The black helicopters are circling. The federal government is orchestrating a sneak attack to take away our liberties, and if we don’t roll out the heavy artillery to halt this subversion in its tracks, we lose our sovereignty. The campaign is on in state capitols, Ohio included, and in Congress to stop the assault … by the federal Department of Education.

And what is the vehicle of this federal subversion? The Common Core State Standards initiative.

Yes, now at the center of a gathering political storm is the reform program that the bipartisan National Governors Association and the Council of Chief State Schools Officers have worked on for at least seven years to beef up curriculum content and testing.

Granted, the rhetoric to save our education freedom hasn’t reached the fever pitch that health-care reform evokes (nothing ever will, I suspect), but it is early yet, and the conservative and tea-party groups leading the charge are just warming up, expressing their grave concerns about a federal takeover of parental control, state control, local control, data control, mind control ….

John Becker, for one, is quite unhappy. The Columbus Dispatch reported last week the state lawmaker is concerned “that source material under Common Core could require reading Environmental Protection Agency manuals, Greenpeace writings and allow for ‘liberal, socialist indoctrination of our children.’ ”

Opponents of the Common Core have swung into action. What they see are bureaucrats and Big Business in cahoots to dumb down elementary and secondary education and make zombies of students with ceaseless testing. As part evidence of the feds trying to slip one past the citizenry, they lament that parents are mostly unaware of the changes in store.

The lack of awareness I can believe. Most people have enough on their plates with their own problems as it is. To expect them to monitor capitol agendas may be asking too much. But a federal agenda to take over education?

First, the Common Core did not begin with the federal government or with President Obama and Arne Duncan, his education secretary. The drive to raise content standards and develop more accurate ways of assessing what students know and can do began in the mid-2000s with Republican and Democratic governors seeking best practices in education. It evolved in response to business leaders’ complaints about the declining quality of American schools and the graduates they produce. It also was an effort to address comparisons that indicate American students perform at academic levels below many of their foreign counterparts.

Ultimately, the Common Core is supposed to produce students who graduate from high school equipped to make it in college or a career. How subversive is that? The idea of the Common Core program is to ensure that students — no matter where in this country they study — receive a common base of knowledge and skills of a quality that can be vouched for anywhere in the country (and in the world, for that matter). If that is “nationalizing” education, I am all for it. In a highly mobile world, the education you get in Akron or Mogadore better match the standards in play in Boston, Helsinki or Shanghai.

Also, Ohio was not coerced into signing up for the Common Core, having been an early participant in the reform process from the start and a member of the consortium of more than 20 states, the Partnership for Assessment of Readiness for College and Careers, that is developing the assessments for the program.

The Obama administration has pumped millions of dollars to help implement the program. It favored the standards in making Race to the Top grants — rightly so, in my view, as the effort coincides with its educational priorities. Participation in the Common Core and in the grant competition is optional. The State Board of Education voted in 2010 to implement the program starting in 2014.

Are there serious issues to be raised about the Common Core? Plenty. Begin with the intense debate we have had over the fairness and frequency of standardized testing since No Child Left Behind went into effect. Then move to the training and technical challenges of scaling up the hardware for exclusively online testing, which is the way of the future.

The response to these real challenges is to seek solutions that enhance the program and its goals, not use a false pretext of federal interference to kill it. State Rep. Gerald Stebelton, the Republican chair of the Ohio House Education Committee, has been forthright he will resist, “kicking and screaming,” any effort to rescind the Common Core. I couldn’t agree more with him.

Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or be email at lofobike@thebeaconjournal.com.

In effect, what we wind up with in terms of health-care policies depends on the strength and relevance of research on the outcomes of existing policies. It is little wonder then that a research project in Oregon is attracting so much attention with regard to the debate on Medicaid expansion here and across the country.

Oregon several years ago sharply cut back its Medicaid program. Then it discovered in 2008 that it had enough money to cover 10,000 more people. Some 90,000 applied, so the state picked 10,000 by lottery. It also initiated a long-term study to track and compare health-care usage and outcomes for the lottery winners and those who remained uninsured. By force of circumstance, the Oregon Health Study thus became a national first — a large-scale, randomized controlled test of what impact Medicaid access has on recipients.

