Recently I wrote about the growing demand for school choice in many states. (School Choice Demand Growing) New or expanded school choice programs were legislated in Indiana, Florida, Arizona, West Virginia, Iowa, and Arkansas to name just a few. This movement has grown in popularity as low-income families of all races come to recognize that school choice is the key to escaping poor-performing public schools, especially in large cities. And everyone knows that a good education is the key to escaping poverty.

Most of this school choice movement has happened in red states as Republicans support school choice, but most Democrats support teachers unions, who oppose school choice. But one red state has notably lagged behind this movement – the state of Texas. Since Texas is a red state, controlled by Republicans in the state house and the governor’s mansion, you might wonder what’s behind their opposition.

The Wall Street Journal editorial board tells us that Texas has no school choice program for its more than five million K-12 students. While Texas Governor Greg Abbott is a strong supporter of school choice, his Republican legislature is not. The reason is the rural nature of much of Texas. It seems that rural Republican legislators believe rural students won’t benefit from school choice because they have no options beyond their current district schools. They believe that rural district schools will be devastated if students use Education Savings Accounts (ESAs) and leave for alternative schools that don’t currently exist.

Stop and think about what I just said. They worry that students will use ESAs to leave for alternative schools that don’t exist. In other words, they have nothing to worry about! But if ESAs inspire new school options in the future, then rural students would benefit like those in cities and suburbs.

Governor Abbot has determined this is a fight worth having. He has called the state legislature into a 30-day special session starting this week and ESAs are a priority. “I am hopeful that we will be able to put together a package that will allow ESAs to get passed in the first special session,” he said on a recent visit to the Journal. If it doesn’t, “I can call another one right after it, which is what my game plan is to do. I can play this game longer than they can play this game.”By “they” he means Members of the Texas House, chiefly Republicans representing rural districts, who stonewalled efforts to pass ESAs this spring. The state Senate passed a bill to provide ESAs worth $8,000 each to most students, but the House never voted on it.

The problem is not money. Texas public school have some $5 billion in funding if the Legislature passes the ESAs, and a chunk of this money is to raise teacher pay. Lawmakers have options to attract votes in the special session, such as passing a bill with universal eligibility that starts with a limited dollar amount in the first year. Representative Jacey Jetton announced a bill that would provide universal ESAs but put low-income and special-needs students first in line.

Should House Members continue to balk, Gov. Abbott has another point of leverage: Primary elections next spring. Iowa Gov. Kim Reynolds set an example in 2022 by endorsing primary challengers to legislators who opposed school choice, and she defeated several. Iowa passed universal ESAs this year, and Gov. Abbott has suggested he might do the same.

“If we don’t win [in a special session] then I think it’s time to send this to the voters themselves to vote in the primaries,” the Governor told the Texas Public Policy Foundation, KENS5 reported.  “We will have everything teed up in a way where we will be giving voters in a primary a choice. They can choose someone who supports school choice or they can support someone who is against school choice.”

A 2022 GOP primary ballot question found 88% of voters support parents’ “right to select schools, whether public or private, for their children, and the funding should follow the student.” A University of Texas at Austin poll in August found that 52% of Texas registered voters support school vouchers, ESAs, or another school choice program, including 61% who live in rural areas.

School choice is growing in demand and it’s time everyone got on board. It will benefit everyone in the long run – except may be the teachers unions.

Everyone knows that doctors take an oath to “first do no harm.” Since Hippocrates declared this fundamental principle of healthcare in 400 B.C., doctors have routinely taken this oath when they complete medical school. While nurses and other non-physician healthcare workers don’t take this specific oath, it is deeply ingrained in the culture of medicine that the patients come first.

Fast forward today to Kaiser Permanente, the nation’s largest managed care integrated health system, where some 75,000 Kaiser workers walked off the job and stranded sick patients this week. It seems their new mantra is “first pay me more.”

Kaiser is the nation’s largest single-payer healthcare system whereby the same entity pays for and provides medical care. Progressives have been pushing hard to convert the whole nation into this single-payer model. Kaiser Permanente is often hailed by the left as a model of single-payer healthcare. Imagine the whole country having doctors walk off the job, stranding their sick patients and postponing urgently needed procedures. That’s what’s happening in Great Britain where the British National Health Service is also on strike.

The Wall Street Journal editorial board tells us Kaiser serves nearly 13 million patients nationwide, mostly on the West Coast. Patients with Kaiser insurance are treated by doctors and nurses employed by Kaiser. Its managed-care system has been hailed as less expensive than standard private insurance. Kaiser controls spending in part by restricting patient access to outside providers and typically requiring primary-care physicians to authorize specialty care. The flip side is that sick patients may have to wait longer for treatment.

This is socialized medicine by just another name. In every socialized medicine system in the world, expenses are controlled by restricting access to care and in some cases refusing to authorize needed treatment if it is considered too expensive.

