[HN Gopher] New York medical school eliminates tuition after $1B...
___________________________________________________________________
New York medical school eliminates tuition after $1B gift
Author : verve_rat
Score : 127 points
Date : 2024-02-26 21:25 UTC (1 hours ago)
(HTM) web link (www.bbc.com)
(TXT) w3m dump (www.bbc.com)
| slater wrote:
| eliminates tuition _fees_
| dangus wrote:
| You aren't interpreting this correctly, they are indeed
| eliminating all tuition, not just the fees.
| titanomachy wrote:
| "Tuition" is teaching. "Tuition fees" are the fees you pay to
| be taught.
|
| Admittedly pedantic, but they are not wrong.
| kopecs wrote:
| > "Tuition" is teaching. "Tuition fees" are the fees you
| pay to be taught.
|
| Do you have a source for this? I am reasonably sure that in
| American English "Tuition" can certainly mean the fees you
| pay to be taught.
| delecti wrote:
| It seems that "tuition fees" might be a commonwealth term.
| In the US, the name of the fee is simply "tuition".
| lupusreal wrote:
| Correct.
|
| https://en.wiktionary.org/wiki/tuition#English
|
| > _(Canada, US) A sum of money paid for instruction (such
| as in a high school, boarding school, university, or
| college)._
|
| > _Synonym: (UK) tuition fees_
|
| Slater's correction may still be fair, despite the
| context of this being an American school, because it's a
| headline from a British website..
| entropyie wrote:
| Tuition is the act of teaching... I sure hope they aren't
| eliminating that. It is indeed the fees that are being
| eliminated.
| rahimnathwani wrote:
| Semantic drift :(
| samatman wrote:
| In the American dialect of English, the only meaning of tuition
| is the fees students pay to receive their education.
|
| This school is located in America.
| ejb999 wrote:
| Not always - 3 of my kids got awards that paid for their
| entire 'tuition' at a good state school in New England (USA).
| The 'tuition' was $1800/year - the fees added on another
| $14K, and then the housing and food added another $10K on top
| of that -
|
| The state kept advertising how kids could get 'free tuition'
| if the met the academic requirements (combination of testing
| high enough and overall GPA) - but in reality, it worked out
| to less than 10% of the actual cost of attending this in-
| state, public university.
|
| Was still nice to get the $1,800 off the bill, but it was
| hardly 'free tuition'.
|
| PS: Not criticizing this medical school plan - just pointing
| out that the definition of tuition can, and does, vary - even
| in the USA.
| Taikonerd wrote:
| That's incredible. Imagine having $1B and open-ended instructions
| to "do whatever you think is right with it."
| yieldcrv wrote:
| They were married, that's the default when a spouse dies
| jprete wrote:
| In this case her late husband left that specific direction.
| woah wrote:
| Should've used it to pay some dudes in the Bay Area to do
| thought experiments about Roko's Basilisk
| echelon wrote:
| You obviously use it to _build_ the Basilisk. That 's how I
| interpret the instructions, neverminding the fact that this
| would make the Basilisk smile upon me.
|
| FWIW, if an AI "satan" wins and becomes the hyper-advanced
| intelligence that rules our galaxy, it could just reverse
| simulate the light cone and torture each of us for all
| eternity anyway. It doesn't matter how good you are or which
| god you worship or how many "Hail Mary"s you say. We could be
| in that simulation now -- at any moment fire could erupt from
| beneath us.
| jameskraus wrote:
| Wow, the Albert Einstein College of Medicine is about to
| immediately be the most competitive medical school in the US. I
| wonder how this will affect the number of doctors graduating from
| the school and how many will go on to practice in NYC / the
| Bronx.
| gnicholas wrote:
| When UC Irvine launched its law school, they made tuition free
| for the first graduating class (and perhaps gave discounts to
| the next couple years -- I can't remember). They are now ranked
| #35 in the USNWR, which is pretty good for a school that's
| about a dozen years old.