The first survey report was released last August. The newly insured on Medicaid reported themselves healthier. They were more likely to have and visit a regular doctor. They also were more likely to get cholesterol screening and mammograms.

As interesting — and hardly a surprise with health-care expenses reduced — the newly insured felt more financially secure, were less likely to borrow money or skip paying medical and other bills.

Last week, the findings from the second year of tracking were released. Coming as it does in the heat of national debate on Medicaid expansion, the Oregon study likely will receive more than passing reference in the months ahead.

The second set of findings reinforced the first-year findings. People felt healthier. The financial advantages to beneficiaries also appeared stronger: Having insurance practically eliminated catastrophic medical expenses and reduced financial stresses, such as borrowing for or evading medical payments, by more than 50 percent. Observed rates of depression declined by 30 percent.

Also, the use of health services went up — more doctor visits, prescriptions, hospitalizations and preventive services. The probability increased that beneficiaries would get cholesterol and mammogram screenings and diagnosis of depression and diabetes. All came at added cost of about 35 percent.

What the study did not find are significant differences in chronic conditions such as hypertension and high cholesterol rates between the insured group and uninsured control group.

The Oregon study adds to the body of hard data on the place of Medicaid as the nation struggles to provide affordable health insurance and high-quality care to as many citizens as possible. For one, screenings and diagnoses of potentially serious chronic conditions went up, suggesting the message of preventive care has gotten through. Whether the care after diagnosis is effective is a different question.

The lack of difference in hypertension and cholesterol rates between the Medicaid and control groups thus raises intriguing questions: Would there be a significant difference if hypertensive Medicaid patients were compared to privately insured hypertensive patients? Could it be that the quality of care and education about certain chronic diseases, hypertension in this case, is not as effective as it should be?

Millions of Americans are covered by Medicaid. Millions more will be depending on decisions in state capitols across the country. Only the second year in what will be a lengthy study, the Oregon experiment so far shows that given access, people do seek care in the appropriate settings and experience positive outcomes. It suggests some impacts are more immediate (financial security and reduced depression, for example), while other positive outcomes will require rethinking the way care is delivered. The reminder is that a turnaround in public health will not come overnight or be without cost.

Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at lofobike@thebeaconjournal.com.

If the recent dustup over Medicaid expansion in the Ohio Statehouse is anything to go by, three years have not dulled the passions stirred by health reform. As controversies go, the Medicaid debate has provided a useful reminder that “health reform,” whether federal- or state-inspired, is far from a settled issue.

Architects of the Affordable Care Act believe they put together policy machinery whose parts must hum together if we ever are to have a system that delivers better medicine and spends less, much less, of the national wealth on health care. But even they don’t argue their work represents the last word on efficiency. Neither have they promised an overnight miracle in lower spending.

Indeed, for sobering perspective that the Affordable Care Act amounts to just the beginning of hard choices ahead, an analysis of health-spending trends released Monday by the Kaiser Family Foundation suggests that if history holds true, spending most likely will resume a more rapid climb as the economy grows stronger.

From 2008 to 2012, spending on health care grew at the lowest rate in about 50 years, at 4.2 percent a year on average, compared to 8.8 percent a year in 2001-2003. But the Kaiser analysis indicates that 77 percent of the sharp decline in growth can be attributed to a weak economy during the past several years, primarily the Great Recession and unusually low inflation.

A combination of ongoing health-policy reforms (for example, increased consumer cost-sharing, reduced payments to providers and a better managed-care system) in Medicare and Medicaid as well as in the private system account for the remaining 23 percent. The analysts also observe that historically, trends in health spending tend to lag economic changes by about six years.

Besides the central mandates, the Affordable Care Act applies a host of pilot programs, mandates and incentives, with the goal to accelerate those features that help to drive down spending. But put together the analysts’ conclusions, and the notion recedes that the legislation, at least in its early years, will sufficiently “bend the curve” on spending. In fact it sounds like we have yet to hit the rough patch on the road to a more economically sustainable health system. A system that does not consume nearly 20 percent of the national income. One that does not leave about 50 million citizens in the cold. One that offers better outcomes for everybody.

