You consider yourself a top-shelf student.

Over the last four years you have demonstrated an exemplary work ethic, one even your teachers rave about. To challenge yourself, you have taken the most difficult courses your school has to offer.

Even with that demanding schedule you will graduate in June near the top of your class. You have also posted excellent, not perfect, but 700+ SAT scores in all areas.

Just as importantly, you are much more than just some academic nerd. You have been active in extra-curriculars and have even served as team captain of your favorite sport.

You did all these things because of your desire to excel, yes, but you also did them because of a sincere desire to attend a selective college. You have dreamed of earning a diploma from one of America’s most prestigious institutions, one that everyone esteems.

You’ve done so because you know full well that if you graduate from one of those elite, Ivy-covered campuses, you will have extensive advantages in virtually any career of your choosing.

Now those applications are off, your goals and your dreams in the hands of an admission committee, a group of people who have likely never met you or have intimate knowledge of what makes you tick.

Though they do not know you, deep inside you harbor hope that these individuals will be objective, that they will judge you fairly on your record, because if they do, you know in your heart you do have a chance at being accepted.

While you are hoping for fairness, those admissions committees profess to go one step further. They proclaim their objectivity, insisting that decisions will be made on a case-by-case basis.

It will be an extremely difficult challenge to sift through the many deserving applicants, they say, to whittle it down to the most deserving. But they insist that they will do so. And they claim that they will make that decision irrespective of your ability to pay.

But despite your flawless credentials, it appears that you still may get rejected at that elite college and here’s why.

An Unfair System?

While you harbor hope and those committees profess objectivity, it is important to understand that the system is in fact stacked against with you, especially if you are from a family of limited financial means. While those admissions folks at every one of those elite schools will insist otherwise, there are clear indications that the system is not fully based on merit.

In fact, if you listen to Neal Gabler of the Boston Globe, you will begin to realize that the system is anything but fair. In The College Admissions Scam, Gabler insists that it is not an individual student’s record that matters most. Instead, wealth and affluence are the more important factors when it comes to getting into the most selective schools.

Gabler explains in detail, why, despite your astonishing record of merit, you may not receive an acceptance letter to one of those elite schools, especially if your admittance to these high-priced schools means you will be in need of significant financial aid to attend.

He writes:

“The admissions system of the so-called ‘best’’ schools is rigged against you. If you are a middle-class youth or minority from poor circumstances, you have little chance of getting in to one of those schools. Indeed, the system exists not to provide social mobility but to prevent it and to perpetuate the prevailing social order.”

Some Specifics

Gabler first quotes the work of Daniel Golden, author of The Price of Admission: How America’s Ruling Class Buys Its Way into Elite Colleges — and Who Gets Left Outside the Gates. In his book, Golden spends a great deal of time on legacy admissions, what many writers have come to call ‘affirmative action for the rich and famous.’

Legacy admissions essentially involve the acceptance of students who would not have qualified for admission under the school’s specific entrance criteria if not for some connection to the school. A typical example involves a specific school that has previously been home to other members of a student’s family. Golden notes that in such instances, many less-qualified wealthy students get accepted to those schools where relatives have pledged significant sums of money to the school.

In his work, Golden also notes another group of legacy students who may have an unfair advantage, children of the faculty. Because schools offer free or significantly reduced tuition to the children of faculty, professors at elite colleges often seek to get their children admitted irrespective of their qualifications.

In addition to noting the legacy discussion, Gabler goes on to point out how the concept of early admissions also plays a key role. The early admit process in most cases obligates students to attend that school should they be granted admission. Such a decision favors only those with the means to pay since a student cannot wait to make their decision based on their financial aid package.

Gabler makes several other pertinent points related to athletics, racial diversity and the acceptance of economically disadvantaged students, whether black or white.

No Need for Self-flagellation

Gabler insists that many high-credentialed students who in fact meet the admissions criteria end up being passed over at these elite institutions. He further insists that a rejection letter should not be cause for self-flagellation.

According to Gabler, if you are not white and affluent, that thin envelope of rejection should not come as a surprise. He concludes:

“So here’s the bottom line for all those exceptional middle-class and lower-class high school seniors who will doubt their own worth when the near-inevitable rejection letters arrive: The fault, dear Brutus, lies not in you. The fault lies in the system, and the system isn’t going to change.”

Always a poor way to pay for college, private loans are now tougher to consolidate and more difficult to obtain.

When it comes to finding help for college everyone is advised to pursue free funds first. Securing grants and scholarships, money that you are not required to pay back, is always the most appreciated form of help. But somewhere along the line, many students have to turn to a less palatable form of support, loans.

However, every chance we get we caution students regarding borrowing sums of money to pay for school. Accumulating debt is not something to take lightly. That said, if you do have to borrow it is imperative that you understand the one type of loan you should avoid like the plague.

Private or Alternative Loans

In virtually every way imaginable, private bank or alternative loans should be avoided. In fact, students may well want to employ the baseball standard of three strikes and you’re out mentality.

Strike One

First, unlike federal loans, private loans have been less than desirable because both the interest rate and borrowing terms are dependent on credit records and the economic climate. If either you or your family does not have the highest of credit scores, you may be assessed a higher starting interest rate and a point or two surcharge on the face value of the loan. Furthermore, the loans will have a variable interest rate based on the current prime rate plus some buffer. Therefore, your interest rate can change dramatically over the course of the loan.

Strike Two

Second, unlike federal subsidized loans, students are assessed interest from the moment they borrow the money. It is true that you might not have to begin paying on the loan until six months after graduation but your debt will be growing every day you remain in school. And while it is also true the federal unsubsidized loans accrue interest from the time the money is loaned, those federal loans will not have the high variable interest rate or point issues that private loans carry.

Strike Three

Third, if you graduate from school only to have difficulty finding work, or if you are lucky enough to find work initially (no small task in today’s work environment) only to be laid off later with federal loans it can be possible to get an “economic hardship deferment” on your federal loans. Obtaining such a deferment from a private lender has proven to be generally impossible even when you have been granted deferment from the federal government. And most importantly, as is true of all loans for college, federal or private, they cannot be discharged in bankruptcy.

You’re Out!

Fourth, and what has to be the proverbial straw that breaks the camel’s back is yet another issue developing in today’s tougher economic climate. It seems that consolidating individual private loans upon graduation has become almost impossible.

Consolidation is a mainstay of the federal loan process. The process allows for the combining of multiple loans (if a student takes a loan of some amount to help pay each year in school) into a single payment based on one interest rate. Consolidation extends the repayment period and therefore lowers the monthly payment.

Unfortunately, many banks no longer offer consolidation even if they do offer multiple individual loans. And if they do, they will consider consolidation only after running a credit check. If that check provides a picture that you are at risk you can kiss the consolidation option good-bye. You may also be out of luck simply because the sum total of your debt is too large.

Avoiding Private Loans

Unfortunately, for a lengthy period of time students thought very little about the impact of private loans. That has led to some horrific stories of student debt.

