Education and Healthcare Suck for the Same Reasons(betterschooling.in)
betterschooling.in
Education and Healthcare Suck for the Same Reasons
https://betterschooling.in/collection/education-and-healthcare-suck-here-s-how-we-can-change-that
121 comments
>"The way forward lies in open-source initiatives, crowdfunded projects, and collaborative efforts that prioritize human outcomes over institutional metrics."
Is it me, or does it feel like developing software for BigCorp sucks for at least these reasons too?
That said, there's also the Baumol cost disease: in certain service industries, productivity increases are difficult to make (or even measure, really). We've tried to automate teaching and healthcare (&art!), but the results are mixed..
https://en.wikipedia.org/wiki/Baumol_effect
Is it me, or does it feel like developing software for BigCorp sucks for at least these reasons too?
That said, there's also the Baumol cost disease: in certain service industries, productivity increases are difficult to make (or even measure, really). We've tried to automate teaching and healthcare (&art!), but the results are mixed..
https://en.wikipedia.org/wiki/Baumol_effect
Part of it may be that we have already done the easy parts of making medicine and education efficient. I can watch a lecture from a world class professor on my bus ride, or get an alert from my watch if I have an arrhythmia.
If I want to ask the professor a question, or figure out why I have an arrhythmia I need to get personal attention and that is much harder.
If I want to ask the professor a question, or figure out why I have an arrhythmia I need to get personal attention and that is much harder.
It's fairly well accepted [citation needed?] that the most effective form of academic education is private tutoring by skilled tutors. We're (possibly) on the cusp of that being accessible to everyone via LLMs.
In that brave new world schools need to shift towards a focus on development of personal character. MDs, at least those that you speak to in person, need to focus on bedside manner.
In that brave new world schools need to shift towards a focus on development of personal character. MDs, at least those that you speak to in person, need to focus on bedside manner.
I once chatted with a professor Doctor who was of the opinion that most people going into med school probably would've had decent bedside manners if left to their own devices, but between there and internship, 95% of them wind up having it all trained out of them.
You don't think Aldous Huxley would be dandy with android MD's ;)?
Do people wind up in (what we would call) hospital in BNW, or do they get given an overdose* of soma while the next one gets decanted?
* compare George V's last moments (time, manner, and place; especially time) I'd call it an influence, except it happened 4 years after BNW was published.
* compare George V's last moments (time, manner, and place; especially time) I'd call it an influence, except it happened 4 years after BNW was published.
I hadn't read Island but I'd like to imagine those kin of Hugin/Munin are cyborg MDs :)
>Farnaby awakens on the island with a leg injury, hearing a myna bird screaming "Attention"
Here Aldous seems to have gone beyond merely reacting to neoEdwardism..
>Farnaby awakens on the island with a leg injury, hearing a myna bird screaming "Attention"
Here Aldous seems to have gone beyond merely reacting to neoEdwardism..
Huh, found it at https://gutenberg.ca/ebooks/huxleya-island/huxleya-island-00...
So far reminding me a bit (in backstory) of https://en.wikipedia.org/wiki/The_Twenty-One_Balloons
So far reminding me a bit (in backstory) of https://en.wikipedia.org/wiki/The_Twenty-One_Balloons
Grateful for the refs (incl. the aristotelian epigraph, the newbery)
>Will remembered suddenly his favourite worst line of poetry.
https://harpers.org/2009/10/arnolds-to-a-friend/
>The up-beat high Victorian view of art as a cure to the woes of society
https://harpers.org/2009/10/forster-what-the-great-minds-tel...
地獄楽 https://en.wikipedia.org/wiki/Hell%27s_Paradise:_Jigokuraku
>Will remembered suddenly his favourite worst line of poetry.
https://harpers.org/2009/10/arnolds-to-a-friend/
>The up-beat high Victorian view of art as a cure to the woes of society
https://harpers.org/2009/10/forster-what-the-great-minds-tel...
地獄楽 https://en.wikipedia.org/wiki/Hell%27s_Paradise:_Jigokuraku
Did the Victorians and the Soviets both believe that time/access was the only thing keeping the proletariat from being as enthused about Art as their "betters"?
Compare https://news.ycombinator.com/item?id=42185423 (and Katya's sports car, accessorised with radio and small dog)
Huxley called "habitus" well before Bourdieu: Primroses and landscapes, he pointed out, have one grave defect: they are gratuitous. A love of nature keeps no factories busy. It was decided to abolish the love of nature, at any rate among the lower classes.
EDIT: "Hell — is other people" (JPS) "...whose interests aren't aligned [being] thrown into an enclosed space and forced to work together." (YK)
Unless there are any immortals (we saw a one-tail fox this morning) on HN, we're also all (along with several deer yesterday) sentenced to death ... although some of us pledge (logically if foolishly) to seek the Elixir of Life, or die trying.
Compare https://news.ycombinator.com/item?id=42185423 (and Katya's sports car, accessorised with radio and small dog)
Huxley called "habitus" well before Bourdieu: Primroses and landscapes, he pointed out, have one grave defect: they are gratuitous. A love of nature keeps no factories busy. It was decided to abolish the love of nature, at any rate among the lower classes.
EDIT: "Hell — is other people" (JPS) "...whose interests aren't aligned [being] thrown into an enclosed space and forced to work together." (YK)
Unless there are any immortals (we saw a one-tail fox this morning) on HN, we're also all (along with several deer yesterday) sentenced to death ... although some of us pledge (logically if foolishly) to seek the Elixir of Life, or die trying.
