Sibylla Bostoniensis

Informal poll:

I was just watching an activist's video about media in the US in which she showed a clip of Sen. Elizabeth Warren schooling a news anchor about the relationships of the Presidency, Congress, and the Courts to one another. At one point Warren refers to this as "ConLaw 101" – "ConLaw" being the slang term in colleges for Constitutional law classes and "101" being the idiomatic term for a introductory college class. The activist, in discussing what a shonda it is a CNBC news anchor doesn't seem to have the first idea of how our government is organized, says, disgusted, "this is literally 12th grade Government", i.e. this is what is covered in a 12th grade Government class.

Which tripped over something I've been gnawing on for thirty-five years.

The activist who said this is in Oregon.

I'm from Massachusetts, but was schooled in New Hampshire kindergarten through 9th grade (1976-1986). I then moved across the country to California for my sophomore, junior, and senior years of high school (1986-1989).

In California, I was shocked to discover that civics wasn't apparently taught at all until 12th grade.

I had wondered if I just had an idiosyncratic school district, but I got the impression this was the California standard class progression.

And here we have a person about my age in Oregon (don't know where she was educated) exclaiming that knowing the very most basic rudiments of our federal government's organization is, c'mon, "12th grade" stuff, clearly implying she thinks it's normal for an American citizen to learn this in 12th grade, validating my impression that there are places west of the Rockies where this topic isn't broached until the last year of high school.

I just went and asked Mr Bostoniensis about his civics education. He was wholly educated in Massachusetts. He reports it was covered in his 7th or 8th grade history class, as a natural outgrowth of teaching the history of the American Revolution and the crafting of our then-new form of government. He said that later in high school he got a full-on political science class, but the basics were covered in junior high.

Like I said, I went to school in New Hampshire.

It was covered in second grade. I was, like, 7 or 8 years old.

This was not some sort of honors class or gifted enrichment. My entire second grade class – the kids who sat in the red chairs and everybody – was marched down the hall for what we were told was "social studies", but which had, much to my enormous disappointment and bitterness, no sociological content whatsoever, just boring stories about indistinguishable old dead white dudes with strange white hairstyles who were for some reason important.

Nobody expected 7 and 8-year-olds to retain this, of course. So it was repeated every year until we left elementary school. I remember rolling my eyes some time around 6th grade and wondering if we'd ever make it up to the Civil War. (No.)

Now, my perspective on this might be a little skewed because I was also getting federal civics at home. My mom was a legal secretary and a con law fangirl. I've theorized that my mother, a wholly secularized Jew, had an atavistic impulse to obsess over a text and hot swapped the Bill of Rights for the Torah. I'm not suggesting that this resulted in my being well educated about the Constitution, only that while I couldn't give two farts for what my mother thinks about most things about me, every time I have to look up which amendment is which I feel faintly guilty like I am disappointing someone.

Upon further discussion with Mr Bostoniensis, it emerged that another source of his education in American governance was in the Boy Scouts, which he left in junior high. I went and looked up the present Boy Scouts offerings for civics and found that for 4th grade Webelos (proto Boy Scouts) it falls under the "My Community Adventure" ("You’ll learn about the different types of voting and how our national government maintains the balance of power.") For full Boy Scouts (ages 11 and up), there is a merit badge "Citizenship in the Nation" which is just straight up studying the Constitution. ("[...] List the three branches of the United States government. Explain: (a) The function of each branch of government, (b) Why it is important to divide powers among different branches, (c) How each branch "checks" and "balances" the others, (d) How citizens can be involved in each branch of government. [...]")

Meanwhile, I discovered this: Schoolhouse Rock's "Three-Ring Government". I, like most people my age, learned all sorts of crucial parts of American governance like the Preamble of the Constitution and How a Bill Becomes a Law through watching Schoolhouse Rock's public service edutainment interstitials on Saturday morning between the cartoons, but apparently this one managed to entirely miss me. (Wikipedia informs me "'Three Ring Government' had its airdate pushed back due to ABC fearing that the Federal Communications Commission, the U.S. Government, and Congress would object to having their functions and responsibilities being compared to a circus and threaten the network's broadcast license renewal.[citation needed]") These videos were absolutely aimed at elementary-aged school children, and interestingly "Three Ring Government" starts with the implication ("Guess I got the idea right here in school//felt like a fool, when they called my name// talking about the government and how it's arranged") that this is something a young kid in school would be expected to know.

So I am interested in the questions of "what age/grade do people think is when these ideas are, or should be, taught?" and "what age/grade are they actually taught, where?"

Because where I'm from this isn't "12th grade government", it's second grade government, and I am not close to being done with being scandalized over the fact apparently large swaths of the US are wrong about this.

My question for you, o readers, is where and when and how you learned the basic principles of how your form of government is organized. For those of you educated in the US, I mean the real basics:

• Congress passes the laws;
• The President enforces and executes the laws;
• The Supreme Court reviews the laws and cancels them if they violate the Constitution.
Extra credit:
• The President gets a veto over the laws passed by Congress.
• Congress can override presidential vetoes.
• Money is allocated by laws, so Congress does it.

Nothing any deeper than that. For those of you not educated in the US, I'm not sure what the equivalent is for your local government, but feel free to make a stab at it.

