Homeschooling needs either tighter regulation or to be banned

At Alternet there is a great article by Kristin Rawls on homeschooling and educational neglect. I think it makes an excellent argument that homeschooling needs either tighter regulation and oversight, or needs to be outright outlawed:

In recent weeks, homeschooling has received nationwide attention because of Republican presidential candidate Rick Santorum’s homeschooling family. Though Santorum paints a rosy picture of homeschooling in the United States, and calls attention to the “responsibility” all parents have to take their children’s education into their own hands, he fails to acknowledge the very real potential for educational neglect among some homeschooling families – neglect that has been taking place for decades, and continues to this day.

Take Vyckie Garrison, an ex-Quiverfull mother of seven who, in 2008, enrolled her six school-age children in public school after 18 years of teaching them at home. Garrison, who started the No Longer Quivering blog, says her near-constant pregnancies – which tended to result either in miscarriages or life-threatening deliveries – took a toll on her body and depleted her energy. She wasn’t able to devote enough time and energy to homeschooling to ensure a quality education for each child. And she says the lack of regulation in Nebraska, where the family lived, “allowed us to get away with some really shoddy homeschooling for a lot of years.”
“I’ll admit it,” she confesses. “Because I was so overwhelmed with my life… It was a real struggle to do the basics, so it didn’t take long for my kids to fall far behind. One of my daughters could not read at 11 years old.”

As concerning as the stories of overall educational incompetence of children being raised in the quiverfull movement are, the more serious aspect seems to be the routine discrimination between education of boys and girls:

Like Garrison, Diegel Martin recounts notable educational gaps in her own family, where there was little academic encouragement. One of her brothers decided to quit school at 16 and faced no parental opposition. The youngest, Diegel Martin says, ceased his formal education at the age of 12, when she left home and was no longer available to teach him herself. And though she was fortunate enough to receive sex education before leaving public school, her siblings were not so lucky. Their parents never taught the three other children about sex, and Diegel Martin remembers giving her 21-year-old sister “the talk” the week before she got married. She also had to intervene to ensure that her younger brothers learned about sex.
As for herself, when she completed her schooling, she says her parents did not allow her to obtain her GED as proof of high school graduation. Their reason? “The girls weren’t allowed to get a GED because we were told we wouldn’t need it. It would open up opportunities that were forbidden to us. We would work in the family business until we got married, and then become homemakers.
“When I talked about wanting to go to college, my parents said, ‘Well, you’re a girl. You don’t go to college.'”

I know I have homeschoolers (and unschoolers) that read this blog and have gotten angry with me being critical of the movement in the past, but there has to be some oversight of homeschooling. Universal primary and secondary education is part of why our country has been so successful, and necessary for the ultimate success of individuals in our society. Children have a right to a decent education that will teach them math, to read, to write, and provide them with basic skills for life. If there is evidence of failure to provide this to children, whether in a public school, private school, or home then for the sake of the children government should intervene. Worse, to educate male children one way and then purposefully provide the girls a poorer education because their destiny is basically to be chattel is horrifying. It strikes me as a violation of their civil rights. For parents to say it’s a matter of religious freedom to deny their children education, or a future outside their home, can not be justified. You don’t have a parental right to deny children a future, or to enslave them.
Unless a regulatory framework can be designed to incorporate some basic standards into homeschooling, this practice should be outlawed for the sake of these children’s basic civil rights. Surely the homeschoolers who actually believe in educating their children can accept that stories like this are unacceptable, and without data about the performance of homeschoolers, or oversight of homeschooling, this abuse of children’s rights can not be prevented or even detected.
Via Love Joy Feminism

Demanding women deliver dead babies is unethical and unsafe

In a debate on the floor of the Georgia State house over a bill to force women to bring all pregnancies after 20 weeks to term, even in cases of dead or non-viable fetus, this Georgia representative reaches a new low. State Rep Terry England seems to be suggesting pigs and cows do it, why can’t humans?

Rep. Terry England compares women to cows, pigs and chickens. from Bryan Long on Vimeo.