|
| My guess is that having free tuition for all students forever
| will have a much bigger impact. I believe Princeton's policy
| school is similarly endowed, [1] and it's basically the top
| choice for anyone getting an MPP. Of course, it also has the
| prestige of Princeton associated with it; I could imagine some
| student choosing Harvard over this school, which doesn't
| currently have the same name recognition/prestige. But surely
| that will grow as a result of this announcement!
|
| 1: https://spia.princeton.edu/blogs/we-fully-fund-all-
| students-...
| wrs wrote:
| Irvine did that as an enticement to attract students for the
| first years, because the school couldn't be accredited until
| the first class graduated. So the folks who enrolled for the
| first three years were taking a risk.
| gnicholas wrote:
| True, though with the faculty they lined up (including Dean
| Erwin Chemerinsky), there wasn't much risk of it not being
| accredited.
| bombcar wrote:
| A degree from an unaccredited college/university is _not_
| as worthless as you might think; in fact, if the
| education is at least middling, it can be quite a steal.
|
| Hard to find them, however, that aren't just scams.
| acchow wrote:
| A new medical school in coastal California was bound to
| attract talent, in staff and students.
| gnicholas wrote:
| There are plenty of lower-ranked schools in CA, including
| several unaccredited ones. UC Irvine SoL leapfrogged all of
| them, partly because UC tuition is lower than privates. But
| being located in SoCal isn't a guaranteed of top talent --
| just ask University of San Diego SoL (#78) or Southwestern
| SoL (#141).
| hhs wrote:
| If interested, another medical school in NY that offers free
| tuition is NYU. They write, "1st medical school to offer Full-
| Tuition Scholarships for all students" [0].
|
| [0]: https://med.nyu.edu/education/md-degree/md-admissions
| gnicholas wrote:
| Interesting! Does anyone know how this affected their
| application numbers, selectivity, or ranking?
|
| > _We award Full-Tuition Scholarships to all current students
| and future matriculated students, regardless of merit or
| financial need, that cover the majority of the cost of
| attendance, provided each student maintains satisfactory
| academic progress in accordance with NYU Grossman School of
| Medicine's Satisfactory Academic Progress Policy_
|
| I wonder what it means to cover a "majority" of the cost of
| attendance. Does this mean they cover tuition, but living
| expenses (which are not trivial in NYC, but which are less
| than tuition) are not covered? Or are they just referring to
| their own fees?
| huytersd wrote:
| Damn, I wish I could get into here.
| atbpaca wrote:
| I guess this is an example of trickle-down economics? (sarcasm)
| robertlagrant wrote:
| Who knows - it's a perjorative in and of itself. It means
| whatever the citer wants it to mean.
| boomboomsubban wrote:
| A little perspective, from Wikipedia
| https://en.wikipedia.org/wiki/Albert_Einstein_College_of_Med...
|
| >There are 183 first-year medical students in the Class of 2025.
| 9,773 people applied for seats, and 1,200 were interviewed.
|
| Undoubtedly a great thing, unfortunately helping very few people.
| aantix wrote:
| If we were to get to a single-payer healthcare system, it seems
| like we would have to tackle the issue of medical school debt.
|
| $360K of debt would be a massive burden if the system had fixed
| costs.
| echelon wrote:
| It's not just tuition. There are so many issues with the
| workforce and their education:
|
| - We cap the number of residency students per year, creating an
| artificial limited supply.
|
| - We don't allow immigrant doctors to transfer their
| credentials, creating an artificial limited supply.
|
| - Med school is expensive, limiting the pool of applicants.
|
| - Nurses and nurse practitioners are extremely close to the
| action on a daily basis. There should be a path for them to
| graduate into doctors, perhaps by attending night school and
| then some form of on-the-job residency.
| dmoy wrote:
| plus the other 85% of medical expenses (since what only 15%
| is doctor & nurse & tech pay?)
|
| Even if doctors and nurses worked for $0, we'd still have the
| most expensive healthcare system due to admin, drug, etc
| costs.
