David J. Skorton 2013-05-19T02:58:52-04:00 David J. Skorton http://www.huffingtonpost.com/author/index.php?author=david-j-skorton Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for David J. Skorton Good old fashioned elbow grease. The Physician Shortage: A Place for Immigration Reform tag:www.huffingtonpost.com,2013:/theblog//3.2727971 2013-02-20T17:22:16-05:00 2013-04-22T05:12:01-04:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/
As I noted in the Huffington Post two years ago, we need to match our policies to the realities of 21st century innovation and communication, where ideas and jobs more and more easily transcend borders. While we need to safeguard our borders and maintain national security, ultimately, in collaboration with other nations, we need to move toward a world where talented individuals are able to move more easily among countries, creating new networks of knowledge and practice that adapt to local needs while harnessing the power of knowledge no matter where in the world it is found.

A complex area that involves movement of individuals among nations is health care. The U.S. already employs a substantial proportion of physicians (about a quarter) and other health workers (about a fifth) who were educated or trained overseas, and we could easily employ more of them without taking jobs away from Americans. In fact, as the nation ages and more previously uninsured individuals seek treatment under the Affordable Care Act, the health of millions of Americans may depend on the availability of more physicians and other health workers from abroad.

The U.S. already faces a shortage of physicians in rural and inner city areas. The Department of Health and Human Services estimates that as of December 2012, there were 5,848 "Primary Medical Health Professional Shortage Areas" in the U.S. and that it would take an additional 15,928 physicians to adequately meet the primary care medical needs of people in those areas.

The American Association of Medical Colleges (AAMC), on whose board of directors I serve, projects that there will be a shortage of over 90,000 physicians -- including 45,000 primary care physicians -- by the end of the decade, "leaving patients with cancer, Alzheimer's disease and dementia, hip fractures and other ailments without immediate access to necessary care."

American medical colleges are increasing their enrollments, and additional medical colleges are being established. By 2016, the AAMC predicts, medical school enrollment will have increased by 30 percent over 2002 levels. Yet even this substantial increase may not be adequate to meet increasing national demand.

Granting more H-1B visas to international medical graduates who have already completed U.S. residencies in high-demand specialties, including primary care, and who agree to practice for a prescribed length of time in underserved areas, would meet a pressing national need while ensuring that these physicians augment their prior medical training with additional training and practice in the U.S. This experience would serve them well, whether they ultimately obtain a green card and stay here or decide to return home after their service in the U.S. is complete.

And while we're removing the barriers to physician immigration to benefit from the skills and knowledge we need from a global pool of talent, let's also revisit the cap on graduate medical education funded through Medicare. Federally funded residency positions, which are especially critical for academic medical centers, have been frozen at 1996 levels for more than 15 years. This has created a significant bottleneck for new MD graduates -- from the U.S. and elsewhere -- seeking to complete the residency training that is a prerequisite for independent medical practice in the U.S. The AAMC recommends that the number of federally supported residencies be increased by a minimum of 4,000 a year -- with careful attention to changing demographics, the needs of specific states and regions and the evolving ways in which heath care is being delivered.

Of course, while the U.S. and other developed nations benefit from international medical graduates -- and the international graduates themselves often benefit from the opportunity to practice medicine using more advanced technologies -- developing nations lose the highly trained physicians and other health care workers they desperately need and in whom they often have invested substantial resources. The shortage of health professionals in the U.S. pales in comparison to the worldwide need, which the World Health Organization puts at about 4.3 million. Especially in sub-Saharan Africa, the loss of trained physicians and other health workers to the West is making it even harder to secure the health of their citizens.

The flow of doctors and other health professionals from the developing to the developed world is so significant that the 193 member states at the World Health Assembly in May 2010 adopted a voluntary WHO Global Code of Practice on International Recruitment of Health Personnel. The code aims to develop sustainable health systems, protect the human rights of migrant health workers, provide technical and financial assistance for health care personnel development in low- and middle-income countries, and "facilitate circular migration of health personnel, so that skills and knowledge can be achieved to the benefit of both source and destination countries." As of December 2011, almost 70 nations had designated a national authority to exchange information on health worker migration and implement the code.

More and more, we are appreciating the need for strong health care systems across the world to ensure better health in any specific location. The U.S. has stepped up to the challenge through the Medical Education Partnership Initiative and other programs that are supporting local health ministries and academic centers in Africa with technical assistance in order to increase the number and quality of health professionals and encourage them to remain in their own country.

Private initiatives are also playing important roles. My own university, for example, operates a branch of its Weill Cornell Medical College in Doha, Qatar, with support from the Qatar Foundation. Students from Qatar, as well as from several other nations, earn a Cornell MD degree through the program. They have had excellent success in securing residencies in the U.S., as well as at the Hamad Medical Center in Qatar. We also have a close relationship with Weill Bugando Medical Center in Tanzania, where faculty from the Weill Cornell Medical College are on site to help train doctors to practice in Tanzania. Although these programs are still relatively small, they offer models for building capacity for health care in the Middle East, Africa and elsewhere.

Moreover, a growing number of American medical students and young physicians are seeking international experiences as a way to act on the commitment to social responsibility and service that originally drew them into medicine. An increasing number of international medical graduates who immigrated to the United States are also returning to their home countries periodically to help strengthen the health care systems there -- even if they choose to practice primarily within the United States (see "From Brain Drain to Mutual Gain: Sharing the Benefits of High-Skill Migration" and "Social Accountability in Health Professionals' Training"). The AAMC Global Health Learning Opportunities Collaborative facilitates global mobility for students pursuing clinical, research, or public health electives outside their home country.

As a nation, and certainly on a global scale, we are still a long way from having a seamless movement of people, knowledge and ideas across national borders. But I predict that within the lifetimes of those who are now earning their medical degrees, a new model of "brain circulation" will replace the "brain drain" that is holding back the health care systems of the developing world and preventing our own country from adequately meeting the health care needs of our citizens.

To move us closer to that day, removing the barriers that prevent global talent from reaching our shores through comprehensive immigration reform would be a positive start. As President Obama said in his Inaugural Address last month, "Our journey is not complete until we find a better way to welcome the striving, hopeful immigrants who still see America as a land of opportunity; until bright young students and engineers are enlisted in our workforce rather than expelled from our country."

Through enlightened immigration policies, we can address our physician shortage and be a beacon for the rest of the world.]]> My Hope for November 7 tag:www.huffingtonpost.com,2012:/theblog//3.2059152 2012-11-01T15:09:14-04:00 2013-01-01T05:12:01-05:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/
Like many other Americans, I have made my choices and will exercise my right to cast a ballot on November 6. My father, who was an immigrant and naturalized citizen, taught me that voting was a precious right, and I hope that every eligible voter will go to the polls on Tuesday.

This presidential campaign has been extraordinarily divisive and combative. Even more important than the election outcome, in my view, is whether we choose, as a country and as individuals, to leave partisan politics behind and begin to cooperate in the hard work of governing. Frankly, the prospects do not look good.