Last week brought a new report recommending ways to kick up the effort to hold down health spending. Call the authors the Gang of Four for health reform, as Washington appears to need gangs that don’t mind going out on a limb. They are Tom Daschle, a Democrat who used to be the majority leader of the Senate; Pete Domenici, a Republican who used to be chairman of the Senate Budget Committee; Bill Frist, a Republican who was majority leader of the Senate; and Alice Rivlin, an economist who was a founding director of the Congressional Budget Office.

Together, they lead the Health Care Cost Containment Initiative of the Bipartisan Policy Center. They hope to launch a “respectful dialogue” around recommendations they hope break the pattern of “disjointed efforts” that have led to the false suggestion that “we must choose between investments in health care and fiscal health.” The report, “A Bipartisan Rx for Patient-Centered Care and System-Wide Cost Containment,” can be accessed at the center’s website, bipartisanpolicy.org.

The reality that we have barely started fixing the creaky system raises some troubling questions: What does the bitter residue of the recent effort at systemwide reform bode for continuing the discussion? Are we capable anymore of “reasoned negotiation” and respectful dialogue in health care?

Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at lofobike@thebeaconjournal.com.

Granted, the state budget for 2014 and 2015 is a long way from complete, but whether Ohio ends up with a funding system that matches the Statehouse rhetoric about all-around success remains as uncertain as it has been in the past four years.

The continuing numbers game is deeply disappointing in its familiarity. But there is something else only slightly less disappointing in the way the budget-making is shaping up.

Both Kasich and House leaders have played an expectations game, building up anticipation that this time around, things will be different; that they will put schools on firmer footing, providing them adequate means to shine or be hammered for failure.

A newly elected Gov. Kasich in 2011 summarily dumped his predecessor’s funding plan as worthless, suggesting a new model would soon be forthcoming. Meanwhile, a temporary “bridge formula” kept schools in operation. A year passed with no new model in sight. As StateImpact Ohio reported, Rob Nichols, the governor’s spokesman, offered to share some ideas “once we have it right.” Ron Amstutz, chairman of the House Finance and Appropriations Committee and a veteran of a few school-funding battles, interpreted the official-speak at the time: “I think they have discovered that this is not something they can move on as quickly as they had hoped.”

True enough — and a point legislators hope you will keep in mind. As Gerald Stebelton, who heads the House Education Committee, explained last week, it is “really, really difficult” to craft a single formula “when you have 612 school districts and so many different demographics.”

True again, but who said it was going to be easy? We have been at this since 1997.

The Kasich replacement model eventually arrived last month. A good thing is well worth the wait, the saying goes. Fair enough. The trouble is, few people agree the Achievement Everywhere plan got it right, after all.

The House Republican leaders certainly didn’t. They just neutered that long-awaited plan.

For one, the Kasich plan practically wished away a central issue that has driven litigation and Ohio school-budget policies since 1991: How much does it cost to educate a typical student in Ohio and what share of it should be the state’s responsibility?

The response from the Kasich team? “We are not attempting to define, or even propose that we can know, as a state, the correct spending amount that ensures every student in every district will receive just the right amount of teaching and learning for success upon leaving our elementary and secondary schools. …”

But as a state, we do expect every district to achieve a level of success with every student. We do expect from every student the right amount of learning to succeed upon leaving our schools. We are scoring districts for success on performance indicators, achievement gaps and such. We set penalties for lack of success. We demand accountability, threatening schools with closings and educators with firings. Do we do all these without knowing, or attempting to know, and pay for the minimum districts require to achieve the results?

For their part in the expectations game, leaders of the House signaled last year the funding system is fixable. In the spring and summer, with the governor’s plan still a mystery, Amstutz’s committee held a series of meetings and hearings in Columbus and around the state “to promote a shared understanding of the basics of school funding.”

An admirable endeavor, no doubt, that refreshed memories about the many false starts during the past 15 years in funding reform. Still, with all that understanding, the House delivered a plan last week that harks back to a different school-funding basic in Ohio: It is one thing to reach a fair estimate of what schools need to succeed, and quite another to pay for it.

Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at lofobike@thebeaconjournal.com.

