Music for Deckchairs

"In shadowy, silent distance grew the iceberg too": an Australian blog about changes in higher education


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Amongst colleagues

It’s been great to feel supported and people reaching out to make sure I’m doing okay. It was my first experience with global worldwide Internet heat wrath, and it was very difficult. I will admit. My family paid a price for it. I paid a price, but I feel much better being amongst colleagues.

Jeff Hancock, co-author of the Facebook Emotions Study,  Microsoft Resaerch Faculty Summit special session (transcript: Mary L Gray)

Remember #massiveteaching? The Coursera MOOC in which the actions of the instructor seemed strange to many? Probably not. Social media and edtech journalism have churned on for another few weeks, strange and terrible things have happened in the world, and the story has been buried under the next truckload of news and opinion landfill, right alongside the story of #foemooc and those few other cases where a MOOC went off piste.

By the time the story was picked up by higher education media, it had stabilised around the question of human research ethics, and got tangled up with the controversy surrounding the just-published Facebook Emotions Study. The consensus settled: Paul-Olivier Dehaye had also been engaged in improper experimentation on students without their knowledge or consent. And from there it snowballed, not just into what had happened, but why. He was an ego-driven child, a manipulator, an abuser of trust, a novice who hadn’t done his homework, a saboteur, a jerk, a punk.

Dehaye’s few statements didn’t clear anything up, and it helped even less when he said nothing. People who were already appalled by Facebook, but couldn’t get hold of Mark Zuckerberg to shake by the ears, suddenly had a far less powerful figure—and seemingly erratic communicator—to hold up as the test case for stupid.

The Coursera factor contributed. Their trumpeting about super professors and elite institutions has made us all very weary of the celebrity academic, and has introduced a fair game attitude to what Chuck Severance rightly calls anti-MOOC schadenfreude. Surely when someone accepts the reputational coin and then drops it in public, we get to exercise our indignation in a general way, even if we don’t know the facts entirely?

This is the swamp that we’ve all been dragged into by MOOCcorp. We’ve been hustled along by their entrepreneurial haste to create new educational markets, without thinking through the professional and personal risks facing ordinary university teachers who step in front of a global class of thousands. Many of them have not been celebrities at all, even in their own disciplines; they’re not chosen on the basis of experience in online teaching, but because they work at high ranking institutions.

Some have been great at it; some have left their audiences cold. Some have risen to the challenge of negative feedback in a way that should make us all blush. All of them have been put through the mincer of public opinion on their voice, their clothes, their teaching styles, their syllabus, their expertise. They’ve been upvoted and dumped on and blogged about, often by an audience of their peers.

And they’ve survived all this while delivering to MOOCcorp the real product: big fat research datasets with big fat commercial value. This week Gregor Kennedy, Pro Vice Chancellor of Educational Innovation at the University of Melbourne (also a Coursera partner), described this as “incredibly helpful”, without a blush:

Learning analytics use the digital data trails that students leave in online learning environments to develop an understanding of students’ learning processes. Every video watched, quiz answered and comment posted can be tracked, mined and analysed to better understand how students are learning online. Researchers are able to capitalise on the big data sets generated by tens of thousands of MOOC students to uncover productive and unproductive patterns of learning behaviour.

These patterns can be related to a range of other variables such as students’ socio-economic or cultural background, their previous education and prior knowledge, and their motivation to study. They can also be used to predict when students will drop out, whether they will pass the course, or whether they will get a high distinction.

OK then. Clearly the prospect of opportunistic and experimental research using student data without any clear boundaries around aims or potential use (“can be related to … students’ socio-economic or cultural background”), and deploying the lowest possible standard of informed consent, isn’t always a problem—or we’d be blogging up a storm about Gregor Kennedy.

But we’re not, because we have already rolled on this one. We know about the algorithms that recommend books, nudge us towards friends, and parse our interests into a grammar of decision-making potential. We understand that we’ve left our digital fingerprints on everything, and concede that students must have too, so we might as well collect them. This means that MOOCs are already capitalising on the free gift of huge data sets, while privacy and ethics experts are still drafting recommendations for good practice.

Paul-Olivier Dehaye was also pursuing these questions. Watching one of his Coursera office hours I learned that the experiment he talked about wasn’t about pulling stunts to see how students would react, but something much more prosaic: developing criteria for open badges that would reflect peer collaboration across platforms as well as within. Sure, he says “experiment” a lot when he could simply say “test” and cause much less fuss; but his views on issues that MOOCs have introduced to traditional higher education are widely shared. In particular, although he’s a MOOC supporter in a general sense, he’s not alone in recognising the problem that will have to be addressed in order to make MOOCs sustainable over time:

It is in some ways a struggle of power between different institutions, between the professor, between the school, and between the platform itself. … and if you want I am fighting for the professor here, to make sure the professor has a space in this fight.

I went through the whole two hours, and found no evidence of someone trying either to sabotage or proselytise for particular modes of online learning, or planning to play any kind of trick. What he was testing was straightforwardly technical, aimed at helping learners manage their own data across multiple open online platforms. In particular, I was interested in his ideas about using badges to credit the practices of mutual care and support that really help online communities work, and which are often achieved away from the chaotic environment of MOOC forums, and are lost to analytic reach. So I can’t imagine Coursera being thrilled with any of this—or his home institution being particularly interested—but these principles shouldn’t set anyone’s hair on fire.

