Minding Our Health: The Nudge, Part Two

Reposted with permission from Wrench in the Gears.

Center for Health Incentives

The topic of the hearing was reducing healthcare expenditures on chronic illness, which they claimed would amount of hundreds of billions of dollars in “savings.” Given the amount of money on the table, it seems clear this sector is ripe for outsourced, outcomes-based contracts that will deploy emerging technologies like health care wearables. Six measures of good health were identified during testimony: blood pressure, cholesterol level, body mass index, blood sugar, smoking status and either the ability to meet the physical requirements of your job (or on this one the Cleveland Clinic person said unmanaged stress.)

This piece expands upon my prior post about digital nudging and behavioral economics. Disruption in the healthcare industry mirrors the ed-tech takeover that is well underway in public education. If you explore the webpage for Catalyst, the innovation PR outlet for the New England Journal of Medicine (remember, social impact policy makers and many investors are based in Boston), you’ll notice the language being used to direct health care providers towards big-data, tech-centered solutions is eerily similar to the language being used on educators and school administrators.

The FCC’s “Connecting America: The National Broadband Plan” of 2010 outlined seven “national purposes” for broadband expansion. Healthcare and education were the first two topics covered in that report. Both chapters focus on “unlocking the value of data.” Who will the big winners be as we further digitize our lives? My assessment is the telecommunications industry and national security/police state will come out on top. Locally, Comcast and Verizon are key players with interests in both sectors.

Education and healthcare fall under the purview of Lamar Alexander’s Senate HELP (health, education, labor and pensions) Committee, so the similarities in tactics shouldn’t come as a surprise. In researching the $100 million federal Social Impact Partnerships Pay for Results Act (SIPPRA) launch I attended in Washington, DC last month, I noticed one of the Republican Senators who presented, Todd Young of Indiana, had attended the Booth School of Business MBA program at the University of Chicago. Recent Nobel Prize winner in behavioral economics Richard Thaler teaches there, and I was curious to see if Thaler’s thinking had influenced Young. Interactive version of Young’s map here.

I located C-SPAN coverage of a Senate hearing on healthy lifestyle choices, which Young participated in on October 19, 2017 (transcript follows). Lamar Alexander and ranking member Patty Murray, who inserted Pay for Success provisions into ESSA, chaired that hearing. Behavioral economics was discussed extensively. Young’s remarks start at timestamp 34:00.

https://www.c-span.org/video/standalone/?435978-1/senate-panel-explores-healthy-lifestyle-choices

The topic of the hearing was reducing healthcare expenditures on chronic illness, which they claimed would amount of hundreds of billions of dollars in “savings.” Given the amount of money on the table, it seems clear this sector is ripe for outsourced, outcomes-based contracts that will deploy emerging technologies like health care wearables. Six measures of good health were identified during testimony: blood pressure, cholesterol level, body mass index, blood sugar, smoking status and either the ability to meet the physical requirements of your job (or on this one the Cleveland Clinic person said unmanaged stress.)

The claim was that if an insured person met four of the six measures, saw a doctor regularly, and had their vaccinations up to date they would avoid chronic illness 80% of the time. Of course the conversation was entirely structured around individual “choice” rather than economic and racial systems that make it difficult for people to maintain a healthy lifestyle.

This neoliberal approach presumes people have free time for regular exercise, not considering they may be cobbling together several gigs to make ends meet. It presumes the availability of healthy food choices, when many black and brown communities are food deserts with limited access to fresh produce. It presumes the stress in people’s lives can be managed through medicalized interventions and does not address root causes of stress in communities steeped in trauma. It presumes ready access to a primary care physician in one’s community.

It is a gross simplification to push responsibility for chronic health conditions solely onto the individual, giving a free pass to social systems designed to harm large subsets of our communities. By adopting a data-driven approach to health outcomes, as would seem to be the case with the above six measures (check a box health), the federal government and health care systems appear to be setting health care consumers up to become vehicles for data generation in ways that are very much like what is happening to public education students forced to access instruction via digital devices. Imagine standards-based grading, but with health measures.

The people who provided testimony at the October 19 hearing included Steve Byrd, former CEO of Safeway, now at Byrd Health; Michael Roizen of the Cleveland Clinic; David Asch Director of the Wharton School’s Center for Health Care Innovation; and Jennifer Mathis of the Baselon Center for Mental Health Law and representing the Consortium for Citizens with Disabilities. Mathis was the only one who testified strongly on behalf of the rights of the insured to withhold personal information and was very concerned about the discriminatory nature of incentivized medical insurance programs, particular with regards to people with disabilities.