March marked another 10th anniversary, the opening of another hell hole of violence and human suffering.

In Darfur, in the western region of the vast and war-hardened Sudan, Arab militias with military backing from the Arab-dominated central government took on non-Arab rebel forces in a scorched-earth struggle for land and power.

In one of the poorest regions of the world, a campaign of burning by the Janjaweed, the government-enabled militia, destroyed farmlands and whole villages at a time. Year after year, hundreds of thousands of villagers lost their lands and possessions.

Those who could escaped into neighboring Chad. The majority of the dispossessed were left landless and destitute in their homeland. Tens of thousands of others lost life itself. International aid agencies raised the alarm: a genocide in progress.

In 2008, the International Criminal Court accused Sudan’s President Omar al-Bashir of war crimes and crimes against humanity. In 2009, the court issued a warrant for Bashir’s arrest, its first such warrant for a sitting head of state. The court in 2010 issued a second arrest warrant, charging Bashir with genocide.

Ten years on, the casualty estimates put Darfur’s dead from the war at 300,000. Nearly 1.5 million remain internally displaced in refugee camps. Aid agencies and the United Nations, which supports a joint peacekeeping force with the African Union in the region, say the violence that captured the attention of the world is greatly diminished, though the conflict is far from over.

Peace in Darfur is still elusive. Conflicts among the rebel forces and the Arab militias have undercut efforts at a negotiated peace. And President al-Bashir goes about the business of being president without any apparent fear of arrest and trial.

In the decade since 2003, Darfur has lost its place in front-page headlines, overshadowed by other tragedies with the force of immediacy: an earthquake in Haiti; a tsunami in Japan; fires, floods and landslides; droughts and famine. Syria is tottering in a grinding civil war that is threatening a catastrophe of dead and displaced. In Iraq and Afghanistan, bombs are still ripping apart the innocent.

If we didn’t forget some things, if the raw emotions provoked by certain events and experiences did not recede over time, many of us would run a good risk of losing our minds over time. Forgetfulness offers some cover. It offers some emotional distance from the waves of natural and man-made disasters that wash over us in the course of a year … a decade …a lifetime.

But forgetfulness can also give plain evil a pass. In the past few years, I admit, Darfur has mainly slipped my mind into that zone of forgetfulness.

Refugee camps with a million-and-a-half souls don’t simply melt away. Three hundred thousand dead still whisper to the conscience: What does it mean to swear: “Never again”?

The state of Qatar brokered a peace agreement between the Bashir government and one of the Dafuri rebel groups in 2011. In a hopeful sign for Darfur’s displaced population, Qatar hosted a conference of donors this week in Doha, the capital, the purpose to build a fund for reconstruction and development to move Darfur’s battered population toward some semblance of normal life.

According to the conference reports, Qatar, among the wealthiest of the Gulf states, has pledged to contribute $500 million toward a multiyear development project to build roads, water facilities and other infrastructure that would help wean Darfur off food and other emergency assistance. For their part, Britain has promised $100 million over a three-year period to Sudan, half of the funds to be used in Darfur to improve agriculture and work training, and the European Union would chip in $35 million.

Thank heavens that in the face of so much human suffering, with aid agencies straining to finance critical humanitarian efforts, Darfur is not entirely off the international radar.

Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at lofobike@thebeaconjournal.com.

As I learned, the chemical concoctions have nothing at all to do with baths and all to do with the search for novel ways to reach nirvana.

Of course, we don’t own the search for perpetual bliss here in the United States, but the billions of dollars we spend each year as a nation treating drug addictions and fighting drug abuse (not to mention the decades of a shooting war on drugs beyond our borders) indicate clearly enough that the drug culture is extensive and nothing if not resilient. It is always several steps ahead of the best efforts to contain it, with potent new products, designer or not, promising faster relief or higher highs. Bath salts. Meth. Crack. Cocaine. Ecstasy. Heroin. …

The exasperated complaint of many who have become disillusioned by an obviously unwinnable war is that if only Americans could control the insatiable demand for brain-distorting drugs inside the country, there would be no need for the lucrative trade. Or for a war.