Why did he bail on the course? This is something only he can answer. Coursera and his home institution, with all the advantages of professional PR and ready access to educational media, moved swiftly to put out their version of what happened, and the course continued without him. We can’t be surprised at this; universities all over the place are fortifying their brands against risk, especially on social media. But we can be concerned, as it seems that when two powerful institutions are involved, it’s very unclear who takes care of the individual who was working on their behalf.

So this leaves the rest of us, as colleagues to whom he might have been able to turn for support. At the time I raised some of my concerns with Maha Bali, who was also writing about this. Social media in general, and MOOCs in particular, have caught us all without a considered standard for responding when our academic colleagues get into difficulty in public forums. This is what makes Twitter so painful, so much of the time. It’s what makes us come off as judgmental and cliquey when we’re operating within our existing networks, and careless with the professional and personal consequences of the way we talk about others.

George Siemens, who was one of the few who wrote sympathetically about Paul-Olivier Dehaye, congratulated him for starting a conversation that we need to have about MOOCs. I’m late to it, but I’m saying the same—not only for starting a conversation, but for surviving its aftermath. I’m really delighted to see that he’s writing a blog, and is active again on Twitter, and I hope that this time he feels that he’s amongst colleagues.


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On, on, on

Life chez Simpson was not normal, Helen now reflects, principally because a constant eye had to be kept on anything that might affect Simpson’s performance, whether he was racing or not. … “Social life [as a couple] was non-existent. I often used to think it would be really strange living a normal life, going out and having a meal with people.”

William Fotheringham, Put me back on my bike: in search of Tom Simpson (2002)

In the past 4 months I have kept seeing accolades to Andy’s amazing productivity – the 100+ articles, the zillions of case books, etc., and I have always told people that yes, he led a normal life, yes, he got plenty of sleep and yes, he even took plenty of naps. But that’s not really true. His life was not normal, at least not to me, and it certainly wasn’t balanced.

Patty Sun, “Thoughts on Work-Life ImBalance from Those Left Behind“, 2014

It’s Tour de France time again, and I’ve been reading William Fotheringham’s sensitive and ambivalent search for the story of British cyclist Tom Simpson, who died on Mont Ventoux in 1967. In the history of professional cycling, it’s one of the landmark stories of ambition, risk and terrible loss—the grainy prequel to all the doping scandals that came later. Fotheringham spoke directly to Simpson’s widow Helen, and to those who were closely involved at the time of his death, including Harry Hall, the mechanic who helped Simpson back onto his bike on the mountain, and was the last to hear him speak.

He had seen riders pedal themselves into a state of exhaustion or hypoglycaemia before, but of Simpson collapsed against the bank telling him to put him back on his bike, he can only say, ‘At that moment I don’t know what I thought. I just don’t know.’ What Hall does know is that Simpson’s last words were murmured, in a rasping voice, just as he was pushing him off: ‘On, on, on.’ He could have been exhorting the mechanic, or telling himself to keep going; Hall seems to think it was both. (p34)

500 metres further up the mountain, Tom Simpson fell again, and did not survive. He was 29, and he left Helen and two tiny daughters.

What can we possibly do with this kind of career sacrifice? When someone pushes himself to these limits, who takes responsibility? Who exploits ambition, and who profits from it? Fotheringham puts a subtle case historically against both the Tour organisers and the newspapers that followed the race, both of whom had an interest in promoting the heroic struggle of cyclist against mountain.

At the turn of the last century, the public appeal of the Tour de France lay in the fact that the competitors were pioneers, setting off to do things no right-thinking mortal would attempt … That was the great attraction for its first organiser, Desgrange; that was why his paper’s circulation went up during the Tour. (p111)

Fotheringham also lays out sympathetically the personal and cultural circumstances under which any individual might calculate that the price paid for professional success can’t be too high. It’s such a sad read; I can’t imagine how it must feel for his family to have lost someone so publicly, even to the extent that his final wavering moments on the mountain are preserved in shaky black and white footage on YouTube, remixed to funereal soundtracks by many cycling fans. And those fans—and all of us couching it through the Tour again—are part of the problem. Isn’t this exactly what we came to see?

Patty Sun is the wife of law professor Andrew Taslitz, who died earlier this year. Like Helen Simpson, her loss has been shaded by public celebration of her husband’s professional work made in comments like this:

He is one of the most amazing faculty members I have ever met. So many of us excel at one of the three major aspects of being a faculty member. Taz excelled at all three. I was always amazed at how he could write reports for committees, facilitate tenure files, attend events, write multiple law review articles a year, write a book every other year, and still manage to be one of the most effective teachers in the country. … He was certainly one of a kind, and of the kind that this world could use much more.

Tom Simpson memorial (Flickr: Mirko Tobias Schaefer)

Tom Simpson memorial (Flickr: Mirko Tobias Schaefer)

Let’s think about this for a moment. What happens when academics celebrate each other’s achievements in these terms? What happens when we think this is something the world needs more of? Which world? All I can think of is the cyclists who make the pilgrimage to Tom Simpson’s lonely memorial on Mont Ventoux and leave their water bottles there, passing on a powerful message to every young rider who comes along after them, hoping for a spot on a pro team.