In his testimony, David Asch, director of the Center for Healthcare Innovation based in the University of Pennsylvania’s Wharton Business School, described effective designs for health incentive programs, noting that concerns about losing money were more effective from the insurer’s point of view that interest in receiving financial rewards. For that reason Asch said taking away money from someone should be considered before offering a reward. Asch also noted that effective programs included emotional engagement, frequent rewards (tweaked to people’s psychological foibles to they didn’t have to be too large), contests and social norming, including the use of public leader boards.

The date of the hearing is interesting, because right around the same time, public employees (including the teachers) of West Virginia were facing dramatic changes to their insurance plans. These changes included compulsory participation in Go365 an app-based health incentive program that imposed completion of intrusive surveys, wearing a fit bit (if you didn’t there was a $25 fee imposed each month), and meeting a certain step count per day. I include a transcription of testimony from one of these teachers, Brandon Wolford, given at this spring’s Labor Notes conference at the end of this post.

The incorporation of mHealth (mobile health) technologies is a key element of the healthcare disruption process. Increasingly, wearable technologies will transmit real-time data, surveilling the bodies of the insured. mHealth solutions are being built into healthcare protocols, so private investors will be able to track which treatments offer “high-value care.” The use of wearables and health apps also permits corporate health systems to insert digital “nudges” derived from calculated behavioral economic design, into the care provided, and monitor which patients comply, and which do not.

At the moment, the tech industry is working intently to integrate Blockchain technology and Internet of Things sensors like fit bits and health apps on smartphones. Many anticipate Blockchain will become a tool for securing IoT transmissions, enabling the creation of comprehensive and supposedly immutable health data logs, which could be key to mHealth expansion. Last summer the Medical Society of Delaware, a state that touts itself as a Blockchain innovator, announced a partnership with Symbiont, to develop healthcare records on Blockchain. Symbiont’s website claims it is the “market-leading smart contracts platform for institutional applications of Blockchain technology.” The company’s initial seed round of funding took place in 2014 with a second round raising an additional $15 million in May 2017 according to their Crunchbase profile.

The July/August 2018 issue of the Pennsylvania Gazette, the alumni magazine for the University of Pennsylvania, features Blockchain as its cover story, “Blockchain Fever.” The extensive article outlines use cases being considered for Blockchain deployment, including plans by a recent Wharton graduate to develop an application that would certify interactions between healthcare agencies and Medicare/Medicaid recipients for reimbursement. The University of Pennsylvania Health System is deep into innovative technologies. David Asch, director of Penn’s Center for Health Innovation, testified at the October 2017 hearing. The Penn Medicine integrated health system was created in 2001 by former UPenn president Judith Rodin in collaboration with Comcast Executive David Cohen. Rodin went on to head the Rockefeller Foundation, and in the years that followed the foundation spearheaded the creation of the Global Impact Investment Network. GIIN fostered growth of the social impact investing sector, at the same time healthcare began to transition away from a pay-for-service reimbursement towards a value-based model predicated on outcomes met.

Below is a relationship map showing the University of Pennsylvania’s involvement in “innovative” healthcare delivery, which I believe stems from Rodin and Cohen’s connections to Comcast. It is important to note that the Center for Health Innovations claims to have the first “nudge unit” embedded within a health system. Asch is an employee of Wharton, and Wharton is leading initiatives in people analytics, behavior change via tech, and Blockchain technologies. Interactive version of the map here.

New types of employer-based health insurance systems have started to emerge over the past six months. Based on this New York Times article, it seems employees of Amazon, JPMorgan and Berkshire Hathaway will have a front row seat as these technological manipulations unfold. Last fall Sidewalk Labs, the “smart cities” initiative of Alphabet (parent company of Google), announced an expansion into managed healthcare. City Block(read Blockchain) will tackle “urban health” and populations with “complex health needs.”

Reading between the lines, it appears Alphabet aims to use poor black and brown communities that have experienced generations of trauma as profit centers. Structural racism has created a massive build up of negative health outcomes over generations. Now, with innovative financial and technological infrastructures being rapidly put into place, these communities are highly vulnerable. Ever wonder why ACES (Adverse Childhood Experiences) has scores? I expect those numbers are about to be fed into predictive profiles guiding social investment impact metrics.

How convenient that the “smart city” solutions Sidewalk Labs is likely to promote will come with IoT sensors embedded in public spaces. How convenient that healthcare accelerators are developing emerging technologies to track patient compliance down to IoT enabled pill bottle caps; sensors that allow corporate and government interests to track a person’s actions with precision, while assessing their health metrics in excruciatingly profitable detail. Technology platforms are central to City Block’s healthcare program. Many services will take place online, including behavioral health interventions, with the aim of consolidating as much data as possible to build predictive profiles of individuals and facilitate the evaluation of impact investing deals.