Aside from this genius on-the-farm reasoning of Mr England, the failures of reasoning and misrepresentations of scientific knowledge engaged in to pursue this legislation are many.
The legislation is justified ostensibly because of the ability of the fetus to feel pain after 20 weeks, but there is no data or a legitimate scientific basis for this claim. Our knowledge of neurological development would suggest that conscious perception of pain may not be possible for a fetus at any point and the neural framework for transmission of pain is not even mature before 29-34 weeks.
Second is the issue that concern for the pain for a nonviable or dead fetus should not outweigh medical risk to the mother. The American College of Obstetricians and Gynecologists recommend dilation and extraction or induction of labor once the diagnosis of stillbirth has been made. The risks of carrying a non-viable fetus are the higher complication rate of delivery versus dilation and extraction, as well as a very high risk to the mother of complications like disseminated intravascular coagulation (DIC) if the amniotic sac is ruptured and she is exposed to the dying tissue. For stillbirth or nonviable pregnancies, dilation and extraction is far safer and more effective with 24% of patients undergoing labor experiencing complications compared to 3% for D&E.
It has been under-reported that since the 2010 election, the rate of anti-contraception, anti-abortion, and frankly anti-woman legislation has shot through the roof. In 2011 state legislatures have enacted a record number of laws restricting reproductive rights:

In the 50 states combined, legislators introduced more than 1,100 reproductive health and rights-related provisions, a sharp increase from the 950 introduced in 2010. By year’s end, 135 of these provisions had been enacted in 36 states, an increase from the 89 enacted in 2010 and the 77 enacted in 2009.

These include everything from preventing physicians from using telemedicine to prescribe medication to requiring ultrasounds prior to abortion despite the fact no association of OB/Gyns supports universal ultrasound prior to abortion. In an effort to legislate their control of women’s reproductive systems, they are interfering more and more with the physician-patient relationship. It has become so extreme that in 11 states they have legislation requiring physicians to perform unnecessary invasive procedures, basically forcing physicians to engage in unethical medical practices. There is no legitimate medical reason for these measures. These exist to shame women, and increase the expense and difficulty of constitutionally-protected medical procedures and medical decisions like birth control and abortion.
These efforts to ban abortion after 20 weeks, which have succeeded in several states including Nebraska, Idaho, Indiana, Kansas, Oklahoma,Alabama and Utah, are a highly intrusive attack on women’s reproductive freedom. It is once again, an attempt to insert politics in the doctor-patient relationship. Finally it is medically unethical, dangerous, and morally bankrupt to expose women to greater risk by preventing them from having the option of safe termination of pregnancy all for the sake of a dead fetus.
Via Jezebel

CSPI overblows the cancer risk of caramel coloring in soda

The safety of soda has been in the news a lot lately. The news even seems bad for diet coke, which hits close to home for me given my diet coke addiction. The worst seems to be this correlative study proposing a link between diet sodas and stroke risk:

The study, which followed more than 2,500 New Yorkers for nine or more years, found that people who drank diet soda every day had a 61 percent higher risk of vascular events, including stroke and heart attack, than those who completely eschewed the diet drinks, according to researchers who presented their results today at the American Stroke Association’s International Stroke Conference in Los Angeles.

Disturbing news, however, it’s still just a correlative finding from the Northern Manhattan studyand until things are studied more rigorously, I probably won’t quit my current caffeine source. After all, it can reflect patients who are drinking diet drinks because they are diabetic, a known cardiovascular risk factor not excluded in their analysis.
Now the Center for Science in the Public Interest (CSPI) has entered the soda fray with a report suggesting the caramel coloring has unacceptably high levels of a carcinogen called 4-methylimidazole.