In their book The Spirit of Compromise (2012, p. 34-35), Amy Gutmann and Dennis Thompson note:
When parties enter into negotiations in bad faith, deliberately misrepresent their opponents' positions, and refuse to cooperate even on matters on which they could find agreement, they undermine the relationships of respect that are necessary to sustain any morally justifiable democracy under the modern conditions of deep and persistent disagreement.


All too often in recent years, candidates have failed to make the transition from campaigning to governing once the election is over. They dig in their heels and "stand on principle," avoiding "give and take" negotiations and actions that are necessary to get things done. And, thus, we all lose.

For one critical example, unless Congress acts quickly after the election, automatic, across-the-board cuts to defense and domestic spending will be implemented starting in 2013 and extending until 2021, as a result of the "sequestration" provision of the Budget Control Act that Congress passed in 2011 to keep the U.S. government from defaulting on its debt. This provision was triggered last November when the bipartisan Joint Select Committee on Deficit Reduction failed to reach agreement on how to cut $1.2 trillion from the federal budget. So even though it would have been in everyone's best interest to allow legislators discretion in how and what to cut, we may be stuck with a process that, according to many economists, will push the country back into recession.

Why has it become so difficult for our elected leaders to act in ways that would clearly be better than the status quo for all concerned?

As many critics have noted, the campaigning mindset, the need for elected officials to start raising money for their next campaign the minute they take the oath of office, gerrymandering districts to create safe seats for the party in power, and the subordination of information to opinion on Cable TV and in the blogosphere polarize -- and poison -- politics, leaving little space for bipartisanship.

Is there a way to build a less adversarial mindset into the political process? Suggestions include campaign finance reform, term limits, lengthening the tenure in office to eliminate the "perpetual campaign," a congressional work schedule that would keep politicians in Washington D.C. long enough to build relationships on both sides of the aisle, and "open primaries" to keep party activists from having undue influence on the nominating process.

I am convinced that we also need to improve the education for citizenship we offer students, beginning in the K-12 years and extending through college. Unfortunately, many students do not know how bills become laws, the basics of our system of checks and balances, or the critical role compromise has played throughout our history -- and must continue to play in our democracy. They need to hone the analytical and communication skills that will enable them to present cogent arguments and analyze and interpret disparate points of view. They need to understand the tension between standing on principle -- which often is a good thing -- and being inflexible, which often is a recipe for deadlock. Most important, like all of us, they need to develop the ability to advocate for ideas without ignoring or dismissing out of hand those who think otherwise. And because the skills needed for effective civic engagement can be enhanced by experiential learning, we need to develop more and better opportunities for young men and women to participate in activities such as Model Congress, Model UN, and student government and in service learning courses that include opportunities to work with local, state and federal governments.

Compromise in the era of the perpetual campaign and rigid adherence to a party line will be difficult to achieve. It is messy, time-consuming, often frustrating, and subjects the "compromiser" to accusations of waffling. But little can be accomplished without it.

Once the election is over -- and regardless of who wins -- let's take concrete steps to build a political structure and a political culture that will enable us to address the real and shared challenges we face in avoiding the fiscal cliff and in so many other aspects of American life.]]> Promotion of Student Health and Wellbeing on College Campuses tag:www.huffingtonpost.com,2012:/theblog//3.1862344 2012-09-07T10:44:36-04:00 2012-11-07T05:12:01-05:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/ Today's college students, starting the fall semester across the country, roll their eyes when parents and grandparents recollect the rules and regulations that governed our campus life a generation and more ago. Dress codes. Parietal hours. Three feet on the floor. Dorm proctors to enforce curfews.



On most college campuses such rules fell by the wayside in the sixties and seventies as norms of personal conduct were liberalized. Many institutions, including Cornell, have adopted a philosophy of freedom with responsibility -- giving students the freedom to choose their own actions but holding them responsible for the choices they make. Coed dorms and key card access are now pretty much standard, and it is not uncommon for students to stay out all night -- whether to study or to party -- without anyone giving it a second thought.



Nonetheless, I believe that colleges and universities must do more to promote the health and wellbeing of our students. As self-reliant as many of them may seem, undergraduates are still "emerging" adults, susceptible to peer pressure and inclined to engage in risky behavior. And like all of us, they can make poor decisions, suffer from injuries, stress and emotional turmoil.



Here are a few areas where I believe we in higher education need to step up our efforts:



High-risk drinking: Alcohol is the most widely used drug on college campuses. Most students drink moderately or not at all, but high-risk drinking can compromise the safety of the drinker and those around him or her. Many schools disseminate data to correct students' misperceptions about what "everyone" is doing. These efforts have resulted in a significant decrease in heavy drinking at many schools -- as much as 44 percent over 10 years in one instance.



A broader "environmental management approach" includes prevention strategies. At Cornell and elsewhere restrictions are placed -- and enforced -- on the use of alcohol at fraternity and sorority events, and medical amnesty ("Good Samaritan") policies have encouraged bystanders to call 911 when individuals are severely intoxicated or injured after using alcohol or other drugs.



We know, however, that more needs to be done. With that in mind, the National College Health Improvement Project's Learning Collaborative on High Risk Drinking, which involves 32 colleges and universities nationwide, is working with researchers at The Dartmouth Institute for Health Policy and Clinical Practice to discover what works best in preventing alcohol abuse. I am hopeful that this comprehensive approach to discovering and sharing best practices among campuses will reduce high-risk drinking among our students.



Hazing: Although 44 states have laws against hazing, and hazing is also prohibited in the campus codes of many colleges and universities, around 55 percent of college students across the country report having been hazed in fraternities, sororities, athletic teams, or other student groups, and nearly half experienced hazing in high school.



After a Cornell student died at a fraternity house in a hazing episode that included mock kidnapping, ritualized humiliation and coerced drinking as part of the pledging process, I directed student leaders of Cornell's Greek chapters to develop a system of member recruitment and initiation that does not involve the performance of demeaning or dangerous acts as a condition of membership. Our student leaders, staff professionals and alumni are now developing alternative models. We have a comprehensive anti-hazing website and recently launched a campaign to give students strategies to protect themselves and help change the culture of hazing. The bottom-line message, which needs to be heard on all college campuses: "Hazing hurts and is unnecessary. There are many ways for groups to bond without it."



Mental health promotion: College students, like all of us, can experience a great deal of stress from family problems, interpersonal relationships, the rigors of academic work, or other issues. And thanks to better diagnosis and treatment, more students with mental health conditions are enrolling in college.



We in higher education need to take a comprehensive approach to mental health promotion, encouraging students to ask for help when they need it, educating the campus community about how to notice and respond effectively when someone is in distress, and fostering emotional resilience so that students are better able to bounce back from the setbacks.



Concussion prevention: As I wrote in my Huff Post blog last November, an estimated 300,000 sports-related traumatic brain injuries, most of them concussions, occur annually in the United States, according to the Centers for Disease Control and Prevention. As the college sports season ramps up this fall, we need to take preventive and therapeutic action to keep our players safer while retaining the excitement and competitiveness of their sports.