When I was diagnosed with cancer, I started to think about the connection between why professional cyclists dope and why academics overwork, and got about half way there: that it’s impossible to keep up with a doping peloton unless you’re willing to entertain the same personal cost. Richard Hall has taken up this post a couple of times, in a way that has cleared up something for me. In his latest discussion of academic labour within the “anxiety machine” of the university, he connects the shame culture of performance management to practices of self-care, and ultimately to the ways in which both our hidden and attention-seeking gestures of overwork entangle us with the lives of others:

Just as the high-performing athlete recalibrates the performance of those around her, and creates a productive new-normal, so the workaholic professor does the same. And the irony of my sitting here at 11.22pm writing this is not lost on me. And maybe this is because I am committed. And maybe this is a form of flight or a defence against the abstract pain of the world. Maybe it is a form of self-care, through which I am trying to make concrete how I feel about my past and my present. And maybe as Maggie Turp argues, this form of overwork and performance anxiety is a culturally acceptable self-harming activity. I am performance managed to the point where I willingly internalise the question “am I productive enough?”, which aligns with “am I a good academic?”, which aligns with “am I working hard enough”, which risks becoming a projection onto those around me of “are you working/producing enough?”

This is such a vital step: to connect the personal pathology of overcommitment (including to the welfare of others) to the creation of profit from machines and systems that facilitate labour. And then to think about what it means to understand universities in these terms, especially as we lurch towards a more competitive and more marketised higher education system. In other words, in thinking about the hamster-wheel cultures of academic overwork, we don’t need to look much further than the mechanics of the wheel itself, whose whole design and purpose is to keep on keeping on, which is precisely the problem. As Harry Hall, the mechanic who put Tom Simpson back on his bike, later reflected, cycling and rowing were the two most dangerous sports for athletes because of their mechanised nature: “The individual is pushing a machine which doesn’t know when to stop. It always asks for another pull of the oars, another pedal stroke.” (p41)

But the anxiety machine of the academy isn’t a component, like a bike or even a hamster wheel: it’s the whole system. It’s all of us, helping each other on, on, on. It’s the formal incentives and rewards for overwork that we chase, and it’s all the informal ways in which we perform, celebrate and even lament our own willingness to work to exhaustion—without ever stopping long enough to think about how we could change this, and why we should.

Things to read

If you’re looking for one thing to read on academic productivity, Melonie Fullick’s post “By The Numbers” is outstanding. Also thanks to Deborah Brian for sharing the work of Maggie O’Neill on the slow university.

Nadine Muller’s post on stress, self-care and the need to work together to achieve change in academia is great.

And please, please read Patty Sun’s shattering take-down of the personal cost of academic overwork.


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Sightings

Updates below

In a bizarre coincidence, when I opened the book to scan the contents I found myself looking at the section about sharks.  In particular, “surviving if you are in a raft and you sight sharks—”… I wonder if anyone would be interested in using this as a model for an edtech field manual for surviving the Higher Ed apocalypse.

Jim Groom,”Survival: the manual” July 7 2014

Thanks to Jim Groom, I’ve been thinking about Jaws in this plainly bizarre week in the short history of commercial MOOCs. For all its singular qualities, and for all the symbolic load placed on it by film theorists, Jaws is at heart an ordinary mystery: something unexpected and unexplained happens, someone goes missing, and everyone else spends the movie piecing together clues, disputing priorities, and dealing with what comes next.

But there’s a small scene in the middle that often gets forgotten, where two kids prank the holiday crowds at the beach with a cardboard fin—and in doing this set up the perfect opportunity for the real shark to glide in to calm water, unnoticed by everyone until it’s too late.

This week’s edtech weirdness had both mystery and something like a distracting prank, involving a MOOC in which the professor was yanked from view, then bobbed up again briefly, before vanishing again. Paul-Olivier Dehaye, a maths lecturer from the University of Zurich, put up a three-week course: “Teaching Goes Massive: New Skills Required” (#massiveteaching) through Coursera. The landing pages raise questions about the Coursera approval pathway and standards: two weeks of short RSA Animate style videos, and a final week where students will do more or less whatever they like in an “Experiment Area”. Dehaye is likeable, clear and thoughtful about his topic, but the videos aren’t elite brand rocket science—certainly, nothing that an informed and curious teacher in the office next door to you couldn’t have thought up.

And that should have been the first clue, I think. The course goal is “personal growth”, for which—thankfully—no certificate is offered, and the content is quite vague: “‘Readings’ will come naturally during the course as basis for discussion. … In the first week, we will provide a short summary of proposed content of the course. The content of the later weeks will be decided on by the students, and should cover the proposed content and more.”

But after the first week some or all of the content was deleted, and then Dehaye was himself removed, leaving enigmatic clues on Twitter, some participation in Metafilter discussions, some blog comments here and there (including on George Siemens’ blog), and a deleted Etherpad document that he wrote to explain his actions.