So please comment with two things:

1) When along your schooling (i.e. your grade or age) were these basics (or local equivalent) about federal government covered (which might be multiple times and/or places), and what state (or state equivalent) you were in at the time?

2) What non-school education you got on this, at what age(s), and where you were?

...wrenching myself away from the emergency webinar on the disruptive new Federal law that was (but no longer is) going into effect next week – which the speakers assure us is in our patients' best interests and not at all an Orwellian extension of our surveillance state – which I was liveblogging to email for colleagues who are like "hmm but how will our plunging into civil war effect this?" to try to listen to the Code Red Emergency Notifications voicemail that my town has gone from "green" to "yellow" on our state's COVID scale, but having trouble hearing it over all the sirens in my neighborhood...

(h/t Metafilter)

The frequently fascinating Patrick McKenzie (kalzumeus.com, patio11@twitter), explained Furusato Nouzei or, roughly, the Hometown Tax System, "which is aesthetically beautiful, novel and sensible tax policy, and a cautionary tale about incentives all at the same time".

Japan has figured out a solution to at least part of the urban/rural tension. Said solution may be specific to Japanese culture/political landscape, but it's very, very interesting.

In response to my post about Violence and Mental Illness atheist_cheese asks a great question:

I ask this with all good intent, and agreeing that the best course of action is to set up a system that meaningfully supports all vulnerable people, even ones who themselves have harmed, harm or are inclined to harm others. I also ask this as a nursing student who is trying to decide if working in mental health is for me:

where is the line between mental illness and personal responsibility? All your example scenarios were fairly, hm, clear cut? How about someone who is mentally ill and abuses their SO/spouse in a way that is connected to their mental illness? (Abuse can of course, come from people who aren't mentally ill, and certainly people like Lundy Bancroft seem to insist that most of it Is Not At All Related, but that's another thing). Am I doing some false conflating here? I get the feeling there's something I'm not getting here.

There totally is something, and you're very astute to tune in to it, because it's very hard to see. I hope you won't mind my using your question as a jumping off point.

When you ask about "personal responsibility" I think what you're asking about is to what extent one can or should consider an individual morally or legally "responsible" for their conduct.

The term for that – for the state of being "responsible" for the crimes or other wrongs one has commited – is culpability.

( Read more [3,640 Words] )

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Oh, huh. I just found this looking something up in HIPAA:

(a)
(1) Standard: Right of an individual to request restriction of uses and disclosures.

(i) A covered entity must permit an individual to request that the covered entity restrict:

(A) Uses or disclosures of protected health information about the individual to carry out treatment, payment, or health care operations; and
(B) Disclosures permitted under§ 164.510(b).

(ii) Except as provided in paragraph (a)(1)(vi) of this section, a covered entity is not required to agree to a restriction.

[...iii: if you do agree, you have to keep your promise, except in emergencies...]

(vi) A covered entity must agree to the request of an individual to restrict disclosure of protected health information about the individual to a health plan if:

(A) The disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law; and
(B) The protected health information pertains solely to a health care item or service for which the individual, or person other than the health plan on behalf of the individual, has paid the covered entity in full.

In other words: if you pay for it out of pocket, you can require your healthcare provider keep it secret from your insurance – so long as disclosure is not mandated by law.

This is fascinating for a number of reasons.

For one, I've heard of pharmacists refusing to fill prescriptions for controlled substances if the patient's MassHealth won't cover it, even if they patient offers to pay full price out of pocket, on the grounds that MassHealth forbids it. I have no idea if that is true, though I have heard this story two or three times.

For another, it pertains to treatments not diagnoses, or anything else. So if you see a therapist, you could require the therapist not notify your insurance you are being seen by them. But say you have been seeing a therapist for a bit, and then one day reveal to the therapist you have a substance abuse problem. You can't get out of the therapist notifying your insurance that you now have a substance abuse diagnosis by offering to pay for that one session. The therapist is going to have to put your diagnosis into the ongoing paperwork. (I work for a clinic that has to function under some regulation that requires us to promote any substance abuse diagnosis to the primary spot for a patient that has one, and the primary is the one that's on all the paperwork that goes to the insurer.) The only way to really keep that from your insurer is by paying out-of-pocket (it's called "private pay") from there on out.

For another, I wonder what disclosures are mandated by law. I don't know if we have any of those here in MA.

For another, I am really dubious that anybody is building their EHR to support this. Is there a "DO NOT REVEAL THIS TO INSURANCE" flag to put on appointments and treatments? If not, what happens during audits?

Insurance companies audit medical records, yo. Simply saying, "Oh, well we just won't bill for that then they won't know" doesn't cut it if the insurer periodically drops by and demands to read the chart.

I sure as heck know that neither clinic I work for has any way to remove individual records of sessions from a paper chart before an audit.

I am trying to imagine what would happen if we told the MassHealth auditor, "Sorry, give us a moment, we have to remove a bunch of treatment records from those files before you can see them." Head spinning around and exploding is not beyond the realm of possibility. I suspect saying "HIPAA requires it" would not actually help, because they wouldn't believe us.

Yes, I am reading the Murphy Bill. It's about 26,750 words, which you may consider karma if you like.