NYU Makes Tuition Free for All Medical Students
wsj.com
wsj.com
Don't get me wrong, this is fantastic on an atomic level, and the levels of debt required to get an MD these days is insane (have a lot of family in the field). Also, it's not like this is a unique structural disadvantage, just a new one.
Despite being emancipated, FAFSA still considers you a dependent until you're 24. I was told that only with documentation of leaving an abusive household would a dependency exception grant be applied. So according to FAFSA I was supposed to use all this money that I didn't have to pay for college. By 24 I had dropped out and gotten a development job, now putting me outside of the income level where I'd get even federal loans (and quite frankly I still can't take on that debt load).
Just make college free. Trying to make all of these complicated rules to make sure that a few people aren't "getting one over us" is just making more cracks for people to fall into. If you're concerned that the rich are going to somehow use the system without paying, structure the backing tax so that they pay their fair share. No one cares that high school is free for the rich too. Everyone pays in, everyone can participate.
With students able to get loans of nearly any amount, the schools have no reason not to raise tuition prices, and that extra money ends up feeding a bunch of administrative bloat, a significant amount of which gets turned around into crazy marketing and advertising schemes to trick more fresh highschool graduates into taking out loans to pay for the crazy tuition. The first time in most of these people's lives where they are expected to take out a significant loan of money and are easily manipulated into potential financial traps. For many of them it is the first financial decision in their entire life and it rivals the cost of buying a house.
I would find it pretty tempting when graduating to ... default. You've got plenty of time to fish your way out of bankruptcy as you're young, you don't have much for assets or anything...
If they basically shut down all student funding, that doesn't seem like a huge problem either - it's a fairly bad model and I think society would benefit for from the pressure to find a better way to educate people.
It's a difficult question, it would have a lot of unpredictable knock-on effects. But subjecting the industry to market pressures seems a move in the right direction.
Just because the loans can't be discharged during bankruptcy proceedings doesn't mean the lender gets their money back. Default rates are high (and rising). The lender may get some money, but that doesn't mean they get their principal back, let alone a sufficient interest to justify giving out the loan in the first place.
Some people never make enough money to pay it off, after which the government will pay the loan off after a few years. The lender gets payed anyway. These are risk free loans for lenders.
There's one "but" however: this does absolutely nothing to improve affordability, so some mechanism needs to be devised to reduce overhead costs, and put a cap on profits. I would prefer if that mechanism were market-based as well.
First, education is chock full of positive externalities, which will never be realized correctly. While "the economy" doesn't need underwater basket weaving - or art history, or literature - society still does. Even if people don't work in their field, the world is better for the increase in knowledge. Man does not live on engineering alone.
Second, the invisible hand can only do its work in a world where the effects of decisions are predictable. Given the long lead time on a choice of major affecting your income - at least four years, arguably more if you factor in choice of AP classes on high school - that's never going to be the case. Say this system had been in place in the 90s, and say you're okay with underwater basket weaving students getting the short end of the stick because, well, they signed up for it. Fine. But what do you say to the computer science class of 2001?
The law responsible for this situation (the Bankruptcy Abuse Prevention and Consumer Protection Act) was passed in 2005. Prices had already been rising for decades. I'm not saying it hasn't had an effect, but it can't possibly be the "main factor," because it literally didn't exist when prices started to rise.
People call for X to be more affordable > government subsidizes X > X absorbs all subsidies and becomes even more expensive > people call for X to be socialized.
Maybe instead we should start to unwind student financing. For example: let students discharge student loans via bankruptcy. That would give financiers pause and would put an upper bound on what many universities could charge.
https://msu.edu/~conlinmi/teaching/EC860/signallingscreening...
tl;dr: In markets where the cost of education is less than the increase in wages, the real cost of education isn't the fee, it's the relative effort of passing it.
Yes, it will cost a lot and yes we need to find a way to fund it, but giving all communities fair access to education is in everyone's best interest.
Increasing the base level of education makes everyone a more intelligent, informed citizen and voter, and will have a positive impact on the progression of our country. I think it's a bad idea to be penny pinching in this regard. I also think everyone being educated, and learning how to think for themselves (which I find is the key greatest value of getting higher education) will keep the people in power from herding everyone around like sheep, and will lead to more progress and innovation.
I will gladly pay a higher portion of my salary if it means the general populous can think for themselves, has a means to climb if they wish to, and the base level of education of the people in my country increases.
Why? If we’re trying educate the entire populace instead of a few high achieving high schoolers, we should recognize that a majority of people can’t afford to up-end their lives, move far away, and spend 4 years getting a degree.
Community colleges, emphasis on the community term, would allow for people — local people — to educate themselves without drastically affecting their livelihoods. In this way, community colleges can also potentially act as job retraining facilities.
Note that I am slightly biased as a Californian.
People take it a priori that more education is always good — when there’s a lot of evidence that the vast majority of higher education (in both time and dollars spent) is wasted.
No one is stopping you from doing so. Donate some money to local youth or a scholarship fund.
However, it seems like you want to force everyone else to pay a higher portion of their salary to this cause.
You can certainly "game" the system still. One could easy join the military, from there you'd get out around that age, they you'd be independent and you'd still have a GI bill to pay for most of it.
Or like me, I went to a tech school for aviation maintenance, graduated in 1 year, started working full time at age of 20. But by 21, I knew this wasn't the right field for me (too low pay for the amount of work required). I saved my money, quit when I was 24 and enrolled in a 4 year uni for CS full time with only $5k in my bank account.