MOOCs can be used to enhance privacy, or really destroy it. I am in a real bind. I want to fight scientifically for the idea, yet teach, and I have signed contracts, which no one asks me about. If you ask me something, I can tell you where to look for the information. My plan becomes to flip the tables. I want to “break out” and forge an identity outside of the course, on Twitter, because I realize this is the only way for me to fight for this identity, engage with my students, and those big shots all simultaneously (journalists, educational analytics people, etc).  … Meanwhile I want everyone to organize their own learning, which I know is happening by looking a bit around. Some people don’t like my course, which is fine. It’s your choice, that’s part of the point. Still, I get lots of emails from coursera asking what is going on. A lot of pressure from them now. They are confused just like you were, and I intended to confuse them even more because they were not ready to challenge their own pedagogical practices fast enough, judging from past experience.

After blogger Apostolos K pointed out that these strange goings-on hadn’t attracted much coverage, and George Siemens wrote “Something Weird is Happening at Coursera“, the story was quickly picked up. Carl Straumsheim treated it as “The Mystery of the Missing MOOC” for Inside Higher Ed; Steve Kolowich covered it for The Chronicle first as a mystery (“In a MOOC Mystery, a Course Suddenly Vanishes“) and then as an experiment (“University of Zurich Says Professor Deleted MOOC to Raise Student Engagement“). Jonathan Rees had two goes at it, both worth reading: “The worst of the best of the best” on his own blog, and “Even super professors deserve academic freedom” for The Academe Blog. Rolin Moe, whose MOOC blog is touchingly subtitled “Debating, debriefing and defining the learning trend of 2012-“, wrote it up as “Dr Famous is Missing“.

By the end of the week, opinions diverged. Yesterday Michael Gallagher argued in a beautiful post that to exploit students in a research project raises questions of trust that can’t be overlooked even if the intent is to criticise (“Teaching vs. research and MOOC brouhahas“); today George Siemens congratulated Dehaye on starting a conversation about our vulnerability to commercial data mining by companies like Coursera.

I’m still absorbed by the freakishly odd coincidence of Dehaye’s co-authored take on a probability problem that’s apparently well known to mathematicians, involving 100 Prisoners And A Lightbulb, with George Siemens’ July 5 post (published just before all this turned into a thing) on the latent knowledge in any class, involving 100 learners in a room. This is Siemens, but could be Dehaye:

The knowledge and creative capacity of any class is stunning. Unfortunately, this knowledge is latent as the system has been architected, much like a dictatorship, to give control to one person. In many cases, students have become so accustomed to being “taught” that they are often unable, at first, to share their knowledge capacity. This is an experience that I have had in every MOOC that I’ve taught. The emphasis in MOOCs that I’ve been involved with is always on learners taking control, learners joining a network, or learners becoming creators. In a Pavolovian sense, many learners find this process disorienting and uninviting. We have been taught, after a decade+ of formal schooling, to behave and act a certain way. When someone encourages a departure from those methods, the first response is confusion, distrust or reluctance.

I’ll call my theory of knowledge and learning “100 people in a room”. If we put 100 people in a room, the latent knowledge capacity of that room in enormous. Everyone in this room has different life experiences, hobbies, interests, and knowledge. We could teach each other math, physics, calculus. We could teach poetry, different languages, and political theory. The knowledge is there, but it is disconnected and latent. Much of that knowledge is latent for two reasons: 1) We don’t know what others know, 2) connections aren’t made because we are not able with our current technologies to enable everyone to speak and be heard.

At the moment, I’m not sure that we know enough to be sure what the plan was with #massiveteaching. So I’m keeping an open mind to the possibility that what looked like a prank was an attempt to start a different conversation—including, and perhaps especially, with students—about the risks of corporate data mining and the lessons from Google advertisements or Facebook’s experiments with emotional manipulation. The fact that it didn’t work smoothly, and might make Coursera much more twitchy about allowing experimental course design in the future, shouldn’t necessarily be the measure by which it’s finally judged.

Meanwhile let’s keep one eye on the ocean where the real sharks are. As ever, the timely counsel in confusing times is from Jim Groom, who seems to me to be looking in the right direction:

I don’t know what it is, but Sharks remind me we are deeply vulnerable always.

Me too.

Update

People are still writing about this. Two very good posts today:

According to Apostolos K, Coursera/U Zurich have resumed the course without Paul-Olivier Dehaye, which seems to me a reasonably complicated thing to do if the whole designed purpose of the enterprise originates with him. It’s a bit like the Mayor of Amity Island putting on the cardboard fin to prove that there’s no shark.


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Down on main street

“We think it’s fair to ask the student to pay $3 extra a week to get the chance to earn a million dollars more over a lifetime than Australians without a university qualification. … Mr and Mrs Mainstreet are paying almost 60 per cent of the tuition fees of a uni student and they are also paying back the loan at the 10-year government bond rate of 3.8 per cent, whereas the student’s loan is indexed at CPI, currently 2.5 per cent,” Mr Pyne said.

Uni loan changes ‘cost $5 a week’, June 4

Since Christopher Pyne made fairness in higher education the surprise water cooler topic in this budget, there have been strongly negative reactions to the hiking up of student debt from all over the place. The government is now campaigning hard on the idea that fee reforms are both essential and inconsequential: the impact is tiny, the freedom is vast, and the overall costs are just as likely to go down as up (this is what the Minister calls the magic of the market, so do clap if you believe him.)