Fortunately, the economic downturn has made private loans more difficult to secure. And whereas once upon a time it was easy for students to borrow on their own, today they are unable to secure such a loan without obtaining a cosigner that is also well-qualified.

Ultimately, that is a positive development for students. In fact, we advise students to make it a goal to not only graduate with as little debt as possible, whatever debt they accumulate should be devoid of private or alternative loans.

As students and their respective families enter the 2010 financial aid application time period, those filling out applications should be reminded of a letter sent by Secretary of Education Arne Duncan last spring.

As just one aspect of President Barack Obama’s pledge to increase student participation in higher education, the U.S. Department of Education released what has been dubbed a “Dear Colleague” letter. That communication, dated May 8th, encouraged college financial-aid administrators to take into consideration any special circumstances that students and families have faced during the economic downturn.

The key aspect of the letter involves an effort to make families more aware of a concept referred to as professional judgment. However, while the letter sought to have schools take greater responsibility for making more families aware of their rights, those filling out application forms owe it to themselves to understand the concept and the current circumstances surrounding Duncan’s letter.

The Letter

First, The Chronicle of Higher Education describes the fundamental change that Duncan’s office was seeking. While families have always had the right to ask the financial-aid office to exercise professional judgment, many were unaware of this right. The Duncan letter went so far as to encourage “financial-aid administrators to reach out to students and families who may be in trouble.”

In addition, Duncan’s letter clarified the changing circumstances for which financial aid administrators should consider utilizing professional judgment.

“A changed circumstance certainly includes the loss of a job or a reduction in work hours or wages,” wrote Duncan, “but it also includes, for example, the income loss associated with a prospective student’s decision to leave the work force or to reduce work hours in order to return to school.”

The letter further indicated that professional judgment should be used on a case-by-case basis and requires colleges document the changed circumstances.

The Use of Professional Judgment

The idea of financial aid officers exercising professional judgment is simple to describe. According to The Chronicle:

Professional judgment allows aid officers “to adjust student aid to reflect a family’s financial circumstances not reflected on the student’s Free Application for Federal Student Aid, or FAFSA.”

In other words, schools are being asked to look beyond the numbers and examine a student’s and/or families’ immediate circumstances. For example, if the student or parent worked most of last year, the FAFSA form might call for a specific expected family contribution based on those earnings.

However, if the student or parent recently became unemployed or has seen a reduction in hours or hourly wage, then their ability to pay has been significantly altered. And for 2010, another adjustment involves families who took a hardship withdrawal from a retirement account to cover a medical bill. Normally such a withdrawal would be counted as income earned in that respective year but will not be for earnings in 2009.

The use of professional judgment was not something schools practiced liberally in the past. In fact, such a step previously held negative ramifications for institutions.

Previously, the Department of Education had used the professional judgment determination in its risk-based model to select schools for program reviews. The higher the percentage of students qualifying for professional judgment, the more likely the school could find itself in the review process.

The Duncan letter informed colleges that for both 2008-09 and 2009-10, the Department would make appropriate adjustments to its risk-based model.

Implication for Students

Students and families who have been impacted by the economic downturn need to understand their right to request that aid officers make adjustments even if such an adjustment is not offered. Such an adjustment could dramatically affect one’s status, creating a new-found eligibility for grants and other need-based student aid that a student may not have previously qualified for. Students might also qualify for additional federal loans and work study options.

The biggest benefactors would be those individuals who have been laid off or had hours/wage reductions yet are interested in returning to school to retrain. Those individuals could conceivably find themselves in a position to be eligible for significant levels of need-based financial aid based on their current employment status.

Previously, independent students who had been laid off had to report their unemployment benefits as income. The Duncan letter directs institutions to set that student’s earned income from work to zero for financial aid purposes.

But other benefactors could be current students who have had one or both parents lose wages. If a student or family has seen a recent paycheck change they should be sure to alert their respective financial aid office and seek adjustments accordingly. For greater clarity on who might be eligible, the Department of Education and the Department of Labor have collaborated on a web site that offers assistance to those recently unemployed.

Adding further optimism for students and families are a number of other positive aid developments. The maximum Pell Grant will be increasing to $5,350 for the 2009-2010 school year and to $5,550 for the 2010-2011 academic year. Those numbers are up from $4,731 a year ago.

In addition, the Hope Credit (now called the American opportunity tax credit) has risen to $2,500 for the 2009 and 2010 tax years (up from $1,800) and can be claimed for the first four years of post-secondary education (previously available for first two years only). The maximum income level for Hope eligibility is $90,000 for single filers and $180,000 for joint filers for 2009 and 2010.

William D. Coplin, Syracuse professor and author of more than 110 books and articles, discusses how students can use their college academic and non-academic experiences to prepare for a rewarding career.

Today, we offer readers some valuable insight from professor William D. Coplin, the director of the undergraduate public affairs program at the Maxwell School of Citizenship and Public Affairs at Syracuse University. A Meredith Professor for Teaching Excellence recipient, Professor Coplin is also the founder of the Do Good Society and the Chairman of Board for the John Dau Sudan Foundation.

The author of many books and newspaper articles, Mr. Coplin is also a regular contributor to the USA Today. But our interest in the man who has directed the Public Affairs Program of the Maxwell School at Syracuse University since 1976 centered upon two specific books he had written:

* 25 Ways to Make College Pay Off: Advice for Anxious Parents from a Professor Who’s Seen It All
* 10 Things Employers Want You to Learn in College

Professor Coplin is a strong proponent of reforming “both high school and college education to better meet the needs for the majority of students who see education as a path to better employment opportunities.” The 2000-2001 College of Arts and Sciences Award for Outstanding Faculty Advisor also is a strong proponent of internships as well as the other non-academic lessons that college can offer students.

Can you give us a brief overview of your philosophy regarding college studies?

My philosophy about college can be summarized in three statements I always make:

• A college and a dollar will get you four quarters.
• It’s the skills stupid.
• A college education is four years of experience and not 120 credits.

So, are you a proponent of a general liberal arts education? Or do you think colleges should offer a more career-focused job preparation approach?

Students should get what they pay for and most want to improve their chances of finding and succeeding in a rewarding career. A general liberal arts education should provide the basic skills and experiences students need to find themselves on a good career path. However, most of the formal academic requirements are aimed at creating professional scholars. In that way, liberal arts colleges are actually more vocational and narrower than most professional schools.

The argument that liberal arts creates well-rounded, educated citizens is a cop-out for two reasons. First, 85% of the students are not looking for that in college. Second, the highly fragmented and theoretical nature of liberal arts courses today do not provide a broad based educational but just intellectual chaos. So I think the concept of a general education would be a good one if it were focused more on skills than on learning some body of stuff which no one agrees on.

My understanding is that you are a strong proponent of internships. Can you talk a little bit about why you value this concept so highly?

The real world is the best teacher. Any kind of fieldwork is the key to developing the skills and exploring careers that will lead students to the next step after college graduation. Internships will help students decide what careers they want to pursue and will hold them to a higher and more difficult standard than college coursework.