Yes, if only. But how to subvert the demand? Therein lies the problem.

Sit through an evening of television ads, and you begin to realize something. Follow the numbing succession of ads for pharmaceutical products and you have to ask: How can we not believe there is a drug for every condition, a cure for every pain — physical and otherwise? How can our children and teenagers not grow up expecting a remedy for anything even remotely uncomfortable?

Adults and children alike, we seem primed for a drug culture, the legal stuff no less than the illegal. From pimples to low testosterone, from vitamin deficiencies to overactive bladders, there is a pharmaceutical something that offers swift relief.

There are few of us, I am sure, who haven’t said a silent thank-you at one time or another on learning there is a medication, over the counter or by prescription, for some bothersome ailment or other. But the question is whether such ease of access, quite apart from whatever predispositions people may have, encourages a frame of mind that makes it that much easier to search for relief beyond legal offerings. To put it another way, how long a step is it from a culture of legal drugs to a culture of illegal drugs?

An article in the New York Times on Monday raised anew fears that attention deficit hyperactivity disorder, ADHD, is overdiagnosed and overtreated. Controversy over the accuracy of ADHD diagnosis and treatments is not new by any means. But striking about the article, based on new data from the Centers of Disease Control and Prevention, is the finding that the rate of diagnosis for children ages 4 through 17 has risen 53 percent in the past decade. Among children of high-school age, 19 percent of boys and 10 percent of girls have been given an ADHD diagnosis at some point. About one in 10 boys in high school is on ADHD medication.

Characterized by hyperactivity, loss of concentration and uncontrolled behavior, the disorder typically is treated with powerful prescription stimulants such as Ritalin and Adderall, medications that help accurately diagnosed patients achieve focus and balance. Sales of ADHD stimulants rose from $4 billion in 2007 to $9 billion in 2012.

The concern about the rising rate of diagnosis is that a significant percentage of children are being diagnosed improperly and prescribed medications that can promote dependency and abuse, the pressure on doctors to prescribe applied by parents and schools.

Prescription abuse and addictions among teenagers is a growing problem, which makes an observation such as the following from the article a loud wake-up call: “Because the pills can vastly improve focus and drive among those with perhaps only traces of the disorder, an ADHD diagnosis has become a popular shortcut to better grades, some experts said, with many students disregarding the medication’s health risks.”

It is a scary thought that in trying to help young children and teenagers achieve some level of normalcy, a reflex for pharmaceutical fixes may be putting tens of thousands of them on a track to dependency and abuse. For them, prescription stimulants take a place alongside bath salts, Ecstasy and whatever else promises to soften the sharp edges of life.

Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at lofobike@thebeaconjournal.com.

The governor decided, after much studying and thinking, that it would be in the state’s best interest to extend Medicaid so that Ohioans who are not insured can benefit from federal funding offered through the Affordable Care Act. To make that happen, Kasich will need the Ohio General Assembly, which is dominated in both chambers by his Republican colleagues, to approve enabling legislation.

But by conceding that something is worthwhile in anything that bears President Obama’s fingerprints, Kasich picked a fight that has some in his political camp questioning his conservative bona fides. The warmest response that has crossed the lips of House Speaker Bill Batchelder, for instance, is that some in his caucus (himself included, presumably) would have a philosophical problem going along with the expansion. The state treasurer, Josh Mandel, has informed the Statehouse leadership he is ready to mount the barricades to protect taxpayers from reckless spending and debt. Recently, the Gongwer News Service reported that disenchanted legislators plan to consult with the Heritage Foundation. And also with Texas, an interesting choice for consultation. Roughly a quarter of Texas residents lack health insurance, one of the highest rates of uninsured in the nation. Surveying the landscape of opposition, Kasich must take great comfort that Lt. Gov. Mary Taylor has not gone rogue on him as well. She has breathed so much fire for so long against all things “Obamacare” that it must be sheer agony to stand shoulder to shoulder with the governor on Medicaid expansion.

But in this brewing conflict, more than anything, it is the Medicaid program itself that appears to be on trial.

