An inefficient, unreliable system of medical malpractice litigation is hurting doctors and patients alike, writes Dr. Al Strunk in the latest essay on America the Fixable .

Strunk argues that the legal system is responsible for lower quality of care throughout the country: “Our current medical liability system fails to provide appropriate and timely compensation to persons injured, fails to deter real negligence, and impedes efforts to correct medical errors and improve patient safety. Under the current system, medical justice is unreliable for both patients and physicians, and patient care is harmed.”

He continues: “In Southeastern Pennsylvania, 19 hospital maternity units have closed since 1997 due to medical liability concerns and costs. In Philadelphia, only the city's six teaching hospitals continue to deliver babies. Statewide, there has been a net loss of 43 hospital ob units over the last several years.”

Read Strunk’s full article here.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

In the latest entry for America the Fixable , Congressman Jim Cooper of Tennessee says we cannot return to the health care status quo, even if the health care reform law is struck down or repealed.

Congressman Cooper notes that, “I have the battle scars to prove that there are precious few plans that could conceivably pass Congress, other than the one that recently defied the odds.... Ideologues on the left and right should put their dream scenarios on hold—let's make the ACA [Affordable Care Act passed in 2010) work.” He continues: “The ACA is like an overdue software upgrade: painful but vital. Ideal operating systems do not exist and, even if they did, could not be installed in time.”

Read Cooper’s full article here.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

This week America the Fixable focuses on healthcare. Our contributors will tackle the most challenging questions about the cost and quality of care with bold solutions. Philip K. Howard, founder and chair of Common Good, introduces the issue with an essay proposing innovative ideas to fix American healthcare.

"Distrust of justice is pervasive among doctors and care providers," Howard writes. He argues on behalf of creating specialized health courts to handle medical claims: "What's needed is a system of health justice that is reliable: it must be trusted to reliably sort good care from bad care."

Howard also proposes serious reform for healthcare providers: "The way to align incentives, many experts agree, is by providing care through a single provider....Instead of being paid a fee for each service, the provider is paid a fixed annual price to do everything for the patient (with limited exceptions for catastrophic care). Instead of making more money by dialysis and amputation of limbs of patients with diabetes, the provider now has an incentive to keep the patient healthier by nudging them towards better lifestyles."

Read Philip Howard's full article here, and follow the series on fixing American healthcare.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

Education lawyer Chris Borreca argues that the Individuals with Disabilities Education Act has helped millions of children, but has also bogged down the courts and spawned a whole industry based on paranoia in a new essay featured on America the Fixable.

Borreca suggests that a better system would promote trust and cooperation rather than litigation. "A system of dispute resolution similar to the nonprofit Common Good's health courts proposal, which calls for a system of specialist courts to handle medical malpractice claims, would serve the needs of this population well," Borreca writes. "A threshold requirement of mandatory mediation before a lawsuit may be filed could be added...In other words, a degree of common sense added to the entire system-with an emphasis on services received rather than an unending amount of due process provided for every alleged wrongdoing-would go a long way toward serving the original intent of the law."

Read the rest of Borreca's article here.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

New York, NY––April 30, 2012––A new nationwide poll shows that an overwhelming majority of U.S. voters––81%––believes the quality of public education would greatly improve if school system bureaucracy was cut down and teachers and principals were given more flexibility to do their jobs.

Analysis of the survey’s findings shows that 84% of Republicans, 81% of independents and 78% of Democrats want less bureaucracy and more flexibility for teachers and principals. Additionally, 82% of voters polled said that “major changes” are needed in our public education system so America can “successfully compete with other countries.”

The survey was conducted by the nonpartisan Clarus Research Group last week and was sponsored by Common Good, a nonpartisan government reform coalition.

Other findings of the poll:

• By nearly a 5-to-1 margin (47% to 10%), voters believe giving principals more authority to make decisions would improve, not lower, the quality of schools. Less than a third of respondents polled––32%––think giving principals more authority would not have any effect on school quality.
• 65% of voters believe lack of classroom discipline is a “big” problem in public schools, while 25% said it is a “small” problem and only 3% said it’s no problem.
• 78% of the nation’s electorate thinks “fear of being subjected to a long, complicated legal process is causing teachers and principals not to discipline disruptive students.” Of that 78%, 42% said fear of red tape is hindering classroom discipline “most of the time” and 36% said “some of the time.” Only 12% said it is “rarely” happening, and 1% said it never happens.
• Voters think disputes involving teachers and student discipline should be resolved by committees of teachers and parents who were not involved. A 53% majority of survey respondents chose this method for this type of internal conflict resolution. Trailing that choice was having the school principal decide (23%) these matters, having the local school board decide (13%) and having a court of law decide (5%).
• On the issue of school budget discretion and allocations to special education programs, more voters than not (48% vs. 43%) agree with the statement: “To achieve the right balance between educational services for special needs students and education services for all students, school principals should have the discretion to set their own budget priorities, even if it means adjusting the amount of money spent on special education programs.”