>"habitus"
You're egging (ikigaing) me on to find the countermanding quote in Island
You're egging (ikigaing) me on to find the countermanding quote in Island
Definitely (imho)!
For more entertainment in this direction, consider looking at the not-very-conclusive back&forth between SSC (a healthcare practioner) & Robin Hanson (a theorist) on the effectiveness of healthcare spending.
[It's telling that the practioner is in the house that believes that healthcare spending has been mostly effective.. re: SSC is saying that "the easy parts are still there?"]
https://www.astralcodexten.com/p/highlights-from-the-comment...
For more entertainment in this direction, consider looking at the not-very-conclusive back&forth between SSC (a healthcare practioner) & Robin Hanson (a theorist) on the effectiveness of healthcare spending.
[It's telling that the practioner is in the house that believes that healthcare spending has been mostly effective.. re: SSC is saying that "the easy parts are still there?"]
https://www.astralcodexten.com/p/highlights-from-the-comment...
Interesting, that puts doctors and teachers in the same boat as artists and police officers.
I have talked about it here a couple times before but my last couple doctors have generally spent more time typing than talking to me. They've become more stenographer than physician. I have lamented how the need for record keeping has seemingly interfered with actual … listening and empathy. They're just typing away on the computer, and I have even had one Google my symptoms and pull up WebMD.
The new piece to this story and in stark contrast - my wife and I recently had a child and our pediatrician is genuinely fantastic. Friendly, helpful, and actively listens to our concerns. It frankly gives me hope that such physician-ing is still possible in today's system.
I don't know what it's going to take to get us back to a reasonable place, but I am frankly kind of hopeful for like some sort of AI note taker so that the doctor could be the human in the room again.
The new piece to this story and in stark contrast - my wife and I recently had a child and our pediatrician is genuinely fantastic. Friendly, helpful, and actively listens to our concerns. It frankly gives me hope that such physician-ing is still possible in today's system.
I don't know what it's going to take to get us back to a reasonable place, but I am frankly kind of hopeful for like some sort of AI note taker so that the doctor could be the human in the room again.
AI scribes is one of the few good uses of LLMs I'm seeing in the healthcare space currently. My doctor loves it, and have to agree the one he's using does a great job of transcribing and summarising.
And the one we're offering in my company is getting a lot of love from doctors for very similar reasons, and how much time it saves them.
And the one we're offering in my company is getting a lot of love from doctors for very similar reasons, and how much time it saves them.
The need for record keeping isn't what has interfered with listening and empathy.
Courts manage to have record keeping without the judge typing constantly.
It just takes money. Either hiring someone to type for the doctor or paying the doctor enough that they can spend non-patient time typing up record keeping notes.
In practice, just like with air lines, people's revealed preference is for low cost over great service.
Courts manage to have record keeping without the judge typing constantly.
It just takes money. Either hiring someone to type for the doctor or paying the doctor enough that they can spend non-patient time typing up record keeping notes.
In practice, just like with air lines, people's revealed preference is for low cost over great service.
> I don't know what it's going to take to get us back to a reasonable place, but I am frankly kind of hopeful for like some sort of AI note taker so that the doctor could be the human in the room again
Doctolib (premier healthcare startup in France, expanding into Italy and Germany, the vast majority of healthcare appointments happen via them) have an AI scribe project in public beta which seems to be working very well.
Doctolib (premier healthcare startup in France, expanding into Italy and Germany, the vast majority of healthcare appointments happen via them) have an AI scribe project in public beta which seems to be working very well.
I wish singleminded focus on measurable outcomes was the problem we have with US healthcare.
from what i understand beds are really expensive where with beds we mean nurses and with expensive we mean profitable.
The giant, terrible, AI generated header image isn't doing anything to support the page. IMO, either hire an artist for a sketch or remove the image.
Seeing people standing around a classroom... hospital?... as amputees and weird shaped people in a space that's too large for them is very disquieting and distracting from the piece later on.
Seeing people standing around a classroom... hospital?... as amputees and weird shaped people in a space that's too large for them is very disquieting and distracting from the piece later on.
Why are they using an AI image for an article complaining about human autonomy being taken out of education and healthcare? People just don't get it.
I liked this image.
Why? What about it spoke to you?
Was it the messed up human anatomy? The letters and numbers being misformed? The lack of faces? The weird choice of unnecessary detail and bizarre scale?
Was it the messed up human anatomy? The letters and numbers being misformed? The lack of faces? The weird choice of unnecessary detail and bizarre scale?
Agreed, the scaling is because of the CMS. Changed the image
I think a lot of these harms could be mitigated by involving practitioners in metric selection. Let the staff pick a metric to focus on this quarter. Next quarter pick a different one. It's optimizing for the same number for ages which leads to the myopia, so lets find a balance re: how fresh we keep them.
I was being very nitpicky about the ideas shared here before I remembered that BetterSchooling is not a US institution, and so is not talking about US problems. In the US, only the title mostly applies.
How about a quality and happy customer metric?
How about a quality patient care metric?
How about a metric which asks patients if they felt that the doctor could spend adequate time with them?
How about a metric that measures how long it takes from a phone call to see the doctor?
Ultimately, a lot of metric measuring management is not measuring what customers are asking for. They are only measuring BS that looks good to layers of management, with questionable value produced.
No wonder people have become cynical and unhappy. Our institutions have forgotten to serve the people they are taking money and time from.
How about a quality patient care metric?