There are some practical problems with trying to pass off education debt as similar to other kinds of reputable middle-class debt, like mortgages or business loans, rather than, say, experience debts or gambling debts. Education might pay dividends in the end, but while it doesn’t, there’s no asset: no car to repossess, no house to put on the market, no shares to sell. Graduates who don’t go on to the full-time career for which they trained not only don’t see the promised premium earnings, but they can’t get a refund or put their degree on eBay. They’ve had the experience, and their numbers haven’t come up. Now they’re in a hole.

Behind this is the more important problem that there are no standards of responsible lending applied to education debt. If you’re offered a university place, you’re entitled to go into debt to complete your degree, just like that. It’s a no-doc loan of the worst kind, because it has to be — your future capacity to repay is itself the asset you’re going to debt to acquire. So no one’s responsible for even minimal risk evaluation of prospective undergraduates and their families. To put it brutally, universities can recruit underprepared students to make up numbers and protect their revenue stream, and at the moment have no real skin in the game when it comes to graduate employment.

Until now, the risk has more or less worked for Australian students even in non-vocational degrees because interest rates have been low, and it hasn’t worked for the lender because the incentive to repay is correspondingly weak. Students who have been able to pay fees up front have been better off, but not to a life-changing degree. But still, graduates have got stuck below the repayment threshold for a wide range of reasons, or have nicked off overseas, or have died with their debts unpaid. All of this amounts to a prediction that Australia could have $13bn in doubtful debt by 2017—a hill of beans compared to the trillion dollar toxic debt swamp in the US, but significant for a small education market like ours.

So it’s obvious why the government wants to adjust repayment terms: both to get more money back from those who repay tidily, and to use the threat of compounding interest to round up those who aren’t repaying much at all. It should be a low risk strategy: as owners of the national education debt pipeline, the government clearly expected to be able to tweak both interest rates and repayment thresholds while still offering a better deal than any commercial lender, and by these means to turn education debt into a more attractive asset.

But this is proving a hard sell. Having spent a lot of time at home this year, I’ve come to think that if Christopher Pyne had watched more daytime TV, he would understand why we’re not jumping at the idea. It’s because we know more than he realises about disreputable debt: last resort borrowing, predatory lending, and household debt that’s being juggled across multiple credit accounts. Australians at home are hassled all day long by TV commercials focused on compounding debts owed to intimidating lenders, and financial underpreparedness for illness, accident and death. This is what’s in the basement of our national consumer confidence: a realistic sense of how quickly debt picks off the most vulnerable in this prosperous economy.

Like someone spruiking a raw food juicer or a funeral plan to this frightened audience, the Minister has to work hard to convince us to turn a blind eye to what’s lurking in the shadows of deferred payment, and to focus instead on the transformative power of the product. It’s why he’s making his case at the highest perch of generalisation, glossing over earning disparity between male and female graduates, graduates in different disciplines, graduates living in different parts of the country (especially in the country parts of the country), graduates from different social backgrounds, and with variable levels of educational preparedness before they start their degrees. He’s also hoping we don’t understand the impact of part-time and precarious employment, regional employment, misadventure, illness, disability, parenting, or the fact that the economy itself is slowing down.

In fact, everything that makes a real difference to graduate lifetime earnings is invisible from the Minister’s penthouse, leaving us with the simplification repeated in speech after speech after speech: graduates will make 75% more than non-graduates, and in case we’re not sure what that is, why—it’s a million dollars.

Jackpot.

Or not. Just as with cancer mortality modelling—about which I know a thing or two—the aggregates, multipliers and generalisations across a demographic slice that make up this million dollars are all bundled inside speculation about external variables, and can’t possibly predict what will happen with the accuracy required to judge the personal risk of going into long-term debt. When someone says “X life expectancy” or “Y lifetime earnings”, they’re pretty much saying “83% percent reduction in wrinkles”—it’s really up to you what you make of this as you stand at the counter with the wrinkle cream in your hand.

And yet the Minister’s gone on repeating his million dollar pitch long after even the friendliest economist has quietly pointed out that the facts are more complicated. Because this is exactly what you have when you don’t have responsible lending guidelines: a cheap and shouty sales pitch involving lifetime guarantees, a sprinkle of FOMO, and a miracle product. And he’s energetically trying to nudge Australian taxpayers into resenting university graduates, despite the evidence that Australian graduates themselves go on to become Australian taxpayers to a very significant degree.

Yesterday Stephen Matchett, in his excellent daily newsletter on Australian higher education, suggested that student debt has become the equivalent of the $7 Medicare co-payment to health reform: it’s the pill that the electorate just won’t swallow, no matter how it’s sugar coated. I think he’s right. What’s taken us all by surprise in this budget is that across every portfolio, with remarkable tin-ear consistency, the stakes have been pushed too high, the reasoning has been too lazy and too divisive, and the reactions of Australians to the central topic of budget fairness have been really widely misjudged.

Oh, and also, the rustling up of patronising stereotypes to explain it all is really wearing thin.


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Seven dollars in modern Australia

“I think it’s a sad reflection on the modern Australian attitude that they can’t see that all areas have to make a contribution and they look at it as a narrow, sectional issue.”

Commission of Audit Chair, Tony Shepherd, on responses to the Federal Budget, May 23*

This week my daughter turned fifteen, and she went to the doctor—a political act in modern Australia.

