An Inconvenient Truth

Last week a local news outfit reached out asking if someone in the college would be willing to be part of a story on how the pandemic is changing things forever.  I responded to my communications and marketing team that I wasn’t their guy because I didn’t think the pandemic was going to change much and that stories like this are just hype.  They found someone else.

My response was a bit of an exaggeration. In short, I think the changes that will last are those where companies found ways to offer customers greater convenience at a cost they could swallow. This hasn’t been entirely sorted out in that customers sought safety first and that was typically delivered in a convenient manner  often at no cost because companies were willing to sacrifice some margin just to survive. Going forward, if safety is no longer an issue, it will come down to what people will pay for a convenience. I’m thinking things like meal delivery services and telemedicine for minor health issues might fall into this category.

I also admit that my response was driven in part by my own industry where speculation is rampant about the end of face-to-face education because online modalities are just so convenient for everyone. The primary problem I have with this argument is that learning is never convenient. The best lessons are learned hard. Transformation and understanding come from the struggle. If you’re not willing to get out of your pajamas or your house to learn something new, how likely is it that you’re really going to learn something you didn’t already know? This doesn’t mean things should be made needlessly complicated (that’s just annoying). Nor does it mean that good grades or a certification cannot be earned without effort. They clearly can. But good grades and learning are different things. The key point is that the future of education doesn’t lie in convenience; it lies in increasing understanding, transforming minds and giving people hope for a better future. Whatever methods best produce those outcomes at a price people are willing to pay will prevail. That was true before the pandemic and it will be true after it, as well.

Make The Invitational Your Thing

The Invitational is this Friday. If you haven’t decided to go, you should. Click here to find out why. Then make it your thing by getting some advice from those who have been there. Listen to our podcast on The Invitational by clicking here. Don’t be that dude (it’s almost always a dude) who is going to try to fake their GEB assignments (that never ends well). Be the student who prepares for the opportunity and lands the internship or job that will get you to where you want to go…

Filling Up Our Tanks

This week we would normally be celebrating the induction of three alums into our College of Business Hall of Fame. Like so many things, we aren’t having one this year. HOF 2020 was one of the last meaningful things we did in before everything shut down.

Rituals like the HOF are important, not just because they give us the opportunity to honor alums, but because they remind us of our purpose and allow us to celebrate our accomplishments of the past year. In doing so, this event “fills our tanks.” As much work as it is to put on, people look forward to this event. 800 attendees usually show up. We take great care to make it an evening to remember. People leave with a renewed sense of who we are and what we can accomplish. Everybody shows up the next day with a smile on their face.

We are all, I fear, in dire need of having someone fill up our tanks. I have heard way too many staff over the past few weeks talk about how happy they are that they can work from home and how they don’t want to come back to campus. This view isn’t just sad, it is dangerous, and I am challenging the team to do something about it. Not on Zoom but something meaningful in person. I don’t care if we need to do it five people at a time, 45 feet apart in triple masks. It’s time to reconnect, fill our tanks and stop doing the same thing over and over again on Zoom (It’s like perpetual Groundhog Day).

I got a glimpse of a solution Friday when I had an impromptu meeting with a few students who stopped me to ask about Bitcoin. We talked for about 20 minutes, and it is the most fun I have had at work in months.

Stay tuned, people.

I Have A Concern

The pandemic and the shift to remote instruction has put a premium on adaptability.  Everyone has had to learn new ways of doing things and change their mindsets to achieve their goals. In general, people don’t like change. When it happens, anxiety levels spike. I have seen this increase in anxiety in the number of emails I get from students who are concerned about a faculty member policy, how the instructor conducts their course, an unmet need to be linked to a resource, or how they are performing in the class.

Without commenting on the merits of these concerns, I pass these emails on to the appropriate department chair who then talks to the faculty member only to find out, more frequently than not, that the student has not reached out to the instructor with the concern. My guess is that students reach out to me or sometimes me, the Provost and the President because they believe going directly to the top will expedite matters. It does not.

The main reason for this is that the people who are in the best position to address these types of concerns are at the bottom of the organization, not the top. The faculty member was hired because they are seen as an expert in their field. As such, they are given pretty broad discretion to determine how to best teach their course. And contrary to what some students believe, the faculty member wants you to succeed in their course… it makes them feel good and gives them the belief that they are doing something constructive to help shape students’ professional lives. Many concerns turn out to be just misunderstandings about course expectations, such as the need to apply general principles to new situations on quizzes or exams, or a lack of awareness on the part of the student about the resources they have available to them to succeed in the course.

