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As a result we end up with the most bizarre health-insurance system imaginable: One ever better designed to avoid sick people.

America’s giant health insurers are now busily consolidating into ever-larger behemoths.

In reality, they’re becoming huge to get more bargaining leverage over everyone they do business with — hospitals, doctors, employers, the government and consumers. That way they make even bigger profits.

researchers found, for example, that after Aetna merged with Prudential HealthCare in 1999, premiums rose 7 percent higher than had the merger not occurred.

The real choice in the future is either a hugely expensive for-profit oligopoly with the market power to charge high prices even to healthy people and stop insuring sick people.

Or else a government-run single payer system — such as is in place in almost every other advanced economy — dedicated to lower premiums and better care for everyone.

Last week, President Trump’s sketch of a budget underscored how little interest he has in the nation’s social insurance programs — proposing to shift $54 billion next year to the military

Republicans in the House plan to vote this week to undo the Affordable Care Act. That law was Mr. Obama’s singular contribution toward an American welfare state, the biggest expansion of the nation’s safety net in half a century.

Welfare reform did hurt many poor people by converting antipoverty funds into block grants to the states. But it was accompanied by a big increase in the earned-income tax credit, the nation’s most effective antipoverty tool today.

“No other Congress or administration has ever put forward a plan with the intention of having fewer people covered.”

Who knows where this retrenchment takes the country? Maybe attaching a work requirement to Medicaid, as conservatives propose, will prod the poor to get a job. Or perhaps it will just cut more people from Medicaid’s rolls. Further up the income ladder, losing a job will become more costly when it means losing health insurance, too.

Millions of Americans — poor ones, mainly — will use much less health care. They will make fewer outpatient visits, have fewer mammograms and cholesterol checks.

In any event, public health insurance will take a big hit.

Under the House Republican plan, 24 million more Americans will lack health insurance by 2026, according to the nonpartisan Congressional Budget Office.

Might depression and mental health problems destabilize families, feeding down into the health, education and well-being of the next generation?

Yet it is worth remembering that among advanced nations, the United States is a laggard in life expectancy and has one of the highest infant mortality rates.

If American history provides any sort of guidance, it is that continuing to shred the social safety net will definitely make things worse.

Companies that are forced to pay higher health-insurance premiums for their workers are less inclined to raise salaries, says Steve Miller, the chief medical officer of Express Scripts, a company that manages drug benefits for insurers.

The premium increases would be felt most by middle-class consumers who do not qualify for federal aid with either their premiums or their out-of-pocket costs.

The bits and bytes about your life can easily be used against you. Whether you can obtain a job, credit or insurance can be based on your digital doppelgänger — and you may never know why you’ve been turned down.

Stereotyping is alive and well in data aggregation. Your application for credit could be declined not on the basis of your own finances or credit history, but on the basis of aggregate data — what other people whose likes and dislikes are similar to yours have done

Data aggregators’ practices conflict with what people say they want. A 2008 Consumer Reports poll of 2,000 people found that 93 percent thought Internet companies should always ask for permission before using personal information, and 72 percent wanted the right to opt out of online tracking. A study by Princeton Survey Research Associates in 2009 using a random sample of 1,000 people found that 69 percent thought that the United States should adopt a law giving people the right to learn everything a Web site knows about them. We need a do-not-track law, similar to the do-not-call one. Now it’s not just about whether my dinner will be interrupted by a telemarketer. It’s about whether my dreams will be dashed by the collection of bits and bytes over which I have no control and for which companies are currently unaccountable.

The term Weblining describes the practice of denying people opportunities based on their digital selves. You might be refused health insurance based on a Google search you did about a medical condition. You might be shown a credit card with a lower credit limit, not because of your credit history, but because of your race, sex or ZIP code or the types of Web sites you visit.

Advertisers are drawing new redlines, limiting people to the roles society expects them to play

Even though laws allow people to challenge false information in credit reports, there are no laws that require data aggregators to reveal what they know about you. If I’ve Googled “diabetes” for a friend or “date rape drugs” for a mystery I’m writing, data aggregators assume those searches reflect my own health and proclivities. Because no laws regulate what types of data these aggregators can collect, they make their own rules.

LAST week, Facebook filed documents with the government that will allow it to sell shares of stock to the public. It is estimated to be worth at least $75 billion. But unlike other big-ticket corporations, it doesn’t have an inventory of widgets or gadgets, cars or phones.

If you indicate that you like cupcakes, live in a certain neighborhood and have invited friends over, expect an ad from a nearby bakery to appear on your page.

The statin trials, which involved tens of thousands of people, found no more muscle aches, the most common complaint, in patients who took statins than in those who took placebos.

The widely held belief that statins affect memory also has not been borne out in clinical trials, said Dr. Jane Armitage of the University of Oxford. She and her colleagues studied memory problems in 20,000 patients randomly assigned to take a statin or a placebo. “There was absolutely no difference,” she said.

In a separate study, they looked at mood and sleep patterns and again found statins had no effect. Another study, in Scotland, detailed cognitive testing of older people taking statins or a placebo, and also found no effect.

Along the banks of the Maniqui River and in adjacent forests, the Tsimane people hunt, fish and plant plantains, rice and sweet manioc. They live in villages that range in size from 30 to 700 people. During village meetings, decision making is consensus-based. No individual has the right to coerce anyone else.

that doesn’t mean there are no status distinctions. When you attend a Tsimane village meeting, you soon notice that the opinions of certain men are more influential during the consensus-building process. These same men are often solicited to mediate disputes or to represent villagers’ interests with outsiders.