I lived with my grandparents that were about 40 miles from the uni. The $5k got me through one year just fine since I didn't have to pay for rent or food. For the second year, I went back into the aviation field as a contractor making $22 an hour. After 6 months I had $10k in the bank. I then started my second year of college but to my surprise, since I hadn't filed with the IRS the past year and claimed an income of $0 in the previous year, I then qualified for about $6k in pell grants. So with $10k and pell grants, I went to college full time for another 4 years and graduated debt free (yes, it took me 5 years to graduate, perhaps I'm a little slow..). Actually not totally debt free, I still pay $50 a month for my tech school degree loan from 15 years ago...
It's ridiculous.
Parents divorced and one parent is an asshole? All they need to do is refuse to hand over their tax returns.
Parent remarried? FAFSA wants to see the tax returns of the step-parent and takes THEIR income into account, even if the marriage only occurred the previous year.
Needing parental tax returns is a ridiculous thing for an adult.
Sure, have some funding ideas?
https://finance.yahoo.com/news/trump-approves-717b-defense-s...
Germany even made University free for foreigners.
In Germany all universities (with very few exceptions) are completely free and students have just to pay their cost of living (can apply for subsidies for that too).
There were many studies which showed that ANY fee is a deterrent for students from poor families.
In my opinion the current political development around the world shows that better education is absolutely required for humanity. Education should be financed via taxes (and taxes for high incomes should be increased accordingly to finance it).
Additionally fully nationalize the public schools, and work to remove the administrative bloat that has occurred. I know that the libertarian side here on HN is going to see this and say "more government -> less overhead? does not compute", but hear me out. Their pseudo private status has set up the incentives to de facto remove education from the core mission of universities. Chasing grant money, real estate capital, and investments might technically make them more money, but that flies in the face of what they should be doing, IMO.
While I am thankful it worked out for me, I know this is not a route open to everyone. Unless your family has the financial means (or you get a great scholarship), I am not sure there are many ways to go to college without getting into significant debt.
Presumably you mean, increase taxes so we can pay for everyone to go to college? Not everyone wants to go to college. Your proposition means that those people are getting the shaft.
Would you mind saying when and by whom you were told this?
Asking because this was not my experience. While I can't remember if I had to/or was able to finagle my parents' info for FAFSA, I do remember having direct discussions w/my school @ the time so that they weren't trying to factor my parents' assets and income into their aid calculation.
Ironically if I had applied to college while I was 17, they have a category for emancipated minor. But since I was no longer a minor, that didn't apply to me.
And to answer you question, this was repeated from several potential schools' financial aid departments.
I think a good compromise is to make public universities and community colleges free for residents of that state.
Private schools with massive endowments can do what they already do to make college affordable to the exceptionally poor or talented.
There are no income limits on federal student loans.
I faced the same situation; after being rejected, all I had to do was file some extra paperwork ("special circumstances") saying that I'd left my job and no longer had any income.
You can get into NYU from a poor socio-economic background, if you work hard and attain academic excellence.
And while all students will appreciate this discount, it will make more of a difference to those who are not "fine without it", i.e. those below the top richest and most privileged (for whom spending $200-300k on education is easily affordable).
Finally, this isn't exactly pure charity out of the kindness of NYU's heart. It's a response to medical candidates choosing other fields due to cost and debt issues:
https://www.wsj.com/articles/in-search-of-more-doctors-new-t...
These are the exact candidates this subsidy seeks to relieve.
Per "it will make more of a difference to those who are not "fine without it"". Sure, but it would make more of a difference if needs based and scaled broadly (not sure what restrictions exist on the funds for this aim). Although this line of argument admittedly unravels into base utilitarianism when followed.
This is the "social justice" argument.
Now let me ask you this:
If you get sick and require surgery, would you rather be treated by the smart, skilled, hard-working doctor who succeeded in everything he tried, including being accepted into a top school?
Or maybe you'd prefer the under-privileged doctor, who never did well academically, and only got into a lower-tier school, but managed to graduate thanks to your social justice subsidy?
Your argument seems to make society more just and equal, but you support it because it is convenient to appear as just person, and you are isolated from the repercussions of your proposal. In reality, your policy will prefer and encourage mediocre doctors over excellent ones, you just hope it won't affect you.
Thankfully, American society is structured in such a way that a top school like NYU can muster the funds required for the subsidy, and thus we will have more excellent doctors, instead of more poor ones.
Very true. Unfortunately many times the schools where a kid from a lower socio-economic background will attend will not prepare them for a school like NYU. In fact, sometimes it will probably be a net negative.
Not necessarily the school itself, but the whole environment. Other students will be so disruptive to an entire class or school that they will drag down their piers down with them. And by this I'm talking about gangs, drugs, bullying. And if it is not their piers it may be their family themselves who will drag down the kids (alcoholism, drug addiction, domestic violence).
And it is not like you can just say they should know better, because at that age they don't really know any better. Kids from crappy neighborhoods don't even start in the home base, many times they are not even allowed to play.
First school I went to was the lowest performing school in Georgia, in which I was the only white child. By high school I had moved to the highest performing high school in the state, where the senators sent their kids, etc. "Real Housewives of Atlanta" was from my school district then.
Drugs, alcoholism, bullying, and domestic violence happen in every environment, and in my experience they trend towards those with the means to sustain those habits. The rich kids had been doing coke and molly since they were 13 and have been buying it from their classmates. In the richer burbs, the cops are present to keep out people who "shouldn't be there", and less to keep the citizens who "should be there" from breaking the law. The huge emphasis on "upstanding members of the community" having a "traditional household" hides high levels of domestic violence.
I agree that kids from the poorer backgrounds don't even start on first base, but it's not because of any life choices they've made in a lot of cases.
How common do you think this is? I would bet it is no more common than other shitty circumstances regardless of socio-economic status.
This entire sentiment is nonsenical IMO.
