David Reynolds: Births and boards

Column by David Reynolds
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“We held on as long as we could,” was the announcement. It came as no surprise. There were numerous warnings to soften this latest blow to our proud past. Still no one was happy. Parents, particularly mothers, were angry. They wanted time as much as money to work the whole thing out. Maybe a year would do it. After all, we spent millions fixing up the place. And why do those bean counters from out of town keep making our decisions?

And so it goes. And so it closed down. What are we talking about? Not classrooms at two rural schools fighting for their lives. No, the above followed an opening quote by Dr. Thomas McNamara, the president of Carilion’s Stonewall Jackson Hospital – a place where in 15 days life will no longer begin.

Yet “Holding on” seems to be in the job description of every school superintendent, every school board and, yes, virtually every county board of supervisors and city council.

Hospitals and schools cannot survive without customers. The two are linked to a single generation. Schools are desperate for young customers; hospitals avoid them. However, both are now considered businesses. Education and medicine are being forced to lower their unit costs.

But isn’t that what you and I have been demanding all along? Whether as a taxpayer or a patient? Well, not really. It all depends. It depends on where that hospital or school is located. We like them in our back yard – even when they are inefficient operations. No NIMBY demands for these quiet zone businesses.

Still we have a beef. We don’t like how America is changing. We stayed or moved here because we thought that we could avoid or escape change. Sorry. Read the 2010 Census when it is published next year. It won’t be pleasant reading. Paradise has been surrounded. And circling the wagons no longer seems to help.

What will those government figures tell us? Our manufacturing base, here and everywhere, continues to decline. We are not making babies.

The data will also reveal that we live in an age of specialization. Expecting parents are no longer satisfied with midwife deliveries or those performed by state troopers on I-64. They want the safety and assurance that comes from specialized medicine. They want the latest neonatal intensive care nurseries. They want doctors who don’t branch out into other fields. They want peace of mind, practices where there are five other ob-gyn M.D.s to back up their own doctor.

Similarly with students fortunate to have parents who favor special programs over keeping Johnny close to home. What was once taught at the high school level is now standard instruction in the lower grades. That is how one kid can beat another kid. It is now called a “Race to the Top,” not to be confused with “No Child Left Behind,” or “Head Start.” Who in Washington dreams up these titles?

By now, after spending trillions of dollars, we should have learned that a better education is not necessarily a more expensive one. Of course, the teacher unions can not afford to learn this lesson. But those who home school or attend a parochial or charter school know. They are the ones racing to the top.

So what went wrong, both at the hospital and at school? (Plus, of course, Wall Street.) Plenty. However, here is a better question: Why did it go wrong? The Answer: Boards.

While Carilion did not have to contend with any internal board battles, the decision was made when Dr. Murphy in Roanoke looked at the numbers and told Dr. McNamara in his Lexington satellite to shut it down, close the CSJH birthing suite by April 30. Delivering babies is not making us any money.

That is certainly one way to cut health-care costs – the way Washington has wrought – by the numbers, from top down.

Or maybe it was our community hospital board that messed up years ago when it voted to go south instead of north. It decided that Carilion of Roanoke, where spreadsheets are as important as bed sheets, should be the one to stem the flow of red ink, not Augusta Health in Fishersville.

As for those other boards, local school boards, a much larger question can be raised: Do we need them? Consider this: What if the U. S. Congress or Virginia’s General Assembly had a board who submitted annual money requests equal for roughly half of their total budgets – without any responsibility to consider competing demands on the other half and without any responsibility to balance a budget!

Between 2001 and 2007 Virginia’s student enrollment grew by 5 percent, yet its teacher corps grew by 21 percent. This is the type of mischief local school boards bestow on governing officials every spring. Why not change their advocate role to a truly positive one? Have school boards become funnels through which parents and legal guardians express their thoughts and concerns. Such a key role – enhancing parental involvement – pays bigger dividends than fighting for more dollars and teachers. As they say in baseball, you can look it up.


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