My colleagues and I measured the social status of all the men from four Tsimane villages (nearly 200 men between the ages of 18 and 83), by asking them to evaluate one another on their informal political influence. The men also provided urine samples and received medical examinations from physicians

We found that Tsimane men with less political influence had higher levels of the stress hormone cortisol, which has many important physiological functions. This result persisted after controlling for other factors that might affect stress levels, including age, body size and personality.

In addition, we found that the less influential Tsimane men had a higher risk of respiratory infection, the most common cause of sickness and death in their society. Stress may contribute to this disparity in infection risk; when chronic, stress can dampen immune function.

Studying the same individuals over a four-year period, we also found that for men whose influence declined over time, greater declines were correlated with higher levels of cortisol and respiratory illness. Downward mobility is harmful, it seems, even in an egalitarian society.

Why might low status cause such stress for the Tsimane? One possibility is that status offers a greater sense of control.

Another is that status acts as a form of social insurance. Influential Tsimane men have more allies and food-production partners, who can be helpful in mitigating conflict, sickness and food shortage. The relative lack of such support may cause psychosocial stress.

It is interesting that even in industrialized societies, the status comparisons most consequential for psychosocial stress are often among individuals who live near one another or occupy the same social network, not individuals at opposite ends of the socioeconomic spectrum.

Those living just above the poverty line may resent welfare for those living just below it, and a millionaire may envy a multimillionaire more than he envies a billionaire.

The importance of relative status perceptions may have its roots in the small-scale societies of our ancestors, which were similar to that of the Tsimane. In such societies, both our political competitors and our cooperative partners were likely individuals with whom we interacted regularly.

As our society debates the effects of wealth inequality, the Tsimane help us understand why we care so deeply about relative social position — and why our health depends on it.

Mr. Trachtenberg understood the centrality of the university as a physical place. New structures were a visceral sign of progress. They told visitors, donors and civic leaders that the institution was, like beams and scaffolding rising from the earth, ascending. He added new programs, recruited more students, and followed the dictate of constant expansion.

the American research university had evolved into a complicated and somewhat peculiar organization. It was built to be all things to all people: to teach undergraduates, produce knowledge, socialize young men and women, train workers for jobs, anchor local economies, even put on weekend sports events. And excellence was defined by similarity to old, elite institutions. Universities were judged by the quality of their scholars, the size of their endowments, the beauty of their buildings and the test scores of their incoming students.

John Silber embarked on a huge building campaign while bringing luminaries like Saul Bellow and Elie Wiesel on board to teach and lend their prestige to the B.U. name, creating a bigger, more famous and much more costly institution. He had helped write a game plan for the aspiring college president.

GWU is, for all intents and purposes, a for-profit organization. Best example: study abroad. Their top program, a partnering with Sciences Po, costs each student (30 of them, on a program with 'prestige' status?) a full semester's tuition. It costs GW, according to Sciences Po website, €1000. A neat $20,000 profit per student (who is in digging her/himself deeper and deeper in debt.) Moreover, the school takes a $500 admin fee for the study abroad application! With no guarantee that all credits transfer. Students often lose a partial semester, GW profits again. Nor does GW offer help with an antiquated, one-shot/no transfers, tricky registration process. It's tough luck in gay Paris.Just one of many examples. Dorms with extreme mold, off-campus housing impossible for freshmen and sophomores. Required meal plan: Chick-o-Filet etc. Classes with over 300 students (required).This is not Harvard, but costs same.Emotional problems? Counselors too few. Suicides continue and are not appropriately addressed. Caring environment? Extension so and so, please hold.It's an impressive campus, I'm an alum. If you apply, make sure the DC experience is worth the price: good are internships, a few colleges like Elliot School, post-grad.GWU uses undergrad $$ directly for building projects, like the medical center to which students have NO access. (Student health facility is underfunded, outsourced.)Outstanding professors still make a difference. But is that enough?

Mr. Trachtenberg, however, understood something crucial about the modern university. It had come to inhabit a market for luxury goods. People don’t buy Gucci bags merely for their beauty and functionality. They buy them because other people will know they can afford the price of purchase. The great virtue of a luxury good, from the manufacturer’s standpoint, isn’t just that people will pay extra money for the feeling associated with a name brand. It’s that the high price is, in and of itself, a crucial part of what people are buying.

Mr. Trachtenberg convinced people that George Washington was worth a lot more money by charging a lot more money. Unlike most college presidents, he was surprisingly candid about his strategy. College is like vodka, he liked to explain.

The Absolut Rolex plan worked. The number of applicants surged from some 6,000 to 20,000, the average SAT score of students rose by nearly 200 points, and the endowment jumped from $200 million to almost $1 billion.

The university became a magnet for the children of new money who didn’t quite have the SATs or family connections required for admission to Stanford or Yale. It also aggressively recruited international students, rich families from Asia and the Middle East who believed, as nearly everyone did, that American universities were the best in the world.

U.S. News & World Report now ranks the university at No. 54 nationwide, just outside the “first tier.”

The watch and vodka analogies are correct. Personally, I used car analogies when discussing college choices with my kids. We were in the fortunate position of being able to comfortably send our kids to any college in the country and have them leave debt free. Notwithstanding, I told them that they would be going to a state school unless they were able to get into one of about 40 schools that I felt, in whatever arbitrary manner I decided, that was worth the extra cost. They both ended up going to state schools.College is by and large a commodity and you get out of it what you put into it. Both of my kids worked hard in college and were involved in school life. They both left the schools better people and the schools better schools for them being there. They are both now successful adults.I believe too many people look for the prestige of a named school and that is not what college should be primarily about.

In 2013, only 14 percent of the university’s 10,000 undergraduates received a grant — a figure on a par with elite schools but far below the national average. The average undergraduate borrower leaves with about $30,800 in debt.