Alcoholism, drug addiction, bullying, domestic violence are issues that affect people of 'noble birth', too. In fact, a number of kids I knew in school were acutely aware of the fact that their parents saw them as a burden or impediment to their own lives and as such, sent shipped them off to boarding school. And so, the kids drank and drugged... Fast forward to college, I know of one kid whose parents shipped off on a study abroad trip to "cure his drug addiction." Yeah, he ODed while we were on a ship in the middle of the Pacific-- though he'd scored coke, but surprise, surprise, the nice dealer he'd met while were in a SE Asian port gave him something else.
tldr: Yep, kids from poor neighborhoods often don't start out w/the same advantages as those from higher socio-economic backgrounds, but kids from the latter backgrounds often work vary hard to even the playing field by engaging in self-destructive behaviors that for some reason people like to mostly associate w/being poor. Really the only difference is that certain members of society are more willing to forgive even the worst behavior for one group while penalizing mercilessly those of the other for the most innocuous behaviors.
Ps. A pier is something one might take a walk on. A peer is a member of a cohort, class, etc., ostensibly.
But who can get to the best ones? People from poorer environments unfortunately get a poorer education as well (middle and high schools are of less quality), and it makes it way harder for them.
Equal opportunity is really tricky to get right.
I am an anecdote obviously. However, I want it to be known that at Stanford, people at the bottom of the economic ladder receive aid, but people in the middle still get squeezed.
Making tuition free for all would actually be a net positive. Sure. There are people at the top who would benefit, but for the most part, financial aid is financed by the estates of people in that elite socioeconomic class.
I don't really have a point here. This is just my experience of the system.
Edit: Actually more of a comment for the post before.
On the other hand, perhaps some great minds choose to go into medicine rather than banking, or more important but lower-paying medical disciplines, because they know they won't be graduating with crippling debt. That seems like a big win.
Now less privileged people can see NYU med school as something to aspire to. I fail to see the problem here.
This is the definition of "means-testing" and it is bad. Testing and "checking" that the recipients of social welfare is complicated and doomed to create a group of excluded people who believe they should have merited it. Means-testing introduces fiscal cliffs, creates a separate of haves and have-nots, and lots of other unnecessary anxieties between classes of peoples. The savings means-testing produces is tiny in aggregate and the harm to culture is large.
Moreover, means-testing becomes the fulcrum that anti-social welfare reformists use to destroy programs. Means-testing introduces an additional point of failure, brittleness that can be exploited. It's hard to rip away a program that is granted to all comers, but if there is a clear line between haves and have-nots, they you can just move the line. This has happened multiple times to the Affordable Care Act, and states regularly do this to medicaid and food stamp programs, to their detriment.
The most successful social programs have no means testing: social security, medicare. If you value social welfare programs, you will not inflict means-testing on them.
This isn't just for the poor, it's also for the well-educated, solidly middle-class people who still can't afford med school, or have to go deep in debt, thus leading to them being forced to prioritize high-earning careers over those they might otherwise be inclined towards, medical careers that might have a more positive social impact.
Or maybe it starts a trend that if you apply yourself and make sure you do really well at X, you can graduate without a lot of debt. Maybe this leads to a world where we get better at helping people find the thing they can excel at so they can qualify for the free ride and then be awesome at their profession after they graduation. And maybe this becomes a trend where other universities decide a full ride is the only thing that makes sense.
There is an S curve where rich people, who can afford to take risks, try new things. They get to winnow out what doesn't work. The things that succeed become popular and this makes them affordable to the masses.
But, first, someone needs to give it a shot. And that someone is usually pretty well-heeled.
I'm okay with that.
https://www.nytimes.com/interactive/2017/01/18/upshot/some-c...
How do other top-level schools compare?
Stanford is at 17.5% and 18.6%.
For comparison Harvard is better, MIT is significantly better, on par with Texas, Yale and Princeton are slightly worse.
Grammar tip: In English, the word "alumnus" is typically declined as it would be in Latin. Especially amongst academics, I'd say.
So if you're writing for that audience, the appropriate forms of "alumnus" are, I think, as follows [0]:
"alumnus" - One male, or one person of unspecified sex.
"alumna" - One female.
"alumnae" - Multiple females.
"alumni" - Multiple persons whose sex is all male, mixed male/female, or unspecified.
Maybe it's common somewhere else to make those distinctions, but they're not common at McGill.
My friends don't seem to like when I tell them about proper declension when we're in the stadiō.
(Though, to be fair, the native English word children is in fact a double plural as well. [The -re is plural, thus early/dialectal forms childer "child [pl.]", and then later with a plural -n slapped on top of the already plural word, presumably because the -re plural ending had become somewhat obscure, just as Latin plural endings are for some modern English speakers.] Doesn't make me cringe any less at "alumnis", despite that.)
If you're using it by itself as a noun, it's 2nd declension and the ending changes only based on plurality or case, not the gender of the actual graduate(s)
I agree. When thinking about the use of "proper" English, I find myself conflicted.
One the one hand, I truly believe that languages evolve, and it's silly to put any one particular version of English on a pedestal. That includes the version(s) one might associated with English speakers who are well-educated and/or wealthy.
On the other hand, I was raised to speak "proper" English, because my father believed that it strongly affects others' first impressions of the speaker's intelligence. I think my father was right about that, although I'm still undecided about how much it matters, and whether or not it's a concern worth catering to.
Alternatively, if you're using it by itself as an adjective, obviously it will take the appropriate gender. You don't need an explicit noun if you're happy with an implicit "man", "woman", or "thing".
Same grammar confusion happens with "curriculum" (single) or "curricula" (multiple).
"alumnum" is the correct Latin term for a singular person of undetermined sex.
If you have a more authoritative source of information I'd be grateful for a link.
[0] https://en.wikipedia.org/wiki/Alumnus
[1] https://www.grammarly.com/blog/alumna-alumnae-alumni-alumnus...
