Health Care and Background Knowledge

by Robert Pondiscio
September 17th, 2009

Understanding the health care debate requires basic literacy and math skills.  But Checker Finn writing at National Review Online, is struck by “the enormous amount of background knowledge” required to make sense of it.  “It’s almost a litmus test of cultural literacy,” he writes.  To illustrate his point, he looks at a few paragraphs of President Obama’s recent address to Congress last week in which the President took for granted that his audience was familiar with words and phrases like “comprehensive health care reform,” “Democrats and Republicans” “self-insurance,” “coverage,” and ”bankruptcy” among other terms.

What’s an “advanced democracy”? How many are there? What are some others? What’s the point of Obama’s comparison of the U.S. with other countries?  What are Medicare and Medicaid? Where did they come from? How do they work? Who is covered by them? What’s the federal deficit, and why are some people concerned about its size? What is the congressional legislative process, and why is it unusually complex in this instance?

“Perhaps you don’t need to know these sorts of things to succeed in college or the workplace (which seems to be the litmus test for today’s standards-writers and education reformers). But you really do need to know them to be a constructive participant in modern American life,” Finn concludes.  “Who is going to ensure that our schools teach them?”


  1. Yikes! Is this twice this week I’ve agreed with Checker Finn??

    On the other hand, even a strong high school curriculum is only going to scratch the surface of what you need to know to understand health care, so students also need to have learned to follow the news, read news papers, and dig deep enough into all the information that they can find to be able to sort through all the conflicting claims.

    Comment by Rachel — September 17, 2009 @ 4:55 pm

  2. Except that even the folks I know who have graduate training in fields like healthcare economics and healthcare policy from the nation’s top universities can’t agree on what the “truth” is about the proposed reform. So how are the rest of us supposed to be informed voters?

    Comment by Crimson Wife — September 17, 2009 @ 9:56 pm

  3. I am as big of a supporter of a Common Core curriculum as anyone… but it is a tad scary to see two posts about this work related to National Review while the same time seeing Common Core have a post about The Weekly Standard.

    What happened to non-partisan?

    Comment by Matt — September 18, 2009 @ 8:31 am

  4. It’s indeed curious how issues of curriculum tend to upset traditional (and expected) political alliances. E.D. Hirsch has made much of the fact that he’s a political liberal, but believes that the cause of social justice is best served by being what he terms “an educational conservative.” Likewise, political liberals have tended not unnaturally to gravitate toward “progressive education,” which is generally hostile to a prescribed curriculum, even if it actively undermines their goals. Into the fray comes groups like Democrats for Education Reform which lobby for policy prescriptions in direct opposition to teachers unions, the traditional stalwarts of the Democrats. Lots of Democrats look at groups like DFER and accuse them of being Republicans in practice. The waters get very muddy. Me? I want to see kids get a rich, well-rounded education. Anyone who supports that idea is an ally. I don’t bother to check their party affiliation at the door.

    Comment by Robert Pondiscio — September 18, 2009 @ 8:42 am

  5. I agree with Hirsch on his political liberal/educational conservative split. But I might tend to disagree with you Robert. When this work shows up in publications like the ones I just mentioned, it is more likely to be instantly dismissed by the people who need to read it most. I would have a hard time convincing some peers to believe anything from these publication, especially considering some the of CRAZY stuff they published during the last election cycle.

    I am willing to work with anyone, from any background on these important issues. But I think it is prudent to know how the message will be perceived when it is allied with overtly partisan publications.

    Comment by Matt — September 18, 2009 @ 9:23 am

  6. I think Hirsch is faced with a conundrum now that he has a new book out. Forums like the Weekly Standard and National Review are probably good from a book sales point of view.

    But I’m not sure it’s going to help the wider cause of strengthening curriculum in actual schools. I’ll admit I didn’t really take Hirsch seriously until I ran across his writing in the AFT quarterly. Most of what I’d read before had seemed too aligned with the people who could make lists of Great Books that included works by Dickens but not by Jane Austen or Virginia Wolff.

    Comment by Rachel — September 18, 2009 @ 12:16 pm

  7. Health Care Reform has again (as in the past 16 years) dropped (or remained) a political issue.

    What is there to fix? This remains a choice to individuals.

    Is it cost? We can always follow Canada, etc. and build in delays … like only paying some bills this month; or we could further limit lifetime maximums; or we could outlaw any new drugs/procedures since 1955. But certainly don’t add to the list of those included!

    Is it that some are NOT included because of their employment status? Then provide a new government group to include the self-employed and those working without benefits. Maybe the government would also want to add matching 401.k deposits!

    What’s your main complaint with current health care? What would fix your boat?

    Comment by Ewaldoh — September 18, 2009 @ 12:57 pm

  8. RP: “Likewise, political liberals have tended not unnaturally to gravitate toward “progressive education,” which is generally hostile to a prescribed curriculum, even if it actively undermines their goals.”

    Really? There are a lot of assumptions in that statement, many of them not historically substantiated. The first great anti-school progressivism wave was mounted by immigrant parents who were as politically left as they come. The most genuinely progressive school programs, these days, are at well-heeled private schools, which are not running scared over AYP and test scores, like the public schools.

    And I don’t get the “undermining their goals” thing at all. What does that mean? If you don’t believe that curriculum-in-perpetuity is a good idea, then you’re shooting yourself in the foot? Seriously–help me understand what that means.

    Perhaps you’re confusing political liberalism with teacher unions? Teacher unions have a great deal of influence over many school issues, but curriculum isn’t one of them.

    Comment by Nancy Flanagan — September 20, 2009 @ 9:44 pm

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