It’s striking how much our debates over two of Georgia’s most important structural challenges are really the same argument with different jargon. I’m talking about school choice and certificate of need.
Ultimately, both come down to whether one believes the elements that have sparked such dynamism and vibrancy in other sectors can also apply to education and healthcare.
So it was fitting that a pair of bills to address these issues – albeit incrementally – were debated simultaneously under the Gold Dome this past week.
The House on Thursday took up Senate Bill 233, which would create Promise Scholarships for students trapped in some of Georgia’s worst schools. Concurrently, the Senate considered House Bill 1339, which would make modest reforms to some aspects of Georgia’s restrictive CON laws.
Both measures won enough votes to keep proceeding. There will be time later on to weigh each bill’s merits. Today, let’s focus on how the two topics, taken together, show us how lawmakers, market participants and the general public view systemic changes.
While the two issues seem so disparate, they’re quite similar. In each case, state law tips the scale toward existing service providers – traditional public schools and hospitals. Yes, the law allows for some innovation: Public charter schools are an example in education, as are ambulatory surgery centers in healthcare. But the freedom to innovate is limited.
That’s why existing service providers are the loudest voices against change. In no way can they defend themselves solely on their track record: Georgians fall woefully short of national standards by a host of measures for educational achievement and health status.
And it’s not for lack of spending. Georgia has grown per capita spending on K-12 education and healthcare over the past 30 years at a clip comparable to the national average: slightly faster for education, somewhat slower for healthcare. (If you think the latter is related to Georgia’s refusal to expand Medicaid, think again: Per capita healthcare spending has grown faster in Georgia than nationally since 2010, the year Obamacare was passed.)
So why do these existing service providers receive such deference from lawmakers?
Start with fear mongering. In any debate over these topics, it won’t take long for opponents to claim that school choice will “destroy our public schools,” while CON reform will “put our rural hospitals out of business.”
Never mind that we have ample experience with both – in a limited way in our state, and in much broader ways in other states – and nowhere have such fears come to pass. On the contrary, we can see the opposite happening. For example, Florida has dramatically improved student achievement in its public schools as it has expanded school choice, while also seeing the development of new healthcare facilities within a few years of paring its CON laws.
But some lawmakers have difficulty imagining such things when their vision is limited to what they already know. Services such as K-12 education seem to many like a zero-sum game: Allowing more over here means less over there. But experience in every other walk of life – including education and healthcare in states that have embraced reforms – shows that’s not true. Competition and innovation are good.
Tellingly, existing service providers are the ones who consistently show an understanding of just how much things could change. Public schools and hospitals alike know reforms would lead to more alternatives: That’s precisely why they oppose them. They could adjust to the competition; they’d just prefer not to. They’d rather throw their political weight around to avoid having to compete.
It works, because school superintendents and hospital CEOs are among the most prominent voices in any community. Schools and hospitals are often the largest employers in their communities, particularly in rural areas. Lawmakers know that, too. But they often forget there are always more students and parents than school employees, and more patients and families than hospital employees.
If we ever have more lawmakers who can see beyond the status quo, we’ll have a chance at meaningful change.