Kaiser’s single-payer model has other adverse effects. Unions say it skimps on staff, resulting in lower-quality care. It’s not unusual for unions to complain about staffing levels since they want employers to hire more workers to boost their membership. But Kaiser’s model is intentionally lean. Patients “are telling you how long it took to get the appointment, and then you have to tell them how long it will be to get results,” an ultrasound technician who has worked at Kaiser for 27 years told CBS News. “There’s a breakdown in the quality of care.”

Kaiser’s strike is the largest by healthcare workers in U.S. history, and patients will suffer the most harm. “Non-urgent” operations and chemotherapy treatments this week were rescheduled, in some cases reportedly for months later. But because patients are locked into the system, the stakes are lower for both the union and company. Kaiser has offered to increase wages by between 12.5% and 16% over four years, but the unions are demanding a 24.5% raise. Medicare payment cuts and the end of the national pandemic emergency will likely crimp its revenue. Other hospitals and physicians can bill private insurance more to offset government payment reductions, but Kaiser can’t.

This is a real-life demonstration of the consequences when you allow healthcare workers to unionize and you put the same people in charge of determining what treatment is authorized who also pay the bills. The conflicting incentives of providing quality healthcare and saving money means the patients will be the ones to suffer.

Single-payer healthcare is socialized medicine, whether run by a private corporation like Kaiser Permanente or the federal government. Both situations lead to lower quality healthcare, rationing, and reduced access to care. But the real villains in this current situation are those healthcare workers who have forgotten their commitment to the care of their patients in order to serve their own selfish desires. Shame on them!

It’s no secret our population is getting older. That means more and more people are managing chronic medical conditions, trying to stay as healthy as possible. It can be a real challenge to keep track of daily medications, blood pressure, blood sugar and other measures of our health.

Enter the cell phone as an aid in the management of our health. Cell phones already do much more than making phone calls. They connect us with the internet, show us the latest weather forecast, directions to where we are going, and the latest scores of our favorite teams. They even provide us reading materials by downloading the latest e-version of best sellers.

Young people have gotten used to tracking their mileage of their morning runs or bicycle trips. They can tell you how many steps they took every day. But seniors are less apt to use cell phones to monitor their health – and they need this more than anyone.

Regina Benjamin and Andrew Thompson, writing in The Wall Street Journal, tell us personal technology can make routine medical care and healthy living easier. Seeing a doctor can be a hassle, particularly for hourly workers who don’t have a lot of flexibility. But putting off doctor visits can make patients sicker until they finally show up in an emergency room, the most expensive point of care. To ease appointment stresses, Kaiser Permanente (where Dr. Benjamin is on the board of directors) allows patients to visit doctors virtually, including by videoconferencing, via a mobile app. The system is easy to use and works on Android or iPhone. Last year more than 50% of all Kaiser physician interactions were virtual—over a million every week.

A cellphone can also help manage Type 2 diabetes, which is most often the result of being overweight and inactive. A company called Omada Health has built mobile tools to help patients track their food, exercise and weight against goals set to reverse their Type 2 diabetes. The key is that technology makes these interventions convenient, affordable and scalable.

Many patients don’t do a good job taking their pills. Studies show that less than 50% of patients adhere to their medication regimens—often they don’t even pick up the prescription. The huge costs that this noncompliance adds to American health care have been estimated at $290 billion a year. Proteus Digital Health (where Mr. Thompson is CEO) has developed an FDA-cleared solution. Commonly prescribed drugs—such as metformin for Type 2 diabetes or losartan for high blood pressure—are combined with a microscopic sensor that turns on when swallowed. A small wearable patch detects the pills and tracks the person’s wellness, sending information to the patient and, with permission, to the doctor. Studies conducted by Proteus show that patients using the system take their medication 80% of the time or more, with improved outcomes as a result.

Digital technology can also relieve upward pressure on health-care prices. One example: New drugs are expensive in part because pharmaceutical companies have only a limited window, seven to 10 years, to recoup their investment before the patents expire. Digital medicines create new competitive barriers: First, the technology is patent protected. Second, users who become familiar with these systems and accumulate data on them are likely to be loyal customers. These advantages enable drugs to have extended product life cycles. As a result, research-and-development investments can be recouped over longer periods, and prices can be moderated.

Changing the payment model for medicine is vital, too. Today governments, insurers and patients buy expensive components: drugs, devices, professional services. What they really want is outcomes: weight loss, managed diabetes, controlled blood pressure. Digital technology can allow companies to offer solutions and then take responsibility for ensuring that they work. Omada can get paid for delivering weight loss; Proteus can get paid when patients take their drugs on time.

Healthcare is rapidly changing. Not all changes are improvements, in my opinion, but these new digital solutions to managing your health deserve your consideration in this never-ending battle to maintain our health, especially as we get older.