How about a metric which asks patients if they felt that the doctor could spend adequate time with them?
How about a metric that measures how long it takes from a phone call to see the doctor?
Ultimately, a lot of metric measuring management is not measuring what customers are asking for. They are only measuring BS that looks good to layers of management, with questionable value produced.
No wonder people have become cynical and unhappy. Our institutions have forgotten to serve the people they are taking money and time from.
This is not necessarily easy. For example, one of the metrics that patients in my field often advocate for is a stochastic, noisy signal at the end of a long causal chain. It's an important metric, but it's one that's very hard to actually use.
But it's one that feels straightforward: Death.
But it's one that feels straightforward: Death.
> For example, one of the metrics that patients in my field often advocate for is a stochastic, noisy signal at the end of a long causal chain. But it's one that feels straightforward: Death.
Which is why this is a dumb metric.
You don't need to measure time to death. You need to measure time to response and time that the patient got with the doctor.
And then, build systems that minimize mttr and maximize time with patient.
To minimize mttr, hire more doctors who can be available.
To maximize time with each patient, hire more doctors.
Ultimately you need to have the right intent to begin with. And the right intent is to not measure the time to death. It is to measure the time to help and to make sure doctors get all the help in minimizing the time to help.
Which is why this is a dumb metric.
You don't need to measure time to death. You need to measure time to response and time that the patient got with the doctor.
And then, build systems that minimize mttr and maximize time with patient.
To minimize mttr, hire more doctors who can be available.
To maximize time with each patient, hire more doctors.
Ultimately you need to have the right intent to begin with. And the right intent is to not measure the time to death. It is to measure the time to help and to make sure doctors get all the help in minimizing the time to help.
Feel free to start with HEDIS and then move along to whichever healthcare quality metric group strikes your fancy next!
https://www.ncqa.org/hedis/measures/
https://www.ncqa.org/hedis/measures/
What happens when doctor attention is negatively correlated with quality of life?
A very inspiring series on data driven approach to management discusses this: https://commoncog.com/goodharts-law-not-useful/
The article isn't wrong, but mostly reads as one big truism. Until we have an actionable alternative to metrics-based systems, they are here to stay.
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I'm a surgeon; healthcare sucks because people have unrealistic expectation of what it's actually possible and politicians have no interests in defending healthcare workers but they actually double down bashing on them every chance they get.
Since health-care became a commodity, we lost touch about what it really is and what it can really do.
Since health-care became a commodity, we lost touch about what it really is and what it can really do.
Because private alternatives exist, and therefore the wealthy and powerful have no reason to make public education or healthcare work. (Except for long-sighted views that they seem to lack, possibly because their education is also pretty bad.)
> The Tyranny of Metrics
For people interested in this, I can recommend Tory Sutherland's book or interviews with him on YouTube. Tory is also consistently arguing that businesses and governments are too focused on metrics.
For people interested in this, I can recommend Tory Sutherland's book or interviews with him on YouTube. Tory is also consistently arguing that businesses and governments are too focused on metrics.
The worst metric obsession that defines things now is stock price, which really went into overdrive with the financialization of the 70s~80s. Of course financialization was downstream of the money supply and people seeking out returns on their savings in inflationary environments (modern economic theory that thinks never-ending inflation is just a law we must all accept and conform to), which is used a way to finance big government.
Fwiw early childhood education (pre-k) is a slam dunk, one of the highest ROÍ investments a society can make in its people. Yes it can be studied longitudinally and it does make a marked difference.
Not really. Education sucks because it doesn't scale. Every single child needs to be educated and educating them takes thousands (or tens of thousands) of hours of teacher work. Meanwhile an average person probably requires only tens of hours of doctor work in teir lifetime. Imagine doctors having to treat people by a roomful (even if they were pre-sorted by vaguely similar diagnosis). That would suck indeed.
[deleted]
I think it all boils down to goals. If we need a standard health care and standard education, we will need standardization. If we need to handle special personal cases, we need special treatment. Things can be improved, but frankly I am amazed at how process oriented our education and health care has become.
Follow the steps specified by a school, get the minimum marks specified, that means you have learnt the basic skill set needed by you to function in society. If you need to learn extra, there are other channels available.
Same thing with health care. A patient shows some numbers, treat those numbers. If something feels off, the doctor takes the call. That's why we still have human doctors and not AI.
Also, one major difference between education and health care, in education the customer is different from the one who pays. So the goals get differently from the start(make my kid the best mathematician-parent(paying), I want to be a footballer-kid). So who should the school listen to :)
Follow the steps specified by a school, get the minimum marks specified, that means you have learnt the basic skill set needed by you to function in society. If you need to learn extra, there are other channels available.
Same thing with health care. A patient shows some numbers, treat those numbers. If something feels off, the doctor takes the call. That's why we still have human doctors and not AI.
Also, one major difference between education and health care, in education the customer is different from the one who pays. So the goals get differently from the start(make my kid the best mathematician-parent(paying), I want to be a footballer-kid). So who should the school listen to :)
> Also, one major difference between education and health care, in education the customer is different from the one who pays.
That's actually the same in education and healthcare. And probably the real root of the issues with both.
I don't pay for health care I pay for insurance. In fact I don't really pay for that. My company pays for it. I just have to throw some money in the money pit when my employer pays and when I go to get care.
I don't get to choose my healthcare, and I don't get to choose the procedures.
Hospitals pair up with insurance companies and stay with them. The hospitals work for the insurance companies.