Moreover, many internships lead directly to a great job with the organization providing the internship. Even if it does not lead directly to a job, it provides a network for a job search. By September 2009, two of my seniors had a $45K+ job starting in June 2010 with a major financial institution where they had done internships the previous summer, and we all know what kind of job market there was at that time.

Your book, 25 Ways to Make College Pay Off, focuses on “Advice for Anxious Parents from a Professor Who’s Seen It All.” My understanding is that the book seeks to provide advice on how to maximize the college experience for both future financial and emotional success. Can you give us a brief overview of some of the steps students should be taking while in school to ensure future financial success?

The book tells parents what they should do to help their students get the skills employers want and explore careers while completing degree requirements. The most important thing for parents is to treat their children as they would treat an investment in a business.

Among other things, it means not doing their college application for them or writing their papers which parents do all the time and making their children pay at least 20% of their education. Work ethic, personal responsibility and a focus on skills and career exploration will help to ensure success. Parents can contribute to their success by keeping their distance or contribute to their failure by not practicing tough love.

What are some of the critical elements students should focus on to ensure future emotional success?

I have two simple little charts I tell students to fill out to decide what kind of career they might want to pursue. The first gets at the three areas of work activities. Most jobs are some combination of the three.

CHART 1: Skill/Preference Matrix

Please rate each skill as High, Medium or Low, according to two separate elements, whether you are “Good At” the skill and whether or not you “Like to Do” that skill. The three skills are:

Information
People
Physical

The second chart helps students think about quality of life consideration. Students should put an x where they would like to be on each dimension and then use it as a guide and look for consistency.

CHART 2: The Career Field

Place an “x’ on the line which indicates where you want to be when you are 30.

Average Salary_______________________________ Top 5%

Graduate Education __________________________ 4 year Degree Only

What research process did you use (and which companies did you contact) to determine the list that makes up the 10 Things Employers Want You to Learn in College?

Most of it is based on my experience with students when I give them assignments in many of my hands-on courses. In addition, there are many lists around. The one most instructive was developed by the National Association of Colleges and Employers (NACE) which is referred to in the book.

I also work with career services on campus and talk with many employers, some of whom are my alumni. I developed a major at Syracuse built around the skills, and my students are very successful in obtaining employment initially and go on to have successful careers. The Public Affairs Program website has testimonials from them that support the view that general skills are the key.

Reviewers have said of the book, it “teaches you to solve complex problems, influence people, and detect BS—real-world know-how your textbooks don’t teach you.” Can you briefly talk about the real-world know-how that forms the basis of the book that is often not part of the college curriculum?

The vast majority of degree programs in almost all fields in college are top heavy with theory and textbook learning. Theories are just the opinions of scholars that may or may not have application. Having students do community service or a research program for a community agency or participating in a summer internship gives them practice in the skills that are essential like solving complex problems, influencing people and detecting BS. They can develop their own theories, informed but not determined by what they learned in the classroom.

The range of activities students can undertake in college to get these experiences is unlimited. Some like coop programs generate academic credit but most do not. Students can learn a great deal by being a Resident Advisor, President of a Sorority, telemarketer for the alumni fund of the college, research or teaching assistant or managing a snack bar. In these positions, they will learn all about problem-solving and working with people as well as detecting BS.

Can you give us a bit of an explanation as to what you mean by “detecting BS”?

College is a great place to develop the ability to detect BS because there is plenty of it around ranging from what you friends tell you to what glossy college and program brochures tell you.

To detect BS, students need to assess what people say for accuracy. They can do this by checking factual statements through research.

Did the person present the facts selectively, omitting all basic information? Students should always ask what the purpose of the writer or person making a statement is. Is it to convince or to sell you on something they want you to do or believe? Or is it offered as information through which listeners can reach their own conclusions?

Finally, does what an individual say or write correspond with what they actually do? This is especially important in looking for a job because employers might not be completely honest. It is also important on a job where supervisors and co-workers may be trying to get you to do something they want you to do but you may think is not a good idea. You may not challenge them but you should know it is BS and act strategically.

Some of the listed items are extremely clear from the titles of each section of the book: the concept of work ethic, speaking and writing well, and the ability to think critically and problem solve. But please talk about three others you note as important: teamwork, influencing people and number-crunching. How do students go about gaining these critical skills?

Teamwork – More and more classes have teamwork components. Students tend to avoid these because “they hate working in teams; they would rather do it themselves.” However, they should bite the bullet and take those classes. In addition, they will learn teamwork in most jobs whether it is serving food or fund-raising for a charity.

Influencing People – What I said about teamwork goes for this also. Most students and college graduates will tell you getting along with roommates was a very big challenge. That experience will have much more impact than taking Introductory Psychology on their people skills. I also am a big advocate of Dale Carnegie. I make students practice the principles in his book, How to Win Friends and Influence People and give speeches demonstrating how a principle worked for them. You would be surprised how many students learn to avoid arguments with their roommates and convince the police not to give them a ticket by applying the principles.

Number-crunching – All students should learn Excel and make tables and graphs using Excel. Almost every internship and job requires it. Taking a course may work but in my experience unless there are practical applications the students will not be very good at it. Continuous practice of Excel and using percentages and statistics are crucial. I usually have students do a cash-flow projection using Excel based on what will happen when they graduate from college. Taking a statistics course offered by Mathematicians will usually be useful; taking a course in which students have to collect and present data to outside clients will always be useful in developing number-crunching skills.

Today’s job market is the toughest in recent memory and will continue to be as such for the next couple of years at least. What additional advice would you give current juniors and seniors that you think would most help position them to be one of the lucky ones to secure employment at graduation?

My students get jobs because they have the experience and the skills employers are looking for. As for additional advice:

• Minimize debt because the larger the debt, the less choice you have in finding a job.
• Graduate as early as you can because the faster you get into the real world, the faster you will be on a career track.
• Don’t go to graduate school unless you have job experience first.
• If you run into a dead end, take a job offered by a staffing or temp agency – it will lead to a full time job if you have the skills.
• Understand that all starting jobs are not a lot of fun.
• Finally, don’t turn your nose up at sales jobs -everyone eventually becomes a salesperson and it is a way to get ahead quickly if you pick the right company.

Inside Higher Ed suggested that ‘Fitness for Life’ may well have been “the most discussed college course around” in recent weeks. But almost as soon as the course made national news, it has become a footnote in internet lore.

Adopted in 2006 by Lincoln University, the course was to be a graduation requirement for a select group of students: those seniors with a body mass index score of above 30. This year’s seniors were the first to be affected by the requirement: either lose weight or complete the Fitness for Life course by the time they graduated.

Amidst Outrage, Other Colleges Express Interest

According to newspaper sources, Lincoln faculty, concerned with the negative publicity surrounding the requirement, met on Friday and made the course voluntary in a near-unanimous vote. The policy will be one that encourages students who are obese to take the course, but the school has ended “the stipulation that these students enroll in the class as a graduation requirement if they don’t lose weight.”