When I talk to the best high school students in my state I always stress the benefits of the honors college experience at an affordable public university. For students who won't qualify for a public honors college. the regular pubic university experience is far preferable to the huge debt of places like GW.

Carey would do well to look beyond high ticket private universities (which after all are still private enterprises) and what he describes as the Olympian heights of higher education (which for some reason seems also to embitter him) and look at the system overall . The withdrawal of public support was never a policy choice; it was a political choice, "packaged and branded" as some tax cutting palaver all wrapped up in the argument that a free-market should decide how much college should cost and how many seats we need. In such an environment, trustees at private universities are no more solely responsible for turning their degrees into commodities than the administrations of state universities are for raising the number of out-of-state students in order to offset the loss of support from their legislatures. No doubt, we will hear more about market based solutions and technology from Mr. Carey

I went to GW back in the 60s. It was affordable and it got me away from home in New York. While I was there, Newsweek famously published a article about the DC Universities - GW, Georgetown, American and Catholic - dubbing them the Pony league, the schools for the children of wealthy middle class New Yorkers who couldn't get into the Ivy League. Nobody really complained. But that wasn't me. I went because I wanted to be where the action was in the 60s, and as we used to say - "GW was literally a stone's throw from the White House. And we could prove it." Back then, the two biggest alumni names were Jackie Kennedy, who's taken some classes there, and J. Edgar Hoover. Now, according to the glossy magazine they send me each month, it's the actress Kerry Washington. There's some sort of progress there, but I'm a GW alum and not properly trained to understand it.

This explains a lot of the modern, emerging mentality. It encompasses the culture of enforced grade inflation, cheating and anti-intellectualism in much of higher education. It is consistent with our culture of misleading statistics and information, cronyism and fake quality, the "best and the brightest" being only schemers and glad handers. The wisdom and creativity engendered by an honest, rigorous academic education are replaced by the disingenuous quick fix, the winner-take-all mentality that neglects the common good.

I attended nearby Georgetown University and graduated in 1985. Relative to state schools and elite schools, it was expensive then. I took out loans. I had Pell grants. I had work-study and GSL. I paid my debt of $15,000 off in ten years. Would I have done it differently? Yes: I would have continued on to graduate school and not worried about paying off those big loans right after college. My career work out and I am grateful for the education I received and paid for. But I would not recommend to my nieces and nephews debts north of $100,000 for a BA in liberal arts. Go community. Then go state. Then punch your ticket to Harvard, Yale or Stanford — if you are good enough.

American universities appear to have more and more drifted away from educating individuals and citizens to becoming high priced trade schools and purveyors of occupational licenses. Lost in the process is the concept of expanding a student's ability to appreciate broadly and deeply, as well as the belief that a republican democracy needs an educated citizenry, not a trained citizenry, to function well.Both the Heisman Trophy winner and the producer of a successful tech I.P.O. likely have much in common, a college education whose rewards are limited to the financial. I don't know if I find this more sad on the individual level or more worrisome for the future of America.

This is now a consumer world for everything, including institutions once thought to float above the Shakespearean briars of the work-a-day world such as higher education, law and medicine. Students get this. Parents get this. Everything is negotiable: financial aid, a spot in the nicest dorm, tix to the big game. But through all this, there are faculty - lots of 'em - who work away from the fluff to link the ambitions of the students with the reality and rigor of the 21st century. The job of the student is to get beyond the visible hype of the surroundings and find those faculty members. They will make sure your investment is worth it

My experience in managing or working with GW alumni in their 20's or 30's has not been good. Virtually all have been mentally lazy and/or had a stunning sense of entitlement. Basically they've been all talk and no results. That's been quite a contrast to the graduates from VA/MD state universities.

More and more, I notice what my debt-financed contributions to the revenue streams of my vendors earn them, not me. My banks earned enough to pay ridiculous bonuses to employees for reckless risk-taking. My satellite tv operator earned enough to overpay ESPN for sports programming that I never watch--and that, in turn, overpays these idiotic pro athletes and college sports administrators. My health insurer earned enough to defeat one-payor insurance; to enable the opaque, inefficient billing practices of hospitals and other providers; and to feed the behemoth pharmaceutical industry. My church earned enough to buy the silence of sex abuse victims and oppose progressive political candidates. And my govt earned enough to continue ag subsidies, inefficient defense spending, and obsolete transportation and energy policies.

as the parent of GWU freshman I am grateful for every opportunity afforded her. She has a generous merit scholarship, is in the honors program with some small classes, and has access to internships that can be done while at school. GWU also gave her AP credits to advance her to sophomore status. Had she attended the state flagship school (where she was accepted into that exclusive honors program) she would have a great education but little else. It's not possible to do foreign affairs related internship far from D.C. or Manhattan. She went to a very competitive high school where for the one or two ivy league schools in which she was interested, she didn't have the same level of connections or wealth as many of her peers. Whether because of the Common Application or other factors, getting into a good school with financial help is difficult for a middle class student like my daughter who had a 4.0 GPA and 2300 on the SAT. She also worked after school.The bottom line - GWU offered more money than perceived "higher tier" universities, and brought tuition to almost that of our state school system. And by the way, I think she is also getting a very good education.

This article reinforces something I have learned during my daughter's college application process. Most students choose a school based on emotion (reputation) and not value. This luxury good analogy holds up.