When you pay for health insurance you are essentially paying a monthly fee to get healthcare from a specific company. The more they treat the more money they make, because if they over treat and they don't make enough money they just raise rates. You don't have a choice to switch to a new provider. Heck you can't even change your plan except once a year in November.
It's the same thing as stuff that's free. You aren't the customer you are the product.
That's actually the same in education and healthcare. And probably the real root of the issues with both.
I don't pay for health care I pay for insurance. In fact I don't really pay for that. My company pays for it. I just have to throw some money in the money pit when my employer pays and when I go to get care.
I don't get to choose my healthcare, and I don't get to choose the procedures.
Hospitals pair up with insurance companies and stay with them. The hospitals work for the insurance companies.
When you pay for health insurance you are essentially paying a monthly fee to get healthcare from a specific company. The more they treat the more money they make, because if they over treat and they don't make enough money they just raise rates. You don't have a choice to switch to a new provider. Heck you can't even change your plan except once a year in November.
It's the same thing as stuff that's free. You aren't the customer you are the product.
Ok. Guess its different in the US when compared to India. Looks like US system does tie your hands down when it comes to healthcare based on your explanation.
didn't give it much thought but couldn't you eventually run schools and universities on a percentage of student income tax (and remove all other sources) combined with a periodic questionnaire (for life) how [?????] one thinks their education was.
probably a bad idea but it gets me to ponder long term measurements
probably a bad idea but it gets me to ponder long term measurements
This assumes that schools are run purely for the future profitable careers of students. If you were a dean deciding what to invest in, would you ever give the teaching school more money? Would the medical school ever train another tropical disease specialist?
i wonder, is that specialist suppose to not make money their entire career? I think actually good education would allow them to do all kinds of things.
I do feel the raw idea is bad then added the survey to measure [????] say quality of life kind of things. If a school produces somewhat useful people who are really happy it seems to merit more funding. The economy may die if everyone has a good life
I do feel the raw idea is bad then added the survey to measure [????] say quality of life kind of things. If a school produces somewhat useful people who are really happy it seems to merit more funding. The economy may die if everyone has a good life
> i wonder, is that specialist suppose to not make money their entire career? I think actually good education would allow them to do all kinds of things.
School teachers and tropical disease specialists both make money, but they often make less money than others with similar educations. If a school is judged on future earnings it will optimize around that, and the predictable outcome to such an incentive is that programs that lead to lower paying careers will suffer.
School teachers and tropical disease specialists both make money, but they often make less money than others with similar educations. If a school is judged on future earnings it will optimize around that, and the predictable outcome to such an incentive is that programs that lead to lower paying careers will suffer.
wouldn't the scarcity increase the value? Why would we want people to study things we don't need and not study things in high demand? I wonder what the real cost is. My school does about 80:1 in diplomas:jobs every year. I got the job :) no one else did but they didn't do anything wrong. They just wasted years and money both their own and public funds.
> Both healthcare and education faced similar pressures in the 20th century. As knowledge expanded exponentially, systems needed to scale up to serve more people. The solution? Standardization. Create protocols, establish benchmarks, develop universal procedures. It worked – sort of.
I'm not so sure standardisation due to scaling is really as the cause of this. None of the problems the author points out are really novel observations; I've been hearing this sort of thing my entire adult life, 25 years now. So why doesn't anything change?
I suspect the cause is more a lack of trust in people, as well as a fear of things going wrong. Maybe that comes out of scaling: no one really knows what anyone is doing and everyone is a "stranger". So we have all these controls because we don't trust the nurses to nurse, the teachers to teach, etc.
I feel this matters because without identifying the cause, you're not going to find a solution, which is probably to think of ways to increase trust, and to increase societal acceptance that sometimes things go wrong and that's okay, because sometimes the cure is worse than the disease.
I'm not really sure how to go about that though – a big part of the problem are toxic media outlets that will abuse any incident to attack $disfavoured_politician without regard for truth or fairness. The incentives for politicians are pretty skewed.
I don't think that "self-directed learning pods" or "community-funded clinics" are really the path forward. It all sounds very nice, but you can't really run the entire country's system on this for a number of reasons. Sounds more of a libertarian pipe dream than anything else.
I'm not so sure standardisation due to scaling is really as the cause of this. None of the problems the author points out are really novel observations; I've been hearing this sort of thing my entire adult life, 25 years now. So why doesn't anything change?
I suspect the cause is more a lack of trust in people, as well as a fear of things going wrong. Maybe that comes out of scaling: no one really knows what anyone is doing and everyone is a "stranger". So we have all these controls because we don't trust the nurses to nurse, the teachers to teach, etc.
I feel this matters because without identifying the cause, you're not going to find a solution, which is probably to think of ways to increase trust, and to increase societal acceptance that sometimes things go wrong and that's okay, because sometimes the cure is worse than the disease.
I'm not really sure how to go about that though – a big part of the problem are toxic media outlets that will abuse any incident to attack $disfavoured_politician without regard for truth or fairness. The incentives for politicians are pretty skewed.
I don't think that "self-directed learning pods" or "community-funded clinics" are really the path forward. It all sounds very nice, but you can't really run the entire country's system on this for a number of reasons. Sounds more of a libertarian pipe dream than anything else.