Interestingly, according to school administration, once the story hit the national news, phone calls began coming in from other colleges seeking information about how to set up programs to help obese students. While those inquiring might have had a different idea about making course requirements, apparently many schools are concerned with the issue.

Still, many staff at Lincoln, the first historically black college created in the United States, were reportedly upset by the school’s sudden, new-found fame. Instead of the university with “the fat class,” Lincoln’s faculty and alumni preferred a return to the days when the school was known for the likes of Thurgood Marshall and Langston Hughes.

Though the faculty chose to end the requirement, James L. DeBoy, chair of Lincoln’s health, physical education and recreation department, continuously held fast to the idea. Prior to the meeting, DeBoy published a document urging staff to ‘stay the course’ and not dwell on the outside criticism:

“As educators we must be honest with our students and inform them when behavior, attitude, knowledge bases, or habits of mind are not what we, the faculty, deem as acceptable,” wrote DeBoy. “Any factor/trait/characteristic that we believe will hinder students’ maximum development and full realization of life goals must be: (1) brought to their attention; (2) substantiated as being detrimental; and (3) adequately redressed.”

After the vote, Inside Higher Ed noted DeBoy “was not distressed because of the continued commitment to the course and to raising the issues involved.”

Though Legality Unanswered, Students Pleased

The vote left the legality of the requirement up in the air. Many had called the initial requirement discriminatory since it required only certain students complete the course. But school officials insisted that legal concerns were not a critical component of the decision.

Students however, seemed pleased with the results. They also seemingly had an impact on the final vote since several were in attendance at the meeting.

One of the students present at the meeting, junior Sharifa Riley, was unequivocal in her pronouncement when discussing the topic with Philly.com. “It’s discrimination if they tell one group, ‘You’re too fat, you have to take this course,’ and they tell another group, ‘You’re OK, you don’t have to take it,’” Riley was quoted. “If everyone had to take the course, that would have been better.”

And fellow junior Lakeishia Fleet, 20, called the new policy “a good idea; it gives us a choice. Now we can get back to worrying about finals, not a weight class.”

According to reports Lincoln University had been the only college outside the nation’s military academies to invoke some form of physical fitness requirement for graduation.

It was about two weeks ago we saw the alarming headline:

Report says 75 percent of Americans unfit to serve in military.

Calling it another threat to our national-security, the report, Ready, Willing and Unable to Serve (pdf) , indicated that 75 percent of Americans ages 17 to 24 do not qualify for military service because they are either physically unfit, they failed to finish high school or they have a criminal record.

On the education front, about one in four in the 17-to-24 age group lacks a high school diploma. That statistic has Education Secretary Arne Duncan pressing Congress to approve the Early Learning Challenge Fund, a 10-year initiative to improve childhood development programs.

According to MercuryNews.com, roughly one third of all Americans in the age range would be disqualified for a wide variety of health related issues including asthma or for taking pills for depression or attention disorders. And another 27 percent of all young Americans would be disqualified by obesity alone.

New College Requirement

With that as a backdrop, we turn to Lincoln University in Pennsylvania where the school has enacted a physical fitness course requirement. The graduation condition is causing a major fuss because the course is not necessarily a requirement for all students.

Instead, the mandate exists for students with a body mass index of 30 and above, a BMI deemed as obese. Those students in that category must take and pass a fitness course that meets three times a week.

And if they are assigned to the class but do not pass, there is no diploma.

The requirement went into effect in the fall of 2006 but is only now making national waves as the time approaches for the first set of graduating students to be affected by the policy. And one should not be too surprised to learn that the school is now facing criticism from both students and the greater public.

Most articulate that the unfairness comes from the fact that not all students are being held to the same standard. James DeBoy, chairman of the school’s Department of Health and Physical Education, offers quite a strong rebuttal to that assertion.

He likens the requirement to other remedial courses that some students need to take to improve their reading or math proficiency levels. He also went so far as to offer this rather candid assessment:

“We, as educators, must tell students when we believe, in our heart of hearts, when certain factors, certain behaviors, attitudes, whatever, are going to hinder that student from achieving and maximizing their life goals.

“Obesity is going to rob you of your quality and quantity of life,” he went on to add. “We believe that this is unconscionable.”

Lincoln, an historically black college named after the “Great Emancipator,” might be a bit more cognizant of the general issue, since roughly four out of five African-American women over the age of 20 are overweight or obese according to the U.S. Department of Health and Human Services. When summarizing the situation, the folks at CNN added: “Obesity increases a person’s risk of heart disease, type 2 diabetes, stroke, some cancers and other ailments.”

But the same report offers this assessment from the legal perspective:

“The school’s requirement seems ‘paternalistic’ and ‘intrusive,’ David Kairys, professor of law at Temple University Law School in Philadelphia, Pa., offered. ‘The part that seems excessive is forcing them to take this course, or to exercise three hours a week, which isn’t a bad idea for them, but should be their choice.’”

Addressing a Problem

We began by reminding folks of the recent military assessment of Americans ages 17-24 and noted the push for early childhood education to potentially address the 25% of this age group that did not graduate from high school. Of course, while no one questions the overall goal, many will question whether the funding of early childhood will be the answer.

Likewise, with 27% of that age group deemed obese, there should be a call to action to address this alarming trend. It of course has long term ramifications that transcend the military concerns and gets to one critical element of the healthcare debate, the idea of taking personal responsibility for one’s physical well-being.

And there will no doubt be those who insist that the Lincoln requirement, or any such similar expectation at the collegiate or high school level, will do nothing to address the issue.

But then again, there is little doubt that the first step to solving a major issue is to educate the public on that issue. Lincoln appears to be doing just that.

The school even goes one step further. It takes those bright and hard-working students nearing graduation that are most in need of addressing this specific concern and mandates they be educated on the issue.

Today it is not uncommon for a college to claim it will meet 100% of a student’s financial aid needs. The result is that the “meeting 100% of need” phrase is tossed around liberally.

When a student hears such a claim, he or she must do a little digging to determine what the school is actually offering. Meeting 100% of need does not exactly mean you will be able to attend college debt-free.

The Chronicle of Higher Education recently offered a startling data table that helps clarify the issue. Sadly, the writer summarizes the table this way: “The poorer the family, the larger the unmet need for financial aid.”

In summarizing the data, The Chronicle noted that “many poorer students seek supplementary help from relatives other than parents and from private loans. In contrast, students from wealthier families enjoy, on average, a surplus of financial resources compared with need.”

To get a sense as to what that means, let’s look at families with earnings of less than $40,000 per year and examine two scenarios: application at a public four-year school and contrast it with a private four-year school.

In the first scenario, the average financial need for families totals $16,496 while the average aid package totals $11,754. That leaves the average unmet need for a family at a public four-year college at $4,742.

At private schools, for those same families with earnings of less than $40,000 per year, the unmet need averages almost twice as much, $8,417.