Interesting aside, I have two friends who had emergency room visits at Jefferson Hospital this summer and were “seen” by doctors on a screen with an in-room facilitator wielding a camera for examination purposes. This is in a major East Coast city served by numerous research hospitals. Philadelphia is not Alaska. Where is that data going? Where were those doctors anyway?

As these surveillance technologies move full steam ahead, it would be wise for progressive voices invested in the “healthcare for all” conversation to begin considering strategies to address the serious ethical concerns surrounding wearable technologies, tele-health / tele-therapy, and value-based patient healthcare contracting. If guardrails are not put in place that guarantee humane delivery of care without data profiling, the medical establishment may very well be hijacked by global fin-tech interests.

As someone who values the essence of the platform put forward by Alexandria Ocasio Cortez, I worry supporters may not understand that several key elements of her platform have already been identified as growth sectors for Pay for Success. If public education, healthcare, housing and justice reform are channeled by global financial interests into outsourced-based contracts tied to Internet of Things tracking, we will end up in an even worse place than we are now. So, if you care about progressive causes, please, please get up to speed on these technological developments. You can be sure ALEC already has, and remember that Alibaba (Sesame Credit) joined in December. It’s not too much of a stretch to imagine patient rating systems regulating healthcare access down the road if we’re not careful.

Senator Todd Young was the first person to respond to witness testimony during the hearing, and his line of questioning revealed he is a strong advocate of Thaler’s “nudge” strategies. The “nudge” is a key feature of “what works” “Moneyball” government that deploys austerity to push outsourcing and data-driven “solutions” that embrace digital platforms that will gather the data required prove “impact” and reap financial returns. See this related post from fellow researcher Carolyn Leith “A Close Reading of Moneyball for Government and Why You Should Be Worried.”

Young asked David Asch of Wharton’s Center for Innovative Health, what employers could learn from behavioral economists? He also posed several specific suggestions that would scale such programs within the federal government namely: embedding units charged with experimenting with behavioral economics into federal government programs; developing a clearinghouse of best practices; and bringing in behavioral scientists into the Congressional Budget Office.

Asch, a doctor employed by the Wharton Business School, runs UPenn’s Center for Health Care Innovation created in 2011 to test and implement “new strategies to reimagine health care delivery for dramatically better VALUE and patient OUTCOMES” (emphasis added). The 28,000-foot facility houses simulation learning labs and an accelerator where research on use of “smart” hospital systems, social media, and emerging technologies in healthcare is conducted. The accelerator aims to rapidly prototype and scale “high impact solutions,” read Pay for Success.

Besides the Acceleration Lab, the Center also contains the Nudge Unit, which according to their website is the world’s first behavioral design team embedded within a health system. The goal of the unit is to “steer medical decision making towards HIGHER VALUE and improved patient outcomes (emphasis added).” Sample healthcare nudges include embedded prompts in digital platforms (for screenings), changing default settings (to generic prescriptions), framing information provided to clinicians (not sure what this means), and framing financial incentives as a loss.

This is longer than intended and hopefully provides some food for thought. This life datifying impact investing machine we are up against isn’t just coming for public education; it’s coming for ALL human service. We need to begin to understand the depth and breadth of this threat. I’m still mulling over a lot of this myself, and my knowledge base in healthcare is much shallower than my expertise in education. I’d love to hear what folks think in the comments or if you know of others writing on blockchain and IoT in medicine with a critical lens send me some links. Below are transcripts from West Virginia teacher Brandon Wolford about Go365 followed by the Senator Young / David Asch hearing exchange.

-Alison McDowell

Go365 Transcript

Brandon Wolford, West Virginia Teacher: When I first began teaching in 2012 the insurance, in my opinion, was excellent, because I had worked for one year in Kentucky and I had known that the premiums were, although they were being paid five to seven thousand more than we were, they still had to pay much more for their insurance. So it balanced out. However, after the first year or two I was there, that was when they started coming after us with the tax on our insurance. First of all the premiums, we started to see slight increases for one, and another was they started to enforce this “Healthy Tomorrows” policy.

So, the next thing you know, we get a paper in the mail that says, you know, you have go to the doctor by such and such a date. It must be reported. Your blood glucose levels must be at a certain amount. Your waist size must be a certain amount, and if it is not, if you don’t meet all of these stipulations then you get a $500 penalty on your out-of-pocket deductible. So, luckily for me, I eat everything I want, but I was healthy. My wife on the other hand, who eats much better than I do, salads at every meal, has high cholesterol, so she gets that $500 slapped on her just like that.

Okay so, that was how they started out. In the mean time, we have been filling these out for a year or two, and they keep saying you know you have to go back each year and be checked. And then comes the event that awoke the sleeping giants. The PEIA Board, which is the Public Employee Insurance Agency that represents the state of West Virginia, they, um it’s just a board of four to five individuals that are appointed by the governor, they are not elected. They have no one they answer to; they just come up with these things on their own.