There's always some dumb "futuristic" education/health solution when countless of countries do it better than the USA in both of these and they didn't have some big tech douchebag running the show. FUND education. Elect people that care about community and education not profits and reducing taxes for the rich(majority of both Rs and Ds)
We live in a society, we are supposed to act civilized first, then throw AI tech solutions at problems. The problem is we do not act civilized, at least rich people and corps don't and rob society of basic funding. Look at food in schools big corps have regulatory capture and can put whatever shit in front of kids and get a stamp from the FDA. Unregulated hyper-concentration of wealth is going to look like and endless funnel to the richer classes and education won't get better even if you can throw some cheap ollama based tools at it.
We live in a society, we are supposed to act civilized first, then throw AI tech solutions at problems. The problem is we do not act civilized, at least rich people and corps don't and rob society of basic funding. Look at food in schools big corps have regulatory capture and can put whatever shit in front of kids and get a stamp from the FDA. Unregulated hyper-concentration of wealth is going to look like and endless funnel to the richer classes and education won't get better even if you can throw some cheap ollama based tools at it.
> FUND education. Elect people that care about community and education not profits and reducing taxes for the rich(majority of both Rs and Ds)
Your post is, in a nutshell, why American education will never be fixed. The U.S. funds education really well. Inflation-adjusted per student spending is up 34% since 2002: https://reason.org/commentary/four-takeaways-from-the-u-s-ce.... It has tripled since 1970. But test scores haven’t budged at all!
I grew up in one of the most affluent suburbs in the country. My dad once ran into Dick Cheney at our local CVS. Per-student spending when I graduated high school in 2002 was about $16,500 in today’s dollars. The average per-student spending in the U.S. today is $18,900. Is the average school in the U.S. today better than the one I went to growing up? Absolutely not.
Funding is simply not the problem with American education. The biggest problem is probably the quality of the students, followed closely by the quality of the people willing to become teachers.
Your post is, in a nutshell, why American education will never be fixed. The U.S. funds education really well. Inflation-adjusted per student spending is up 34% since 2002: https://reason.org/commentary/four-takeaways-from-the-u-s-ce.... It has tripled since 1970. But test scores haven’t budged at all!
I grew up in one of the most affluent suburbs in the country. My dad once ran into Dick Cheney at our local CVS. Per-student spending when I graduated high school in 2002 was about $16,500 in today’s dollars. The average per-student spending in the U.S. today is $18,900. Is the average school in the U.S. today better than the one I went to growing up? Absolutely not.
Funding is simply not the problem with American education. The biggest problem is probably the quality of the students, followed closely by the quality of the people willing to become teachers.
So you’re saying that the problem with education is not funding, structural inequality, uneven or poor curriculum, or any number of other realistic complaints about American education. It’s simply that the kids are bad.
I mean, rock-solid take, I guess. Don’t bother trying to improve, folks, these kids don’t deserve it.
Assuming we rule out blindingly stupid arguments, perhaps we could ask if the distribution of that average funding might have something to do with the problem? Your anecdotal evidence doesn’t really serve to illustrate that education across the whole country is fine and of similar quality.
I mean, rock-solid take, I guess. Don’t bother trying to improve, folks, these kids don’t deserve it.
Assuming we rule out blindingly stupid arguments, perhaps we could ask if the distribution of that average funding might have something to do with the problem? Your anecdotal evidence doesn’t really serve to illustrate that education across the whole country is fine and of similar quality.
> So you’re saying that the problem with education is not funding, structural inequality, uneven or poor curriculum, or any number of other realistic complaints about American education. It’s simply that the kids are bad.
Those aren’t “realistic complaints” about education, as distinguished from my “unrealistic” ones. Those are simply the factors you assume must explain observed educational differences given your worldview. For most people who think this way, evidence won’t change their mind because it’s these factors that must be the explanation for their worldview to make sense.
The distribution of funding across the country is not a problem in most places. Some of the worst school districts spend the most money. The affluent school district where I grew up spends $19,750 per student per year. Baltimore spends $22,400 per year. Chicago is at $29,000. Detroit is at $28,000. Portland spends almost $49,000 per student.
Those aren’t “realistic complaints” about education, as distinguished from my “unrealistic” ones. Those are simply the factors you assume must explain observed educational differences given your worldview. For most people who think this way, evidence won’t change their mind because it’s these factors that must be the explanation for their worldview to make sense.
The distribution of funding across the country is not a problem in most places. Some of the worst school districts spend the most money. The affluent school district where I grew up spends $19,750 per student per year. Baltimore spends $22,400 per year. Chicago is at $29,000. Detroit is at $28,000. Portland spends almost $49,000 per student.
Exactly,
Utah has just about the least spending per student and just about the highest test scores.
Spending != education.
Utah has just about the least spending per student and just about the highest test scores.
Spending != education.
No state does significantly better than Utah on NAEP’s 8th grade math testing (a number of states are comparable) while in 2022 Utah spent the least on education per student. https://nces.ed.gov/nationsreportcard/subject/publications/s...
Its even more interesting if you look at the grade 12 scores for 2022.
I don't think the problem is lack of funds. I live in the same district I attended thirty years ago, and my daughter will soon attend.
It's a very well-to-do district, and funding per student is comparatively through the roof. Every kid has their own laptop. Small class sizes, smaller than when I attended. Smart boards and all that jazz. Test scores and the graduation rate have significantly decreased since I attended.
The problem is more fundamental than lack of funds. It's what we're teaching and how. Throwing money at the problem blindly has not helped.
It's a very well-to-do district, and funding per student is comparatively through the roof. Every kid has their own laptop. Small class sizes, smaller than when I attended. Smart boards and all that jazz. Test scores and the graduation rate have significantly decreased since I attended.