She went because of a constellation of puzzling symptoms which we’ve been sort of monitoring for a few months. Finally, we came to the conclusion that these symptoms are persistent, significant, and affecting her school attendance, and we couldn’t diagnose them ourselves. So off she went.

Our GP asked her questions, considered the symptoms widely, and sent her home with the trifecta of health care copayment: a prescription, and referrals to both pathology and diagnostics.

Whether these tests find something, or nothing, she learned something that will affect her future health care costs, which are entirely likely to fall on Australia’s public health system; someone who is neither a teacher nor a parent listened to her, and took her puzzling symptoms seriously, in a trustable way. And she learned a bit about how the system itself works, and what happens when you ask for help.

At fifteen, she’s entering a period of consequence well known to health professionals. Over the next few years, she’ll either take or avoid the risks that will have long-term impacts on her adult health and wellbeing. Thanks to this positive encounter with someone who minded enough to ask tactful, sensible questions, it’s just fractionally more likely that she will know that Australia’s health workers have her back. So whatever the technical results of this visit, she learned something that will last but will be very difficult for our healthcare system to measure as a positive impact.

I was thinking about this when I read this morning’s remarks by the Chair of the Commission of Audit, the group that advised the Federal Government that we bring an end to the principles of universal health care in Australia. These are the principles that mean that any teenager can learn how teenagers should be able to access healthcare services at no cost.** And here’s the thing: although we’re public health care patients, we already don’t attend a bulk billing GP practice, so the fact that the proposed health care copayments have come to matter to me as much as they do isn’t self-interested or sectional—even in the context of cancer treatment.

I can’t believe we have to spell this out in modern Australia, but what matters here is the fairness of ensuring that those who are already the most disadvantaged get the benefits of whatever we can collectively provide. This is why it’s so important that teenagers’ access to the people and services who will make most difference to their later health (and the later health costs that they impose on all of us) isn’t determined by their capacity to pay. Teenagers are minimum wage workers if they’re lucky, and they’re not all safely located in a family who can pay for them. Seven dollars is a big deal; twenty-eight dollars even more so.

So although I’m not generally one for marching and placards, tomorrow I’ll be joining the local rally to save our Medicare system from these damaging, divisive healthcare cuts, and it’s quite likely that I’ll do it again next weekend in Sydney.

This really is a turning point for modern Australia, and the evidence all around us is that Tony Shepherd is decisively wrong: it’s precisely because of how this affects other people that so many of us are taking to the streets.

Links

If you want to know more about the Save Medicare campaign, it’s here. Do also check out Co-Payment Stories. There are campaigns being run by medical researchers who don’t want the promised squillions for their research at this social and health cost; and campaigns being run by doctors and nurses also. The coverage of all of it at Croakey blog is excellent, and there’s a Pozible crowd funding campaign to support South Western Sydney GP Tim Senior to write for Croakey here.

The Save Medicare Rally in Wollongong is at midday on Saturday 24th May, and there’s another in Sydney on 31st May.

If you’re not a marcher, here are some petitions:

And really, there’s something about this maddening Budget that is also very inspiring: its fundamental unfairness has proved that we can all still see beyond “narrow and sectional issues” to something worth standing for.

 

* I read this article thanks to Mary-Helen Ward.

** Thanks to Tim Klapdor for the reminder that in many regional centres there are already no bulk billing options. I’m curious about the source of our Health Minister’s “Having 70% of non-concessional patients bulk-billed is unsustainable.”  


6 Comments

A couple of beers

I can think of no more significant benefit from community contributions in health than to invest in cure and discovery research by our people for our people … As a result, it may be an Australian who discovers better treatments and even cures for dementia, Alzheimer’s, heart disease or cancer. If we start investing now, this new and historic commitment in medical research may well save your life, or that of your parents, or your child.

Federal Treasurer Joe Hockey, Budget speech,  May 13

It’s been a while, but I’m still here. Cancer treatment is an absorbing, revealing, boring, depleting experience, sometimes all on the same day. The drugs used to treat cancer have powerful side effects, and the drugs to alleviate their side effects have side effects, and sometimes these drugs also provoke allergies, both allergies to the drugs, and triggered allergies to other things.

Cancer is also administratively taxing—there are forms, and appointments, and deadlines, and things to remember, all at a time when chemotherapy and Mariana Trench depths of fatigue make it quite hard to finish sentences.

Then there’s the way cancer messes with the people who love you, and disrupts their experience of work, school, and everyday life, and at the same time surrounds you with the kindness of both friends and strangers. All of this deserves time and care and attention.

And finally there’s the weird billboard politics of cancer, which means that it rears up when you least expect it. This week my daughter joined a local soccer team, and I found myself frozen at the washing machine holding up a soccer shirt that says “Are You Breast Cancer Aware?”

Gosh, yes we are, thanks for asking.

Cancer also popped up this week in Australia’s Federal budget, as our Treasurer tried to sell a proposed services tax on GP visits, blood tests, diagnostic imaging and prescriptions that will disproportionately whack patients in cancer treatment, in the name of an imaginary Australian funded by revenue from this impost who finds a cure for cancer. You couldn’t make this up.

