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A Friendly Attempt to Balance Steve Mintz’s Piece on Higher Ed Hard Truths | Inside Higher Ed

Nothing that Steve Mintz writes in his piece on Hard Truths That Higher Education Has Evaded for Too Long is wrong. I’m in complete agreement on all the areas in which he enumerates the shortfalls of the U.S. postsecondary system.

Steve points out that our higher education system reflects and exacerbates social inequality, privileges the privileged, consigns millions to crushing levels of debt, fails to adequately prepare graduates for the changing labor market and is characterized by persistently low graduation rates. On Steve’s critique that universities have inadequately taken “into account the insights of the learning sciences” to improve teaching and student learning, I co-authored an entire book with this observation as a central theme. 

All of us in higher education benefit from efforts like Steve’s to forthrightly own up to the shortcomings of the system in which we work. As we think about Steve’s list of systemic failures, it is important to contextualize the status of the U.S. system of higher education within a broader and more comparative narrative.

It can be equally true that the U.S. postsecondary system is severely flawed and is, at the same time, a comparative marvel. We can decry all that is suboptimal, unjust, and downright insane about our higher education system while celebrating the system’s absolute and relative achievements.

Perhaps I’m more sanguine about higher ed due to my proximity to that other complex and contested system, U.S. healthcare. My wife is a pediatric sub-specialist in oncology/hematology, chief of her section, and a professor at the medical school at the College where I also work. Each day, I hear about the challenges of medicine and our healthcare system. Living in a household with feet in both the academic and medical worlds, I can confidently report that healthcare is exponentially worse off.

Of course, you don’t need to be a medical professional (or married to one) to understand how badly healthcare in our country is screwed up. It is well known that the United States spends a higher proportion of national income healthcare (near one-in-five GDP dollars) than any other country while simultaneously achieving some of the world’s worst comparative health outcomes

The reason that healthcare in the U.S. is wildly expensive while producing relatively poor results has everything to do with how medical care is financed. Rather than focusing on preventive care and population health, hospitals and providers are incentivized to provide expensive care to patients with the best private (employer-based) insurance and public (Medicare) insurance. The U.S.’s bizarre combination of for-profit healthcare and insurance, poorly funded public insurance for the poor and kids (Medicaid), and more generous public insurance for the elderly (Medicare) have resulted in an inefficient and ineffective healthcare system.

The U.K.’s National Health Service (where healthcare is universal and publicly provided) and Canada’s system (private doctors and universal public insurance) are not perfect. Still, both systems drive better population health outcomes at much lower costs than in the U.S.

Our higher education system in the U.S. may have many problems, but our colleges and universities are still the envy of the world. Each year, nearly a million international students come to study at U.S. institutions. 

Again, this comparison between the higher ed and healthcare systems is not designed to exonerate the former. As Mintz points out, our higher ed system has big challenges. Top on my list would be public disinvestment.

The point that I want to make is that the current higher ed system is sound enough – despite all its flaws and shortcomings – that those working in the system can make meaningful improvements. Higher ed people have a range of agency and possibility that I don’t think is possible for anyone currently working in healthcare.

If you are a provider or administrator working in healthcare, you are working in a fundamentally broken system. At best, healthcare workers can hold the system together, do their best to provide care amidst deep and chronic understaffing, and then gather their strength to make it through another day. There is not much optimism among the nation’s healthcare workforce. Everyone is mostly in survival mode.

This is not true of those of us in higher education. We believe that what is wrong with higher ed can be fixed if we are smart and diligent with what is right with higher ed. Yes, systemic changes are needed, but there is possibility. Colleges and universities are innovating, teaching and learning is improving, and solid policy and organizational ideas exist to increase access and lower costs.

Let’s keep talking about the issues Mintz raises while also adopting the comparative lens that enables optimism about our ability to improve and advance our higher education system.

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