The problem is more fundamental than lack of funds. It's what we're teaching and how. Throwing money at the problem blindly has not helped.
Baltimore spends more money per student than the rich suburb where I grew up. But the school district is probably run worse than the one in the Bangladeshi village where my dad grew up. At least in my dad’s village there is a motivating fear because there is no welfare state to support these kids after they learn nothing in school: https://katv.com/news/nation-world/23-baltimore-schools-have...
We fund both education and healthcare at a much higher rate than the rest of the developed world. Funding is unequivocally not the problem.
Standardization isn't reduced when a thing is publicly funded and everybody has a stake in fighting over how it works.
I’m so tired of people who don’t know anything about healthcare opining confidently about it.
Pretending that the issues in care are metrics and not stupid fee-for-service incentives (ignoring the myriad Rx issues and system failures) and an abject failure to improve the supply of providers is ridiculous nonsense.
Pretending that the issues in care are metrics and not stupid fee-for-service incentives (ignoring the myriad Rx issues and system failures) and an abject failure to improve the supply of providers is ridiculous nonsense.
Honest question: do you think this article would be worse off without that horrendous image at the start? In other words, was it necessary for the author to add a horror-movie drawing of a hellish hospital within a distorted reality full of misshapen demons in order to make their point?
Point taken. Used a different image.
> Take ApniPathshala, for instance – they're creating learning pods where children can engage in truly self-directed learning
Yeah, children now spend days looking at Youtube hip-hop videos, learning nothing.
> Rethink Metrics
In other words: "The victims of our 'non-education' approach crater on standardized tests. So we must destroy the standardized tests"
Yeah, children now spend days looking at Youtube hip-hop videos, learning nothing.
> Rethink Metrics
In other words: "The victims of our 'non-education' approach crater on standardized tests. So we must destroy the standardized tests"
kill all quants
If I never hear a manager utter “if you can’t measure it, you can’t manage it” again, it’ll be too soon.
It’s one thing to suffer from a blinkered, reductive view of the world. It’s another thing to be proud of it.
It’s one thing to suffer from a blinkered, reductive view of the world. It’s another thing to be proud of it.
The reverse is also true though -- hearing from folks that we need to measure nothing because "trust me". Both lead to poor outcomes, ime.
A good engineering team has measurements in place that are reasonable approximations, where it is reasonable to build them, but also treats them as prompts rather than absolutes. Asking "why is this metric out of band?" is infinitely more valuable than stating "this metric is out of band, we've failed".
A good engineering team has measurements in place that are reasonable approximations, where it is reasonable to build them, but also treats them as prompts rather than absolutes. Asking "why is this metric out of band?" is infinitely more valuable than stating "this metric is out of band, we've failed".
Out of band means communicated on different channels than ordinary information. For example a metric communicated out of band would be told to you in person instead of showing up on your universal agent smith react widget dashboard. :-)
Two different jargon phrases overlapping here, as I’m sure you know. Yours is “out of communication band” whereas GP is “out of predictive band.” Yours is a bit more common to me, but I hear both.
The latter should be “out of scale” (think 3.6 Roentgen…) “out of band” is quite literally outside the prescribed channel.
A band, on a metric, indicates a minimum and maximum safe value. For instance, if you alarmed when your latency is below 50ms or above 150ms, that'd be your band. Being out of band is being out of that 'safe' window.
It's a totally valid and common jargon phrase from the web services world, apologies though, I assumed that it was wider jargon than it turns out it is...
It's a totally valid and common jargon phrase from the web services world, apologies though, I assumed that it was wider jargon than it turns out it is...
And the band could be the expected value range, as is commonly shown on many gauges by having a section colored.
There's no language rule that a phrase can have only one meaning. You seem to be taking this too precisely, as the earlier explanations of there being two interpretations are quite entirely reasonable.
It's also "you manage what you measure" - measure the wrong stuff ...
I agree with empathy and 'EQ', better still if we can measure the outcomes we really want (vs the easy ones). That requires knowledge and insight.
Whats are some ways to manage unmeasurable things?
Intuition and experience-based decision making.
Team member says they are feeling less creative because their kid is having bullying problems in school.
"Can't measure the creativity, can't measure the bullying... Can't manage this situation, sorry"
Team member says they are feeling less creative because their kid is having bullying problems in school.
"Can't measure the creativity, can't measure the bullying... Can't manage this situation, sorry"
That’s also the kind of stuff I always hear from people that love to shoot from the hip and trust their gut feel. The results those people have is invariably inconsistent, there’s no way to scale any of their knowledge and honestly at the end of the day it’s just a person reacting to a situation.
You assume there is a way to scale certain kinds of knowledge, or that the current metrics-supremacy is it. I get it, humans are inconsistent and squishy, but at least we can be reasoned with. Stripping complex realities down to “metrics”, often without error bars even, gives fake authority to dangerous approximations. You can’t argue with numbers! They’re so precise and correct.
Discussions like these always feel too reductive to me. Both of you take extremist positions, when I’m sure you do both agree that the proper approach is obviously a middleground: Strive to gather objective numbers and measure things as much as possible to become able to make factual decisions, but don’t disregard human intuition just because it’s not measurable; after all, it’s a tool shaped by millions of years of evolution, culminating in creatures ruling the world due to their ability to assess social contexts correctly.
To put it differently—measure what you can; trust your feelings on the rest.
To put it differently—measure what you can; trust your feelings on the rest.