This data demonstrates that voters across the nation, regardless of party, believe education needs big change,” said Philip K. Howard, Founder and Chair of Common Good. “It also indicates that voters want principals and teachers to have more authority and flexibility to run their own schools and classrooms¬¬––free of unwise, often nonsensical, bureaucratic mandates.”

The nationwide survey was conducted April 25-26, 2012 by Clarus Research Group, a polling firm based in Washington, DC. The survey’s sample of 1,000 self-identified registered voters has a margin of error of +/- 3.1 percent. Interviewing was conducted through live telephone calls, using both landline and cell calling. For verification of the results, contact Dr. Ron Faucheux, President of Clarus Research Group, at rfaucheux@ClarusRG.com.

Education reform has been the topic for April of an online discussion series, titled America the Fixable, hosted by TheAtlantic.com in partnership with Common Good. The series brings together prominent leaders from both major political parties, as well as other leading experts, to discuss how to fix broken government. The essays contributed by those leaders and experts are also archived at America the Fixable.

For more information or to speak with Philip K. Howard, contact Emma Mittelstadt at 212-576-2700 x250 or emittelstadt@goodmanmedia.com.

The latest entry in "America the Fixable" comes from Kevin Welner, professor of education and director of the National Education Policy Center at the University of Colorado Boulder School of Education.

Welner argues that we should pay more attention to what we know works, and what doesn't work, to improve schools. "Education policy, like so many areas of lawmaking, is rife with reform proposals that, while attractive on paper, are supported by little or no evidence," Welner writes. "Some are even proven failures. Yet once a lawmaker becomes fixated on a proposal, it seems that no amount of evidence will dampen that pursuit."

Read the rest of Welner's piece here.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

Read Philip K. Howard's collection of essays--proposing bold, big ideas to fundamentally reform our governmental and legal systems. Available for download.

Click here to view and download the 20-page Start Over publication.

P.L. Thomas, professor of education at Furman University, joins our America the Fixable series with an essay on the pitfalls of bureaucracy in American public education. "Bureaucracy bestows authority and a hierarchy on education that allows and perpetuates leadership without expertise or experience," Thomas writes.

"Universal public education needs a new wall, paralleling the wall of separation between church and state: a wall between education and government and corporate America," says Thomas. "Power over funding and broad performance benchmarks can remain vested in political leaders. But granular operational details should be left to educators and local administrators, the people best suited to achieve these goals in their schools and classrooms."

Read the rest of Thomas's essay at The Atlantic.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

The drowning last June of Marie Joseph, 36, in a state-run Fall River pool has elicited the response that such sad events often do -- the imposition of complex changes but not the expectation of greater responsibility. Guidelines for supervision of such public facilities by lifeguards and other staffers have long been clear.

Incredibly, at the Vietnam Veterans Memorial Swimming Pool, the body of Ms. Joseph, who apparently couldn't swim, was undiscovered for two days after she drowned. The excuse given was that the water was murky.

But if it were that murky, why didn't some staffer notice? Indeed, state officials said the water did not meet state standards and that the pool shouldn't have been opened last year.

So the people who use these public pools will suffer as officials try to show that they're doing something. Officials are suspending the use of all water slides at the state-run pools. Less fun for the low-income folks who tend to be the biggest users of these pools. That is despite Massachusetts Recreation Commissioner Edward Lambert's saying that the slide at the Fall River pool did not appear to be a direct factor in Ms. Joseph's death.

Meanwhile, the depths of 11 of the 24 pools run by the state will be lowered to 5½ feet by June 23, and security cameras installed, The Boston Globe reported.

The remaining 13 will eventually also be transformed if money is found. More lifeguards will be hired and there will be a couple of weeks of additional training. And, of course, a new administrative structure will be created to oversee all this, with the new post of state aquatics director.