So they come to us and they say we’re raising your premiums. This was somewhere between November and December of last year. We’re raising your premiums. You’re going to need to be enrolled in a program called Go365, which means that you have to wear a fit bit, as well record all of your steps. You have to check in with them, and it included private questions like how much sexual activity do you perform, and is it vigorous? All of these things that they wanted us to report on our personal lives, and that was all included. In addition to that we had to report all of those things, and if we refused to wear that fit bit and record all of our steps, or if we didn’t make our steps, we were going to be charged an additional $25 per month.

So, when everyone sees this along with the increased premiums, then they’ve also introduced a couple more bills to go along with that, because the PEIA Board, they have the final say. Whatever they do, it’s not voted upon by the legislature. It’s basically just law, once they decide it. But in the meantime our legislature was presenting these bills. We were currently on a plan of sixty, uh excuse me, eighty/twenty we were paying out of pocket. Well, they had proposed a bill that would double that and make us pay sixty/forty.

So, they presented that along with charter school bills and a couple of other things that were just direct attacks on us. We had been going by a process of seniority for several years; and they also introduced a bill to eliminate seniority to where it was up to the superintendent whether or not you got to stay in your position. It was up to the principal and regardless if you were there thirty years or you were there for your first or your second year…they were trying to tell us you know, it’s just up to your principal to decide. The superintendent decides. They don’t want you to go, you’ve been there for thirty years and you have a masters degree plus forty-five hours, you’re gone. It’s up to them. Your seniority no longer matters. So those things combined with the insurance is actually what got things going in our state.

Excerpted Testimony Healthy Lifestyle Choices, Senate HELP Committee 10/19/17

Lamar Alexander: We’ll now have a round of five-minute questions. We’ll start with Senator Young.

Senator Todd Young: Thank you Chairman. I’m very excited about this hearing, because I know a number of our witnesses have discussed in their testimonies behavioral economics and behavioral decision-making. I think it’s really important that we as policy makers incorporate how people really behave. Not according to an economist per se, or according to other policy experts, but based on observed behaviors. Often times we behave in ways that we don’t intend to. It leads us to results that we don’t want to end up in.

So, Mr. Asch, I’ll start with you, with your expertise in this area. You’ve indicated behavioral economics is being used to help doctors and patients make better decisions and you see opportunities for employers to help Americans change their behaviors in ways they want from tobacco mitigation to losing weight to managing blood pressure and you indicate those changes are much less likely to come from typical premium-based financial incentives and much more likely to come from approaches that reflect the underlying psychology of how people make decisions, encouraged by frequent rewards, emotional engagement, contests, and social acceptance and so forth. And you said in your verbal testimony you haven’t seen much of this new knowledge applied effectively by employers, but there’s no reason why it cannot be. So, my question for you sir is what might employers learn from behavioral economists. Just in summary fashion.

David Asch, Wharton Center for Health Care Innovation: Sure. Thank you senator. I think I’ll start by saying there is a misunderstanding often about behavioral economics and health. Many people believe that if you use financial incentives to change behavior you’re engaged in behavioral economics, and I would say no, that’s just economics. It becomes behavioral economic when you use an understanding of our little psychological foibles and pitfalls to sort of supercharge the incentives and make them more potent so that you don’t have to use incentives that are so large.

So I think that there are a variety of approaches that come from behavioral economics that can be applied in employment setting and elsewhere. I mentioned one, which is capitalizing on the notion that losses looms larger than gains, might be a new way to structure financial incentives in the employment setting in ways that might make it more potent and more palatable and easier for all employees to participate in programs to advance their health. The delivery of incentives more frequently for example. Or using contests or using certain kinds of social norming where it’s acceptable to show people on leader boards in contests and get people engaged in fun for their health. All of these are possibilities.

Senator Todd Young: Thank you very much. You really need to study these different phenomena individually. I think to have a sense of the growing body of work that is behavioral economics. Right, so we need the increased awareness, and I guess the education of many employers about some of these tics we have. That seems to be part of the answer. In fact, Richard Thaler who just won the Nobel Prize for his ground-breaking work in this area indicated that we as policy makers ought to have on a regular basis not just lawyers and economists at the tables where we’re drafting legislation, but ought to have a behavioral scientist as well.

And the UK, they have the Behavioral Insights Team. The United States, our previous administration, had a similar sort of team that did a number of experiments to figure out how policies would actually impact an individual’s health and wellness and a number of other things. Some of the ideas that I think we might incorporate into the government context, and tell me if any of these sort pop for you; if you think they make sense?