The entire education problem can be solved by MOOCs lots and lots of them plus a few closely monitored tests and personal interviews with people. Of course many many people make MONEY off of our entirely inefficient way of "educating" -- are we even really doing that -- getting a degree does NOT mean one is actually educated

As a first-generation college graduate I entered GW ambitious but left saddled with debt, and crestfallen at the hard-hitting realization that my four undergraduate years were an aberration from what life is actually like post-college: not as simple as getting an [unpaid] internship with a fancy titled institution, as most Colonials do. I knew how to get in to college, but what do you do after the recess of life ends?I learned more about networking, resume plumping (designated responses to constituents...errr....replied to emails), and elevator pitches than actual theory, economic principles, strong writing skills, critical thinking, analysis, and philosophy. While relatively easy to get a job after graduating (for many with a GW degree this is sadly not the case) sustaining one and excelling in it is much harder. It's never enough just to be able to open a new door, you also need to be prepared to navigate your way through that next opportunity.

this is a very telling article. Aimless and directionless high school graduates are matched only by aimless and directionless institutes of higher learning. Each child and each parent should start with a goal - before handing over their hard earned tuition dollars, and/or leaving a trail of broken debt in the aftermath of a substandard, unfocused education.

it is no longer the most expensive university in America. It is the 46th.Others have been implementing the Absolut Rolex Plan. John Sexton turned New York University into a global higher-education player by selling the dream of downtown living to students raised on “Sex and the City.” Northeastern followed Boston University up the ladder. Under Steven B. Sample, the University of Southern California became a U.S. News top-25 university. Washington University in St. Louis did the same.

I currently attend GW, and I have to say, this article completely misrepresents the situation. I have yet to meet a single person who is paying the full $60k tuition - I myself am paying $30k, because the school gave me $30k in grants. As for the quality of education, Foreign Policy rated GW the #8 best school in the world for undergraduate education in international affairs, Princeton Review ranks it as one of the best schools for political science, and U.S. News ranks the law school #20. The author also ignores the role that an expanding research profile plays in growing a university's prestige and educational power.

And in hundreds of regional universities and community colleges, presidents and deans and department chairmen have watched this spectacle of ascension and said to themselves, “That could be me.” Agricultural schools and technical institutes are lobbying state legislatures for tuition increases and Ph.D. programs, fitness centers and arenas for sport. Presidents and boards are drawing up plans to raise tuition, recruit “better” students and add academic programs. They all want to go in one direction — up! — and they are all moving with a single vision of what they want to be.

this is the same playbook used by hospitals the past 30 years or so. It is how Hackensack Hospital became Hackensack Medical Center and McComb Hospital became Southwest Mississippi Regional Medical Center. No wonder the results have been the same in healthcare and higher education; both have priced themselves out of reach for average Americans.

a world where a college is rated not by the quality of its output, but instaed, by the quality of its inputs. A world where there is practically no work to be done by the administration because the college's reputation is made before the first class even begins! This is isanity! But this is the swill that the mammoth college marketing departments nationwide have shoved down America's throat. Colleges are ranked not by the quality of their graduates, but rather, by the test scores of their incoming students!

The Pew Foundation has been doing surveys on what students learn, how much homework they do, how much time they spend with professors etc. All good stuff to know before a student chooses a school. It is called the National Survey of Student Engagement (NSSE - called Nessy). It turns out that the higher ranked schools do NOT allow their information to be released to the public. It is SECRET.Why do you think that is?

The article blames "the standard university organizational model left teaching responsibilities to autonomous academic departments and individual faculty members, each of which taught and tested in its own way." This is the view of someone who has never taught at a university, nor thought much about how education there actually happens. Once undergraduates get beyond the general requirements, their educations _have_ to depend on "autonomous departments" because it's only those departments know what the requirements for given degree can be, and can grant the necessary accreditation of a given student. The idea that some administrator could know what's necessary for degrees in everything from engineering to fiction writing is nonsense, except that's what the people who only know the theory of education (but not its practice) actually seem to think. In the classroom itself, you have tremendously talented people, who nevertheless have their own particular strengths and approaches. Don't you think it's a good idea to let them do what they do best rather than trying to make everyone teach the same way? Don't you think supervision of young teachers by older colleagues, who actually know their field and its pedagogy, rather than some administrator, who knows nothing of the subject, is a good idea?

it makes me very sad to see how expensive some public schools have become. Used to be you could work your way through a public school without loans, but not any more. Like you, I had the advantage of a largely-scholarship paid undergraduate education at a top private college. However, I was also offered a virtually free spot in my state university's (then new) honors college

My daughter attended a good community college for a couple of classes during her senior year of high school and I could immediately see how such places are laboratories for failure. They seem like high schools in atmosphere and appearance. Students rush in by car and rush out again when the class is over.The four year residency college creates a completely different feel. On arrival, you get the sense that you are engaging in something important, something apart and one that will require your full attention. I don't say this is for everyone or that the model is not flawed in some ways (students actually only spend 2 1/2 yrs. on campus to get the four yr. degree). College is supposed to be a 60 hour per week job. Anything less than that and the student is seeking himself or herself

This. Is. STUNNING. I have always wondered, especially as my kids have approached college age, why American colleges have felt justified in raising tuition at a rate that has well exceeded inflation, year after year after year. (Nobody needs a dorm with luxury suites and a lazy river pool at college!) And as it turns out, they did it to become luxury brands. Just that simple. Incredible.I don't even blame this guy at GWU for doing what he did. He wasn't made responsible for all of American higher ed. But I do think we all need to realize what happened, and why. This is front page stuff.

I agree with you, but, unfortunately, given the choice between low tuition, primitive dorms, and no athletic center VS expensive & luxurious, the customers (and their parents) are choosing the latter. As long as this is the case, there is little incentive to provide bare-bones and cheap education.

