A Management Guru's ideas are applicable
One way to foster experimentation in education is to break the monopoly of government-funded schools in K through 12. Instead of spending 136 billion dollars on public education, the government should allocate this money to the consumers (parents) who can choose the best educational options for their children. This would create a competitive and profitable education industry, where low-performing schools would be driven out of the market, and high-performing schools would expand and scale. Schools that developed effective teaching methods would be emulated and improved by others. Moreover, the market would offer a variety of schools that cater to different needs and interests, such as manual arts, STEM subjects, art, etc.
Your conversation with the bureaucrat whose inability to see beyond his limited notion of “controlled experiments” conjures an image of Dilbert’s pointy haired boss (whose best line was “The goal of this meeting is to figure out why nothing ever gets done around here”). In years past my employer got on the Deming bandwagon about process improvement. Even though I am a cynic about business fads, I had to agree with Deming’s basic principles and used them in our work processes for genuine positive results. I could also see application beyond manufacturing. If there were ever an industry that could stand quality improvement, it’s education – at every level.
re: “Can we do something about parental substance abuse?”
Well, mandatory parental sobriety laws would be one way to ensure fertility rates continue to decline. And child protective services make both Type I and II errors: https://www.cato-unbound.org/2018/11/09/diane-redleaf/when-child-protective-services-system-gets-child-removal-wrong/
In practice "making the improvements early in life" tends to boil down the the following:
1) Subsidizing pre-k and daycare (but not SAHM)
2) Embracing educational fads in elementary school (many of which turn out dumb like giving up on phonics)
I think your view that kids before age eight mostly need a small peer group in and informal setting that spends a lot of time outside playing with some direct instruction on the three Rs mixed in is probably correct. Learning pods were awesome. My kids kindergarten was basically a lot of outdoor playtime with some phonics and math worksheets mixed in (she did a great job learning to read and write without draining away her childhood).
Trying to improve early childhood education will tend to end in more money (more jobs) with kids sitting inside rooms away from their family being regimented more and wasting time (but not in a fun way).
While I agree with Deming over all, an ounce of prevention and all that, I am not sure how well that applies to life outcomes for people. The issue I have with it is that it presumes both that the government should attend to the production of good life outcomes for people (whatever that means), and that the government can achieve those same good life outcomes. There are many, many problems with those two notions.
First would be that the amount of process control, tracking and reporting in industrial processes applied to individuals would mean the government spying on you all day, every day, in every aspect. Car parts do not have a private life.
Secondly, it would mean that the government would have a great hand in determining what your outcomes will be. Do you want to be an artist or an accountant or a boxer? Too bad, you don't get to choose. Car parts do not get to decide they want to be in a lawnmower instead.
Thirdly, the government has very little reason to care whether or not their processes produce the stated outcomes, and indeed often want them not to. Instead, they want the processes to produce power and wealth for the government officials, regardless of what is good for the people. Car parts are not what is important to the company, profits are.
The list could go on...
Deming did some great stuff. It works well in a setting with repetitive tasks and willing participants. In health care we mostly don't have willing subjects. The tasks don't seem repetitive. Fixing a person can difficult. Obesity and substance abuse are largely problems we don't know how to fix. Maybe some providers are more successful but it's a bit like picking stocks except that it's theoretically possible everyone can win. But that's not going to happen with today's capabilities. As for early education, good parenting, etc., we have been going in the wrong direction on what might be most important. More and more kids grow up in single parent households. Statistics suggest this has far worse outcomes. Various studies look at this or that intervention for young
kids with mixed results. Maybe some successful trial improvements can be scaled but even that is mostly doubtful.
Whether what you propose is good or not, possible or not, I'm more than a little surprised to hear it from you. I don't see a way to even attempt it other than by a big government program.
Re: "In the case of health, getting treatment is the equivalent of inspecting and fixing defects in cars as they come off the assembly line. The cost is high relative to the benefits. There is more leverage to be had in people choosing behaviors that promote health. Avoiding substance abuse and obesity. Obtaining treatment for mental illness."
Wouldn't the Deming approach be to choose behaviors that promote mental health, before the onset of mental illness? (And to favor institutions that help youths cultivate behaviors that promote health.). I have in mind diet, exercise, positive social interaction, rapport with teacher/coach/mentor/chaplain, drama-avoidance, avoidance of situations fraught with unreasonable expectations (given individual ability and temperament), practical search to discover one's comparative advantage (talents) and individuality, etc.
Quality Education is good, but what does it mean for the 1/3 or more folk with below avg IQ (depending on how big the middle 'around avg' group is; technically 1/2 minus 1 are below avg.)
Everybody can improve behavior, but there is some optimal education that results in max IQ potential, and those with low potential shouldn't be expected to go to college.
The MBTI (Myers-Briggs Personality) is better than Big 5 (OCEAN) model in the N-S axis (iNtuitive-abstract vs Sensitive-concrete). College is more for NTs & NFs, the abstract Thinkers & Feelers who usually lead and are most usually the decision makers and almost exclusively theoretical experts; plus most often having higher IQs.