So this is a great news for many people like me. I wish this was around when I was applying.
That said, insane cost growth is obviously the overwhelming issue in education over everything else. Almost any system that reins that in is going to be superior to one that doesn’t—-even if it is otherwise less fair.
The natural solution is invest more in scholarships, at least here. I'm sure that the situation in US is fully different though.
If you're worried about inequality, you need to take the money away from the rich people, not worry about this or that little thing.
Sounds largely private.
It’s an imperfect analog I think, but it’s helped me contextualize my situation and remove some feelings of bitterness towards the debt I still owe.
[1] I’m not military so I don’t know 100% how that works - open to corrections
Most of your tuition is covered while you are active duty, $750 per credit hour. If not you can tap into your GI Bill to pay the rest; I did this as I didn't want to fund any of it. Though I could have paid the difference, saving my GI Bill, which would have netted more money for school.
Overall, you analogy is correct. But the military is an easy route when you are 18 - 22 (easier than most people think), as most jobs are not combat related. My job provided services to the general public as well.
You're analogy works for academic programs that lead to careers that pay reasonably well. But, not for underwater tiddlywinks - no amount of time spent in that field will allow you to pay down the debt.
1 - They pay for four years, plus some expenses. Generally, if you drop out of the ROTC program after the start of year two, you owe Uncle Sam whatever has been paid on your behalf. If you finish the program, you are committed to 4+ years of service (differs by branch and job role, with some allowing the commitment to be split between active duty and reserve).
2 - ROTC programs prioritize technical degrees and foreign languages over other degrees.
Agreed, but that’s your onus to calculate the cost/benefit (whatever those benefits may be) of any pursuit, not just academic. It’s just especially important for studying in the US, given the insane cost of education.
Like you said, there’s a skew towards technical degrees, but I think about me and my peers at 18 and man we had no idea what we were doing and had little context for how such a big life decision would affect us down the road.
These things are tough to reconcile but we are all wrestling with them, and we have to keep our heads healthy to contend.
The only mistake I’d warn against is letting this influence your judgement of others, or your prescription for future generations. They are counting on us and we are counting on them. The point about the military speaks to the reality that you are not alone, but the bottom line is we have been dealt an injustice. We must not pass this nonsense on to those depending on us to make it right. We’ve got to stand together against the agregious opportunism undermining the livelihoods of Americans.
If nothing else, I don’t want to bare this weight through my middle age and still have the kids speaking of me in the way they speak of baby-boomers today. This isn’t to say the baby-boomers are to blame, but it is tough to feel sorry for them given the opportunities they had.
I’d much rather get the praise the Great Generation gets. Let’s work for it.
Love yourself, and all the moreso by loving others as well.
I’m curious what your segue is from contextualizing and rationalizing decisions I’ve/we’ve made for myself/ourselves to judgements on others.
My point, I guess, was that it’s easy to think of university costs purely in monetary cost and ignore the inherent time-cost required to pay.
The calculus I did when looking at schools was: it costs X much, median starting salary for this field is Y, I’ll have to “do my time” for Z years as payment for my education. Looking at it that way, I’m paying for school with time, not money.
Yeah they paid for everything - but it had its issues - but he was also exceedingly lucky.
So only do this if you want to do medical and military for a really long time.
Most folks can train as a CNA and do some sort of home health care, for example. Most folks have the ability to work in school kitchens, provide janitorial services for schools, hospitals, and government buildings. Many folks have the capacity to work in day care centers, as substitute teachers, bringing meals to the elderly, mowing lawns for folks that need it, different sorts of service for parks and other public places, and so on.
You can specialize this for some areas: Art degrees? Make beautiful areas. Theater? Free to the public plays. Language degrees? Help out at community centers or translate for folks that need it.
These things allow for necessary training - like plumbers, electricians, car mechanics, business managers, and so on - that aren't traditionally the "give back to the community" sorts of jobs, yet are pretty good to have. Including all sorts of schooling allows for a better educated, well-rounded society in general. As a bonus, the civil service will give folks a chance to be around people they might not otherwise meet.
We can do this before, during, or after college. Part time or full time.
I'd also exempt some folks. Doctors, nurses, teachers, and anyone else in such roles - the folks that by the nature of their jobs, give back to the community and are better off simply doing their jobs as soon as possible.
Now I'm a radiology resident and have much more time.
There are more roles in medicine than simply delivering care.
As an aside, I went to UNC Chapel Hill 1992-1996 and it cost $2k/year tuition. Now it's $20k. We've had a shift in attitude in this country of "why am I paying for something that benefits someone else," but it's going to bite us in the ass down the road as intelligent / hard working people say "why should I accumulate debt to work that hard? I'll just choose something else."
General Surgery and OB/Gyn have gone from being the hardest residencies to get, to now only requiring you graduate from medical school. The hours and the pay are the reason. Orthopedic surgeons get $1000 to put a scope in a knee and scrape a little whereas general surgeons get $400 to take out an appendix in the middle of the night. Ortho is hardest residency to get.
I was top 25% of my class and if I tried to become a surgeon 10 years earlier, I wouldn't have. Most older surgeons were top 1% of their class. My senior partner was, and man is he super smart. Anyway, I still love my job, but the hours suck (80/week). Society benefits from my service (returning sick people to the workforce) and taxes I pay ($200k / year). Not too bad return on investment, imo.
This is exactly why I pressed a giant pause button halfway through my MD to get a PhD in computer science. There was no other time I could do it. After 4th year? Too much debt; also looks bad for residencies to take time off. After PGY-1? Too much debt; would hurt me if I wanted to do a full residency. After residency? Too much debt; also that forces me to wait quite a few more years before pursuing my research/software dev ideas.