If a faculty member does miss the mark, is unresponsive or fails to perform their duties, the best person to help get them back on track is another expert in the subject matter who knows about the course and how it is typically conducted…that is a departmental colleague who occupies a department chair position. That person is also the faculty member’s direct supervisor. If you still have a concern after meeting with the faculty member, visit the chair. If there is a general pattern of concern among students, it’s the department chair who will see it and encourage the faculty member to fix it. If they repeatedly fail to do this, I will replace the department chair.

Of all the concerns I see from students, 99.99 percent of them are successfully addressed either by talking to the instructor or with the help of the department chair.

If intervention by the dean’s office is required, it is usually about a wider policy issue that has been brought to our attention by a department chair and is addressed by one of our associate deans. 

In short, going directly “to the top” just slows things down, and from the student perspective, time is usually of the essence. Start at the bottom. If your concern has merit, you are way more likely to get a timely remedy there.

For more information on where and how to address a variety of concerns about your experience in the college, including formal grade appeals click here.

Health and Health Care in 2021 Part 2

Jorge Amaro is a graduate of our Executive MBA program, Dean’s Advisory Board member and President and CEO of A3i. A3i offers professional solutions in patient services, analytics, and actionable insights. He offers his insights in 2021 and beyond below…

The global pandemic challenged deeply held, societal dogma in brick‐n‐mortar medicine, i.e., if I am sick, I go to the hospital/doctor. Capacity filled emergency rooms and hospital beds fueled the need for alternative models of care, such as tele‐medicine and the acceleration of new and novel therapies and vaccines.

The arrival of the COVID‐19 vaccines certainly heralds the end of this global pandemic; it also has amplified an inherent distrust from communities of color in the US due to the horrific experiments, documented and undocumented, performed on minorities within the US. This experience is now compounded by government and cash rich health systems’ inability to steer COVID‐19 impact so that it does not disproportionately impact one group over another. The third leg of this dissociative stool comes from a fractured political climate sowing seeds, and fanning flames of dissent and fear in one another. These invisible, yet active forces of fear and greed (recognized by business scholars as marketplace motivators) have placed considerable strain on the strongest of all passive forces – Trust.

Current mortality alone does not move the needle on reducing healthcare costs and increasing access to quality healthcare. We have crested 400k deaths1 in the US, and I would argue that this alone contributes to the message of “spare no expense” (which I agree with) when it comes to controlling this deadly virus. Phrases like “the war on the pandemic” and “war time President” have historically diverted the conversation away from health insurance and health systems affordability/access, instead celebrating innovation (vaccines, transplants, etc.) that typically increase cost and further fray access.

In 2019 NHE accounted for ~18% of GDP and is currently projected to grow to ~20% by 2028.2 Each decade NHE gets larger as percent of GDP, indicating that healthcare cost rises disproportionately to GDP. This gap impacts access to healthcare, i.e., low income bracket cannot afford to buy healthcare.

Based on the above I make the following predictions for 2021:(provided the vaccine works and is accepted by 85% of Americans):

‐ More research dollars will be available for new and novel therapies.
‐ Hospitals will have raised the bar on service optimality leveraging lessons learned from
operating under significant stress.
‐ Hospital systems will invest heavily in access alternatives (partnerships with supermarkets, and tele‐medicine platforms).
‐ Nurses will demand higher pay.
‐ Home health organizations will see rise in per‐capita revenue but will see shift in EBITDA and
balance sheet capital due to increased investment in technology and employee salary
requirements.
‐ NHE as percent of GDP will increase sharply due to cost of vaccine and vaccine distribution,
‐ Healthcare insurance companies will renew conversations about how to be effective in the
marketplace and will seek to introduce additional policies/plans, and attempt to develop payer
integrated networks (as opposed to clinically integrated networks) (example Cigna and Express
Scripts, Aetna and CVS).
‐ Biden will introduce the ACA Public Option, but congress will not have enough bandwidth to
make material progress on this proposal in 2021. This will be deferred to 2022 and 2023.
‐ The tug of war between progressives and federalists in our government will not move the
needle on healthcare coverage in 2021 because of the pendulum shift towards left‐center policy (Biden in office, slim democrat control of both house and senate). The conversation on quality healthcare access will begin again in earnest towards the middle of Biden’s term.

