Private savings accounts don't attract less educated

This article would also seem to indicate a limited future for health savings accounts

Recent research by behavioral psychologists might shed some light on why President Bush had difficulty in selling his concept of private retirement accounts as a central feature of reforming Social Security. As you might recall, the president promoted the plan through the idea of moving to an "ownership society" and providing the opportunity of choice regarding our retirement funds.

However, according to a team of psychologists from Swarthmore and Stanford, who discussed the results of their work recently in the New York Times, Americans do not uniformly welcome more choices into their lives. Specifically, whereas higher-income, better-educated individuals welcome the empowerment of more choice, working-class Americans, who represent the majority of our workforce, often do not. "For them, being free is less about making choices that reflect their uniqueness and mastery and more about being left alone, with their personality, integrity and well-being intact."

When college students were asked to pick adjectives that capture what "choice" means to them, those from homes with college-educated parents were more likely to select the words "freedom," "action" and "control," whereas those from homes whose parents had only a high-school education more often selected "fear," "doubt" and "difficulty." Other tests that these psychologists report appear to confirm that those with more education put greater value on items that they were able to choose, whereas those with less education tend to value articles they receive the same, whether or not they chose them.

Polling on Social Security private accounts appears consistent with the general research of these psychologists on the issue of freedom and choice. According to polling done by the Pew Research Center about a year ago, 46 percent of those polled favored introduction of private Social Security retirement accounts and 38 percent were opposed to the idea. Looking into the reasoning of those who favor private accounts, most said they favor them because "Individuals will have more control." This is twice the number who responded that they favor them because the accounts will earn more money. Of those opposed to private accounts, most of the opposition came from those who expressed fear that the accounts would be potentially too risky.

Further examination showed breakdown that is consistent with education and income. Fifty percent of those with a college education favor private accounts whereas only 35 percent of those with less than a high-school degree do. More than half of those earning more than $50,000 per year favor private accounts whereas only 38 percent of those earning less than $20,000 a year do.

The specific polling on Social Security private accounts appears consistent with the more general work reported by the behavioral psychologists regarding the propensity to embrace more choice. Those who are better educated view it positively and as an opportunity and those more poorly educated view it negatively and as a threat.

Blacks, who are on average less wealthy and less educated than whites, are far less supportive of private accounts than whites - 36 percent of blacks favor them compared to 46 percent of whites. However, on the issue of school choice, blacks and whites are equally supportive of vouchers. Polling done by the Joint Center on Political and Economic Studies shows 48 percent of blacks and 48 percent of whites favor vouchers.

What conclusion might be drawn here? Why would polling regarding choice on private accounts appear consistent with more general research correlating level of education and preference for independence of choice, but school choice not correlate I think that the inner-city public schools are so bad that there leaves little question to blacks that they would be better off if they had the option of choosing where to send their child to school.

My guess is that the team of psychologists from Swarthmore and Stanford provides us with an accurate picture when they report that lower income, less educated individuals embrace freedom to choose less enthusiastically than higher income, more educated individuals. However, the correlation breaks down when a status quo-blocking choice is so clearly unattractive that even those naturally disinclined to loosen the reins of control want choice introduced.

Regarding Social Security private accounts, it has been my view that the current system based on payroll taxes and government determined benefits hurts low-income folks more than high-income folks. For them, the payroll tax confiscates the only funds they have available to save and invest.

But if my conclusions above are correct, we probably won't see private Social Security accounts until low-income people in general conclude the status quo is not an acceptable option.

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UK: "Over-efficient" surgeon must delay operations

A senior surgeon has made a public apology to patients whose operations are being postponed - because he has been too efficient. Peter Cox, a general consultant surgeon at the West Cornwall Hospital, Penzance, and his colleagues have been told to slow down by the local health authorities. Not only has Mr Cox met the current six-month waiting list target but he has surpassed it. As a result, more than 50 of his patients are being sent letters telling them that their surgery dates will be put back.