Because I’ve had more to do with Medicare in the last six months than I have in the twenty years since I emigrated, I really mind about this rubbish. The fact that my breast cancer was diagnosed at all was the result of GP visits when I was reluctant to think that I had something to worry about. GPs are critical to early cancer detection; any barrier to GP access is one that risks much more significant costs to our public health system later on. So it really doesn’t even make sense from the perspective of health budgeting.

When copayment for health services was first mooted, we heard quite a bit about behavioural economics: if people had to pay for their access to no-longer-universal healthcare, they’d be more conservative in their use of it. So it was genuinely surprising when copayment extended to pathology services. Are we really now suggesting that chemo patients, as well as others with chronic disease, should think twice about out-of-hospital blood tests or X-rays? Or do we think these patients should rock up to Emergency Departments and hospital pathology departments (which are two different things) to get their blood taken?  Even though chemo patients specifically require disruptive special treatment when they get there, because of their heightened risk of infection?

On the other hand, do we really think that local pathology collection centres will run more efficiently if they have to figure out how to process these copayments for everyone, now they’re not allowed to take cash?

The Treasurer’s answer to this has been to swerve towards another imaginary Australian, an idler with all the wrong priorities. I was standing in the middle of my kitchen on Thursday morning when this insulting nonsense came out of the radio:

But, but, I’d say to you, Chris, one of the things that quite astounds me is some people are screaming about $7 co-payment. One packet of cigarettes cost $22. That gives you three visits to the doctor. You can spend just over $3 on a middy of beer, so that’s two middies of beer to go to the doctor.

Let’s have some perspective about the costs of taking care of our health. And is a parent really going to deny their sick child a visit to the doctor which would be the equivalent payment of a couple of beers or one-third of a packet of cigarettes?

This is a crude and stupid switch from the conventional “price of a cup of coffee” device governments flourish when they want to persuade us that rising costs are trivial. Trading beer and cigarettes for healthy choices is just so much more obvious. It’s the foundation of responsible citizenship, isn’t it?

Except that, as the interviewer wearily pointed out, this stereotype of the delinquent parent choosing another beer over their children’s health trivialises the pressure on low-income families, that aren’t confined to simple choices between one modest thing and another. Sometimes neither are within reach, even if this is very hard to imagine from a more privileged position.

So now think about the parent on welfare in a country town whose sick child’s health visits includes travel costs, that will now be hiked up by rising fuel prices. Or imagine the parent of a sick child who’s also trying to hang on to part-time study, facing rising tuition costs and the prospect of significantly increased interest rates on deferred loan repayment.

And these imaginary parents aren’t sequestered from the rest of the economy. So have a think about the person who’s serving that beer: probably young, perhaps also a uni student, maybe another parent, about to be hit by changes to welfare for the under 30s. Discretionary spending on small items like a cup of coffee or a beer aren’t trivial to the casual workforce sector they hold up, who in turn are making choices about what they can afford. The retail and services precariat are always the canaries in the mine of consumer sentiment, the first to feel it when a combination of factors limits the money left over from food, rent and cost to work. This is behavioural economics.

Anyone can play the game of the imaginary Australian, and sometimes it’s good for us to do this—it’s a really basic exercise in political empathy. But the point of a universal healthcare system is that we don’t have to trade in these limiting stereotypes. Instead, we accept that we all win when these most basic healthcare services aren’t withheld—from anyone—for the price of a couple of beers.

So as both a taxpayer and a public health cancer patient, and with all due respect to my university colleagues in medical research, I don’t care whether cancer is cured by an Australian. I don’t. But I really do care about the experience of other Australians living with serious and chronic illness. If making it easier to see GPs, access pathology services and fill prescriptions helps reduce the numbers of people who go on to need hardcore (and costly) medical care, and then also reduces the cost of living through treatment itself, that really is something to defend.


13 Comments

Seriously, Mister Jones

The good or bad faith with which power is exercised is irrelevant; raising the question on these terms will not be effective. Power cannot be shamed into limiting itself in this way. It seeks to limit us.

Jason Wilson,  “Moderation, speech and the strategy of silence”, Detritus

You know something’s happening/and it’s happening without you/yes it is/Mister Jones

Bob Dylan, “Ballad of a Thin Man”, this beautiful live version

I’ve been thinking a bit more about Steve Wheeler’s invitation to discuss whether jokes are a good way to promote discussion of serious topics, and I’m going to take him seriously for precisely one minute and add something to what I wrote yesterday.

Three reasons, all personal, why I wouldn’t make those jokes myself. First, since I’ve been writing about the relationship between illness and overwork, I’ve been contacted by people working in education from all over the map, all saying that they recognise in themselves or their colleagues some aspect of the neglect of self that this involves: the sense of panic, despair and exhaustion; the relationships stretched to snapping point; and sometimes full blown illness. They really do have their heads in their hands, like the photo Steve used of himself in his prank. And I have to say that those of us whose illness is physical, especially of the kind that scares the underpants off everyone around us, fare much better in terms of other people’s cheap jokes than those who are wrestling (often in secret) with mental health. Because mental health still fuels the metaphors of everyday life. It’s ground right into the language of joking around, and I really can’t imagine how it feels to have to navigate this.