We need to continue to have a unit or units embedded within government that do a lot of these experiments. We need to have a clearinghouse of best practices that other employers included might draw on. This doesn’t have to be governmental, but it could certainly be. We on Capitol Hill might actually consider aside from having a Congressional budget office than an official budget office, we might have an entity or at least some presence within the CBO or individuals that understand how people would actually respond to given proposals. Do any or all of those make sense to you?

David Asch: Thank you for your remarks. Yes, I think they all make sense. And one of the lessons that I guess I have repeatedly learned is that seeming subtle differences in design can make a huge difference in how effective a program can be and how it is perceived and that will ultimately care about the impact of these programs. So, I am very much in favor in the use of these programs, but in addition, greater study of these programs, because I think we need an investment in the science that will help all of us in delivering these activities, not just in healthcare, but in other parts of society.

Senator Young: That makes sense. I am out of time. Thank you.

 

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Is Robert Dugger setting up Robin Hood to steal from the poor?

Reposted with permission from Wrench in the Gears.

Dugger - Robin Hood

Patty Murray, a democratic senator from Washington state, crossed the aisle to collaborate closely with Lamar Alexander on the Every Student Succeeds Act, which included Pay for Success provisions. She also teamed up with Paul Ryan to push bi-partisan legislation, the Foundations for Evidence-Based Policymaking act, that would greatly expand access to program data, including student-level data on the nation’s children.

More on the people behind ReadyNation’s Global Business Summit on Early Childhood, November 1-2, 2018 New York City

Who is Robert Dugger?

Robert Dugger is the co-founder of ReadyNation and serves on the board of the Council for a Strong America. He began his career as an economist with the Board of Governor’s that oversees the Federal Reserve System, later serving as a senior advisor on banking and financial policy in the US House of Representatives and the US Senate. From 1988 until 1992 Dugger worked as policy director for the American Bankers Association where he was involved with the development of the Resolution Trust Corporation in the aftermath of the savings and loan crisis. He went on to become managing director of Paul Tudor Jones’s hedge fund, Tudor Investment Corporation, a position he held from 1992 until 2009. Dugger now runs Hanover Provident Capital in Alexandria, VA, while also serving on the boards of the Virginia Early Childhood Education Foundation and as the Chair of ReadyNation.

Tudor Investment Corporation and the Robin Hood Foundation

It is important to note Dugger’s ties to Paul Tudor Jones II, his employer for fifteen years. Jones created The Robin Hood Foundation in 1998. A 2007 feature in New York Magazine, “The Emperors of Benevolence: A Dossier on the Board of Directors of the Robin Hood Foundation where everybody either knows a rock star or is rich enough to buy one,” described the “anti-poverty” foundation as “one of the most influential philanthropic organizations of all time.” Robin Hood, associated with initiatives like the Harlem children’s zone, has only grown more influential.

Paul Tudor Jones and Bill Gates Gala

During the organization’s annual gala earlier this month, over $15 million was raised in minutes as Jones, according to Bloomberg’s coverage of the event, enjoyed fennel-braised beef with Bill Gates.

New York’s first social impact bond drew a $300,000 investment from the foundation. Clearly Robin Hood could have access to almost limitless capital if Pay for Success opportunities around Pre-K open up in New York. The New York State Early Childhood Advisory Council prepared a 2012 report, “Using Pay for Success Strategies to Increase School Readiness.” The clock is ticking…

The Robin Hood Foundation has developed a sophisticated system of metrics to track the programs they fund, which means they have considerable infrastructure in place to take advantage of social impact investment opportunities. They have an exhaustive list of very specific equations aligned to education, work readiness, and health outcomes. You can review the equations here and/or watch the video summary. Thanks to blog commenter Laura Chapman for that lead.

Sara Watson and the Pew Charitable Trusts

Dugger and Heckman both served on the advisory board of The Pew Center on the States’ initiative Partnership for America’s Economic Success that launched in 2006. Dr. Sara Watson ran the program in her capacity as senior program officer for the Pew Charitable Trusts. She has conducted extensive research in the pre-k investment space, including a 2014 analysis of Pennsylvania’s Pre-K Counts in partnership with ReadyNation and America’s Edge Pennsylvania. Below is a relationship map showing the connections between Dugger/ReadyNation and Watson/Pew. Click here for the interactive version.

During her tenure at Pew, Watson regularly joined Dugger to develop reports and speak at conferences promoting the economic impact of early childhood investments. Among these were presentations in 2007 in Washington, DC supported by PNC Financial Services; in 2008 to the Milken (Michael Milken, indicted junk bond trader and founder of K12, Inc.) Institute; the National Conference of State Legislatures in Washington, DC in 2013; and a Pay for Success conference sponsored by the Pritzkers in San Diego in 2015.