Over and over, opponents of expansion point to the cost of the current program as the first and foremost reason not to expand it further. Medicaid, they point out, is consuming an ever-larger portion of the state budget and crowding out funding for other important functions. And there is a point to that, to be sure. It is conceivable that if Ohio didn’t have to commit $19 billion this year (all funds) on health care for its poorest citizens, there might be more spending, say, on elementary education.

But the rise in the cost of Medicaid services is related to the upward spiral of health-care costs in general, a decades-long trend that still remains the impetus for national reform. If anything, Medicaid is acknowledged as a lower-cost program than either Medicare, the program for seniors, or private insurance, its structure giving states flexibility to keep costs down by setting and paying the lowest rates for services, setting eligibility requirements and benefits limits as their budgets permit and, increasingly, shifting its clients into managed-care systems.

Sure, there are arguments to raise about unfair advantage, about government relying on its reimbursement leverage to impose cost controls. But set against the overall cost growth in the health-care system, Medicaid is anything but a renegade in running up costs.

Another knock on the program that is likely to feature prominently in this fight is that the program as we know it fails as a system of care for the poor. Citing various studies, the Heritage Foundation, for example, has suggested that it is worse to have Medicaid coverage than no insurance at all. Among the damning findings, we learn that Medicaid patients lack access to the same quality of care as patients with private insurance; that they are more likely to have extended hospital stays; and are less likely to survive life-threatening conditions, such as cancers.

Medicaid is a safety-net program. It offers comprehensive health services for more than 2 million Ohioans (the majority of them children and poor mothers) who would have no means on their own of paying for care. Medicaid helps thousands more Ohioans cover the huge cost of long-term care. Medicaid also pays some of the costs for mental health services, breast and cervical cancer treatment and school health programs. Consider the totality of the program’s functions and what it can offer 594,000 more Ohioans with expansion, and it begs asking whether having Medicaid is the worst that can happen to an uninsured Ohioan.

Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at lofobike@thebeaconjournal.com.

What’s that all about?

That’s the summation of the latest federal advisory panel on primary and secondary education. Commissioned by Congress two years ago and delivered a couple of weeks ago, the report by the Equity and Excellence Commission offers some pretty harsh observations. In achievement and in the way K-12 education is funded, governed and administered, we have become “an outlier nation.” “No other developed nation has inequities nearly as deep or systemic” the report says.

“We are also an outlier nation in how many of our children are growing up in poverty. … We are also an outlier in how we concentrate those children, isolating them in certain schools … which only magnifies poverty’s impact and makes high achievement that much harder.”

Good intentions and initiatives aside, the U.S. is not serious enough yet in facing its slippage as a leader in education attainment and the challenge posed by dramatic change and competition from other countries, the panel observes. And if you think that is all hyperbole, think again, say the writers of “For Each and Every Child: A Strategy for Education Equity and Excellence.”

They draw telling contrasts with the high performers, highlighting the areas where America lags its global competitors: the widespread fiscal inequities; the diffuse governance structure and quality (50 state operations, 15,000 districts, 100,000 public schools); teacher quality and status (only 30 percent of educators recruited from the top third of college pool); and non-universal access to high-quality, early childhood preparation.

The timing of the federal report couldn’t be more appropriate as a backdrop to the budget debate heating up in Ohio’s Statehouse and school districts. The diagnoses closely echo nearly two decades of arguments in Ohio. For example, the study notes: “With few exceptions, states continue to finance public education through methods that have no demonstrable link to the cost of delivering rigorous academic standards. … Few states have rationally determined the cost of enabling all students to achieve established content and performance standards, including the cost of achieving those standards across diverse student populations and geographic locations.”

The DeRolph diagnosis writ on a national canvas? To a degree, there is some comfort that Ohio is not alone in this tank. It is no comfort, however, that as a whole the nation is yet to find answers to problems with long-term implications. The report frames one such potential impact this way: If over the next 20 years, U.S. public schools were to perform at the same level as Canada in PISA, the international math test for 15-year-olds, the improvement in our gross domestic product for the next 80 years would be “equivalent to an average 20 percent boost in income for every U.S. worker each year over his or her entire career.”