But the real kicker comes from the aid package itself. In most instances, schools consider federal Stafford loans as part of the aid package. In other words, the aid package is often not 100% grants and scholarships, it also includes an expected level of borrowing.

In fact, when we return to The Chronicle numbers we see the real issue. For those families earning less than $40,000 per year, the expected total student work/loan burden is over $4,000 per year making the unmet need plus student commitment a robust $8,800. For those students considering a private school, the total student work/loan burden plus unmet need is almost $15,700 per year (for a family with similar earnings).

When schools consider Stafford Loans as part of their aid package, the borrowing can be significant, especially over four years. Students must understand that these loan amounts are currently $3,500 per year for freshmen, $4,500 for sophomores, and $5,500 per year for juniors and seniors for the subsidized portions alone.

So a quick run of the numbers reveals that students could be expected to borrow as much as $19,000 through the subsidized Stafford loan process. Yet, at the same time, the school will insist that these loans guarantee meeting 100% of student financial aid needs.

In sum total, when it comes to the 100% need met, students and their families must read the fine print carefully.

Some Examples

Let us consider one of the finer state universities, the University of Michigan. It is an institution that states it “is committed to meeting the demonstrated financial need of undergraduate students who are Michigan residents.”

Though that statement is true, it is important to review the sample on their aid site. As but one example they provide, for a cost of attendance of $22,729 against an Expected Parent Contribution of $8,300, a total need for aid is listed at $14,441.

For the financial aid offer, the school lists in its hypothetical example a grant of $6,082, work study of $2,500 and loans totaling $5,859 to complete the $14,441 aid package. In such a case the school is ensuring funds are available but to complete the aid package a student would need to borrow the $5,859 in year one. Over four years, the sum borrowed would exceed $23,000.

As another example, consider Wellesley’s Enhanced Financial Aid Policy that was activated in February of 2008. The Wellesley plan goes so far as to eliminate loans for students from families with calculated incomes under $60,000. And for those families with incomes between $60,000 and $100,000, borrowing is capped at $8,600 over four years.

In other words, while Wellesley may require some borrowing, the school will not require a student from families of limited or even middle class means to max out their federal Stafford Loan borrowing each and every year. 

Another great example is the University of Richmond, a best buy among American colleges and universities. First, the school adheres to a truly need-blind admission policy. Second, the school’s claim that it will meet 100 percent of each admitted student’s demonstrated financial need results in the school capping need-based loans and work-study aid at $4,000 a year.

Yet another school, Williams College in Williamstown, Mass., provides some very specific scenarios on its financial aid site. One is most telling.

A Texas student, the eldest of three children, is from a family where the father is the sole breadwinner, earning $55,000 per year. The family has very little equity in their home and likewise limited savings.

The aid package by Williams in this situation is extraordinary. The school will provide the student with scholarships and grants totaling $37,710. It will also provide the student a work study opportunity so as to earn $1,550 over the course of the school year to be applied towards tuition and fees. The school is therefore awarding the student a serious aid package of $39,260.

And while the school claims no loans will be required, it must be noted that the cost of tuition, fees, etc., totals $43,460 per year. That means the school will expect a yearly parental and student contribution of $4,200.

At less than 10% of the cost, the aid package is truly generous. But if the family is living paycheck to paycheck because of house and car payments and everyday living costs, the $4,200 could be tough to come up with. The end result is that a family still could wind up borrowing in the long run.

Examine the Fine Print

College costs can be lumped into three distinct categories: parent and student contributions, grants and scholarships, and loans. When it comes to the idea of meeting student’s financial needs, some schools will insist on all three categories playing a significant role.

If a school insists on factoring in loans, then that borrowing should be thought of as part of the expected family and student contribution when considering an aid package. Schools that take this step may be able to say they meet 100% of a student’s financial need, but in reality it is simply arranging for the student to take on debt as part of the aid package.

Clearly, a student and his or her family must do some serious homework regarding a school’s claim that it will meet “100% of a student’s financial need.” A failure to do so could result in a significant surprise when the financial aid letter arrives.

When asked as to how you did last semester, nothing can top the sound of that simple four-word explanation:

Made the Dean’s List.

It certainly has a positive connotation to it. It also carries a special sense of pride, whether you are talking to your parents, grandparents, or one of your former high school teachers. And most importantly, it is a great thing to be able to place on your resume.

When you say “I made the dean’s list” it means one simple thing – you can handle the expectations associated with the rigors of college.

We know you want to be part of the select group that is able to make that claim and here is our six step method to making it happen.

1. Be Organized

Almost all college courses follow a troubling pattern – front loading information and back loading assignments. Too many courses begin with lots of reading and little in the way of written work only to end with major projects and papers due just as semester exams approach.

The most important step for academic success is to create a master schedule/calendar of your courses and the assignments due for the semester. It does not matter which format you use, digital or traditional, you just need to create a master with all pertinent information.

That means taking the entire syllabus for each course and plotting all written assignments, projects, papers and exams on one master calendar. Be sure and highlight any extra credit work options that are noted or add them to the calendar when the professor makes them known.

Once complete, to ensure you have a complete sense of the demands ahead, spend 30 minutes each Sunday evening reviewing the upcoming week and the two weeks that follow. Look carefully at that work and then plan your study time for the week. In the early going, when less written work is required, make a commitment to doing more than the required reading. A good goal is to work towards being at least a week ahead at the end of the first five weeks of the semester.

Second, organize all materials into folders and notebooks. There are way too many expectations to have you wasting time searching for some paper or papers you have misplaced. Such materials include all the original class handouts, the additional materials provided by the professor during the semester and your returned assignments, quizzes and tests. Don’t forget, those returned papers can be extremely helpful when it comes time for final exam preparation.

2. Find a Quiet Place to Study

One of the most critical aspects of college success is to be able to place the social scene on hold so as to be able to focus on the task at hand. While most think of the need to limit such time to the weekend, the reality is that the dormitory is often a social scene, one that can be a constant source of disruption. Limiting the time you spend in your dorm room is the only way to eliminate those distractions.

It is imperative that whenever you are reading challenging materials or preparing for an exam you have a quiet place where you can truly disappear. It might be the back stacks at the library, the basement lounge at your dorm or a study area in one of your campus classroom buildings. Ultimately, you must utilize this place whenever you need to find some real quiet time.

3. Attend and Participate in All Classes

It goes without saying that it is extremely important that you go to all of your classes every week. Your professor will not only spend class time on the subject matter, he or she will also help you identify how class projects and homework assignments will be graded and what you will need to know for tests.

In addition, some college professors make class participation a component of the overall grade. In such instances, they expect the students to be more than just present, they want to see you ask questions and contribute your thoughts to class discussions.

Obviously you cannot participate if you are not present. And you cannot participate in a meaningful way if you are not prepared.

And even if there is no grade for attending or participating, your presence and your participation can be extremely helpful. Your presence and participation will indicate to your professor that you are interested in the material and that you are committed to your responsibilities.