To this end, the presidents of the Ivy League have adopted significant changes to the way our football teams practice and play. We are now examining other sports such as soccer, ice hockey and lacrosse, for both men and women.



The Ivy League and Big Ten Conference have begun a joint research project to examine and address head injuries among athletes. While we await the results of this research, I urge coaches, administrators and other involved with college sports to make modifications in their practice regimens and their requirements for protective equipment in order to reduce the likelihood of concussions or other traumatic brain injuries and to recognize the need for and importance of cognitive rest following a concussion.



Colleges and universities in New York and other states do not have a legal responsibility to protect their students from their own risky behavior or the risky behavior of other students. And try as we might, it would be impossible to remove all potential risk.



Nonetheless, colleges and universities need to think creatively about the nearly intractable challenges of hazing, high-risk drinking, suicides, concussions, and other risks. Together with parents, community leaders, legislators, and students themselves, we must tackle these issues more aggressively. While students will always be faced with risky choices -- and some will continue to exercise poor judgment -- colleges can and should fulfill their educational missions by promoting safety through education and the provision of support services that will assist students in exercising their freedom responsibly.

]]> College Affordability: A Defining Issue That Won't Go Away tag:www.huffingtonpost.com,2012:/theblog//3.1256081 2012-02-05T17:27:00-05:00 2012-04-06T05:12:02-04:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/ In the wake of President Obama's State of the Union Address last month, many Americans are talking about college affordability. As they have been. As well they should. Along with health care and unemployment, the cost of college is a defining issue for our country. It is an issue that won't go away.



Despite the outcry from some inside and outside of the "higher education establishment," President Obama framed the issue in an important way. "Higher education can't be a luxury," he said, "[I]t is an economic imperative that every family in America should be able to afford."



The unemployment rate for those with only a high school diploma is almost twice that of college graduates, and high school graduates earn substantially less than college graduates. Yet a far lower percentage of high school graduates from the lowest income groups enroll in college than their peers from the highest income groups. In 2009, there was a 29-point spread between the two groups, with 84 percent of students from high-income families enrolling in college right after high school, compared to only 55 percent of their low-income peers. One reason for this difference is the price of a college education.



The White House proposal, it is important to note, would reward schools that keep down net tuition (actual tuition that families pay, after subtracting financial aid) or restrain tuition growth, provide "good value" to students and their families, and enroll and graduate relatively higher numbers of students eligible for federal Pell Grants (which generally go to students from families earning less than $40,000 a year). The proposal offers incentives to promote affordability and quality, helps students and their families make more informed choices about colleges, keeps student loan interest low, and makes the American Opportunity Tax Credit -- a college tax credit -- permanent.



College affordability is a complex issue, however, and there is no "one-size-fits-all" model that can or should be imposed by the federal government.



A very few institutions, including Cornell, have been able to make substantial investments to enhance access. While Cornell's tuition and recent tuition increases are higher than I wish they were, our decision to increase our need-based financial aid substantially has, since 2008-09, reduced the net cost of attendance for students in all income groups with demonstrated financial need. I recognize that Cornell's policy has meant higher tuition for our wealthiest families, and that it has required cost containment in other areas. But for students from families with incomes up to about $112,000 (representing most American families and the first four quintiles of Cornell's aid-eligible students), it actually cost less to attend Cornell in 2009-2010 than it did in 2001-02.



At Cornell we, too, are struggling to find the resources to sustain our commitment to access. And the vast majority of schools don't have the resources to do what we have done. So, the Obama administration needs to work with institutions of higher education to customize approaches.



In particular, public colleges and universities, which enroll two-thirds of four-year college students, need to be treated differently than institutions in the independent sector. As President Obama said in his State of the Union Address, "States also need to do their part, by making higher education a higher priority in their budgets." If state support for higher education does not stabilize and, eventually, increase at a reasonable rate, public colleges and universities will have no alternative to raising their tuitions to maintain quality - and our nation will no longer be an equal opportunity society. State support and tuition are major sources of revenue for public colleges. When state support declines -- as it has dramatically nationwide -- then colleges have two alternatives to maintain quality: increase tuition and reduce costs for operation. Our great public colleges and universities deserve robust public investment, in good times and bad. Without it we cannot offer the superlative education for which our country remains the world leader.



Of course, vigorous cost containment must be pursued by all colleges and universities. As a higher education community, we have not made sufficient changes in how we operate our institutions that could reduce the price of college.



We should work more seriously to achieve such operating efficiencies, and learn from other not-for-profit and for-profit organizations.



Going forward, I call on the U.S. Department of Education to work with higher education leaders and business experts to propose solutions that are workable for public and private institutions across the country. President Obama made a good start by inviting a group of college presidents to the White House last year. To add momentum -- and a sense of urgency -- to the critical government-college partnership begun at the White House, I ask Secretary Duncan to consider appointing a small advisory group of college leaders, representing community colleges, public universities, and independent institutions of higher education, and empower this group to work fist-in-glove with higher education professionals in the Department of Education to flesh out the President's initiative and to make it practical, workable, flexible, and "shovel-ready."



What is needed now is a consensus across the political spectrum about the importance of investing in higher education in this challenging and competitive economic environment. And a commitment to reduce the costs of that education, where appropriate, to ensure that equal opportunity is a reality for this generation of Americans -- and the next and the next.



]]> Concussions in College Football: Time for a Real Game Changer tag:www.huffingtonpost.com,2011:/theblog//3.1097191 2011-11-16T10:54:29-05:00 2012-01-16T05:12:02-05:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/
An estimated 300,000 sports-related traumatic brain injuries, most of them concussions, occur annually in the United States, according to the Centers for Disease Control. Concussions can happen in a variety of sports, but it is football and the martial arts that have taught us the most about their incidence and severity.

The adverse effects of concussions may appear immediately or may occur weeks, months, or even years later. In former pro football players, we see higher than average levels of memory loss and even dementia. Further, it is not just the "big hit" that causes harm: data indicate that multiple smaller hits may be causing cumulative damage to neurological and cognitive function. We have also learned that after a concussion, patients need cognitive as well as physical rest -- a finding with important implications for college students.

We must act now to prevent the immediate and long-term harm caused by concussions in football. Of course, some argue that football is in essence a violent sport and in fact that is one reason both players and fans like it. Some may claim that protecting our athletes will somehow harm the sport. But such claims pale in light of the fact that young athletes are suffering unnecessary harm and that we can do something about it.

We can take preventive and therapeutic action without destroying the sport. Coaches know that athletes can prepare with less contact in training -- and thus fewer opportunities for injury -- than they're having now. Many of us have forgotten that there was a time when helmets were not worn and that the NCAA was formed in 1906 primarily to change football rules to protect the health and safety of players who were dying on the field. Football can -- and must -- change more.

The NFL has tightened some of its rules that govern when players can return to the game after concussions and has made efforts to educate players about the risks. These are good steps, although more can and should be done in pro football.

What about college football?