Right now I can manage the debt from the first two years with my graduate stipend + summer internship gigs in the industry. If I had waited even one more year to do this, the debt would have been be prohibitive.
One related challenge of inexpensive education is the 'brain drain'. I am Canadian and hold a PhD in Engineering. Tuition was about 3,000 CAD a year throughout my education, with scholarships I ended up no dept at all. Now the temptation is move to the US or Europe is pretty strong, but I am still far from having 'repaid' the gouvernement's 100s of thousands of dollar (with ~160,000$ of in-pocket scholarships) investment in me.
I think free or near-free education is great, but it's a bit of a gamble.
according to TV series residents don't even have time to sleep :)
Unless it's with each other...
Countries like Germany show that university/med school can both be free and high quality. Od course also in Germany some private elite universities exists where you have to pay (it is ok, I like diversity). But to get a perfect career, a state run university is all you need.
Would you be better off if all publicly funded roads where instead private and required you to pay tolls per usage? You would defiantly get an bill more matching your usage, and people who don’t drive would pay less. But it at least feels like we are better off with public roads because they all add value to society as a whole.
The same goes for education. You don’t care about Akkadian studies, but perhaps someone does who thanks to his education can focus on that and earn enough money to buy a car from you auto mechanic keeping him in business making life better for you.
In the past, when a smaller percentage of people were "educated" the marginal value of educating an extra member of society was very high. It seems much lower to me now that information is cheap and freely available.
People who use roads should be paying a lot more for their usage and they should be paying much more directly. So, in short, yes.
The current system is far too diffuse, masks enormous externalities, and generates incredible waste.
Especially grateful for the Islamic Civilization course giving me an informed attitude toward Muslim friends and colleagues, and for my Latin and French studies helping my SAT scores and enabling me to immigrate to Quebec.
My degree was in computer science overall. Though aspects of student life and paid employment at my university helped my career and skillset way more than even the CS classes.
In my particular case, my parents paid for my education, but they could only afford that because US science education funding policies when they were students let them gain cheap entry to well-paying professions. Both of their undergraduate degrees were in the humanities.
Before that, my one grandfather who went to college got a good education at what was then a free city university, and I'm sure it helped his attitudes toward my dad's education. Many of my great-grandparents were poor Jewish immigrants at a time when the US immigration policies were extremely open for healthy light-skinned immigrants from Europe (even their low-class type).
I've had several high-paying tech jobs and paid plenty of taxes to society, but clearly these elements of my family history are factors in enabling that, not just anything about my career-related classes.
All of which is to say, we all benefit from affordable education, in surprisingly broad ways that rebound down generations and across spheres of activity. We shouldn't take a narrow vocational approach to this.
It’s commonly understood that “free” in the context of public services means paid for collectively by government. We totally get that and are still cool with it.
Your return on investment comes later when they’re paying taxes, which are on average higher than they would have been without assistance.
At scale, this kind of investment will pay for itself. There will undoubtedly be outliers on the down side you’d be able to point to, but did you know that philosophy degrees are disproportionately represented among CEO’s?
Don’t pick the subjects, just invest in it all and reap the rewards.
It will help offset your "social assistance" costs as well. Food stamps, housing supplement, welfare... education gets people out of that.
Spend money to make money.
I did know this, but I wonder which way the causality goes. perhaps CEO's are disproportionately likely to have come from wealthy families who could afford to send them to elite liberal arts colleges and/or afford to pursue a degree without direct applications.
Your thinking is flawed in this regard. Sure you are paying "my" tuition fees. But in an either indirect or direct way, you (you as the society, not necessarily you as the single person) are also profiting from my services. And as you are more than a being measured by money, but a human with a cultural background, even studying Akkadian on taxpayer's money might be ok (as long as not everyone does it).
I am a semi-libertarian myself so I get your argument somehow. Then again I am for equal opportunity (not equal outcomes) and providing education for free is a great equalizer and a great way that people can actually live up to their potential (or not, in which case they still need well educated doctors, car mechanics, whatever...). Good education also does not have to be really expensive by itself, it is a matter of organizing. When I hear the big US universities hording billions, I know that there is too much money in the system.
>Countries like Germany show
All these kids are more than welcome to go to Germany and save $500K in tuition fees.
Yet... that would cease to be the case. You wouldn't be paying for rich people's education. You'd be paying for education for whatever person put in the study time to be a doctor, based on actual merit instead of merit + money. It means that you would have that same chance at schooling. It would mean that doctors could make less money and it probably more likely to live in areas with fewer doctors. And hey, if they become rich, they'll be paying it back into the system and paying for more education that you, as an average-income worker, ever would.
Maybe if you had had free education you could have been a high income guy, perhaps even a doctor!
Once higher education is a public service and not a personal investment, there is much lower returns expected.
Be careful what you wish for, brain drain is a real phenomena.
1. This isn't an "either/or" proposition. This is one university that is making medical education free. There are other universities and programs that have free or low cost programs for the jobs you discuss.
2. Medical school education is phenomenally expensive in the US, unlike training for the other jobs you give as examples, and this expense has a structural impact that negatively impacts our health care system. The high cost of education is one reason that so many doctors opt for higher paying specialties that have higher salaries but don't necessarily result in an overall healthier society.
We sometimes talk about college as a binary -- "Did you go to college? Yes/No? Should we pay for college? Yes/no?" -- but there are enormous differences in experiences and outcomes across majors and institutions.
[0] https://www.aamc.org/download/379220/data/may2014aib-graduat...
And yes, there are other professions equally necessary. To be fair, though, most of those jobs don't require the same level of debt either, and are more obtainable by folks with lower incomes pre-schooling.
edit: Just so I am clear I know that there are lots of other influences on healthcare costs and doctor debt isn't the only pressure they face. Doctors do have some influence on cost (if not large) and if pressure on them is removed in any way some of them may choose to spend that extra time helping their patients money go further. Small early influences can have large effects on a system so I am hoping that this kind of influence might change attitudes enough to have a large longer term change.