An independent study commissioned by the Center for Science in the Public Interest (CSPI) uncovered 4-methylimidazole, or 4-MI, in Coke, Diet Coke, Pepsi and Diet Pepsi at levels 4.8 times greater than those allowed in beverages in California.
4-MI is a byproduct of the reaction that produces the caramel coloring in brown sodas. The chemical has been found to be carcinogenic in animal studies.
The state of California has banned 4-MI in any amount that could potentially lead to one cancer case in 100,000 people. However the levels found in these 4 leading Cola brands indicated a lifetime risk of 5 cancers out of 100,000, assuming that people drink one soft drink per day. That risk rises to 10 cancers out of 100,000 people who drink only soft drinks containing caramel coloring.

But what is the evidence this level of 4-MI could pose a health risk?
Continue reading “CSPI overblows the cancer risk of caramel coloring in soda”

Accountability in Science Journalism: two recent examples of failures in the NYT and Forbes

ResearchBlogging.orgEd Yong demands higher accountability in science journalism and has made me think of how in the last two days I’ve run across two examples of shoddy reporting. These two articles I think encompass a large part of the problem, the first from the NYT, represents the common failure of science reporters to be critical of correlative results. While lacking egregious factual errors, in accepting the authors’ conclusions without vetting the results of the actual paper, the journalist has created a misleading article. The second, from Forbes, represents the worst kind of corporate news hackery, and shows the pathetic gullibility of reporters regurgitating the fanciful nonsense of drug companies without any apparent attempt to vet or fact-check their story. With a google search the facts are smashed.
The first article Digital records may not cut costs, I think is typical of most science reporting. That is, it’s not grossly incompetent but it overstates the case of the article involved and fails to amplify the shortcomings of the research.
The NYT article is describing this article from Health Affairs, which caught my eye before the NYT article was even published because I believe electronic medical records (EMRs) will prevent redundancies and lower costs. So, am I wrong? Will EMRs save us money or possibly increase redundancy as the HA article suggests?
I haven’t given up hope. This article is a correlative study based on survey data, and proves precisely nothing.
Continue reading “Accountability in Science Journalism: two recent examples of failures in the NYT and Forbes”

What is the cause of excess costs in US healthcare? Take two

We’ve discussed it before, why are costs so much higher in US healthcare compared to other countries? The Washington Post has a pointless article which seems to answer with the tautology costs are high because healthcare in America costs more. How much more? Well, we spend nearly twice as much per capita as the next nearest country while failing to provide universal coverage:
In the WaPo article they make a big deal of the costs of individual procedures like MRI being over a thousand in the US compared to $280 in France, but this is a simplistic analysis, and I think it misses the point as most authors do when discussing this issue. The reason things costs more is because in order to subsidize the hidden costs of medical care, providers charge more for imaging and procedures. For instance, Atul Gawande, in his New Yorker piece “The Cost Conundrum” wonders why is it costs are higher to treat the same conditions in rural areas and in a major academic centers like UCLA than at a highly specialized private hospitals like the Mayo Clinic? I think the reason is it’s not nearly as expensive to administer and provide care for a select group of insured midwesterners at the Mayo than it is to provide care to the underserved in the poor areas of inner-cities and in poor rural locations.
When you are serving a poorer, under-insured population like you get in LA or Baltimore for that matter, the insured are charged more because EMTALA requires hospitals to treat all comers, regardless of insured status. Medical centers like UCLA or University of Maryland are the final common pathway for the sickest and poorest patients who, even if stabilized at smaller local hospitals, are immediately transferred to such centers. These patients are expensive to treat, often have more co-morbidities like HIV or drug use and mental illness, and there is no reimbursement guarantee for taking care of them even though it is our legal and ethical responsibility to do so.
Further, the cost of defensive medicine, which applies to this patient population as much as any other, ramps the costs of all hospital admissions and medical practice in general. It is also incredibly hard to quantify its contribution to the overall costs of care.
As a result, to pay for excessive care of the uninsured, all procedures, all tests, all imaging, and all hospitalizations cost more. Caring for inpatients and the uninsured is expensive, so the costs are transferred to the prices of outpatient elective care and procedures which are often administered in a fee-for-service model. Hospitals have an incentive to provide as much outpatient elective care as possible in order to offset these other costs and to generate revenue. The providers that perform procedures or expensive testing then become far more expensive to pay as they are the major revenue generators for the hospital (hence surgeon vs pediatrician pay). Especially because in order to generate more revenue they are paid based on how many procedures they perform. All the incentives are towards more utilization, more procedures, more revenue generation. This is the hidden tax of the uninsured.
In a way, we have universal healthcare already, but we pay for it in the most irresponsible and costly way possible. We wait for small problems to become emergent, treat them in the most expensive outpatient provider possible (the ER), and then when we can’t pay the bills for the uninsured, we transfer the balance by increasing the costs of the care of insured patients showing up for their cholecystectomies or back surgery. Tack on the costs of defensive medicine and the fear of being sued unless everything is done to cover your ass, and you have a recipe for extremely costly care.
Other factors figure into higher costs as well, including hugely higher costs of medicare administration since Bush privatized it, higher prescription drug costs since Bush passed medicare part D and prevented bargaining with drug companies, and our incredibly high ICU expenditures at the end of life. the McKinsey report on excess costs demonstrated most of these issues in 2008. This is not news. The US spends far more on medical administration, outpatient/ambulatory care (with hospital-based outpatient care increasing most rapidly in costs), drugs, doctors salaries, and end-of-life care than we should as a percentage of our GDP.
So what should we do about it? At every step we need dismantle the tendency towards increasing costs. Here are my suggestions:
Continue reading “What is the cause of excess costs in US healthcare? Take two”