Such a step cannot hurt when that prof is about to provide that final grade for the semester and you are right on the line between a B+ and an A-.

Lastly, remember – taking notes is also a form of participation. Jot down everything that appears relevant, especially the information presented in overheads, in power points or written on the board. And if you are not good at note taking, get a tape recorder and record the class.

4. Implement the 15-Minute Review

To ensure you make the most of each class, arrive 15 minutes before the scheduled starting time and implement the 15-Minute Review.

At that point, instead of seeking out others to socialize, take the time to review two items briefly but as thoroughly as you can. First, review your notes from the prior class to remind yourself of what was being discussed and where the class ended. Then, quickly glance through the required reading in your text so as to have a sense as to where the professor will go during the class.

Doing these two tasks in a focused manner will not only ensure that you are in a proper mindset for the class when the professor begins, it means you will have a much better sense as to how the material the professor is presenting connects to the prior learning. Those two things will ensure your class is extremely productive.

To maximize the benefit of this concept, begin by implementing the review the evening before. If you have three classes the following day, take 45 minutes and break that time into three segments where you review your notes from the prior class and the reading material. Doing so the night before, then repeating just prior to class will again make class attendance far more productive. It will also greatly reduce your need for last minute study time when exams loom.

5. Limit the Social Scene

College offers enormous academic and social opportunities. It goes without saying that the social opps are far more enjoyable.

At the same time, all experts concur, that taking some time from studies is critical to maintain an emotional balance. But there is a difference between an occasional recharging of batteries on the weekend and shortchanging your responsibilities during the week. If you do not remind yourself of the task at hand, it is all too easy to get pulled away by your classmates at times when you really should be focused on completing some critical assignments.

Ultimately, you must remember why it is that you are attending college – that the academics must come first. The failure to do so is the undoing of far too many students – in some cases it is the difference between that A or B grade and a C. Sadly, in other instances, it is the basis for why so many are forced to drop out, their C’s having fallen to F’s.

There will be people around you who are taking a less rigorous academic program and thus can spend more time socializing/partying. There will be even more people around you who have forgotten why they are attending college.

You cannot forget, not if you want your name on that magic list.

6. Study

Yes, it does come down to the fact that you will need to study. But when it comes to studying, forget those stories about the all-night cram sessions, the weekend in a motel room with nothing but your books, some Ramen noodles and your hot water pot.

Simply stated, cramming sucks, from an emotional standpoint and from an academic preparation standpoint.

In college it is truly the story of the tortoise and the hare. You need to be a turtle, slow and steady with an emphasis on the word steady. The key is to do a small amount of work every day.

Unlike high school, when you are not in class, your time will be yours. There are no study halls and no required places to be. If you have a one hour class at eight, another at eleven and a third at three, it can be very easy to waste away the time from nine to eleven, or from one to three.

This is where your calendar comes in – you need to schedule that time, assigning a specific chapter to read or constructing an aspect of a paper or writing up those math problems. If you are not careful, you will find ways to fill that time with other things that seem more enjoyable yet do not match up with the reason you are actually attending college, the idea of earning a diploma.

And scheduling that time means time and location – where are you going to go so as to ensure you do the work you set out to do.

Making the Dean’s List

We must add that taking care of your physical health is also critical. You need to eat right, get to bed at a decent hour and find some way to exercise consistently. Such steps are critical to remain physically and mentally healthy.

In addition, select the right courses, those that you have the required prerequisites and background for, and be sure not to overload yourself with too many reading-based courses, too many lab based courses, etc. Five classes can be too many if each course expects hundreds of pages of reading between each class. Think through your schedule carefully to ensure you have a reasonable and balanced workload.

All in all, getting good grades in college is not beyond the realm of the serious student who displays the proper attitude.  If you attend class, work hard, and stay on top of the expectations, at the end of the semester you will be one of the select few, the proud, the student who can offer a humble shrug as you answer that question as to how you did last semester.

Made the Dean’s List.

Once upon a time, the price of a year of schooling at elite private colleges matched the price of the average new car – not any more.

The news from The Chronicle of Higher Education certainly was not positive for students and families. After surveying private schools as to the charges for a year of attendance (tuition, fees, room and board), The Chronicle revealed that 58 private colleges had passed the 50K pricing milestone for 2009-2010.

Leading the way was one of the perennial front-runners, Sarah Lawrence College, at $55,788. Rounding out the top five were Landmark College, a school for students with learning disabilities ($53,900), Georgetown University ($52,161), New York University ($51,993), and George Washington University ($51,775).

Not Actually a New Barrier

While news, it is important to note that the $50K threshold had already been broken. It was just that a year ago, the Club had but five members.

And it is the calculus or rate of change for these numbers that is raising eyebrows. Ultimately, the sheer number of schools topping the threshold led The Chronicle to call $50K the new norm.

Amazingly, the $40K threshold once represented a major psychological milestone for many. But that figure has been rendered obsolete in the matter of just six years time.

In 2003, just two colleges set their tuition, fees, room, and board above $40,000. Including the members of the $50K club, 224 schools were above that threshold in 2009.

Unfortunately, reading the folks at The Chronicle, the average citizen may have even more bad news on the horizon. While some are wondering aloud if we are not on the edge of a precipice, others insist college prices are nowhere near a ceiling.

In fact, The Chronicle reports that “the most expensive institutions have seen no drop in demand.” Sadly, of these high costs, one school, Harvey Mudd, offered this assessment: “So long as we’re staying roughly in the same range, we don’t worry about it too much.”

Some Good News Exists

One positive in the midst of this data is that grants and other forms of financial aid help many students pay far less than the sticker price. Even more importantly, it seems that colleges have actually increased their financial aid at a faster rate than they have increased tuition and fees.

As one might expect, a large number of students receive need-based grants or merit-based scholarships with a significant amount of those funds come from the colleges themselves. The Chronicle was able to dissect data for 42 of the 58 colleges whose list price was more than $50,000 for 2009-10.

For 2008-2009, the average grant per full-time student was just over $13,000 – that meant that the “average bill last year for tuition, fees, room, and board, after grants, was about $36,000.”

However, the best news might be that some of these elite private schools are beginning to become concerned. Leadership at one of the schools that has become a member of the $50K club, Bryn Mawr, revealed they were “concerned because we fear the loss of access for students who deserve this education but might be priced out of it.” It should be noted that Bryn Mawr appears serious on both ends having offered an average grant package of about $30,000 last year.

$50K Too Pricey

But such figures also mask the real issue, that the costs of college are soaring at a rate that is unsustainable for the average student. And the clearest sign that $50K should flat out be considered too much is to return to the once relatively firm, age-old equivalent for private schools.

A year of college at the elite private institutions, the total costs including tuition, fees, room and board, should match the sticker price of a new Chevrolet.

And that might well be the most telling fact as to where things stand today. As at least one interviewee told The Chronicle:

“You don’t have to pay $50,000 for a new Chevy these days.”