Pew Charitable Trusts joined the Chicago-based MacArthur Foundation in 2011 to spearhead a “results-first” initiative. It’s useful to know that Pritzker is also based in Chicago, and 2011 was the year BEFORE the first social impact bond came to the US. The goal of their initiative was to pressure states into adopting “evidence-based” approaches to funding social programs. States that participated agreed to a year-long analysis using return on investment as a key determiner as to whether a program would be included in the budget.

In 2016 “Results-First” joined the Urban Institute, The Brookings Institution, and the American Enterprise Institute in the Evidence-Based Policy Making Collaborative funded by the pension-busting, pay-for-success promoting John and Laura Arnold Foundation. Pew and MacArthur based their cost-benefit approach on work done by the Washington State Institute for Public Policy, created by the Washington State Legislature in 1983. Sara Watson worked in Washington state in the mid-1990s as an analyst for the Family Policy Council.

Patty Murray, a democratic senator from Washington state, crossed the aisle to collaborate closely with Lamar Alexander on the Every Student Succeeds Act, which included Pay for Success provisions. She also teamed up with Paul Ryan to push bi-partisan legislation, the Foundations for Evidence-Based Policymaking act, that would greatly expand access to program data, including student-level data on the nation’s children.

Sara Watson served as Executive Vice President of America’s Promise in 2012, the year it released a study promoting the use of Pay for Success Finance for workforce development programs. Page six of the document notes that in addition to relieving pressure on state and federal budgets, early childhood social impact bonds will be able to be bought and sold by investors, traded worldwide and aggregated into asset-backed securities.

In 2014 Watson joined ReadyNation as their global program director. ReadyNation International is doing work in Romania, Uganda, and Australia. Members of their taskforce promote the investment potential of early childhood interventions to bodies including the United Nations and the World Bank. In 2016 they held an invitation-only event with representatives from Switzerland, Belgium, the Netherlands, Portugal, Italy, Romania, and the United Kingdom in Marbach Germany. The gathering promoted “business activism” in the early childhood space and featured speakers from the World Bank, KPMG, and Bain & Co. Are these the people we want making decisions about our children’s care? People who see toddlers as human capital? Their education as an investment opportunity?

Absolutely not.

As I noted in my previous post, Pay-for-Success promoters are the sort who would elect NOT to feed hungry children unless they can make a return on their investment. Dugger/ReadyNation, Jones/Robin Hood, and Watson/Pew are not organizing business leaders to SOLVE global poverty. Rather, they are organizing business people to maximize the profit that can be extracted by strategically managing poverty and the securitized debt associated with public program service delivery. Their plan is to enrich the funders and non-profits that are willing to play the data-dashboard game, at the expense of humanity.

-Alison McDowell

Previous posts about the ReadyNation Global Business Summit on Early Childhood:

Pre-K Profit: ReadyNation Hosts Global Business Leaders in New York City This November: Link

Making Childhood Pay: Arthur Rolnick, Steven Rothschild and ReadyNation: Link

Galton and Global Education Futures Forum: Scientific Racism Looking Backwards and Forwards: Link

Heckman and Pritzker Pitch Apps as Poverty “Solutions” Yielding A 13% Rate of Return: Link

The Chicago School of Economics and George Soros: New Theories for An Impoverished World: Link

Biocapitalism, Corporate Colonialism & Education Policy

Reposted with permission from Educationalchemy.

Clearcutting_in_Southern_Finland

To learn more about how biocapitalism controls bodies and minds of children via public education policy read Clayton Pierce –Education in the Age of Biocapitalism: Optimizing educational life for a flat world. Pierce explores how generations of “extractive schooling” (of which standardized testing has been a part since the birth of the Eugenics movement in the early 1900’s) and how this has begun to transform itself through “technologies of control” of which the increasing push toward computer learning, machine learning, and artificial intelligence as the mode of education delivery for all children. He concludes, “education life is ever more becoming the target of an expanding range of sophisticated technologies of control (p. 142) … calling for greater and greater degrees of regulation and discipline over the body of the students” (p. 143). This makes me wonder even more about Class Dojo and other uses of privately owned technologies to monitor the student body and mind. And the purpose of them becomes yet more evident.

In the last few years a lot of debate has been had over promise and perils of ESSA. Many education advocates argued we must embrace ESSA because it promised to reduce federal choke hold of high stakes standardized testing that was wielded starting with NCLB and ramped up further under Race to the Top. The promise of EESA seemed too good to be true. Why would the same people who devoted decades to dismantling public schools, creating avenues for defacto segregation, and privatizing a public system suddenly want to turn around and “do the right thing?” ESSA authors (Lamar Alexander) claimed that testing would take a “back seat” And it has. The argument in support of ESSA was “to restore responsibility to state and local leaders what to do about educational decisions. If a state decides to move away from Common Core, they don’t have to call Washington and ask permission—they can just do it.”