Are Liberals really more likely to accept science than conservatives Part II?

About a month ago I asked if denialism is truly more frequent on the right or is it that the issues of the day are ones that are more likely to be targets of right wing denialism? After all, one can think of slightly more left wing sources of denialism like GMO paranoia, 9/11 conspiracies, altie-meds, and toxin fear-mongering. The mental heuristics that cause people to believe, and then entrench themselves, in nonsense seem generalizable to humanity rather than just those attracted to conservative politics. Why should those who identify as liberal be any different? Wouldn’t they just believe in nonsense with a liberal bias?
Lately, Chris Mooney has been taking a different tact on explaining the apparent discrepancy between liberal vs conservative rejection of science with the suggestion the conservative brain is fundamentally different.
First of all, it’s not a matter of education. Whenever people complain that disbelief in evolution or climate change or whatever is a matter of education, they’re simply wrong. We can not educate our way out of this mess, and the problem isn’t that the Republicans arguing this nonsense are any less educated. Chris agrees and cites evidence:

Buried in the Pew report was a little chart showing the relationship between one’s political party affiliation, one’s acceptance that humans are causing global warming, and one’s level of education. And here’s the mind-blowing surprise: For Republicans, having a college degree didn’t appear to make one any more open to what scientists have to say. On the contrary, better-educated Republicans were more skeptical of modern climate science than their less educated brethren. Only 19 percent of college-educated Republicans agreed that the planet is warming due to human actions, versus 31 percent of non-college-educated Republicans.
For Democrats and Independents, the opposite was the case. More education correlated with being more accepting of climate science–among Democrats, dramatically so. The difference in acceptance between more and less educated Democrats was 23 percentage points.

And it’s not specifically education on or awareness of the specific topic, as self-reported knowledge of the topic resulted in opinions among conservatives more likely to be aligned against the scientific mainstream. Orac points out this is not an old phenomenon and maybe the Dunning-Kruger effect which we incorporated into our unified theory of the crank. This is the “incompetent but unaware of it” phenomenon, that the more incompetent people are, the more likely they are to be falsely confident of their own abilities and unable to recognize competence in others..
But the most fascinating part of this article is when Mooney mentions a study to see if liberals were comparatively incompetent in judging the science in an area of high liberal bias – Nuclear power. This would seem to provide an answer to the question from my earlier post, that is, are we missing an equivalent liberal tendency towards denialism because we’re not asking the right questions?
It looks like my hypothesis of possible equivalence might have to be rejected …
Continue reading “Are Liberals really more likely to accept science than conservatives Part II?”