Hospitals in America aren't actually a free market. You cannot choose not to buy, and in emergency situations you can't actually compare prices between sellers. Hospitals charge whatever they can get away with and insurance companies get a discount because they have some leverage- but you and I don't.
All this would really do is help lower the medical providers costs. Likely it will give them additional funding to lobby against socialized health care.
I don't see a problem with this, so long as doctors can earn a decent living. An idea I've thought about is that medical school is free, but doctors primarily earn their income by working for the government, for a salary. It might attract different people, who stand to benefit from that bargain.
What I've noticed about the debate is that everybody who is getting rich, is pointing the finger of blame at everybody else. Chances are, they're all gouging us.
Physician earnings account for about 7% of total spending on healthcare. Of that 7%, the fraction due to student debt specifically is significant from the physician's perspective, but negligible from a systemic picture.
This is, of course, assuming that physicians are charging for services that are not be needed in order to boost their earnings, which happens in some cases, but is not as systemic or widespread as people often think, due to the shift away from fee-for-service payment models and towards capitated care, and the opacity of the payment model to the physician at the point-of-care in many care delivery situations.
The priestly incomes that these NYU graduates will go on to earn is precisely why NYU can offer free tuition. Attracting the best medical talent, even if you pay for all their training (call it half a million dollars a pop), can probably still be profitable if this talent can be leveraged by NYU's network of private care facilities.
[1] https://www.politico.com/agenda/story/2017/10/25/doctors-sal...
I have no student debt but I still would take a higher-paying job, all else being equal. Not sure why it would be different for doctors.
I'm not an economics expert so please let me know if this is a well-studied question and I'm just talking out of my ass.
Other developers I know took a pay cut and contracted half the year. You can make those choices if you don’t have outrageous expenses- including student loans.
Were there people in my class who were in it largely for the prestige, etc.? Sure. Those people tended to go into high-profile specialties like plastics. But they were the minority, and I think that schools recognize in general these types of students are bad for the profession.
But as long as health is not a free market, then the price isn't going to necessarily go up or down in response to costs. The price will continue to be function of political power and monopolistic practices as it is now.
Do you think that when Mylan raises the price of EpiPens from $50 to $500 that it's a market-based decision, for example? No; that's just an exercise of monopoly power.
Some people and institutions optimize for other things once they have enough money.
Alas, this couldn’t have a large effect on health costs anyway, since costs are dominated by things other than doctor pay.
results from high cost of malpractice. So instead of treating the symptom - insurance, one has to treat the original condition - malpractice. To continue the analogy - the trial lawyers in case of malpractice is just like the immune system. When infection (malpractice) happens you see the heavy effects of immune system acting like high fever, yet it would be a grave mistake to suppress immune system instead of dealing with the original cause - infection (malpractice).
I especially love that this was done with private fundraising over government funding. Philanthropy can be effective, often far more so than governments!
All in all, in order to effectively analyze these occurrences (particularly in admissions), one must ask: how will the institution benefit? They wouldn't pass these changes otherwise.
Bingo. Also, even if we somehow forced all doctors to work for free and magically ended up with the same quality of care, we'd still only reduce total spending by about 7%.
That's a hard upper bound on the effects that increasing the supply of physicians can have.
No, but it might mean more doctors in the kind of practices and specialties that are socially useful but not serving the wealthiest of private pay clients, because the necessity of chasing the maximum returns is reduced.
As an European I always find the dichotomy "government vs people" strange. If the state pays for something, it's solidarity, not communism.
Germany isn't a good example. Germany stands because it can exploit its weaker neighbors, the east block out of their resources and force the companies to book profit and get taxed in Germany.
Germans see each others as bothers. Show me a few German companies where a foreigner is in the executive role?
The whole point of Germany is Germans first. Ofcourse, they can make education free in this setting.
But I liked family practice, and I like public health, and I'm proud to work in those fields. I definitely understand the push to go to higher-paid specialties with a burden like that, though.
I think this is only partially true, because it misunderstands the motivations of many would-be doctors. Sure, the cost of medical education factors into specialty decisions, but as long as derm and ortho are regarded as more _prestigious_ than family med and general peds, you're going to see similar residency application numbers. There's still a social hierarchy within the medical profession, which the price of tuition doesn't immediately change.
Still, this is great for people set on primary care as a career. Interestingly enough, my general observation has been that students who need the money the _least_ (i.e. people whose families are paying for their educations) are the ones who are gunning for the highest paid (and typically most prestigious) specialties.
Over time this dynamic translates into to the prestige gap.
There are doctors of physical therapy who make 60-100k.
Physicians have a government monopoly on prescription and referrals.
The scarcity in MD and DO licenses drives up the cost due to the power granted by the license.
For the long commitment that doctors make and the debt they take on, they receive basically guaranteed highly paying employment for as long as they wish.
There's also a shortage of medical school spots, we can't create enough doctors.
I think this is probably an attempt to compete with other medical schools for top students. NYU is pretty well respected bit probably loses a lot of candidates to Harvard, Yale, etc.
A risk averse person would rather stick to what they know (student life, exams) for a guaranteed reward.
The debt isn't really that much. Probably the average is 200k. You can pay that off within about 1-2 years of residency, and interest rates tend to be low since they're low risk loans for banks to give out.