We need more vocational education, and probably more outdoor play & fun in pre-K day care & even Kindergarten. Also edu could probably improve with more male teachers 6-12, more so than K-5. As you noted earlier about smaller size gov't more often being better, we should be looking for what school systems are producing ... a) the best top outcomes? or b) the fewest criminals? or c) the fewest unmarried mothers?
Since it's pretty known, accepted, and data consistent that, on average, kids raised by married parents do better, maybe it's time to have more gov't support for being married with kids. Like a $10k gov't check on the first year anniversary to a married couple who have a child, or on the birth of their first child after at least one year of marriage. (Or some 1, 2, 3, or 4 month avg wage of ~$5k/month).
This kind of social support is not "need based", but would be "rewarding good social behavior" based. Our society, in reducing the real problems suffered by folks who have bad social behavior, have increased the bad social behavior. In our rich (post-) Christian Capitalist societies, such help for those needing it isn't going away -- but should be somewhat offset by significant govt reward, which equals gov't cash, for good behavior.
We need more gov't incentives for good behavior - if we want more good behavior. Incentives need to be tried.
Along those lines, some large direct cash to students for doing better homework and getting more text questions correct are likely to work better than more cash for teachers and admin. So far as I know, little has been tried at paying students to "learn" and test well. I think lots of folks, especially poor folks, would be interested in having their kids get paid to learn. I would have been motivated.
Glad that you brought Deming into the conversation. As you well discuss, his principles have wide application and could be quite helpful if applied to present problems.
In 2012 Jim Manzi wrote a book titled Uncontrolled: The Surprising Payoff of Trial-and-Error for Business, Politics, and Society that covers the same issues at greater length.
Your statement: "He asked me if as a parent I would want to see my child used in an experiment, as if this was an argument against experimentation. My jaw dropped." does say what is wrong with almost all the social science / eduction areas of academia and government. They don't understand the scientific method or scientific thinking. The damage done by this "feels correct" and "feels good" or "I believe" type belief systems is huge. Show me the data.
Being the victim of "whole word learning" displacing phonics as a reading/learning method in the 40's and 50's I ended up not being able to spell and read almost nothing. After sputnik from the USSR went into orbit, my understand of math and physical reality got me into UCLA. I am now more functional with spell-check, but that is long past my prime productivity. Without my wife as an editor, I don't think I would have been able to finished writing my thesis.
re: “less government money should go to fund fee-for-service medicine”
Unfortunately, this might be construed as “Eliminate Medicare benefits and leave the old people out on the ice floe with 1970s health technology.” And one might be forgiven for wondering how much traction proposals for Social Security cuts and eliminating Medicare benefits would get if eliminating lavish defined benefit retirement and fee-for-service federal civil service health plans and fee-for-service benefits for retired military officers were also part of the package. Remembering back to the Hillary Care proposal which would have originally incorporated the bureaucrats’ health plan, one suspects that once again the patriciate would circle the wagons and protect their own. A good trust building exercise for entitlement reform would be to test it out on the special programs that operate for the benefit of the feds first, before attempting it on the masses.
Interestingly, MetaMed in which Peter Thiel invested a half million, appeared to employ a Deming-style approach to medicine:
“MetaMed provides high net-worth individuals with access to its team of doctors who dig deep into patient history, metabolism, genomic variation, results from companies like 23andme, and other research to deliver a full medical report.”
And they recognized that not all health problems are the individual patient’s fault:
“He cites some terrifying statistics from recent reports to highlight the extent of the problem they are trying to solve: Over 30 percent of fatal illnesses are missed during diagnosis, doctors only spent an average of 11 minutes with patients during primary care visits — and this figure hasn’t changed since the 1930s — and cancer death rates have decreased by less than 5 percent over the past 40 years.”
(https://venturebeat.com/business/peter-thiel-backed-metamed-brings-personalized-health-care-to-the-1-percent/ ) But MetaMed went defunct in 2015. But it does seem to illustrate that there may be plenty of room for improvement for both patients and providers.
The rap against obesity in the USA may be somewhat overstated:
“While it's easy to assume that the easy availability of rich, decadent foods in the world's wealthiest and most developed countries would make them the most obese, this isn't always the case. The United States and the United Kingdom are two of the most economically rich and developed countries globally. However, they'd place 18th and 48th respectively when ranked by BMI, and 123rd and 95th when ranked by percentage of obese adults.”
(https://worldpopulationreview.com/country-rankings/most-obese-countries ) Which kind of makes you wonder about why such a big difference between BMI and percent obese?
It would have been interesting if MetaMed had succeeded. Finding a way to incorporate what seems to be massive new amounts of information on genetic causes of diseases (https://www.nejm.org/doi/full/10.1056/NEJMp2030694 ) to the improvement of health would be a marvelous thing. And even if the “democracy is incompatible with freedom” ideology got in the way, there are other similar potential avenues for broad improvements. For example if the Galleri cancer screen gains FDA approval (https://health.clevelandclinic.org/the-galleri-test/ ) we might see significant improvements to both control costs as well as improve a wide variety of cancer survival rates.
Tampering is an experiment in progress. A well designed "tamper" and well designed outcome could move the needle to better whatever.
So let's tamper and see if the things you are investigating has a better out come. The ?? is: better for who!