It likely goes without saying that the ongoing healthcare debate in Washington has become confusing to the extreme. Even the most educated of folks are struggling to sift through the rhetoric and blatant falsehoods in order to feel secure about discussing the details of the topic intelligently.

Perhaps that complexity is the reason why so many young folks are remaining on the sidelines when it comes to this matter. While we can understand the reasons for such a response, that development is extremely disappointing for two reasons.

Richard Becker, writing for the Kentucky Kernel, offers the following statistics from the National Conference of State Legislators: 13 million of the some 30 million Americans (one estimate of the uninsured) who don’t have health insurance are between the ages of 19 and 29. Becker also notes that four million of those 13 million are college students.

Second, the lack of interest is especially disappointing to see given the impact young people had on the most recent election. Last we checked, this age group was a critical component of bringing to fruition a campaign that featured the motto: “Change we can believe in.”

A Moral Issue

Because when it comes to change we can believe in, universal healthcare is one today’s young people can and should get behind. In fact, we unequivocally agree with Nicholas Kristof of the New York Times who offered the following assessment:

“The collapse of health reform would be a political and policy failure, but it would also be a profound moral failure. Periodically, there are political questions that are fundamentally moral, including slavery in the 19th century and civil rights battles in the 1950s and ’60s. In the same way, allowing tens of thousands of Americans to die each year because they are uninsured is not simply unwise and unfortunate. It is also wrong-a moral blot on a great nation.”

Add to that the view of Ethan Mermelstein:

“Health care reform is one of those rare issues in our country’s history where the essence of the discussion is between right and wrong. To use the ever-poignant words of Dr. Martin Luther King Jr. (which were aptly often heard from the president this past election season), the power of our collective voice on the issue of health care needs to be heard loudly and clearly because of the ‘fierce urgency of now’.”

While we agree with these two comments, we regretfully must note that in a recent Gallup Poll, just 34 percent of Americans between the ages of 18 and 34 indicated they wanted their representative to vote for health care reform. An equal number, 34 percent indicated they wanted their representative to oppose health care reform.

But the real disappointment, the major regret, was the status of the remainder. A full 31 percent of those ages 18-34 said they weren’t sure where they stood on the issue (that percentage is about 10 percentage points higher than any other age-group polled). 

Perhaps our youthful vigor gets in the way when it comes to the idea of sickness and medical care. Or maybe, it is the complexity of the issue. Whatever the case, young people are not standing with their presidential candidate on the one issue that he deems the most important issue for our country moving forward.

We believe that should change immediately.

Universal Care as a Fundamental Right

The first basic question is the moral one, the idea that every American should have access to basic health care as a fundamental right. To get an answer to that question, we need only look at the other developed nations that form our now, globally flat world.

Today, 32 developed nations have some form of universal health care. In regards to the creation of a public option, it must be noted that healthcare is not necessarily government run in all 32 countries, but care is available to all citizens.

As for yet another sense of how far behind the times America is when it comes this issue, universal healthcare has been available in places like Norway since 1912, Germany since 1941, and Canada since 1966. That’s correct: Canada has offered universal health care for more than 40 years already.

Clearly, America is in the minority of contemporary practice on this issue. Yet, stating one backs universal healthcare does carry some risk of criticism in certain corners. It means supporting the notion that even those people with eating habits that result in extreme obesity, or smoking and drinking habits that put their bodies at early risk of significant health problems, or sexual habits that have placed them at risk still deserve access to fundamental care.

In fact, Mark Perry at Carpe Diem reviews basic insurance practices in other arenas, home, auto, etc., and renders the point that refusal based on preexisting conditions is how all forms of insurance typically work. While his point is valid, we disagree with the one arena that involves healthcare. One only read John Hewko’s editorial, Health care is a crisis that sees no party, to get a real understanding as to how the notion of preexisting conditions is being abused by the industry.

We believe everyone should have access to healthcare from birth and because of the denial some have faced to this point, they must be let into the system. Moreover, to accomplish full access, healthcare must also be required of all citizens.

Will Insuring Everyone Mean Higher Costs?

The general assertion is that by bringing young folks into the insurance mix, a larger pool of subscribers will be created. Given that many of these young, uninsured individuals are extremely healthy, many insist that bringing this group into the insurance pool will further decrease the overall costs of everyone’s insurance.

Certainly, any savings gained by enhancing that pool could well be eaten up by another group, those currently uninsured who have been denied coverage for various reasons. In fact, insurance companies maximize their profits through two practices, rescission and purging.

“Rescission” is the practice of removing a sick policy holder for having omitted a minor illness or pre-existing condition at the time that person applied for coverage. In such cases, the insurance company may cancel the policy regardless of the length of time people may have paid into the system.

The practice known as “purging” involves the process of removing unprofitable accounts from the system. Generally, this process is accomplished by raising premiums to unrealistic rate levels, sums that the insured group or individuals cannot conceivably afford.

These processes are part of the insurance industry’s push to limit what is called “medical-loss.” The idea is simple: it doesn’t cost as much to insure healthy people.

With this in mind, it is now easy to see why the numbers being thrown about for costs of universal healthcare vary significantly.

Karl Denninger of “The Market Ticker” offers two simple suggestions for dealing with those currently outside the system and the current practice of insurers. Denninger focuses on the nature of American enterprise, the need for market competition, while insisting that all insurance plans must become open plans.

“If you sell insurance” to anyone in a given state,” Denninger writes, “you must accept all persons in that state on the same terms and at the same price. If an insurer has a ‘we accept anyone at the same price’ policy for a business, you must be able to buy into their plan for the same amount of money that the employer is charged on a per-person basis. That is, all plans must be ‘open enrollment’ for everyone within the state – period.”

This concrete step would finally eliminate one of the major flaws in our current system, the process of tying health insurance to one’s employment, and thus making it nearly impossible for the self-employed or unemployed to access reasonably-priced insurance.

Denninger adds the traditional insurance caveat that exists within the business sector when an employee does begin working for a particular company. That employee can “only elect out or into a policy or plan on an annual basis” and once in “you’re obligated to participate for a full calendar year.” Using this traditional step would certainly eliminate the process of someone seeking to purchase insurance only after they get ill.

Ultimately, the goal should be to bring everyone into the system and a good many people think it can be done. The bottom line is everyone should have access to healthcare insurance and to gain that access, we would even go so far as to agree with the suggestion that acquisition of insurance be required of all of us.

Insurance Companies Are Not Necessarily Making Enormous Profits

While even our president has espoused a disdain for the profits made by insurance companies, it must be noted that such profits are not excessive when it comes to the concept of private business. According to a number of internet sites, insurance company profits top out in the four percent range.

Here we turn again to Mark Perry at Carpe Diem who offers direct data, noting that “Health Care Plans” as an industry sector ranks #86 by profit margin at about 3.3%. That site notes that “four health insurance companies (Molina, Health Net, Coventry, and Universal American) have profit margins below 1% for the most recent quarter, and another four (Humana, Magellan, WellCare and Centene) have profit margins between 1 and 2 percent.”