Please try looking at the numbers again. Assuming you pay off undergraduate loans, a private medical school will cost $30-45k a year (not including living costs, so tack on another $30k a year), so assuming ($150-$300,000) will be total assumed debt (not including books, unexpected expenses, etc) during those 4 years. Residency salary is basically stuck at around $50k/yearly for 3-5 years (based on residency type), you can contribute back to loans but there's not a chance you're paying that off in residency. (source: current medical resident)
More people want to go to medical school than there are spots open. If you create more spots, you get more doctors. Cost is not a barrier to medical school, loans for this profession are very easy to obtain.
Though that's not what I was addressing. I was addressing the criticism of universal healthcare that we'll somehow run out of doctors. The issue is it costs money for a school to run a med school. Making the government pay for it enables more med schools to be built.
But what do they get from these top students? Clearly not tuition anymore!
I would not say nurses get paid "peanuts". Not many jobs would let you earn close to $100k in New York City with only a bachelor degree (or in some cases only a two-year associate degree)
4 year md +
3-7 year residency ( hourly pay is ~ 1/4 a nurses on an hourly basis) +
(optional) 1-4 year fellowship (cardiology, surg-sup specialties like trauma, hand surgery, etc) +
(optional) 4 year PhD (20%+ of rad onc physicians have a PhD too.
This is a rather elaborate conspiracy theory, and one that falls apart entirely once you think about the actual costs of residency programs, the mechanics of matching students, and the real ROI that they would make in the process. It's absurdly out of proportion with what would be needed to make this theory work.
I wish it was.
> and one that falls apart entirely once you think about the actual costs of residency programs
What are the `actual` costs of residency program?
> the mechanics of matching students
As someone who has seen how the sausage is made ... the junior attendings (usually paid like shit because it's an academic institution) sort through a few thousand ERAS applications who narrow it down to a few dozen candidates. We hold a few interview dates and have a dinner at somewhat nice place. We have a meeting. We make a rank list. An algorithm matches our residents. That's it.
Consider that what the average applicant spends on traveling for interviews (I'd guess ~5-15k, more if couples matching or competitive specialty; many take out loans for this)... I don't feel bad for the programs holding a few interview dinners.
> real ROI that they would make in the process
What are you basing this on? Most teaching hospitals would fall over without cheap resident labor. In practice, my experience is that residents function like extremely cheap, slightly-more capable mid-level providers.
Because who in their right mind wants to sacrifice 16 years of earning potential, take on 500K of debt only to become an MD with long work days and now prices that are fixed with no other form of negotiation leverage in sight.
[1] https://www.congress.gov/bill/115th-congress/senate-bill/180... [2] https://www.mercatus.org/system/files/blahous-costs-medicare... [3] https://www.peoplespolicyproject.org/2018/08/15/provider-pay...
Asians/Indians make most MDs in the US because being a doctor is valued a lot in their communities even if you've infinite debt, you still get respect.
Second, most doctors come from doctor families. They've already transversed the path once, and their kids can reuse the knowledge and connections.
So yea, my father is MD and he can easily support 16 years of MD education for me. If you don't have a family with similar resources, obviously either you can take debt which comes with enourmose stress/worries which decrease your chance to complete or not compete at all!
Individualistic people aren't going to find it easier to compete with community backed people.
I work with 3-4 MDs that chose not to practice who are now working on defining software/ML product feature requirements; their MD experience makes them solid product specialists for clinical solutions that hopefully will help a lot of people...not having to stare down the barrel on loan payments may help people make these kind of career moves that may ultimately progress the system.
All that being said, we (obviously) need good docs at the bedside.
I just wish there was a middle ground here. The problem is that tuition is too high, not that it exists at all. Lowering tuition would solve the problem just as effectively, and could be done for more students.
I mean I love this, but who is footing the bills on this & are we sure they won't taint the results with ulterior motives...
It's worth noting that NYU tuition for regular undergrad is $50K before room and board and $68K with room and board [1].
The cynic in me has to wonder if they share the same concern for the rest of the legion of debtors they are churning out every year.
I'm not doubting the importance of research and primary care physicians in our society. But six figure debt loads for university are commonplace in the US. And are likely causing skew in career choices in non-medial fields as well.
I also have to think that there's something in this arrangement for NYU and that there are motives outside of just societal altruism here. I just don't know what those are. Research money? 501(c)(3) maintenance? Something else?
[1] https://www.investopedia.com/articles/personal-finance/01091...
Radiology job market improved since then, residency spots are not going Unfilled anymore.
ML may put radiologists out of a job, but it will take some time I think. Lots of changes will happen by then. Radiology is a nice place to be for hacker types in medicine. It’s actually a fun place to do ML research which I do also (radiologist / AI researcher)
Edit: Medicare has walked back some compensation cuts for medical imaging (for multiple procedures on the same day). My tin foil hat theory is the cost cutters got spooked by the prospect of no more us graduates in radiology.
Still I look forward to a world where this scarcity of ivy league schools, news organizations, self-driving car software etc. is a thing of the past and everyone collaborates on a growing snowball of knowledge.
I believe universities will eventually turn into centers for labs, certification and socializing, while information delivery (the commodity) would be done entirely online and students would form their own groups. Then, school would be much cheaper - and we could even have free subsidized tuition for all!
I've been confused why so many large-endowment colleges still charge tuition. It seems pointless, gathering crumbs from students each year. It creates institutional obstructions to whole classes of student etc. Is it just tradition?
[1] https://www.indiehackers.com/podcast/046-austen-allred-of-la...
Having to sacrifice 10 years of first jobs savings to reimburse the student loan is just insane. Especially considered tuition is skyrocketing without any meaningful reason: education is not better in that proportion than 10/15 years ago.
Edit: Also, at least in my state (Michigan) there seems to be no shortage of medical students (we went from 4 med schools to 7 earlier in the decade). The real bottleneck is residency programs.
1) A free collage will end up being more like extended high school.
