What can happen when you trust a state agency to point you to high-quality day care? If you are Chris and Shawn Lear, your son can be shaken until he is near death and have injuries so sever he may never fully recover.

The day care facility where the Lears put their son Lucas had a five-star rating from the state, but it had been investigated a year earlier for an infant’s broken bone. According to the Raleigh News & Observer story, the Lears “assumed Alston’s high rating was emblematic of an untarnished record.” Their lawyer told the N&O “There was nothing that alerted them to check further. Had there been, they would have.”

But the state’s star rating system is as useless to determine daycare quality as state certification is to determine teacher quality.

This episode further undermines confidence in the ability of the federal government to determine comparatively effective medical treatments better than patients.