So how do we get from here to there? Besides increased federal funding (“there is no constitutional barrier to a greater federal role in financing K-12 education,” it says), the panel asks that states identify the teaching staff, programs and services needed to provide a meaningful educational opportunity to all students and to determine the actual costs of the resources based on efficient use. (Sounds like Ohio’s erstwhile experiment in building-blocks/evidence-based funding?)

The report cites as one element in a bid to improve teacher recruitmenta and professional status, market research indicating that the percentage of new teachers in the top third of the pool who would go to high-poverty schools would rise from 14 percent today to 68 percent if the range of annual teacher pay rose from roughly $37,000 to $70,000 today to $65,000 to $150,000.

“For Each and Every Child” casts a cold, unblinking eye on public education. Unfortunately, it is hard to see from whence the will will arise to turn the recommendations into reality because politically they certainly are not palatable.

Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at lofobike@thebeaconjournal.com.

At least not by the sheer weight of the legislation. (Remember when all the rage in Congress was to raise the almost-3,000-page legislation and hope the heaver didn’t topple over? Just to note: Gov. John Kasich’s new two-year budget reportedly weighs in at a respectable 4,000-plus pages. Killing Ohioans softly with his numbers, you think?)

And not unless the president has co-opted many of the nation’s medical societies, it would appear he isn’t planning to kill Americans, either, by promoting “comparative effectiveness,” studies that would identify medical practices — procedures, tests, devices, drugs and such — that are most efficient in treating illness.

Comparative effectiveness, the fiercest critics of the idea insist, is how you push Americans on the slippery slope to rationing. Bureaucrats are going to come between you and your doctor, waving their research data. They are going to decide what treatment you receive and, ultimately, who lives and who dies. Care is going to be delivered or withheld on the basis of cost, and heaven help you if your treatment is not favored under “Obamacare.”

Fear and distrust about reassessing treatments have been hyped so high, it makes suspect any effort to weed out treatments that owe their survival more to tradition than to their proven effectiveness. But as it happens, growing collaboration among medical societies and consumer organizations — occurring independently of government — is providing a politically neutral platform to address what would be realistic for us as patients to expect in the way of effective treatment from our doctors and hospitals.

Last week, 17 medical specialty associations each offered a list of tests and procedures whose routine use should be questioned. The list of 90 recommendations follows a previous list of 45 recommendations issued by nine other medical societies last April. More such recommendations are due later in the year as part of a national campaign called Choosing Wisely, involving the American Board of Internal Medicine Foundation, numerous medical associations that represent roughly a half-million members, Consumer Reports and consumer advocacy groups.

The partners in Choosing Wisely hope that based on credible evidence, patients and their doctors will be able to hold conversations on which treatments are really necessary, which ones duplicate others with little value added and which ones are likely to cause more harm than good. All this dialoguing, they hope, would lead to “the most effective use of health care resources.”

Among items on the various lists: The American Academy of Pediatrics suggests using CT scans much less often during emergency room visits to evaluate children with minor head injuries. The academy recommends instead clinical observation as a first and effective approach, pointing out the lifetime risks of cancer from X-ray exposure for children. Children younger than 4 years should not be given cough and cold medications for respiratory problems. Why not? Because they offer little benefit and potentially serious side effects, including the risk of accidental overdose.

The American Urological Association’s don’ts include routine bone scans for men with low-risk prostate cancer and testosterone prescriptions for men with erectile dysfunction who have normal testosterone levels.

The American College of Obstetricians and Gynecologists thinks it is not a good idea to induce labor or schedule an elective Caesarean delivery before 39 weeks of gestation unless there is a very good medical reason to do so. Same goes for elective inducements between 39 and 41 weeks. Don’t prescribe antipsychotic drugs as the first option for elderly dementia patients with behavior issues, counsels the American Geriatric Society. The drugs have limited effect, and the potential harms include strokes and premature death.

The premise of Choosing Widely is that good information, presented in language that the average layman can grasp, will lead to intelligent conversation and good decisions about appropriate treatment. The project is appealing as an ongoing exercise in determining what is worth the money in medical care.

It is especially appealing because when the recommendations come from practictioners themselves, it helps to strip a sensitive discussion of the toxic exaggerations so often the currency of the political arena.

Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at lofobike@the beaconjournal.com