Last summer Ivy League presidents adopted recommendations from an ad hoc committee of coaches, administrators, doctors, trainers and expert consultants to significantly change the way our football teams practice and play, in order to reduce the chances of concussion and to limit the harm of concussions that do occur. We made the following changes:

  • Limit the number of full-contact practices in season to two per week, although the NCAA allows five.

  • Reduce the hitting that occurs during preseason and spring practice.

  • Better educate student-athletes about head injuries and about proper tackling techniques.

  • Limit physical and cognitive activity in the period following a documented concussion.

  • Increase penalties for helmet or head hits.


It may be hard for young players or pros to accept the fact that what they're doing could seriously damage their quality of life years from now. But we have plenty of data to compel us to limit the chances of head injury now and to treat our athletes after concussion in ways that will maximize their long-term health and well-being.

The Ivy League has taken an important step. Administrators, coaches, trainers -- anyone with authority in football programs, from middle school to the pros -- needs to do the same. Or find an even better way to protect our players.

]]> Immigration Reform: The Economic Argument tag:www.huffingtonpost.com,2011:/theblog//3.914973 2011-08-01T12:30:06-04:00 2011-10-01T05:12:01-04:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/ Last week, in the midst of the turmoil related to the nation's debt ceiling, I testified at a hearing of the Senate Judiciary Committee Subcommittee on Immigration, Refugees, and Border Security, chaired by Senator Charles Schumer (D-NY), focusing on the economic imperative for enacting immigration reform. The thrust of the hearing was to explore the economic benefits of immigration reform, with provisions to make it easier for foreign nationals to work in selected sectors of the U.S. workforce.



What? Won't those foreign workers displace equally qualified Americans? How can more immigration be good for America's economy? The answer, simply put, is that foreign workers make a substantial contribution to our country, particularly in the growing high-tech areas of science, technology, engineering and mathematics, the so-called STEM disciplines.



The hearing was a lively interchange among individuals of varying backgrounds and experiences. I was joined on the panel by



  • Robert Greifeld, CEO and president of NASDAQ OMX


  • Bradley Smith, general counsel of Microsoft


  • Puneet Arora, M.D., clinical research medical director of Amgen, who has waited 15 years, so far, for a green card to allow him to live and work in the U.S permanently.


  • Ronil Hira, professor at the Rochester Institute of Technology, who has focused much of his academic work on high-skill immigration policy, the American workforce and the U.S. economy.



I had the privilege of testifying on behalf of the Association of American Universities, a 110-year-old consortium of over 60 research-intensive universities.



As in any such hearing, there were substantial differences of opinion:



  • Mr. Greifeld indicated that NASDAQ companies often have trouble finding sufficient numbers of American workers with the skills and experience to fill vacancies.


  • Mr. Smith concurred, stating that in May of this year, Microsoft had over 4,000 unfilled jobs.


  • I pointed to data gathered by the Partnership for a New American Economy -- a national bipartisan group of over 300 mayors and business leaders created by New York City Mayor Michael Bloomberg -- that confirms staggering projected shortages of workers in fields like industrial engineering and math as well as reminding us of the many hugely successful companies started by immigrants.


  • Professor Hira disagreed, pointing to high current unemployment rates among American high-tech workers. He suggested that one motivation for easing restrictions on immigration was to entice lower-paid workers from abroad to take jobs that would cost employers more if filled by Americans.



This apparent contradiction highlights the mismatch between the skills of many American workers and those needed by some of America's most tech-intensive firms. I believe that, as we sort through these differences of opinion and perspective and work to improve the immigration system, we must simultaneously attend to the inadequate and leaky pipeline of STEM students in our K-20 educational system. American students' lack of interest in and qualifications for high-tech careers is a problem in its own right that needs urgent attention. But it cannot be fixed overnight. Meanwhile (as I noted in a previous post), our nation's growth in this innovation economy will depend in no small measure on agile access to the most talented foreign students and scientists -- access that, in turn, depends on a well-functioning immigration system.



All witnesses agreed, and the senators concurred, that our current system is not working well. Professor Hira pointed to major problems in the "guest worker" programs: those involving the H-1B and other visas. Dr. Arora gave moving testimony to the demeaning delays and bureaucratic hurdles. Mr. Smith told of Microsoft opening a research center in British Columbia to overcome barriers of the U.S. system in nearby Washington State. And I pointed to the roughly 50 percent of our current graduate students in high-tech disciplines who are foreign nationals. Based on what I have learned as a member of the National Security Higher Education Advisory Board (a group of some 20 university presidents/chancellors who meet regularly with senior officials of the FBI and other agencies), I also acknowledged the infrequent but potentially very serious national security challenges posed by the presence of foreign nationals in the laboratories of U.S. research institutions.



These sobering statistics and observations led the witnesses on the panel to conclude that only broad immigration reform would allow our country to maintain and even enhance national security while increasing the supply of skilled workers and entrepreneurs from around the world to populate our high-tech companies, large and small. Without the contributions of highly educated and skilled immigrants, the U.S. will lose ground in critical and robust high-tech areas such as the life sciences, nanotechnology, and sustainable energy systems.
Can our currently gridlocked political environment produce the bipartisan cooperation needed to design and enact broad immigration reform? Hard to imagine. But here are three things that we could urge our elected leaders to tackle:



  1. Create a streamlined green card process for international students who graduate with STEM degrees from U.S. institutions, especially advanced degrees.


  2. Reduce the backlog of skilled immigrants waiting to become permanent residents by increasing the number of employment-based visas and lifting the per-country caps on green cards.


  3. Pass the DREAM Act, giving undocumented children who are in the U.S. through no fault of their own the chance for citizenship through hard work in college or the military.



Here's hoping that Senator Schumer's hearing will help Congress to focus on this imperative of fairness and economic development. Here's hoping.

]]> The Humanities: Fundamental but Utilitarian tag:www.huffingtonpost.com,2011:/theblog//3.877386 2011-06-15T11:29:47-04:00 2011-08-15T05:12:01-04:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/
That was the take-away message from the briefing I was privileged to moderate last month before approximately 60 Congressional staffers and representatives of higher education. Entitled "Addressing National Security and Other Global Challenges through Cultural Understanding," the session was sponsored by the National Humanities Alliance and the Association of American Universities, in cooperation with the Congressional Humanities Caucus. The aim was to help us all better understand what is at stake -- and why support for the humanities is a wise investment in the future of the U.S.

In his opening remarks, National Endowment for the Humanities Chairman James Leach noted "The challenges of the day, the politics of the moment, are surface issues. Stewards of public policy need to understand immediate problems that pose threats to the security of our country and have the capacity to advance and defend the national interest. But to understand what's on the surface -- the reasons for discord -- it is necessary to know what is below the surface: the history and culture of a society or region."

Following Mr. Leach's observations, we heard from three distinguished faculty members from around the country.