And so many supporters of democratic public education “bought in” to the hype. Exactly what ARE states deciding to do instead? Those are the details we need to examine, and it’s vital (if we are really to reclaim public spaces and democracy) that we understand that there is a global paradigmatic shift occurring beyond the scope of what we already think we know or can anticipate. We must broaden our understanding of the end-game.

In unwritten or loosely defined ways, ESSA also ushers in a host of opportunities for corporations and private entities to avail themselves of every child’s most private funds of data. See Emily Talmage. The data surveillance tactics have found their ways into what otherwise might have been meaningful community and classroom practices.

Companies and government agencies still have access to students test scores (via online daily competency based education data), despite claims of reducing end-of-year testing. ESSA may in fact be reducing the role that HST testing does play in education policy and practice. But don’t be fooled. It is not because those of us in the opt out movement “won” the battle. The powers-that-be manufactured that move as a distraction. The formulators of ESSA have created the illusion that these new policies will be what we want. The opposite is true. The new avenues of data collection formulated for ESSA, in addition to academic (test) data,  include social emotional data, measuring such things a “grit and tenacity.”  They evaluate “mindfulness.” Some might be asking the question “why?”—what is to be gained from this data collection? The answer is: A great deal if you are keeping up with the research. You know this answer– at least in part.

In part, it is because in the traditional neoliberal framework, any data means money. For example, “Silicon Valley is going all out to own America’s school computer-and-software market, projected to reach $21 billion in sales by 2020.”

Data also means knowing how to anticipate outcomes through predicative analytics, how to sort and track students as future consumers, workers, or prisoners (using 3rd grade data to build prisons goes back decades). But wait….there’s more. We need to understand what this “more” is, and why HST (as insidious as it is/was) PALES in comparison to the new data collection mechanisms and forms of data being mined, and the ways in which this data will significantly erode global democracy and human rights. This is because “a mechanism that is at the heart of biocapitalism in its ever-expanding attempts to commodify all aspects of life.” (Haraway).

The capitalist/consumer paradigm is shifting beneath our feet. With the growing capacities of new technologies, such as artificial intelligence and the push for Big Data (McKinsey),  we have seen in the last few decades the development of education policies mirroring something more (i.e. Common Core becomes CBE which becomes online learning which means more and more uses for AI and tracking student behavior because now the computers must monitor the children once the teachers are all gone)…. See a summary here. The growing technological advances are slowly forming a new relationship between human and capital. It’s called biocapitalism. And the education policies underway, invited in through the gates of ESSA and other tactics such as social impact bonds, are the way forward for biocapitalism to successfully engender us unto it. Those “innovative assessments” being developed for ESSA are a vehicle by which corporations can build a new biocapital world for all of us. In a biocapital reality, data becomes surveillance becomes total control.

Biocapitalism transforms the interdependent systems of capital and labor (as external phenomena) into a capitalist system that utilizes more abstract form of labor that are internal and intangible. The relationship between man and machine is far more enmeshed in a biocapital relationship.

One website describes it as follows:

“(T)he concept of biocapitalism refers to the production of wealth by means of knowledge and human experience, through the use of those activities, both intellectual and corporeal, that are implicit in existence itself. We might add that every process of production reflects not only material realities, but also social contexts. Thus, relations of production not only characterize different modes of production, but also societal forms. Gradually, the process of production turns into a process of production and reproduction of itself, which is the fundamental activity of a living organism. Although this basic idea is shared by all social forms of life, it becomes absolutely central in biocapitalism.”

As this article Harpers from 1997 clearly describes, “Scratch the surface of information and biotech revolutions ….and what one discovers underneath is a ‘control revolution’….a massive transfer of power from beauracries to individuals and corporations. In an unregulated control revolution free markets and consumer choice become even more dominant forces and in virtually every arena social regulation gives way to economic incentive. …even such social intangibles as privacy become commodified.”

To learn more about how biocapitalism controls bodies and minds of children via public education policy read Clayton Pierce –Education in the Age of Biocapitalism: Optimizing educational life for a flat world. Pierce explores how generations of “extractive schooling” (of which standardized testing has been a part since the birth of the Eugenics movement in the early 1900’s) and how this has begun to transform itself through “technologies of control” of which the increasing push toward computer learning, machine learning, and artificial intelligence as the mode of education delivery for all children. He concludes, “education life is ever more becoming the target of an expanding range of sophisticated technologies of control (p. 142) … calling for greater and greater degrees of regulation and discipline over the body of the students” (p. 143). This makes me wonder even more about Class Dojo and other uses of privately owned technologies to monitor the student body and mind. And the purpose of them becomes yet more evident.