The perverse state of affairs has come about because the Royal Cornwall Hospitals Trust - which yesterday announced 300 redundancies and an 8 million pound deficit - has treated 4,600 patients more than were budgeted for in this financial year. Mr Cox said yesterday: "This is all about finance. The thing that really annoys me is that I cannot see how this will really save any money. All they are doing is deferring the payments to a later date. "Now I will have spaces in my operating list. They may give me other patients who are close to the waiting time deadline but this will take some time to organise."

In a letter to The Cornishman, newspaper Mr Cox said: "I am writing this letter to apologise to the 50 or more patients who have been given dates for operations under my care, who will shortly receive letters explaining why they have been delayed. "Although I have tried to prevent this, I am powerless to do so. The directive has come from the Primary Care Trust for the next financial year. "They have informed the Royal Cornwall Hospitals Trust that they will not pay for routine operations unless the patients have waited at least 18 weeks from the time that they were put on the list. "This is particularly upsetting to me because my team has set up an out-patient booking system where patients are given dates for their operations, either in out-patients or within 24 hours after seeing me, in line with government directives. "This has been working particularly well and has enabled me to see and operate on patients in a timely fashion." Mr Cox said his patients, waiting for operations for conditions including hernias, varicose veins and piles, will now have to wait weeks longer in pain and discomfort. His waiting list had been down to five or six weeks, he added.

The directive has come from three primary care trusts: West of Cornwall, Central Cornwall, and North and East Cornwall. They said in a statement that hospitals had "over-performed" and apologise for the disruption. "We will ensure that those patients whose operations have been postponed will have a new date within four weeks," they added. Last December a colleague of Mr Cox, Alastair Paterson, a surgeon at the Mermaid breast cancer centre, at the Royal Cornwall Hospital in Truro, was told he could only deal with urgent cases.

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More crookedness in the Queensland public health system

Doctors whose allegedly poor treatment caused the deaths of eight Queenslanders are escaping scrutiny despite the medical board's vow to prosecute disgraced surgeon Jayant Patel. The circumstances of the "unquestionably sub-optimal" care are known only because of an exhaustive investigation into almost 90 deaths originally linked to Dr Patel.

The board strategy to ignore the eight deaths but take on Dr Patel in the Health Practitioners Tribunal prompted his defence lawyer to accuse the board of a dangerous "double standard". "This can only be a political exercise to make the medical board look good in light of its neglect in the past," solicitor Damian Scattini said. "The doctors involved in the other eight deaths are still practising. "The board should be checking to ensure these other eight doctors are up to scratch, instead of focusing on someone who will never practise again."

Dr Patel, who is blamed for more than 13 deaths after exhaustive expert analysis, did not contribute to the deaths of the forgotten eight, according to the expert medical witness for Queensland Health and the royal commission-style inquiries, vascular surgeon Peter Woodruff. Responsibility for the demise of the eight has been sheeted home to other doctors in Brisbane and Bundaberg, who have not been reviewed or audited despite their culpability being raised more than six months ago, The Courier-Mail has learned. Of the eight deaths, four are classified by Dr Woodruff as the result of "medically caused mishap or injury or a lack of reasonable care". He said the treatment of the four, three of whom were women, was "unquestionably sub-optimal". The patients had not been expected to die within a month of a surgical procedure because they were in otherwise healthy condition.

Of the remaining four deaths, doctors other than Dr Patel were "significant contributors". As these four patients suffered terminal conditions such as cancer, they were more likely to die within a month of surgery than an otherwise healthy patient.

The findings of Dr Woodruff were accepted without challenge by the health inquiry's commissioner Geoff Davies, QC, and his predecessor Tony Morris, QC. The findings in relation to Dr Patel's contribution to 13 deaths are the basis for the regulatory body's action for "unsatisfactory professional conduct" in the Health Practitioners Tribunal. The findings underpin a police brief of evidence to Director of Public Prosecutions Leanne Clare, who may seek charges of manslaughter, grievous bodily harm and fraud.

Medical board executive officer Jim O'Dempsey said the health inquiry had made no findings in relation to the doctors linked to the eight deceased patients, however inquiry sources said this did not indicate a clearance.

Dr Patel's shocking United States disciplinary history was overlooked by the Medical Board for the two years he was Director of Surgery at Bundaberg Base Hospital.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.

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