Our panelists demonstrated that the humanities are vitally important to our national life and the security of our nation. A professor of Central Eurasian, Iranian, Indian, Islamic and international studies at Indiana University at Bloomington, Jamsheed Choksy studies a range of issues in Asian cultures. Debra Hess Norris is chair and professor in the Department of Art Conservation at the University of Delaware. Her research helps promote cultural understanding and heritage preservation globally. The work of Jacob Shapiro, a professor of politics and international affairs at Princeton University, has influenced U.S. military strategy in Afghanistan and Iraq.

They pointed to numerous projects, funded in part by the NEH, that help us to better understand our friends -- and those with whom we disagree -- around the world, from research on Arab demographic trends to a study of attempts by pariah regimes to procure uranium for nuclear programs.

Professor Shapiro said his research on the impact of reconstruction spending in Iraq and Afghanistan has documented initiatives that have reduced violence in those countries. Along with the findings of others, his work on the relationship between civilian casualties and insurgent violence in Afghanistan has informed the U.S. military's overall war effort.

Noting that "Iran has held the United States' attention and vexed our leaders since the Islamic Revolution there in 1979," Professor Choksy indicated that an ongoing, multi-year, NEH-funded project at Columbia University has produced a comprehensive collection of knowledge about Iran -- data that is now available online. At Cornell, one NEH grant funded an online preservation tutorial in Arabic; another funded a Southeast Asian literature microfilming project.

Professor Norris provided examples of projects to restore important cultural artifacts and to train those who will restore many more, making a compelling and convincing case that they have a powerful impact on cultural understanding and respect between people of widely divergent backgrounds.

As I've observed in earlier blogs, when our generals and diplomats speak of securing our future by "winning the hearts and minds of the people," they are talking about understanding the language, culture, religion, and values of people in Iraq, Afghanistan, Egypt, and elsewhere, endeavors supported by the NEH.

The Minerva Initiative is another example of the link between the humanities and social sciences and national security. It was launched by the Department of Defense to improve our knowledge of the social, cultural, behavioral and political forces that shape regions of the world that have strategic importance to the U.S. The current upheavals in the Middle East have brought the need for such understanding of critical languages and culture to the fore once again.

I believe that the study of literature, the arts, history, philosophy, law, linguistics, religion, and other humanistic disciplines, is indispensable if we are to grasp where we come from, and why, in order to lead us into the future.

Yet the funding we allocate to the humanities through our government has never come close to the value the humanities add to individual lives and to the life of our nation. It should be -- it must be -- unacceptable, to Democrats and Republicans alike, to further reduce that support. Even in times of austerity, especially in times of austerity, sound investments must be made.

In response to a bipartisan request from U.S. Senators Lamar Alexander (R-Tennessee) and Mark Warner (D-Virginia) and Representatives Tom Petri (R-Wisconsin) and David Price (D-North Carolina), the American Academy of Arts and Sciences has formed a special Commission on the Humanities and Social Sciences. Conceived by American Academy President Leslie Berlowitz, this commission had its first meeting recently, and we all await these deliberations and the way forward that it may indicate.

Most immediately, amidst uncertainty about how the FY12 budget debates will play out, where do we stand? At a minimum, let's not cut NEH any more.

Let's aim for funding of NEH at the FY10 level of $167.5 million. A push for funding at the FY10 level is a realistic approach, based on the level of cuts in the president's FY12 budget request and the overall fiscal situation, although it falls far short of the appropriate level of federal support for the humanities through NEH.

Despite -- and perhaps because of -- stark budget realities, we must have the political will and discipline to support the humanities. Never has this been more apparent, never has this been more important, never has this been something for which we need to fight more vigorously or successfully. I hope you'll join us.
]]> Education Will Bring Societies Together -- We Can't Depend on Governmental Diplomacy Alone tag:www.huffingtonpost.com,2011:/theblog//3.846590 2011-04-08T10:38:50-04:00 2011-06-08T05:12:01-04:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/
Government diplomacy, an age-old craft with a proud tradition, has not been successful in reaching beyond differences because the conversation of official diplomacy is, by definition, a conversation between governments and not directly between the people of the involved countries. What is needed is more effective "public diplomacy," which in part uses what Joseph Nye, former assistant secretary of defense for international security affairs and former chair of the National Intelligence Council for the U.S. government, termed "soft power": the use of attraction, rather than coercion, to influence others' opinions. Non-governmental diplomacy has the potential to effect closer ties between cultures even -- and perhaps most importantly -- when official diplomatic ties are strained or nonexistent.

Higher education has the potential to be one of the most effective tools of public diplomacy for the United States. Surely cultural exchange -- music, art, dance, theater, film, fiction, poetry -- reaches across the chasms we are experiencing. As small examples, some of the most memorable cultural events on my own campus have been staged by our international students and scholars and our glee club and chorus have been warmly received on tours to Brazil, Venezuela, China and elsewhere.

The world of business and its globalization, with all its problems and inequities, is another mechanism that links societies. The device on which I am writing this blog was conceived and designed in California, manufactured in China and marketed widely. And of late there have been efforts to promote sustainable global enterprise as a vehicle to improve the prospects of those at the base of the economic pyramid.

But the most far-reaching way to link societies across the world is through education. In virtually every culture, people recognize that education is an effective path to personal and societal advancement. Parents want their children to achieve security, to move to a higher standard of living. Throughout most of the developing world, primary and secondary education is becoming more available, albeit at varying rates and with varying quality. And educational organizations are using videoconferencing, the Internet and other technologies to bring together young people to learn about and share perceptions on global issues. Since 1998, for example, the Global Nomads Group (gng.org), an international NGO, has connected students with their peers around the world to discuss global issues related to civics, social and global studies, geography, world history, science, economics and politics in real time via videoconferencing.

Yet, there remains a gap in the availability of good quality higher education opportunities in much of the developing world -- a gap that American higher education could help to fill by offering coursework and, more importantly, by helping to build the capacity of local higher education. The availability of high-quality postsecondary education, moreover, is significant beyond the personal benefit of a college degree: the problem-solving capacity of a modern college or university and its graduates is enormous.

Multiple approaches to international higher education interactions have been employed over the past half-century. Student exchanges, for example, have opened the world to American students and opened American campuses to the world. For many years, through most of the 1980s, the U.S. Agency for International Development (USAID) brought large numbers of students from developing countries to the U.S. for graduate education in order to develop technical capacity and leadership for higher education, the government and the private sector in these nations.

While international students are still an important part of many graduate programs in the U.S., USAID now focuses mainly on short-term training in the U.S., the home country or a third country for managers, local leaders, teachers, education administrators, technicians and NGO staff. And because of the high cost of undergraduate higher education, relatively few international students from families of limited means are able to study in the U.S. as undergraduates.

In addition to finding ways to make higher education more accessible to undergraduates from abroad, we must encourage more U.S. students to study abroad. And we must guard against further limiting access to higher education for those of limited means within our own country, by, for example, reducing or eliminating Pell Grants, as is now under discussion in Congress. Such action would be a detriment to the students directly affected and also harmful to American higher education's ability to provide opportunities for students to learn within diverse communities.