"Measure what you can" isn't the right approach.
You can measure many, many things. Instead, you should measure things whenever they are good proxies for the outcomes you want to drive AND there is good cost benefit in measuring+analyzing them.
Surprisingly few things meet these criteria.
You can measure many, many things. Instead, you should measure things whenever they are good proxies for the outcomes you want to drive AND there is good cost benefit in measuring+analyzing them.
Surprisingly few things meet these criteria.
Of course I agree that the right thing is some sort of middle ground, of roughly what you lay out. But the current hegemonic position is that of metrics-supremacy, so I feel I have to argue most strongly against that to get us to that middle ground.
When you argue like that, that’s what’s generally referred to as “pushing an agenda” and people sour to it quickly. You’re better off sticking to your actual argument than embellishing things.
I'm not embellishing anything, I'm making my "actual" arguments. I've never argued against seeking a sensible middle-ground. I've said elsewhere that metrics have their place.
The world isn't black or white, zero or one. The main problem with metrics-centric management is that its proponents try to reduce everything to metrics.
I was simply pointing out that many situations can't be solved through metrics. In my experience, the best managers try to solve most problems without metrics, but always insist on them in places where they are valuable.
In other words, they use metrics as a tool and make metrics work for the team instead of the team work for the metrics.
I was simply pointing out that many situations can't be solved through metrics. In my experience, the best managers try to solve most problems without metrics, but always insist on them in places where they are valuable.
In other words, they use metrics as a tool and make metrics work for the team instead of the team work for the metrics.
Empathy, trust, and experience.
Leadership, humility, kindness
Actual intelligence. The measurable is always, once you have your number, make it go up!!!!!!!
It makes sense if the goal is "maximise the pay of managers".
The shenanigans I have seen…
Given a choice between two metrics, managers will usually choose the most gameable, indirect, activity-oriented metric, even if it is far less useful for driving results.
And I can’t blame them. That’s the game. They have to make a number go up, their boss also has numbers that need to go up, and so on. In the worst cases, everyone is complicit in creating a forest of bullshit numbers that went up even while the company tanked.
Given a choice between two metrics, managers will usually choose the most gameable, indirect, activity-oriented metric, even if it is far less useful for driving results.
And I can’t blame them. That’s the game. They have to make a number go up, their boss also has numbers that need to go up, and so on. In the worst cases, everyone is complicit in creating a forest of bullshit numbers that went up even while the company tanked.
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if a metric is too simple, choose better metrics! don't throw away metrics altogether
What alternative do you see? At the end of the day it is philosophically impossible to manage situations that cannot be detected. It is like the OODA loop to catch a ghost; the ghost can't be observed because it doesn't exist and the ODA part becomes a questionable exercise.
Managers who react to known signals in predictable ways are strategically better than managers who just make stuff up on the day in unpredictable ways.
Managers who react to known signals in predictable ways are strategically better than managers who just make stuff up on the day in unpredictable ways.
To use a famous, well-known example relevant to the HN user base: Software productivity can't be measured with any simple metrics - essentially every attempt at coming up with software output metrics can be trivially gamed, yet that hasn't stopped people from trying mightily (I'm probably showing my age in recalling how much effort was put into "function points" from a couple decades ago).
At the same time, nearly all of us can identify developers who are highly, highly productive, and others who are not. We may not have great metrics for software productivity, but I can guarantee that Fabrice Bellard is about 100 times more productive than I am.
Metrics are inherently an oversimplification in attempt to get complex phenomena down to a strictly ordered value, but the real world doesn't work like that. I think your mistake is thinking that just because things can't be reduced so a small set of numbers would also mean they can't be observed, and that isn't true.
At the same time, nearly all of us can identify developers who are highly, highly productive, and others who are not. We may not have great metrics for software productivity, but I can guarantee that Fabrice Bellard is about 100 times more productive than I am.
Metrics are inherently an oversimplification in attempt to get complex phenomena down to a strictly ordered value, but the real world doesn't work like that. I think your mistake is thinking that just because things can't be reduced so a small set of numbers would also mean they can't be observed, and that isn't true.
You also have a problem that a team can benefit from people who are less productive as coders, but more productive at paperwork, organizing, mentoring, meetings, etc.
I’ve seen several teams fire less productive coders and then the team fell apart into individually good coders.
That teams require a blend of capabilities and personalities is anathema to the “everyone a widget” mentality of most corporations — but remains persistently true.
I’ve seen several teams fire less productive coders and then the team fell apart into individually good coders.
That teams require a blend of capabilities and personalities is anathema to the “everyone a widget” mentality of most corporations — but remains persistently true.
As a manager, there is diminishing returns to measurements. At a certain point, you have to trust the team to do the right thing without having full documentation, specification, and provable outcomes.
Many of the most important decisions do not have quantifiable outcomes. How many incidents did this architecture or refactor prevent? What cultural effect would that person we didn’t hire have had over the next year?
At least in early stage or growing startups, I think if every one of your actions is measurable and fully specced, you’re in trouble.
Many of the most important decisions do not have quantifiable outcomes. How many incidents did this architecture or refactor prevent? What cultural effect would that person we didn’t hire have had over the next year?
At least in early stage or growing startups, I think if every one of your actions is measurable and fully specced, you’re in trouble.
> At a certain point, you have to trust the team to do the right thing...
Yeah, but that is explicitly not managing them. That is the standard "I can't measure this situation, therefore I will not attempt to manage it" response of a good manager.