The net effect will probably be fewer pools and fewer days of operation, as money and other resources are diverted for these changes -- all aimed at giving the appearance of preventing tragedies that attention and common sense should block in the first place. So fewer people will probably have a chance to enjoy this healthy exercise.

Without a culture that re-emphasizes personal and institutional responsibility, such changes won't measure up to the publicity associated with their creation.

Making New York Work: What Gets In The Way?

Please join Common Good, the Manhattan Institute and the Citizens Budget Commission for an evening forum discussion on the ways in which outdated rules and unreasonable constraints tie the hands of those managing key agencies in municipal and state government.  A panel, including both those who understand the problems posed by such rules and managers who have had to work within and around them, will bring to light how government really works, from an insider’s perspective—and how difficult it is to make it work well.  At a time when budget constraints increase the need for government that is both efficient and effective, we will explore, as well, reform proposals to achieve those goals. Please join us Monday, May 7.

Opening remarks will be given by attorney Philip Howard, author of The Death of Common Sense and Founder & Chair of Common Good.

A panel discussion, moderated by Howard Husock, VP of Policy Research at the Manhattan Institute, will include:

• Anthony Crowell – Counselor to Mayor Bloomberg and incoming dean of New York Law School.
• Patrick Foye – Executive Director, Port Authority of New York and New Jersey, and former chair of the Empire State Development Corporation.
• Robert Doar – Commissioner, New York City Human Resources Administration, and former Commissioner of the New York State Office of Temporary & Disability Assistance.

Event Details:

When:  Monday, May 7, 2012 - 5:30 PM to 7:00 PM
             Discussion begins promptly at 5:45 PM.
             A cocktail reception will follow the discussion.
Where: Covington & Burling LLP
             The New York Times Building
             620 Eight Avenue, 43rd Floor
             New York, NY 10018

To RSVP, please e-mail your name, position, affiliation, and contact information to mbrown@commongood.org. If you have any questions, please contact Matt Brown of Common Good at this email address.

Andrew J. Rotherham, co-founder and partner at Bellwether Education, joins "America the Fixable" with an article on the three factors that prevent us from making progress in education reform:

• "Buying reform" is the time-honored practice of sugarcoating tough problems with money.
• Schools lack for an adequate way to measure teacher performance.
• Education policy is by its nature change-averse. "[W]e've created an environment in which our schools can't really respond to the demands for improved student performance, or think creatively about productivity-enhancing reforms."

Read the rest of Rotherham's analysis here.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

Jeffrey Mirel and Simona Goldin of the School of Education at Michigan University say teachers work best when they work together, sharing ideas and teaching methods. "[T]eachers spend only about 3 percent of their teaching day collaborating with colleagues," write Mirel and Goldin in the latest installment of "America the Fixable." "The majority of American teachers plan, teach, and examine their practice alone. In other countries, such as Finland and Japan, where students outperform those in the U.S. in international tests such as PISA and TIMMS, collaboration among teachers is an essential aspect of instructional improvement."

The authors suggest that a common curriculum and new approach to teacher evaluation would encourage teachers to work together improving their skills. Read the full article here.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

When it comes to the management of government, both Democrats and Republicans are guilty of malpractice.

Focusing on bureaucratic waste and dysfunction is an opportunity to transcend contentious partisanship. It is something the left and the right should embrace. But, for some reason, neither side has fully engaged this issue.

Liberals believe government should be consequential, an active problem solver. Doesn’t it make sense, then, that they should push for more efficient government? Shouldn't they view wasteful spending and bloated bureaucracy as the enemy of useful programs and essential services?

If conservatives truly want to cut government, shouldn’t they focus on structural reform and better management? Shouldn't they identify waste in specific agencies and call daily press conferences to expose bureaucratic idiocies, one by one?

The GSA scandal is not just about short-term blame. It's a symbol of a much bigger issue. And both sides are missing the boat.

The front page of today’s New York Times features a story on the Americans with Disabilities Act in New York City. Lawyers, trying to create fee opportunities, scan small businesses for code violations. Once a violation is discovered, the lawyers then seek out a disabled person to serve as plaintiff. Most cases are settled without advancing to trial. The plaintiff typically receives $500 while the lawyer can win thousands of dollars in fees.

The Times reports that one plaintiff alone has filed 143 suits, as many as nine per day.