A second approach to public diplomacy through higher education involves the establishment of complete campuses by American universities in a host country, as several American universities, including Cornell, have done in Education City in Doha, Qatar and other colleges and universities have in other locations. These arrangements (which are often predicated on budget neutrality or better for the American university) can greatly increase the availability of higher education and other services, although they do not immediately increase the capacity of universities in the host country to deliver education. The hope is that such capacity will develop over time, as graduates of these institutions become the next generation of leaders within their own countries.

A third method by which higher education reaches out to those in other nations is through faculty-to-faculty linkages around a common interest or problem. With funding from the Gates Foundation and the United Kingdom's Department for International Development, for example, some 20 universities and research institutes throughout the world -- and scientists and farmers from more than 40 countries -- are joining forces to combat a deadly wheat pathogen that poses a dangerous threat to global food security including in the poorest nations of the developing world.

No matter what specific organizational structures we adopt to advance public diplomacy through higher education, a bedrock principle should be to improve over time the internal capacity of the host higher education system to develop its own faculty, matriculate and graduate its own students, develop researchers and research projects that will solve the country's most trying problems, take advantage of the country's most attractive economic development opportunities, and set the stage to advance the host country as a power in international education in its own right.

As Congress moves ahead with its budget deliberations for FY 2012, I urge our elected leaders to consider investment in international capacity building through higher education (through USAID and other agencies) as one of the most far-reaching, cost-effective, and proven strategies for bridging the divides of culture and addressing the daunting challenges of our world. And I call on other leaders in higher education not to wait for new revenue but to insure that study abroad programs, international exchanges at faculty and student levels, and public engagement of partners in the developing world continue and advance -- for the common good.]]> A Nation of Immigrants in a Borderless World tag:www.huffingtonpost.com,2011:/theblog//3.827735 2011-02-24T13:51:22-05:00 2011-05-25T18:35:25-04:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/
But early in the 21st century, we are losing our understanding and appreciation of immigration as an integral part of the American Dream. Why have immigration issues become so politically radioactive? The real and growing security risks to our nation and the economic competition we face, particularly from emerging economies, color our perception. Yet, despite the incendiary rhetoric about immigration, it has always been true -- and is still true -- that the benefits of immigration significantly outweigh the risks. For just one example, with an aging population, we face the prospect of a labor force that is too small. Immigrants can help.

We must, therefore, keep our nation accessible to the world by developing comprehensive immigration reform that deals with our physical and economic security, the realities of our growing immigrant population, and our national workforce needs. One example of such an approach is that being discussed by Senators Lindsey Graham (R-S.C.) and Charles Schumer (D-N.Y.).

The issues are broad and complex, but a key part of immigration reform must be focused on international students and scholars at American colleges and universities.

In the 20th century, there was a clear national emphasis on making sure that the best minds trained -- at least in part -- at American universities and then returned to their home countries. The idea was that American-educated foreign nationals would become leaders in their own countries, bringing back an appreciation and understanding of the U.S. that would benefit us both politically and economically. We wanted bright international students to come and enroll in our undergraduate and, especially, graduate programs.

And come they did: these excellent students were successful in education and research, contributing to robust, innovation-based economic growth. And when they returned to their own countries -- from Western Europe to the Far East to Iran -- they often attained positions of leadership in education, government and industry and stayed connected, scientifically, culturally, and emotionally, to the U.S.

Lately, though, our views on international students have become more complex. On the one hand, some argue that we should let international students remain in America to contribute to the advancement of our economy. After all, we could use their talent and ideas. As scholar and columnist Vivek Wadhwa noted in a speech this week, foreign nationals file a quarter of all patent applications in this country, and from 1995 to 2005, 25 percent of all start-up companies had at least one immigrant founder. On the other hand, some fear that immigrants will take jobs away from Americans and bring "un-American" beliefs and behaviors to our shores. Recently, and especially after 9/11, it has been more difficult for international scholars to come -- or to stay -- in the U.S.

We should be working toward the adoption of comprehensive immigration reform tailored to the economic, political, social, cultural and scientific realities of a world in which ideas and jobs more and more easily transcend borders. What is needed is a set of immigration policies that gives us the best of both worlds -- policies flexible enough to offer green cards to talented individuals who want to stay, while encouraging others to return home with some of the best education we have to offer and the potential to make a lasting difference in the world. As recent events in the Middle East have demonstrated, no government, no matter how repressive, can inhibit the flow of ideas. The new approach to immigration policy must recognize the need for knowledge workers, as well as ideas, to move more easily back and forth between countries.

By making it so difficult for so many bright international students and scholars to remain in America, we are fostering a reverse brain drain of dizzying proportions and helping our competition. Already, partly because of our immigration policies, the U.S. is no longer always the top choice for students from Asia when they apply to graduate school in science and engineering. We are at risk of having both a decline in the number of international students that matriculate, which will affect our capacity to conduct research in American universities, and a decline in the quality of the graduate students, which will affect the impact of that research.

It is in our national interest to make some changes -- and make them now. Although colleges and universities are exempt from the cap of 65,000 H1-B visas (which should be lifted), we need to ensure that, on graduation, foreign workers can be employed in focused fields, including high-tech science. Second, we must permit families to be together and allow reasonable visits back to the home country for, say, family medical emergencies with an expedited process to return to the U.S. Of course, critical to the development of immigration reform, particularly if leading to larger numbers of immigrants, is further attention to border and other national security issues.

A new, more enlightened and effective policy must also recognize the benefits of even illegal/undocumented foreign nationals eventually becoming part of mainstream America. The DREAM Act was an attempt in this direction. The time may not be right for the DREAM Act (though I and many college leaders think it is), but the underlying idea is robust and very important.

Among our national priorities related to innovation, economic growth and national security, let's find the intellectual and political breathing room to forge a new set of immigration policies that will fulfill former Secretary of State Colin Powell's vision of "secure borders, open doors," match our policies to the realities of 21st century innovation and communication, and let my father's story be repeated again and again.
]]> Higher Education Legislative Priorities: An Open Letter to Newly Elected Representatives and Senators tag:www.huffingtonpost.com,2011:/theblog//3.809740 2011-01-16T17:23:33-05:00 2011-05-25T18:25:24-04:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/
I write to congratulate you on your election, to thank you for shouldering this responsibility at a difficult time for our nation, and to ask you to consider supporting some critical legislative priorities related to higher education.

I won't bore you with the usual exhortation about how higher education is a jewel in America's crown. I'm afraid that lately we have been on the national radar screen in negative ways: runaway tuition, a greater emphasis on research than on undergraduate teaching, and lack of response to the needs of the greater society. Like all caricatures, these oversimplifications contain some truth. But the higher education community increasingly is facing these issues more squarely, and I offer for your consideration a few assertions and suggestions for pending and potential legislation that would have a momentous impact on America's ability to remain a major force in the world of our children and grandchildren:

Assertion: More, Not Less, Access to Higher Education Will Characterize the Most Successful Societies in the Future.

Legislative Priority: Improve Access to Higher Education Based on a Combination of Enlightened Student Financial Aid Policies and Incentives for Cost Control in Colleges and Universities.