Wesleyan University in CT is one school that is moving down the rankings. Syracuse University is another. Reed College is a third. Why? Because these schools try hard to stay out of the marketing game. (With its new president, Syracuse has jumped back into the game.) Bryn Mawr College, outside Philadelphia hasn't fared well over the past few decades in the rankings, which is true of practically every women's college. Wellesley is by far the highest ranked women's college, but even there the acceptance rate is significantly higher than one finds at comparable coed liberal arts colleges like Amherst & Williams. University of Chicago is another fascinating case for Mr. Carey to study (I'm sure he does in his forthcoming book, which I look forward to reading). Although it has always enjoyed an illustrious academic reputation, until recently Chicago's undergraduate reputation paled in comparison to peer institutions on the two coasts. A few years ago, Chicago changed its game plan to more closely resemble Harvard and Stanford in undergraduate amenities, and lo and behold, its rankings shot up. It was a very cynical move on the president's part to reassemble the football team, but it was a shrewd move because athletics draw more money than academics ever can (except at engineering schools like Cal Tech & MIT), and more money draws richer students from fancier secondary schools with higher test scores, which lead to higher rankings - and the beat goes on.

College INDUSTRY is out of control. Sorry, NYU, GW, BU are not worth the price. Are state schools any better? We have the University of Michigan, which is really not a state school, but a university that gives a discount to people who live in Michigan. Why? When you have an undergraduate body 40+% out-of-state that pays tuition of over $50K/year, you tell me?Perhaps the solution is two years of community college followed by two at places like U of M or Michigan State - get the same diploma at the end for much less and beat the system.

In one recent yr., the majority of undergrad professors at Harvard, according to Boston.com, where adjuncts. That means low pay, no benefits, no office, temp workers. Harvard.Easily available student loans fueled this arms race of amenities and frills that in which colleges now engage. They moved the cost of education onto the backs of people, kids, who don't understand what they are doing.Students in colleges these days are customers and the customers must be able to get through. If it requires dumbing things down, so be it. On top of tuition, G.W. U. is known by its students as the land of added fees on top of added fees. The joke around campus was that they would soon be installing pay toilets in the student union. No one was laughing.

You could written the same story about my alma mater, American University. The place reeked of ambition and upward mobility decades ago and still does. Whoever's running it now must look at its measly half-billion-dollar endowment and compare it to GWU's $1.5 billion and seethe with envy, while GWU's president sets his sights on an Ivy League-size endowment. And both get back to their real jobs: 24/7 fundraising,Which is what university presidents are all about these days. Money - including million-dollar salaries for themselves (GWU's president made more than Harvard's in 2011) - pride, cachet, power, a mansion, first-class all the way. They should just be honest about it and change their university's motto to Ostende mihi pecuniam! (please excuse my questionable Latin)Whether the students are actually learning anything is up to them, I guess - if they do, it's thanks to the professors, adjuncts and the administrative staff, who do the actual work of educating and keep the school running.

When I was in HS (70s), many of my richer friends went to GW and I was then of the impression that GW was a 'good' school. As I age, I have come to realize that this place is just another façade to the emptiness that has become America. All too often are we faced with a dilemma: damned if we do, damned if we don't. Yep, 'education' has become a trap for all too many of our citizen.

I transferred to GWU from a state school. I am forever grateful that I did. I wanted to get a good rigorous education and go to one of the best International Affairs schools in the world. Even though the state school I went to was dirt-cheap, the education and the faculty was awful. I transferred to GW and was amazed at the professors at that university. An ambassador or a prominent IA scholar taught every class. GW is an expensive school, but that is the free market. If you want a good education you need to be willing to pay for it or join the military. I did the latter and my school was completely free with no debt and I received an amazing education. If young people aren't willing to make some sort of sacrifice to get ahead or just expect everything to be given to then our country is in a sad state.We need to stop blaming universities like GWU that strive to attract better students, better professors, and better infrastructure. They are doing what is expected in America, to better oneself.

"Whether the students are actually learning anything is up to them, I guess." How could it possibly be otherwise??? I am glad that you are willing to give credit to teachers and administrators, but it is not they who "do the actual work of educating." From this fallacy comes its corollary, that we should blame teachers first for "under-performing schools". This long-running show of scapegoating may suit the wallets and vanity of American parents, but it is utterly senseless. When, if ever, American culture stops reeking of arrogance, greed and anti-intellectualism, things may improve, and we may resume the habit of bothering to learn. Until then, nothing doing.

Universities sell knowledge and grade students on how much they have learned. Fundamentally, there is conflict of interest in thsi setup. Moreover, students who are poorly educated, even if they know this, will not criticize their school, because doing so would make it harder for them to have a career. As such, many problems with higher education remain unexposed to the public.

I've lectured and taught in at least five different countries in three continents and the shortest perusal of what goes on abroad would totally undermine most of these speculations. For one thing American universities are unique in their dedication to a broad based liberal arts type education. In France, Italy or Germany, for example, you select a major like mathematics or physics and then in your four years you will not take even one course in another subject. The amount of work that you do that is critically evaluated by an instructor is a tiny fraction of what is done in an American University. While half educated critics based on profoundly incomplete research write criticism like this Universities in Germany Italy, the Netherlands, South Korea and Japan as well as France have appointed committees and made studies to explain why the American system of higher education so drastically outperforms their own system. Elsewhere students do get a rather nice dose of general education but it ends in secondary school and it has the narrowness and formulaic quality that we would just normally associate with that. The character who wrote this article probably never set foot on a "campus" of the University of Paris or Rome

The university is part of a complex economic system and it is responding to the demands of that system. For example, students and parents choose universities that have beautiful campuses and buildings. So universities build beautiful campuses. State support of universities has greatly declined, and this decline in funding is the greatest cause of increased tuition. Therefore universities must compete for dollars and must build to attract students and parents. Also, universities are not ranked based on how they educate students -- that's difficult to measure so it is not measured. Instead universities are ranked on research publications. So while universities certainly put much effort into teaching, research has to have a priority in order for the university to survive. Also universities do not force students and parents to attend high price institutions. Reasonably priced state institutions and community colleges are available to every student. Community colleges have an advantage because they are funded by property taxes. Finally learning requires good teaching, but it also requires students that come to the university funded, prepared, and engaged. This often does not happen. Conclusion- universities have to participate in profile raising actions in order to survive. The day that funding is provided for college, ranking is based on education, and students choose campuses with simple buildings, then things will change at the university.