Schools need autonomy and accountability rather than politics and bureaucracy, argues Paul Hill, founder of the Center on Reinventing Public Education, in an article for “America the Fixable”.

“School leadership, personal responsibility, and accountability have been driven out of schools,” Hill writes, “especially in big cities where local politics adds to the burden of regulation.” But, thanks to innovative educational models, “The combination of chartering and instructional technology is also opening public education to individualization and innovation that could make schools much more effective for all children.”

See the rest of Hill’s analysis here.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

There is too much focus on what "can't be done" to improve America's schools and not enough on what "can" be done. So argue Frederick Hess and Whitney Downs of the American Enterprise Institute in the latest installment of "America the Fixable".

Hess and Downs contend that resourceful principals and school boards can often take control of their schools despite obstacles posed by outdated laws, senseless regulations, and burdensome contracts. Unfortunately, they say, "in selecting, training, socializing, and rewarding leaders, we do not equip or encourage them to lead.'"

A school system can only work as well as the people who run it. "Happily, across the country there are examples of determined state chiefs, principals, superintendents, and school boards who are ready to stop getting pushed around. In Sacramento, many low-performing 'turnaround' schools have been staffed with bright young teachers," write Hess and Dunn. "The problem: California is one state where state law meant these teachers would be the first to go during layoffs. Rather than play the victim, researcher Heather Zavadsky reports that the district figured out a work-around. The superintendent battled with the union, negotiating a deal which stipulated 'that if a teacher had been specifically selected for a turnaround school, and the district could document that the training was different and specific, then the teachers would not be subjected to seniority-based layoff.'"

Read Hess and Downs' full article here.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

If you've ever tried to read through federal regulations, you're familiar with sentences that read like this: "This subpart identifies those products in which the Administrator has found an unsafe condition as described in Sec. 39.1 and, as appropriate, prescribes inspections and the conditions and limitations, if any, under which those products may continue to be operated."

Thanks to this kind of convoluted language, government rules and directives are often impenetrable. This is especially true when those rules are intended to serve as detailed instruction manuals for every eventuality. It's a big problem for individuals and small businesses that lack the resources to employ compliance experts who can decipher complex regulations and bureaucratic mandates.

New Jersey Representative Rob Andrews, the latest contributor to our “America the Fixable” series, believes the No Child Left Behind Act should be mended, not ended.

Andrews argues that the law “has helped close the achievement gap between minority students and white students, decrease the high school dropout rate, and help many schools realize their true potential. But,” he says, “the law is outdated and fails to fully address our students' --and our nation's--educational needs.”

Andrews proposes three changes to the No Child Left Behind Act:

• We must implement a longitudinal data method to measure success.
• Special education students should have individual and personalized standards for progress.
• We need a better system to measure progress for English learners.

See the complete reform proposal here.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.

In the latest “America the Fixable” essay, American Federation of Teachers president Randi Weingarten explains how America should move past the shortcomings of the No Child Left Behind Act and why we should embrace proven strategies for rehabilitating American schools.

Richard Arum, director of the Education Research Program of the Social Science Research Council, worries that the legal environment of our public schools makes it harder for teachers to maintain order in the classroom. In an article for “America the Fixable,” Arum argues that what began as an effort to improve students’ rights has become an obstacle to good teaching.

Wendy Kopp, founder of Teach for America, believes that micromanaging teachers and principals keeps them from doing their jobs. As part of our ongoing series, “America the Fixable”, she writes that “we've built an education system based on our distrust of educators, and we didn't rethink it when we embraced accountability.”

“For years, well-intentioned policy makers have attempted to safeguard children by micromanaging principals and teachers through mandates and process requirements,” says Kopp. “Our education policies are a patchwork of thousands of top-down regulations that tie educators' hands rather than empowering them with the freedom over how they run their schools and classrooms.”

Kopp envisions a new system based on empowering teachers instead of handcuffing them. She cites the New Orleans charter school example, crediting it with “increasing autonomy along with accountability.” She argues that the New Orleans approach has “become a magnet for mission-driven educators who are drawn to the freedom to innovate and focus on essential work.”

Read the rest of Kopp’s article here.

"America the Fixable" is an online magazine collaboration between The Atlantic and Common Good. It provides a bipartisan forum for the presentation of bold, new ideas to reform America's governmental and legal system--ideas that need to be part of the 2012 debate.