Yeah, but that is explicitly not managing them. That is the standard "I can't measure this situation, therefore I will not attempt to manage it" response of a good manager.
You are not perfect though. There will always be factors overlooked and simply acknowledging that before it becomes a problem is something most management has failed to grasp which is what motivates this sentiment. I can bet now often than not on this thread alone now people have felt the negative effects of every action being quantified for the sake of 'profitability' by someone who lacks a firm grasp on the field being measured, which leads to high performing employees being let go.
I don’t really know what that means. Management is not about control, it’s about outcomes.
I am responsible for the outcomes of my teams, full stop. I am responsible for the growth and development of the engineers who report to me.
If that means sometimes standing back and letting the cook, then that’s the right thing to do. I’m not here to involve myself because otherwise people will ask “well what are you doing??”
(The answer to that is that the more independent teams can run at a high velocity of quality output, the fewer managers your company needs. That is good!)
I am responsible for the outcomes of my teams, full stop. I am responsible for the growth and development of the engineers who report to me.
If that means sometimes standing back and letting the cook, then that’s the right thing to do. I’m not here to involve myself because otherwise people will ask “well what are you doing??”
(The answer to that is that the more independent teams can run at a high velocity of quality output, the fewer managers your company needs. That is good!)
> Management is not about control, it’s about outcomes.
Management is about controlling the outcomes. Nobody could claim to be managing a situation well if they are responsible but exercising literally no influence over the process. If the manager could be replaced with a garden gnome and it doesn't change the outcome then the situation is effectively unmanaged.
We seem to be in furious agreement so I don't know why my perspective is eluding you. You're looking at a situation that might have an outcome that is unacceptable. You've identified that there is no measurable way to assess progress or quality. You've concluded that there is nothing you can say, do or observe that will help. The situation is then left unmanaged because there is nothing to measure and you're waiting for something you can measure before you act. This is the basics of management, what you can measure you can manage what you can't you can't.
It just happens that in the small software is unmanageable, as quickly becomes clear if you have management experience of a non-software process and compare it to managing a software team.
Management is about controlling the outcomes. Nobody could claim to be managing a situation well if they are responsible but exercising literally no influence over the process. If the manager could be replaced with a garden gnome and it doesn't change the outcome then the situation is effectively unmanaged.
We seem to be in furious agreement so I don't know why my perspective is eluding you. You're looking at a situation that might have an outcome that is unacceptable. You've identified that there is no measurable way to assess progress or quality. You've concluded that there is nothing you can say, do or observe that will help. The situation is then left unmanaged because there is nothing to measure and you're waiting for something you can measure before you act. This is the basics of management, what you can measure you can manage what you can't you can't.
It just happens that in the small software is unmanageable, as quickly becomes clear if you have management experience of a non-software process and compare it to managing a software team.
You're claiming that it's "philosophically impossible" (whatever that's supposed to mean) to do X, as if philosophy is some immutable and fully-understood constant like a gravitational constant. This is what reading too many management books and theories does to people - management theory isn't some sort of physical constant which is unquestionable or even testable
Detected != measured. A good manager has no problem to evaluate and manage situations even if they can't put numbers on what is happening.
Detected = measured. They are equivalent actions. You can even trivially metricise such a situation - plot it on a graph, x axis time & y axis a plot of "did we detect it?".
Are the companies you most admire run that way? Is that how the technologies that you love were invented? Is that how the individual technologists you look up to operated? Is that how the most impactful, world-altering inventions were created?
For me, the answer is no. Perhaps for you the answer is yes.
For me, the answer is no. Perhaps for you the answer is yes.
You are not thinking at all carefully about what it is to measure something and how much meaning you get from that. Metrics need to convey a lot of useful meaning, and measure something that is worth measuring, otherwise they are worse than useless. I’ve seen otherwise-intelligent people led totally astray because of this totally blinkered fetishisation of metrics over everything else. You cannot meaningfully reduce even a small complex system to a handful of graphs. There is a place for metrics, but responsible use demands humility, not supremacy.
The stupid graph will only say "goodness" with arbitrary values.
https://www.amazon.com/Seeing-Like-State-Condition-Paperback...
The alternative is to do the thing that doesn't scale, because all the purported ways of scaling are worse than that.
The alternative is to do the thing that doesn't scale, because all the purported ways of scaling are worse than that.
Our ancestors made do for thousands of years, hell they coordinated the logistics of wars with far greater complexity than even the largest of companies.
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>Return to First Principles We must reconnect with the fundamental purpose of these institutions.
Hmmm... I suspect this guy has some misguided picture of what the first principles are.
Last time I checked, the first principle of healthcare was "make sure as many wounded soldiers get back to the front line", and the first principle of healthcare was "don't let hordes of poor teenagers roam the streets and earn their booze and alcohol with pretty crime and prostitution by keeping them busy somewhere".
Hmmm... I suspect this guy has some misguided picture of what the first principles are.
Last time I checked, the first principle of healthcare was "make sure as many wounded soldiers get back to the front line", and the first principle of healthcare was "don't let hordes of poor teenagers roam the streets and earn their booze and alcohol with pretty crime and prostitution by keeping them busy somewhere".
1) Healthcare in the USA sucks because politics prevents you from remembering how insurance works. The most basic of basic financial calculations, the advantages of a large pool to absorb risk, vs smaller pools.
2) Education has different reasons for being problematic, and it’s not just in the USA. The USA has only caught up to the problems in the rest of the developing world, having never had to content with these problems before.