One industry trade publication, America’s Health Insurance Plan, reported that annual health insurance premiums averaged $2,985 for individual coverage and $6,328 for family plans in 2009. Again, noting the work of Perry, using the “industry average profit margin of 3.3% means that insurance companies make less than $100 per policy in profits for individual coverage, and a little more than $200 in profits for each family policy.”

Such numbers pale in comparison to the rhetoric and hyperbole. Reducing policies by $200 would result in savings of about $17 per month. When one is paying $500 or even $1,000 per month in premiums, a $17 reduction does not resemble any form of being a game-changer.

Of course, one can get into the realm of executive pay, one of the largest costs associated with such companies and an item reducing overall profitability. Perhaps, that is one area where insurance companies could be addressed in the long term but given their current net profits, simply insisting they become non-profits will not greatly impact the current status.

Reform Is a Must

David Tuber, writing on North by Northwestern, insists that reform of the entire healthcare system just isn’t warranted. Tuber insists, ”President Obama, Senator Baucus and Speaker Pelosi would have you believe that lack of decent health care is a crisis, and a complete and total overhaul is necessary.

“But if you look at the numbers, you’ll see that an overhaul doesn’t make that much sense.  When 85 percent of your population is insured, that’s a very good thing. An 85 percent insurance rate says that the system, however flawed, works as a whole. Spending billions upon billions of dollars to rework it so that 15 percent of the population is covered seems, well, stupid.” 

We could not disagree more with his general point, that reform is simply not needed. First, we again believe it is a moral obligation that we provide access to basic health coverage for all citizens, not just the lucky 85 percent who currently have access. Most importantly, under today’s current structure, when the average worker receives a pink slip, they immediately lose access to healthcare unless they can come up with significant sums of money to cobra their current plans.

As for maintaining status quo, every indication is that Medicare is about to become bankrupt. In 2008, annual spending exceeded revenue brought in from taxes. Therefore, to fund Medicare, it was necessary to begin spending some of its reserve.

Medicare trustees indicate that reserve fund will be exhausted by 2017. Given current trends, others insist that the actual date of bankruptcy could be as early as 2015.

There are basically two ways forward: increasing revenues, i.e. increasing taxes, or cutting services. Status quo is not an option.

Add to the Medicare issue the most glaring one, that the roughly ten percent of the population who lost jobs during the current downturn often could not maintain their coverage during their unemployment period and we concur that reform is a must.

The idea being we can shore up the loose ends with a little bit of tweaking here and there is simply not realistic.

We Must Find Savings In the System

Currently, America spends more per capita on healthcare than any other country. Johns Hopkins researchers reported that in 2002, Americans spent $5,267 per capita on healthcare. At that time, the rate was 53 percent per capita more than the next highest country, Switzerland. It was also 140 percent above the median industrialized country per capita rate.

Other sources have a smaller differential but none contend that any country pays more per capita than the US.

Perhaps even more importantly, the lead author in the Hopkins study, Gerald Anderson had the following caveat:

“Paying more (for healthcare goods and services) is okay if our outcomes were better than other countries. But we are paying more for comparable outcomes.”

Clearly, we must find ways to make our healthcare costs more competitive. Of course, this is the spot where the divergence really sets in.

Some insist that limits on medical malpractice lawsuits would result in enormous savings. Those who want to see reform in tort law insist savings would come in two distinct formats.

First, there would a reduction in overall malpractice insurance costs if tort reform were implemented. Yet, while many insist that the savings in this area could be significant, tort reform would also free up doctors from practicing defensively. That would mean enormous potential savings because doctors would seemingly order up fewer unneeded tests.

Ricardo Alonso-Zaldivar, a writer for the associated press notes the impact of defensive medicine as follows: “Some doctors will order a $1,500 MRI for a patient with back pain instead of a simple, $250 X-ray, just to cover themselves against the unlikely chance they’ll be accused later of having missed a cancerous tumor.”

For those who wonder if the practice of defensive medicine is real, we turn to Lawrence J. McQuillan, from the Pacific Research Institute, who had this to offer:

“A recent survey of doctors published in the Journal of the American Medical Association found that 93 percent of physicians admit to practicing defensive medicine.”

More importantly, he adds:

“Defensive medicine wastes patients’ and doctors’ time and costs $191 billion annually, according to the best scholarly research. Such waste drives up the cost of medical care and the price of health insurance.”

But when it comes to health care savings, the really large numbers could well be found at the level of doctors and hospitals. Just this week, Thomson Reuters released a white paper study, “Where Can $700 Billion in Waste Be Cut Annually from the U.S. Healthcare System.” This report identified six factors that could help create anywhere from $600 to $850 billion a year in savings: administrative inefficiency, provider inefficiency, lack of care coordination, unwarranted use, preventable conditions, and fraud.

Brett Arends at the WSJ notes information from the 2007 Commonwealth Fund study of health costs in the world’s nine richest countries.

“We spend three times as much on doctors’ services as the average, twice as much on pharmaceuticals, and three times as much per day of in-patient acute hospital care,” writes Arends. He goes on to note the insights of Jonathan Skinner, an economics professor at Dartmouth College.

“…the system suffers from too many bad incentives and waste. Doctors get paid to perform needless MRIs. Hospitals blow a fortune on proton beam accelerators.

“Serious reform needs to examine costs at hospitals and clinics – and that reform may yield other investments with potential.”

The Elephant in the Room

But when it comes to healthcare, it must be noted that personal decisions do in fact matter. And if we are to insure everyone, those personal decisions also affect the rates of others.

By some estimates, fifty percent of the nation’s health care costs are attributable to lifestyle choices, such as smoking, alcohol abuse, improper diet, lack of exercise. In addition, by some other estimates, “roughly 75 percent of all health care spending is associated with a small number of patients with one or more chronic conditions.”

Therefore, there is reason to discuss the notion that meaningful reform must somehow help provide incentives to changing these risky behaviors. The idea is that meaningful reform will need to include both segments of the population, those with chronic conditions and those who simply need insurance for that rainy day issue.

But if personal decisions do matter, than so does personal experience. Here we turn back to Kristof who has created this modest proposal:

“If Congress fails to pass comprehensive health reform this year, its members should surrender health insurance in proportion with the American population that is uninsured.

“About 15 percent of Americans have no health insurance, according to the Census Bureau. Another 8 percent are underinsured, according to the Commonwealth Fund, a health policy research group. So I propose that if health reform fails this year, 15 percent of members of Congress, along with their families, randomly lose all health insurance and another 8 percent receive inadequate coverage.”

We Believe

We believe Kristof is dead-on with his suggestion, that there are cost-effective, viable models out there for us to consider and it is high-time our elected officials stopped the bickering and the rhetoric and worked towards the path of real reform.

More importantly, we also believe it is time for young people to step up to the plate on the most important moral issue of our time, universal healthcare. In fact, the idea that 31% of the 18-34 age group simply has no opinion on the matter just might be the most troubling statistic of all.