Ultimately, access to higher education will require both robust and predictable student financial aid and a commitment to reducing the cost -- and price -- of higher education.

There have been many recent arguments about "return on investment" calculations that relate the net price of higher education (i.e., tuition "sticker price" minus student financial aid) to the increment in salary after graduation, but the preponderance of evidence supports the assertion that a college education is a personal as well as a societal economic benefit.

Your predecessors in Congress deserve credit for recently improving the federal student financial aid system and helping to reduce student debt. It would be incredibly short-sighted in this time of economic crisis -- when we need an educated, creative and motivated workforce -- to undo that progress and put postsecondary education further out of reach for a majority of American families.

The longer-term answer, of course, lies not only in increased student financial aid, but in curtailing the rate of rise and eventually reducing the cost of higher education and, in time, its price. Many colleges and universities, particularly public institutions, have done a remarkable job of belt-tightening when cyclical reductions in state funding have occurred. But in the wake of the Great Recession, all colleges and universities must take more vigorous steps in cost containment for the long term. In some instances, however, it is necessary to spend money in order to save money, such as through investments in systems and energy efficiency. Please consider an idea suggested by Professor Ron Ehrenberg of Cornell: a federal matching program in which large, complex universities or consortia of smaller institutions would be eligible for incentive funds to undertake rigorous administrative streamlining and strategic planning initiatives focused on maintaining quality while reducing costs.

Legislative Priority: Reform Immigration Policies that Impact Higher Education, Starting with Implementation of the DREAM Act.

Across the globe, societies are struggling -- and succeeding -- in increasing access to postsecondary education. Look at China, India, Japan, Korea and many other countries that are putting huge resources into obtaining the best higher education for their best students. Look no further than the finest science and engineering graduate programs in the U.S. and you'll find that as many as half of the graduate students in some programs are foreign nationals. The United States is in a critical, global competition for talent and ideas that will determine our long-term prospects as a society.

We need to tap all the talent at our disposal to solve the nation's problems wherever in the world that talent originates. Former Secretary of State Colin Powell, in 2003, described the goal of "Secure Borders, Open Doors," and we have been trying to find the correct formula ever since. We need a better balance between national security and maintaining the critical, bidirectional flow of people and ideas.

Please reconsider passage of the DREAM Act. Why would we educate children at public expense from kindergarten through high school and then deny them the ability to pursue higher education because they were brought into the country illegally through no fault of their own? And while we're at it, let's find ways for more of those highly trained foreign nationals in our science and engineering graduate programs to continue to use their talents in the U.S.

Assertion: Universities and Colleges Are Critical to Economic Growth, Innovation and Job Creation.

Legislative Priority: Maintain Research Funding for the Life and Physical Sciences and Engineering.

Look into the origin of any modern advance that has become a new worldwide market, from Internet search engines to pharmaceuticals, and you will find university and corporate research and development, with universities not only making the majority of basic discoveries but also filling the pipeline of talent that feeds corporate research and the development of new products, processes, and services.

In one of their last votes, the 111th Congress wisely passed a three-year reauthorization of the America COMPETES Act for increased research funding to fuel the innovation and invention essential to a strong economy. Now we must ensure that appropriations match the authorization.

As George Will has said, "Today, the prerequisites for economic dynamism are ideas." Don't consign generations of Americans to a deflationary economy because of lack of will to maintain research funding in the life and physical sciences and engineering. Let's keep those ideas flowing and the pipelines full of people capable of and interested in discovery.

Assertion: A Broad Understanding of Our World and Its History, People, Cultures and Values Is Our Best Approach to a Secure Future.

Legislative Priority: Halt the Erosion of Support for the Humanities.

As I peruse the headlines and news alerts, it seems that the main strains that separate people around the globe -- often violently -- are related to poor understanding of each other's cultures, languages, histories, religions, and values. From the "person on the street" in our cities and towns to the soldiers on battlefields in Afghanistan, our best hope for a secure future is understanding and engagement, not just military strategy and strength. The public reactions to the tragic recent shootings in Tucson underscore the increasingly urgent need to communicate more effectively, to listen before we pontificate, to connect with each other, using skills and knowledge gained from a deeper understanding of the world and its people.

The National Endowment for the Humanities is one of the very few federal research agencies that have seen appropriations reduced substantially, in this case by over a third in inflation-adjusted dollars in the last decade and a half. Why? Because of political and culture-wars-related backlash in previous Congresses, with neither Democrats nor Republicans recognizing the huge losses our nation will incur without a robust scholarly community in the humanities.

When military leaders talk of winning the hearts and minds of the populace in another country, they are talking about understanding language, culture, values, religion and history. And global cultural understanding -- so essential to our security, our economic viability and our children's future -- is tied closely to our ability to connect, person to person. Just as surely, the State Department, Department of Homeland Security and intelligence agencies will only be as effective as their analysts are educated in the humanities.

I commend these four overarching legislative priorities to you as critical investments in our nation's future and the legacy we will pass on to succeeding generations. Thanks for considering them and for doing what you do.]]> We Can Do Better on College Costs tag:www.huffingtonpost.com,2010:/theblog//3.798220 2010-12-17T11:22:12-05:00 2011-05-25T18:20:30-04:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/
The Delta Cost Project and other economic studies inform the discussion of the causes of rising college costs and the effect of financial aid on the "net price" that students actually pay. It is a complex and controversial set of issues, but economists Robert Archibald and David Feldman (authors of Why Does College Cost So Much?) said it best in a recent New York Times "Opinionator" blog post:
"Many families are indeed priced out of the market or forced to choose education options that are less desirable... We have no doubt that the recent recession has made college and university charges less affordable no matter how one measures affordability."


So let's stop the intellectual shoving matches and get about the business of dealing with those factors that can and should be controlled to attenuate the rate of rise of both cost and price. And let's also stop apologizing for investments that are necessary to keep higher education one of America's premier "products."

Post-secondary education is sought after around the world because it serves individuals and the larger society. We can argue long and hard about "return on investment," calculated as incremental personal income, compared to the net price of a baccalaureate or advanced degree, but in a recent survey by the American Council on Education, more than 89 percent of young alumni reported that their college experience had been worth it, and 85 percent reported that their education had prepared them, at least adequately, for their jobs. The increasing emphasis on higher education in China, India and other emerging economies is testimony to the near-universal agreement that success in this world, not to mention national competitiveness, requires more, not less, higher education. Thus, we as a country need to expand, not contract, the availability of higher education and increase public investment in colleges and universities.

In addition to its traditional missions of teaching, research and public engagement, higher education is a major employer throughout the United States. No magic bullet will replace the human service-intensive nature of modern higher education and its associated costs. Information technology, for example, may extend the reach of higher education and hugely increase the efficiency of delivering certain kinds of material, particularly at the remedial and introductory levels. But it is unlikely ever to supplant our college and university campuses, especially those where research is conducted. Technology is only part of the answer to issues of cost, affordability and access.

