicago: University of
Chicago Press.

Vaughan, Diane. 2006. NASA Revisited; Theory, Analogy, and Public
Sociology. American Journal of Sociology 112(2): 353-93.

Werner, R.M., D.A. Asch, and D. Polsky. 2005. ?Racial profiling: The
unintended consequences of CABG report cards.? Circulation 111:
1257-1263.

*****************************************************
Jennifer Booher-Jennings
Columbia University
Department of Sociology
1180 Amsterdam Avenue
413 Fayerweather Hall
New York, NY 10027
Phone: 646/319-7642
http://www.columbia.edu/~jlj2102