Another Health Care and Education Discussion

11/12/2010 05:21 pm ET | Updated May 25, 2011

Weight is one of the most important indicators of human health. My health care provider requires a weight test to be sure members pass the health test. Let's use a patient that weighs 1,000 pounds to see how the numbers on the test might not be what they seem (this is more than 400 pounds less than the heaviest person).

This 1,000 pound man is so unhealthy he can't get out of bed, do anything on his own or pass the health test (he scores in the lowest 1 percent of people his age). So the health care provider requires that a health team develop a plan to improve the man's health (don't we wish that was true?). The team consists of the patient, his family, a doctor, a nutritionist and a psychologist.

The team develops a plan, and after a year the man has lost 100 pounds. The family is pleased, but when the health test is administered again, he still scores in the lowest 1 percent for health (after-all he still weighs 900 pounds). The team receives a letter from the insurance company admonishing them at making no progress on the test and reminding them that they must make adequate yearly progress in health achievement.

The team develops a new plan they hope will achieve health for the patient. At the end of the next year, the man has lost an amazing 200 pounds! The family has noted the progress throughout the year and is ecstatic at the improvement. But he still weighs 700 pounds, so when the health test is administered, he still scores at the lowest 1 percent... no progress at all.

A new nutritionist replaces the fired one and the team re-visits the plan again. At the end of the third year another 200 pounds has been lost, and at 500 pounds the man is able, with much assistance and scaffolding, to walk down the hall and back for the first time in six years. The man and several members of his family weep with joy at this accomplishment. But his health test score hasn't changed a bit. At 500 pounds, he is still in the bottom 1 percent for health. He just isn't improving at all.

The insurance company fires the entire health team since they have made no progress with the patient and brings in a new team that includes a physical therapist. At the end of the next year, the man has only lost an additional 10 pounds. It turns out the man's family snuck him unhealthy and extra food and signed reports that he was doing his physical therapy when he was not. With so little progress in weight loss, the man fails his health test for the fourth year in a row (he still weighs 490 pounds).

No team members are fired since the family sabotaged the plan, but they manage to re-tweak the plan yet again. At the end of the fifth year the man has lost an additional 80 pounds. He can get out of bed on his own now to take short walks, use the bathroom himself and even eat some meals with the family. But at 410 pounds he still scores at the lowest 1 percent for health on the health test. After five years and thousands and thousands of dollars, the man has made no progress on the health test. This is the sorry state of a medical profession that leaves us waiting for... Waiting For ... (well you get it).

I originally wrote a version of this 10 years ago when all the testing done in my school district (and most others) was mostly the worst kind of "standardized" testing. The testing has improved very slightly, but still is used to jump to poor conclusions like the ones reached above. I post it here not to say that no testing should be done in our schools to note progress and quality of schools and teaching. But to make the point that we too often oversimplify important, complex issues in education and rely on testing in ways it wasn't designed to be used by people that don't really understand that.

Let's get the best, accurate assessments that can be used not only to rate how we are doing, but help us improve learning BEFORE we use them too much to rate how education is doing. I wonder too if the education we will achieve by teaching to the current poorly designed tests is really the education we want or need? Just a thought.