This is the inevitable result of privatizing higher education. In the not-so-distant past, we paid for great state universities through our taxes, not tuition. Then, the states shifted funding to prisons and the Federal government radically cut research support and the GI bill. Instead, today we expect universities to support themselves through tuition, and to the extent that we offered students support, it is through non-dischargeable loans. To make matters worse, the interest rates on those loans are far above the government's cost of funds -- so in effect the loans are an excise tax on education (most of which is used to support a handful of for-profit institutions that account for the most student defaults). This "consumer sovereignty" privatized model of funding education works no better than privatizing California's electrical system did in the era of Enron, or our privatized funding of medical service, or our increasingly privatized prison system: it drives up costs at the same time that it replace quality with marketing.

There are data in some instances on student learning, but the deeper problem, as I suspect the author already knows, is that there is nothing like a consensus on how to measure that learning, or even on when is the proper end point to emphasize (a lot of what I teach -- I know this from what students have told me -- tends to come into sharp focus years after graduation).

Michael (Baltimore) has hit the nail on the head. Universities are increasingly corporatized institutions in the credentialing business. Knowledge, for those few who care about it (often not those paying for the credentials) is available freely because there's no profit in it. Like many corporate entities, it is increasingly run by increasingly highly paid administrators, not faculty.

GWU has not defined itself in any unique way, it has merely embraced the bland, but very expensive, accoutrements of American private education: luxury dorms, food courts, spa-like gyms, endless extracurricular activities, etc. But the real culprit for this bloat that students have to bear financially is the college ranking system by US News, Princeton Review, etc. An ultimately meaningless exercise in competition that has nevertheless pushed colleges and universities to be more like one another. A sad state of affairs, and an extremely expensive one for students

It is long past time to realize the failure of the Reagonomics-neoliberal private profits over public good program. In education, we need to return to public institutions publicly funded. Just as we need to recognize that Medicare, Social Security, the post office, public utilities, fire departments, interstate highway system, Veterans Administration hospitals and the GI bill are models to be improved and expanded, not destroyed.

George Washington is actually not a Rolex watch, it is a counterfeit Rolex. The real Rolexes of higher education -- places like Hopkins, Georgetown, Duke, the Ivies etc. -- have real endowments and real financial aid. No middle class kid is required to borrow $100,000 to get a degree from those schools, because they offer generous need-based financial aid in the form of grants, not loans. The tuition at the real Rolexes is really a sticker price that only the wealthy pay -- everybody else on a sliding scale. For middle class kids who are fortunate enough to get in, Penn actually ends up costing considerably less than a state university.The fake Rolexes -- BU, NYU, Drexel in Philadelphia -- don't have the sliding scale. They bury middle class students in debt.And really, though it is foolish to borrow $100,000 or $120,000 for an undergraduate degree, I don't find the transaction morally wrong. What is morally wrong is our federal government making that loan non-dischargeable in bankruptcy, so many if these kids will be having their wages garnished for the REST OF THEIR LIVES.There is a very simple solution to this, by the way. Cap the amount of non-dischargeable student loan debt at, say, $50,000

The slant of this article is critical of the growth of research universities. Couldn't disagree more. Modern research universities create are incredibly engines of economic opportunity not only for the students (who pay the bills) but also for the community via the creation of blue and white collar jobs. Large research university employ tens of thousands of locals from custodial and food service workers right up to high level administrators and specialist in finance, computer services, buildings and facilities management, etc. Johns Hopkins University and the University of Maryland system employ more people than any other industry in Maryland -- including the government. Research universities typically have hospitals providing cutting-edge medical care to the community. Local business (from cafes to property rental companies) benefit from a built-in, long-term client base as well as an educated workforce. And of course they are the foundry of new knowledge which is critical for the future growth of our country.Check out the work of famed economist Dr. Julia Lane on modeling the economic value of the research university. In a nutshell, there are few better investments America can make in herself than research universities. We are the envy of the world in that regard -- and with good reason. How many *industries* (let alone jobs) have Stanford University alone catalyzed?

What universities have the monopoly on is the credential. Anyone can learn, from books, from free lectures on the internet, from this newspaper, etc. But only universities can endow you with the cherished degree. For some reason, people are will to pay more for one of these pieces of paper with a certain name on it -- Ivy League, Stanford, even GW -- than another -- Generic State U -- though there is no evidence one is actually worth more in the marketplace of reality than the other. But, by the laws of economics, these places are actually underpriced: after all, something like 20 times more people are trying to buy a Harvard education than are allowed to purchase one. Usually that means you raise your price.