Longer term I predict:
‐ Therapeutic innovation will introduce the world to new drugs (biologics) and technology
advancements that will refocus the conversation to healthcare innovation and away from
healthcare coverage. However, Biden’s approach to leadership will champion the quality
healthcare access conversation for poor and low‐income families, (front‐line workers that kept
America running during the pandemic), i.e., nurses being paid $12.50/hr, grocery clerks getting
paid minimum wage, etc. This will lead to the divided congress debating and deciding on
advancing ACA with a scaled version of the “Public Option” Biden has proposed. This will be
pushed hard since 2024 is an election year and healthcare will once again be top of mind.
Adoption of the Biden Public Option will depend greatly on how strong the republican party
emerges after the stigma of January 6, 2021 events.

Health in 2021 Part 1

The virus taxed our health care system and people’s health in a variety of ways in 2020. Melanie Guldi is an associate professor of economics here in the college with a strong interest in health. She offers her thoughts on how the pandemic will impact 2021 below ..

The 2020 COVID-19 pandemic has roared into 2021, stretching many US hospitals beyond capacity. Yet, a little over a year after the first outbreak there is hope. On December 11, 2020, the FDA gave emergency use authorization for the first vaccine in the US and did the same for a second vaccine within weeks.

To end the pandemic approximately 80% of individuals need to be vaccinated or develop immunity. The original US goal was to vaccinate 20 million people by the end of 2020 (approximately 6% of the population). Unfortunately, only around 3 million had been inoculated by this date. Furthermore, just as the first vaccines began to roll out mutations of the virus that are more contagious emerged, underscoring the urgency of vaccinating as many individuals as possible, as soon as possible. Here again, there is hope. A single-dose vaccine is expected to be approved during spring 2021 and recently the allocation of resources toward vaccine distribution has increased.

When will the pandemic end? Experts expect that even with the virus still circulating, the pandemic will end at some point during the latter half of 2021, once vaccines are more widely distributed. The pandemic has changed us and once it ends, we will have shifted to a new normal.

The pandemic has claimed many lives in the US (over 400,000 to date), leading to an estimated decline of a year of life expectancy. This health cost is not evenly spread across the population. The estimated decline for Blacks is 2 years and for Latinos 3 years. This highlights the dramatic health disparities present in the US population. Health researchers are currently studying the multiple causes of the mortality disparities and these insights will be useful in other health contexts as we look forward.

Remote work and remote schooling resulting from social distancing measures have led to a mix of positive and negative effects. Many employees who were able work at home have actually been more productive. The medical sector embraced telemedicine, and this will likely shift how some routine medical visits occur going forward. In sum, the location where work occurs will be more flexible.

While some children live in families who could augment remote learning with effective educational experiences, those who rely on schools for access to a stable learning environment and other services suffered disproportionately and the socioeconomic gap in learning outcomes will likely increase.

As children spent more time in remote school, the burden to simultaneously work and supervise children largely fell on women, who exited the labor force at a much higher rates than men during the pandemic. Economists have shown that time out of the labor force negatively affects long term labor market outcomes, so the employment cost for women is anticipated to last years after the pandemic has ended.

The pandemic led to a recession and tremendous loss of employment in the US. Economic research has shown that parental job loss negatively affects children’s health and education and that graduating in a recession leads to lower lifetime earnings.

The job loss during the pandemic combined with the time spent isolated from social settings has also led to many individuals experiencing mental health issues such as difficulty sleeping or eating and increases in substance use. This suggests that as we exit the pandemic more resources will be allocated to address persistent mental health issues.

The long term health effects of the pandemic are unknown. One silver lining is that the rate of pre-term births has declined during the pandemic. Since health at birth is correlated with adult health, children born during the pandemic may be healthier than they might have been otherwise. Whether actually contracting COVID-19 affects health post-recovery is undetermined but the effects could be serious and will be studied in years to come. Given that many essential workers were not able to transition to remote work, those who remain employed are at greater risk of contracting the virus and will bear a disproportionate share of any of the long term health effects.

One lasting positive outcome of the pandemic is that the vaccine development timeline for other viruses will likely accelerate. The genome of the coronavirus SARS-CoV-2 that causes COVID-19 was sequenced and posted online by scientists on January 10, 2020, and a vaccine was first approved for use before the end of the same year.  This is lightning fast by historical standards. The prior record holder for speed was the mumps vaccine at 4 years; the polio vaccine took over 45 years. Part of the reason COVID-19 vaccines came to market so quickly is that they were built upon years of existing scientific research. Given the profound benefits we are experiencing, investment in basic science research will likely find increased support in the future.