Nor should we begrudge funds spent on certain "nonacademic" activities. Sure, to put it mildly, the higher education community is no paragon of efficiency and cost-effectiveness -- more on that below. But most non-faculty-related activities are not "administrative bloat." There is evidence aplenty, for example, that student support services such as counseling improve persistence and graduation rates and are critical to student health and well-being.

And we must understand that as the states continue to reduce their relative investment in higher education -- between FY 2001 and FY 2009, the inflation-adjusted average state appropriation per FTE student fell by over $1,000, or 13 percent -- tuition will continue to rise. It's simple economics, and no amount of wishful thinking or browbeating will change that inverse relationship. But the rate of rise will depend on the balance between total revenue available to each college and its cost structure.

So what can be done to control college costs? The recession we are experiencing is not a normal, cyclical "blip" on an ever-upward revenue curve. It is unlike anything that most of us have ever experienced, and it will be with us for some time. Consequently, we in higher education have to make some fundamental changes in the way we do business. We are used to balancing our budgets almost completely on the revenue side. Like other establishments, we utilize all revenue reasonably at our disposal: tuition, state appropriations, federal appropriations, grants, gifts and, in a relatively small proportion of institutions, endowment income. Most institutions allocate some of this revenue, including tuition dollars, to manage the "net price" of attendance for individual students, factoring in the financial resources of the family and the attractiveness of the student from the institution's perspective.

But the rate of tuition rise is unsustainable. Attenuating this rate of increase can only be achieved through cost-containment. It's as simple and complex as that. Given the current financial pressure, this will take time. Three sets of activities are needed, and we'd better get about them:

1. No campus can be all things to all people. Now is the time to decide, campus by campus, what we can do best and aspire to improved quality in those fields. And the other disciplines that we know to be less well-developed on campus A? Leave them to campus B, across town or across the state. Better, foster communication between the faculties of A and B to realize economies of scale in providing instruction in less popular fields, optimize coordination, and reduce competition. This is an area where information technology can be extremely useful. Bottom line: focus and connectivity.

2. We can no longer avoid true, tough and thoroughgoing reviews of faculty productivity and quality, including after tenure is granted. Our colleges vary widely on the presence and effectiveness of reviews of faculty quality and productivity and of post-tenure evaluations. No outside entity will ever perform this function as well as we ought to be able to within the academy. It's likely that more rigorous faculty accountability - conducted by peers and colleagues -- will result in some reduction in the costs of education and of the infrastructure of research. Bottom line: accountability.

3. "Administrative" activities are as essential to the success of higher education as they are to any enterprise of any type anywhere. But the discipline and expertise needed to contain the costs of those activities is often lacking in our colleges. More uniform, managed methods of procurement, fewer layers of bureaucracy and larger spans of control for those in administrative positions can help, as can a rethinking of our support paradigms in information technology, finance, and facilities services. Some colleges have found that reducing support costs allows greater focus on the highest priority aspirations of the institution. At Cornell, we recognized early in the recession that we lacked the detailed skills to identify all of the potential areas for cost savings and to design remedies, so we brought in a consulting firm to assist, guide, and cajole us. Not all schools can afford to engage a consulting firm, but all can find ways to spend less on administrative functions. Bottom line: administrative streamlining.

Given our continuing uncertain economy, I call on my colleagues in higher education to reduce the rate of rise of our operating costs through focus, connectivity, accountability and administrative streamlining. Improvements in higher education's pricing and accessibility will follow.
]]> What We Need to Know in Good Times and Bad tag:www.huffingtonpost.com,2010:/theblog//3.780142 2010-11-07T21:31:24-05:00 2011-05-25T18:10:25-04:00 David J. Skorton http://www.huffingtonpost.com/david-j-skorton/
Yes, I am talking about the humanities. But before you groan at yet another university president seeking to feed at the public trough by proclaiming the value of a liberal education, let's get serious about what our nation needs. To be sure, jobs, regional economic development, and careful control of expenditures in the public and private sectors are keys to a robust recovery. But we got where we are in part through a loss of values, a lack of understanding of the lessons of history and, increasingly, a loss of civility and of the sense of fair play. Witness, for example, the nastiness of the recent midterm elections, which demonstrated our collective loss of the ability - or even the desire -- to understand and respect each other. I would echo James Leach, chair of the National Endowment for the Humanities and former U.S. Representative: "The temper and integrity of the political dialogue are more important for the cohesiveness of society than the outcome of any election."

Do we want our children to find better and more effective ways to understand their world and work with each other to improve it? Of course. Then we better think twice about the education they should receive.

Course work in the humanities is often promoted, legitimately, as a way to teach basic skills of contextual thinking, communication and ethics to scientists, engineers, businesspeople and others. But we must also recognize the value of the humanities as a discipline of research and critical analysis in its own right. The past cannot be changed, but our knowledge of it can be enhanced through rigorous study. As we have learned the hard way in Iraq and Afghanistan, if we want to "win the hearts and minds" of those in the line of fire in war-riven areas of our world, we must understand their histories and their cultures, languages, religions, and values.

All of us, and especially policymakers in Washington, need to recognize that the risk of losing the underlying disciplines that make these understandings possible is real. Students are voting with their feet by choosing courses in "practical" fields that they think will yield employment. They are often wrong, but who can blame them? As the number of bachelor's degrees in the humanities as a percentage of all degrees has declined (from a high of nearly 18% in 1967 to about 8% in 2007), so has the funding for these fields.

Democrats and Republicans in Washington fail to recognize that we are steadily divesting from support of the humanities and the arts. To wit, the NEH and the National Endowment for the Arts have been tempting targets for those seeking to advance particular political, social or religious agendas or to show fiscal restraint; since 1994 their budgets have dropped by more than a third in inflation-adjusted dollars.

The amount of funding needed to turn this around, let me emphasize, is modest. While our government now operates in large part under a Continuing Resolution (a legislative procedure that funds a new fiscal year at the same level as the last while appropriations decisions are considered), the NEH budget is pegged at $167.5 million, with the President's budget suggesting a cut to about $161 million (hardly a rounding error in comparison to the more than $30-billion budget of the National Institutes of Health). If the trends continue, it is not hyperbolic to suggest that these critical areas of study may reach a tipping point and go into an irreversible decline. We need to appreciate and communicate to the country the important role that the humanities play in our national life.

Of course, as a physician and biomedical researcher, I firmly believe in the power of science and technology to advance knowledge and to improve our lives and the economy. But make no mistake: the most significant problems in our country and world will not be solved by science alone. We need aware and educated people and approaches to act upon that knowledge, recognizing its power as well as its limitations.

How can we reach the future to which we aspire without a broad educational curriculum and research portfolio that give vitality to our laws, ethics and cultural values? And how can we divest ourselves of the humanities at a time when our economic, political and military struggles increasingly underscore the costs of ignoring history, literature, languages, and philosophy?

Despite -- and perhaps because of -- stark budget realities we must have the political will and discipline to stabilize and, yes, increase investments in state and federal agencies, such as the NEH, that support the humanities. It's good for our children, it's good for our security, it's good for America.
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