Overalll a good article, except for - "This comes on the heels of Richard Arum and Josipa Roksa’s “Academically Adrift,” a study that found “limited or no learning” among many college students." The measure of learning you report was a general thinking skills exam. That's not a good measure of college gains. Most psychologists and cognitive scientists worth their salt would tell you that improvement in critical thinking skills is going to be limited to specific areas. In other words, learning critical thinking skills in math will make little change in critical thinking about political science or biology. Thus we should not expect huge improvements in general critical thinking skills, but rather improvements in a student's major and other areas of focus, such as a minor. Although who has time for a minor when it is universally acknowledged that the purpose of a university is to please and profit an employer or, if one is lucky, an investor. Finally, improved critical thinking skills are not the end all and be all of a college education even given this profit centered perspective. Learning and mastering the cumulative knowledge of past generations is arguably the most important thing to be gained, and most universities still tend to excel at that even with the increasing mandate to run education like a business and cultivate and cull the college "consumer".

As for community colleges, there was an article in the Times several years ago that said it much better than I could have said it myself: community colleges are places where dreams are put on hold. Without making the full commitment to study, without leaving the home environment, many, if not most, community college students are caught betwixt and between, trying to balance work responsibilities, caring for a young child or baby and attending classes. For males, the classic "end of the road" in community college is to get a car, a job and a girlfriend, one who is not in college, and that is the end of the dream. Some can make it, but most cannot.

as a scientist I disagree with the claim that undergrad tuition subsidizes basic research. Nearly all lab equipment and research personnel (grad students, technicians, anyone with the title "research scientist" or similar) on campus is paid for through federal grants. Professors often spend all their time outside teaching and administration writing grant proposals, as the limited federal grant funds mean ~%85 of proposals must be rejected. What is more, out of each successful grant the university levies a "tax", called "overhead", of 30-40%, nominally to pay for basic operations (utilities, office space, administrators). So in fact one might say research helps fund the university rather than the other way around. Flag

It's certainly overrated as a research and graduate level university. Whether it is good for getting an undergraduate education is unclear, but a big part of the appeal is getting to live in D.C..while attending college instead of living in some small college town in the corn fields.

This is not what the G.O.P. seems inclined to do. Instead it lets lukewarmers poke holes in liberal proposals for climate insurance policies, and then sits back satisfied that no insurance policy, no extra effort, is necessary at all.

the anti-Paris sentiments that moved Trump weren’t entirely reality-based either. And a clear Republican plan for how to “prepare for and adapt to whatever climate change brings” does not actually exist.

In its absence, lukewarmism is a critique without an affirmative agenda, a theory of the case without a party that’s prepared to ever act on it.

I also want to concede two problems with this approach. The first is that no less than alarmism, lukewarmism can be vulnerable to cherry-picking and selection bias

when you’re dealing with long-term trends, there’s a lot of evidence to choose from

This means that every lukewarmer, including especially those in positions of political authority, should be pressed to identify trends that would push them toward greater alarmism and a sharper focus on the issue.

the closer the real trend gets to the worst-case projections, the more my lukewarmism will look Pollyannish and require substantial reassessment.

some paid as little as half as much as the M.T.A. employees who did the same work before the pandemic began, and many without access to health insurance.

a labor force that has been desperate for work at a time when hundreds of thousands have lost jobs in cleaning, construction and restaurants.

she had worked for nearly three months without a place to eat lunch or access to the station bathroom.

Contractors are required to supply proper personal protective equipment, or P.P.E., and cleaning materials to their employees, officials said.

were alarmed by workers’ accounts.

Their accounts paint a picture of dismal working conditions, and highlight their unequal treatment compared with transit cleaners, who are paid up to $30 an hour and enjoy health insurance and other benefits, uniforms and MetroCards to swipe themselves into the system.

A worker named Juan described chasing down purse-snatchers and running to help co-workers threatened by homeless people who had commandeered their brooms and mops.

“Many people were getting paid minimum wage or just a dollar or two more,” Mr. Tecaxco said. “The conditions were terrible.”

When inspectors came, she said, no one said a word. “Truthfully, we were all afraid.”

Ms. Muñoz said she was fired in November without explanation. As the sole provider for her four children and parents in Puebla, Mexico, she pleaded to keep her job.

This new kind of celebrity is the ultimate costume ball, far more exclusive and decadent than even the most potent magnates of Hollywood’s studio era could have dreamed up.

after decades of widening income gaps, unequal distributions of opportunity and reward, and corroding public institutions, we have gone back to Gatsby’s time — or something far more perverse. The celebrity monuments of our age have grown so huge that they dwarf the aspirations of ordinary people, who are asked to yield their dreams to the gods: to flash their favorite singer’s corporate logo at concerts, to pour open their lives (and data) on Facebook, to adopt Apple as a lifestyle. We know our stars aren’t inviting us to think we can be just like them. Their success is based on leaving the rest of us behind.

People with heart failure-related difficulties could monitor blood flow and body temperature; those with central nervous system issues, including schizophrenia and Alzheimer’s disease, could take the pills to monitor vital signs in real time.

Future generations of these pills could even be convenience tools.

Once that pill is in your body, you could pick up your smartphone and not have to type in a password. Instead, you are the password. Sit in the car and it will start. Touch the handle to your home door and it will automatically unlock. “Essentially, your entire body becomes your authentication token,

“The wonderful is that there are a great number of things you want to know about yourself on a continual basis, especially if you’re diabetic or suffer from another disease. The terrible is that health insurance companies could know about the inner workings of your body.”

And the implications of a tiny computer inside your body being hacked? Let’s say they are troubling.

After it has done its job, flowing down around the stomach and through the intestinal tract, what happens next?“It passes naturally through the body in about 24 hours,” Ms. Carbonelli said, but since each pill costs $46, “some people choose to recover and recycle it.”

More F.S. Oliver: Nothing in politics is sadder than: the man of sterling character whose genius is so antipathetic to the particular emergency in which he finds himself as to stupefy his thoughts and paralyze his actions. He drifts to disaster, grappling blindfolded which are beyond his comprehension, failing without really fighting.