2) At some point new institutes of for pay higher education will pop up. They just won't be called colleges. People who can afford them will clearly have a advantage and top companies will start to seek out people who attended these organizations.
3) The quality of the education will drop. It already has at a lot of schools with the introduction of loan for everybody gig.
While this will reset thing for a while. Maybe even a generation of two. We will end up again with people wanting the next level of education free.
EDIT: now that I am not trying to type on a tiny phone.
The problem with free is it will then need to cater to the LCD. Right now we we have a filter on the LCD because there is some effort and risk required by the person going to school. There is something special about buying something, and owning it. You tend to tend for it better, give it the attention it needs and ensure it last a long time. If we bypass this step we will end up with masses going to school doing the same thing they do in high school today. This might be hard to visualize as the HN crowd is a fairly smart crowd and probably took advantage of the offerings of their high school, and likely were not aware of those who did not.
This won't be as big of an issue for those who are "gifted" as they will be sheltered in their special classes slotted away with like minded ilk. But for the less "gifted" student the expense will be dragged down to the LCD. So if you are not lucky, smart enough, or had the right coaching from parents to get into those gifted classes you will be left with a much worse education.
In making university a £9k a year proposition universities seem to have significantly increased student expectations along the lines of "I paid for this, I expect top marks", along with vast increases in appeals etc. It does not seem to have increased educational expectations - just transactional. This seems to be particularly prevalent with overseas students who pay even higher fees.
Universities have, in the main, happily adopted the profit mentality by providing and offering less and increasing class sizes.
My conclusion is by adopting a high fee model we have significantly weakened further education in the UK.
We need something just right, something that both the schools, and students still have some skin in the game so they are obligated / motivated to perform their best.
I think a free market mostly can cover do this, and it seemed to work out fine for many many years in the US until we started giving crazy loans out to everybody.
And don't get me started, on the bs that we need free school because low income kids won't be able to go. Harvard has a fund for low income students that goes untapped every year, they even make a effort to get low income kids (from my understanding mostly underprivileged minorities) to take advantage of the funding available, but yet, hardly anybody does.
To a degree, expecting college education of people is really just filtering for the baseline that we would like a high school degree to guarantee, but which it isn't.
I doubt those outcomes will come to pass. Tuition used to be basically free in the USA, and it already is in many European nations, and we didn't/don't see those outcomes that you worry about.
Just because I don't agree with free does not mean I am for the inverse which is crazy high tuitions. In my opinion the crazy high tuitions is a result of guaranteeing people loans. Demand went up on a near fixed supply thus cost went up. Then when people who probably should have not been going to school started dropping out the schools saw that as a loss of revenue and fixed the problem by lowering the bar to make sure they did not have as many dropouts thus keeping their revenue up. Nobody ever likes to see a drop in revenue even if the spike was caused by artificial means.
Free market really only works if you don't have people messing around with it. It's not a free market for schools if everybody can get a loan.
As far as I can tell you still pay in the UK but tuition is fully covered in both Germany and France, expect France has already started the thing I said they would with a second more elite school. And you better bet a grad from a free university vs the elite university competing for the same job the guy who paid is going to probably win more often than not.
For what it's worth free and or guaranteed loan is the same, and I would expect the same outcomes in the long run. At least with the loan part we might wise up and stop demanding every kid goes and gets a higher education.
Note, I am not coming from somebody who was able to pay, or took loans out to go to school. I did the math, and I simply could not afford to go to any university, not even the cheap ones that were local. I tried, and saw the deb increasing while working for $8 a hr.
What did I do? I quit, and focused on my job, and spent every free second learning a skill that I could make money with. That just so happens to be computers/programming/and data centers. For a while there my friends and peers that went to school looked like they were going to pass me up, but by the the time they got out of school loaded with deb I had already double the income they would be able to start out with. Today I know very few people who went to school who make more than me, and those that do still have massive amounts of debt. Now I maybe lucky, but I know to many people like me, and meet to many people who have taken the same path as I did to put it all on the notion that I was just lucky.
Of course, no tuition doesn't mean no debt in a town like NYC. But what a difference!
Economics says that things are designed to work this way. You have felt the economic indicators and made changes accordingly.
The economy(you, your friends, your community, the world) benefits when you make profit. If your prior path was burdened with massive debt with little way to repay it, it sounds like a bad decision.
I cant imagine too many situations where doing something that pays significantly worse and puts you in more debt is better for society.
Also, I think you’re missing some variables. Or, as they might be called in economics, externalities.
The less money we spend on prisons the better for state and federal coffers, in the short run. The less a company pays a prison guard for their services, the better for the share holders. But what about everything that happens on the day an inmate is released back into society? Are their neighbors happy they were incarcerated by near minimum wage persons with little guidance or oversight and perhaps a bit too much enthusiasm? Are their employers happy they were not given access to higher education or the ability to learn a trade?
Or let’s talk about educators. Or defense attorneys for the indigent. I’ll leave the remaining examples to be worked by the student.
Seriously though, as someone that graduated with dual degrees in political science and economics, worked for a couple years in local government, then went to Manhattan to work in the financial markets for 5 years, and is now working a “tech” job. Sorry I don’t have patience for this.
And if you don’t mind going through Facebook (no login required)
https://www.fullwsj.com/articles/nyu-offers-full-tuition-sch...
On a meta level. Can you really be accused of not RTFM if it’s behind a paywall - that doesn’t seem fair.
NYU's endowment is $4.1 billion. They make 7.5%/year on that according to this report: https://www.nyu.edu/content/dam/nyu/investmentOffice/documen...
That's $300 million/year in growth, not counting donations.
Their medical school apparently has 679 students. At $50k/year each, that's $34 million a year. Or approximately 10% of the appreciation in their endowment.
Will students be obligated to pay anything to the school in the future after they start earning?
Who is funding this?