Secondly, at the end of last year, when I was still flapping about like a bird that has flown into a plate glass window with “cancer” etched on it, I came across Francesca Milliken, who was just at that moment starting her own blog about her daily experience of living with clinical depression in its most depleting extreme.  I’ve followed her writing ever since, and I’m really a huge fan, because of the clarity and courage with which she lays out what she’s here to say. And that’s why jokes about clinical depression can’t sit well with me, because when you say it, I see this person. And this one. And this one.  And this one.

Thirdly, I’ve followed Audrey Watters since I first started writing online, for her frankly indispensable service to education blogging. Through her and many other women tech writers or activists, I’ve learned that joking about online threats to bloggers truly doesn’t work for me either. Because:

So for these three reasons, it just doesn’t seem to me that there’s a serious issue on the planet that’s worth trivialising what other people have to live with, when we have instead an opportunity to care for each other, and to speak without clutter about the fact that the things in Steve Wheeler’s post are serious.

Should this cramp Steve Wheeler’s style?  No, of course not. I’m not his mother.

But I now realise that what troubled me about his prank goes a bit deeper; it connects to the very odd political culture in Australia at the moment. So I’ve been thinking back to Jason Wilson’s beautiful essay on the proposed repeal of the 18C provisions in Australia’s Racial Discrimination Act. These provisions set out that we have a high standard in Australia that makes it an offence to offend, insult or humiliate others on the basis of race. And now, with the considerable hubris of its thumping political majority, our new conservative Government is proposing that these amount to a sanction against “hurt feelings”—even though this suggestion has been robustly tested in law and found to be as daft as it sounds.

When I first read Jason’s essay last year, the bit that really stayed with me was this simple advice: power cannot be shamed into limiting itself.

It came back to me yesterday because it’s such a solid and intelligent caution against letting frustration be the compass to your reactions when dealing with conservative thought.  That’s one compass that will always be spinning, because it is in the very nature of privilege to be able to maintain a dizzying range of positions all at once.

And that’s exactly why privilege also cannot be shamed into recognising itself.

This is the painful lesson played out again and again in coordinated Twitter activism, for example. #notyourAsiansidekick, #CancelColbert, #destroythejoint: these campaigns build solidarity among the exhausted and frustrated, but rarely achieve reflection or change in the expression of privilege itself. In fact, mostly the opposite: they trigger a doubling down on the original whatever, often in the form of a patronising explanation of what was intended and how life woks, in case the sophisticated nature of privilege has somehow slipped by those who criticise its operation.

None of this is new, or personal. It’s the well established set of routines that continuously polish the dance floors on which privilege performs. When I read yesterday that Steve Wheeler, oddly enough choosing Bon Stewart’s own words from her comment on this blog, is prepared to “own the post and be accountable for it”, I found myself humming Bob Dylan.  And then suddenly I remembered a very old article by film theorist Laura Mulvey. In “You Don’t Know What You’re Doing, Do You, Mr Jones?” (1973), Mulvey riffed on the lyrics of “Ballad of a Thin Man” to rebuke a complicated pop art joke based on making the bodies of women into furniture — a joke that as it happens was recently reprised as some kind of racial satire, and then defended all over again. Because, you know, joke.

So none of this is new. It’s the platform from which conservative thought launches its banal, recurrent manifesto: the double-back-flip vision of privilege as victim. It’s how people for whom the dice of privilege have been loaded to win every game get to advise others to stay hopeful that this is not actually how things are. And this is how privilege continually serves up to others, as Tressie McMillan Cottom puts it in her outstanding essay on hope as the ruse of progressive thought, “the cornbread that turns to shit in your mouth.”

So this is how privilege gets to feel responsible, heroic, misunderstood, and sorry for itself, all at once.

And at the moment, for some quite weird reasons, we’re seeing this dredged up conservative woundedness all over the place—in politics, in corporate leadership, in entertainment, and online.

To me, both Jason Wilson and Tressie McMillan Cottom are right about the practical mechanics of it. Jason Wilson talks about the strengthening of power through “pantomimes of accountability”, in a way that matches up to Tressie McMillan Cottom’s description of the “solicitors of hopefulness” policing the same agenda. Never having to say you’re sorry means that the privileged continually get to define just how much they’re willing to share, how much accountability is just enough, how much hope will do.

But even though Mister Jones is all around us, in recurring multiples like Agent Smith, there are signs of change happening without him. There are people everywhere writing back, stepping up, and giving their own human time to indicate that they care for each other, and will risk their own convenience to make a stand. (Looking at you, Bill Ryan.) And of course, these include all the people who wrote in good faith to express concern about Steve Wheeler’s apparent disclosures of trouble, those who missed his joke, to whom I just want to say: don’t change a thing because you really are part of something good, and we’re all here with you.

So there’s every reason this morning for optimism because there are so many of us ready to say: enough, we’re done with this. The serious fault lines of privilege aren’t between one online writer and another, one educated blogger and another. They’re the daylight between all of us and the people whose lives are being trashed by the global economy, by environmental damage, by incarceration, by the staggering cruelty of refugee camps, by preventable disease, by both underemployment and overwork, and by the sense that there is nothing the powerful are prepared to do about this beyond snarking at each other for the win.

And the repeal of our Racial Discrimination Act is now actively in the public consultation phase. Australian readers, you can write in and say what you think.

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