Bad choices over the past decade by Republican political leaders opened the way to Donald Trump, yes.  For a decade, Republican voters have signaled they wanted to protect Medicare, cut immigration, fight fewer wars, and nominate no more Bushes. Their party leaders interpreted those signals as demands to cut Medicare, increase immigration, put boots on the ground in Syria, and nominate another Bush.

Their task ahead, in the Biblical phrase, is to pluck the brands from the fire—rescue as much of their party as can be rescued—while simultaneously minimizing the damage to party and country by the nominee their rank-and-file has imposed on them. They need to maneuver so that Trump’s defeat is as solitary as possible, and so that he cannot shift the blame for the failure he has earned onto the heads of others

Trump’s taught Republican politicians that they’ve neglected the interests and values of their core supporters. He’s demonstrated that much of their party ideology is obsolete, and that their language no longer moves their voters. He’s proven that their party is less culturally conservative than they believed, less hostile to social insurance than they imagined, and more worried about the economic and social costs of mass migration than they realized. Those are valuable lessons that need to be absorbed and pondered.

He’s also demonstrated that he himself is a dangerous person

To save themselves and their country, Republican politicians will have to rediscover the politician’s arts of deftness, flexibility, and self-preservation—while stealthily hastening Trump toward the defeat that almost certainly awaits him in November.

That’s a big job and a hard job, all the harder because they cannot acknowledge what they are doing. They will seem to help Trump win, while actually working to ensure he fail

What Walter Lippman said of presidents is really true of all politicians: They are not “working through noble institutions to dear ends … but trying to grind out a few crude results from a decadent political machine.”

The harms they stop are more important than the good they cannot achieve. What they’re called upon to do is to practice statesmanship without fine phrases; to protect the republic without receiving any credit for it

The Sinclair group's NAD paper drew attention partly because it showed a novel way that NAD and sirtuins work together. The researchers discovered that cells' nuclei send signals to mitochondria that are needed to maintain their normal operation. SIRT1 helps insure the signals get through. When NAD levels drop, as they do with aging, SIRT1 activity falls off, which in turn makes the crucial signals fade, leading to mitochondrial dysfunction and all the ill effects that go with it.

Test-tube and rodent studies also suggest that pterostilbene is more potent than resveratrol when it comes to improving brain function, warding off various kinds of cancer and preventing heart disease.

It doesn’t help that the Trump administration is rapidly stripping away as many regulations as it can, promising to repeal two for every new one implemented — an ultra-wealthy administration’s attempt to formalize the plutocratic free-for-all that has followed decades of growing corporate power, defined by massive income inequality, regulatory capture, a revolving door between agencies and the industries they oversee, and steadily eroding consumer rights. The empowered consumer is a figment of our imagination.

Experiences that used to be standardized are being divided into tiers denoting various rights, access and costs. The result is to both pit consumers against one another — as they compete for a limited pool of guaranteed seats on an airplane, for example — and to extract more money out of better-heeled customers.

If we violate any of the strictures of the contract we’ve implicitly signed by buying a ticket, then the airline — backed with the imprimatur of state authority, perhaps even with the help of local police — has every right to remove us from the plane without apology.

Survey the economic landscape and you’re likely to find similarly scrambled power relationships. During the foreclosure crisis, banks acted like arms of the state, with local sheriffs becoming the banking industry’s eviction force. Health insurers dictate access to health care for millions while a small coterie of chief executives reaps huge payouts. The telecommunications industry has consolidated into a handful of industry behemoths that maintain regional monopolies

The result is a lack of competition and slow, pricey service

Increasingly we’re not just paying more for less; we are sacrificing our privacy rights in the process, as personal data has become a huge driver of the digital economy

Those are the economic costs of this arrangement. The social and cultural costs are harder to define but no less important. As Sandel explains, common experiences become increasingly fragmented and subjected to the vicissitudes of the market: “At a time of rising inequality, the marketization of everything means that people of affluence and people of modest means lead increasingly separate lives. We live and work and shop and play in different places. Our children go to different schools.”

traditionally guaranteed rights become more contingent and benefits accrue to the wealthy.

We get what we pay for, which increasingly means whatever a company like United decides.

an upsetting instance of knowledge gaps in the last decade was the profound misunderstanding of complex financial products that contributed to the market collapse of 2007. Investment banks were unable to protect themselves from exposure to these products, because only a few people (either buyers or sellers) understood exactly what was being sold. Those individuals who did comprehend these product structures ultimately made huge bets against the market using credit-default swaps. The willingness of companies like AIG to sell large quantities of credit-default swaps reflected a gap in their knowledge about the riskiness of products they were insuring.

To discover the things you can't explain, take a lesson from teachers. When you instruct someone else, you have to fill the gaps in your own knowledge

Explain concepts to yourself as you learn them. Get in the habit of self-teaching. Your explanations will reveal your own knowledge gaps and identify words and concepts whose meanings aren't clear.

Engage others in collaborative learning. Help identify the knowledge gaps of the people around you. Ask them to explain difficult concepts, even if you think everyone understands them

When you do uncover these gaps, treat them as learning opportunities, not signs of weakness.

But the Picasso biographer John Richardson once called “Le Tricorne” the artist’s “supreme theatrical achievement,” and many art historians and architects consider it an integral part of the Four Seasons.

The curtain has apparently been on the verge of eviction for months. In November, Mr. Rosen called the conservancy to say steam was leaking from the wall in what is informally known as Picasso Alley, and needed repairs that could be done only by taking down the curtain.

“But then the question is when anyone would ever see it again,” she added, “if it survived the move.”