So as we continue to fight yesterday’s battle, i.e for a reduction in standardized testing and believe that that’s a “win” while also ignoring the profound destruction these other education policies (see McDowell) being quietly floated under our noses are having, the effort to control the next generation (our children) will be complete. We cannot become distracted by a bait-and -switch set of tactics.  Look for the forest, not the trees. We have to see the picture for these corporate reformers is much bigger than most parents and teachers and citizens can even imagine. It explains why global billionaires and tech giants like Bill Gates and Google have such a vested interest in “disrupting” education and taking education over with “21st century technology.” Biocapitalism relies on “the use of the relational, emotional and cognitive faculties of human beings.” LINK. In a biocapitalist framework of which 21st century education is a necessary part, “what is exchanged in the labour market is no longer abstract labour (measurable in homogeneous working time), but rather subjectivity itself, in its experiential, relational, creative dimensions. To sum up, what is exchanged is the ‘potentiality’ of the subject. Whereas in the Fordist model it was easy to calculate the value of labour according to the average output and professional skills based on workers’ education and experience, in bio-capitalism the value of labour loses almost any concrete definitional criterion.” LINK

The goal is not merely to sell us all iPads or market education materials and services. The scope is greater than that, and personal data (to be gathered via educational systems sold out to private interests) will use our children’s data not simply to sort and track them by test scores, not simply to close schools in black and brown neighborhoods to profit Wall Street charter schools)….sure all of that is true….but that’s not the end game. We cannot continue to fight yesterday’s demons and expect to reclaim the rights to our schools, our children’s futures, or our democracy. First, we have to see and understand the nature of biocapitalism as an all encompassing and global phenomena and the clear pathways between the new ESSA assessments and education delivery systems and the mechanisms of control being constructed.  We have to construct systemic avenues of wholesale resistance instead piece meal compromises. We cannot afford distractions or avoidance.

The devil is in the details.

The devil is in the data.

-Morna McDermott

Is the Teaching Profession Being Downsized?

Kick Out Teachers

Original Title: The Strange Future of the Teaching Profession. Reposted with permission from Save Maine Schools – Helping You Navigate Next-Gen Ed Reform.

KnowledgeWorks, which has received upwards of 50 million dollars from the Gates Foundation and successfully lobbied Congress to include “innovative assessment zones” in the reauthorization of the Elementary and Secondary Education Act, has even prepared a menu of possible roles educators might play in this new system of public education.

In 1991, just after stepping into his new role as secretary of education, Lamar Alexander envisioned a system of public education where school districts would not have an “exclusive monopoly” to operate public schools.   Instead, a public school “could be redefined as a school that receives public funds and is “accountable to public authority,” and “could be operated by public entities such as the Smithsonian Institution, by private nonprofit organizations, or by businesses.”

Twenty-five years later, it appears that Alexander’s dream is closer than ever to becoming reality.

As billionaires like Mark Zuckerberg of Facebook, Reed Hastings of Netflix and Bill Gates of Microsoft invest millions of dollars into “personalized learning” experiments, corporate-sponsored bills are rapidly popping up across the country to move states toward competency-based education models that investors hope will allow learning to happen “anytime, anywhere.”

Organizations like the Center for the Future of Museums are now predicting the end of neighborhood schools:

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The U.S. Department of Education in collaboration with The After-School Corporation describe a system in which students are “no longer tethered to school buildings or schedules,” but are instead free to tote data backpacks from one locale to the next in pursuit of digital badges.

In Pittsburgh, the Remake Learning Network, in partnership with the MacArthur Foundation, Common Sense Media, and Digital Promise, is currently trying to turn the city into “a campus for learning.” In Salt Lake City, where StriveTogether, United Way, and Target have teamed up to build “Community Schools,” parents are being encouraged to waive their FERPA rights so that data can be shared across the city’s organizations (including the Chamber of Commerce).

Meanwhile, groups like the National Commission on Teaching and America’s Future and KnowledgeWorks are deciding how best to manage the teaching workforce in a world in which teaching is no longer an actual profession.

KnowledgeWorks, which has received upwards of 50 million dollars from the Gates Foundation and successfully lobbied Congress to include “innovative assessment zones” in the reauthorization of the Elementary and Secondary Education Act, has even prepared a menu of possible roles educators might play in this new system of public education.

Here is how KnowledgeWorks explains the impending shift:

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And here are some of the job opportunities KnowledgeWorks envisions for us:

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KnowledgeWorks has even set up a make-believe job platform site called VibrantEd to help us explore some of these future possibilities.

As strange as some of this sounds, it helps explain what Tom Carroll, president of the National Commission on Teaching and America’s Future, meant when he encouraged leaders of schools of education to get “out of the teacher preparation business,” and “into the workforce development business in partnership with school districts.”

Yes, teachers, they really do want to get rid of us.

Save Maine Schools