| HEmanZ wrote:
| Yes, it is similar skill and effort for an np who got a one
| year online degree that took 15th/wk of studying and a doctor
| who spent 80hrs per week of studying for 4 years to complete
| med school, then did 4-7 years of 80-100hrs per week of
| intense residency.
|
| Do you really believe this when a loved one's life is on the
| line?
| echelon wrote:
| Do you really believe there's no path they could take to
| become a doctor?
| ejb999 wrote:
| I for one am glad we don't just let foreign doctors transfer
| their credentials - the education and standards are not
| always the same, and not really sure I want to go see a
| doctor that moved here after taking a accelerated/minimal set
| of courses at whatever country happens to have the
| easiest/cheapest graduation requirements. Certainly there are
| some countries that probably have similar course of study and
| requirements as the USA, but I think you would need to
| approve transfer's very carefully after serious review of the
| sending countries education and training requirements.
|
| NP vs MD education is not even close to being similar - that
| is why their is no easy path from one to the other - a
| typical NP will graduate having done ~600 to 700 hours of
| patient care hours. A typical MD will have had 12,000 to
| 16,000 hours of patient care experience before they start
| practicing - there are plenty of things were seeing an NP is
| more than enough - but you can't just give a few months of
| extra training to bump an NP to an MD - their education and
| knowledge is not even close to comparable.
|
| There is a place for both in our health care system - but
| they are not the same job.
| Scoundreller wrote:
| Canada has managed to undertrain its own people domestically
| for med school for a while with many going to the
| US/caribbean/europe for training at full rates.
|
| We've had to change our terminology from "international medical
| graduates" to "foreign medical graduates" because a lot of
| those trying to get foreign credentials recognized are locals.
|
| Probably a tough slog upon return to pay back the debts but
| net-positive in the long-run (unless interest rates go up, uh
| oh).
| abeppu wrote:
| Is it necessarily the case that median physician pay must go
| down for a single-payer system? I would hope that we could have
| savings if the total payments to actual care providers was
| similar, but billing, and insurance parts of the system were
| dropped out of the picture.
| HEmanZ wrote:
| Medical school debt and physician insurance. Some specialties
| have just wildly high insurance.
|
| My wife is an OB and has to pay $140,000/yr per year for tail
| insurance in my state. So she literally needs to make, after
| all other costs of the practice, $140k just to break an even
| $0/yr.
|
| And people wonder why it costs so much to have a baby.
| Scoundreller wrote:
| Why is insurance just a flat rate? Shouldn't it be per
| procedure or something else better correlated to risk?
|
| (Sure, charging precisely for risk would just result in some
| patients/scenarios being avoided, but per case or a
| percentage of billing would make much more sense).
| HEmanZ wrote:
| It isn't flat, that's the average of the last two years. It
| does adjust for a lot of things, like any insurance. It is
| higher than avg in the state for my wife right now because
| she is only a few years out of residency.
|
| Mid career, she should only expect to pay about $120k/yr...
| ldoughty wrote:
| The interest should cover about 1750 students/semester (assuming
| about 10%)
|
| The school has about 1250 students (Wikipedia). I'm guessing the
| difference comes from other sources.. or it slowly will drain
| downward.
|
| Interesting to see nonetheless.
| wbeckler wrote:
| You're assuming there was no need-based tuition program already
| running. Average tuition may not be full tuition.
| thehappypm wrote:
| Why would the school having less students than the interest can
| cover be a problem?
| dmurray wrote:
| Not many investors would assume a long term return of 10% over
| inflation. If they target 7% instead, it would almost exactly
| fund that enrolment level.
| divbzero wrote:
| 10% interest seems like a stretch in today's environment. 5%
| interest from US Treasuries would be a more reasonable
| baseline: yielding $50,000,000 per year total, or $40,000 per
| year for each of the 1,250 students.
| DaleNeumann wrote:
| "I wanted to fund students at Einstein so that they would receive
| free tuition," Dr Gottesman said she immediately realised. "There
| was enough money to do that in perpetuity."
|
| I have never heard of a school getting this lucky from there
| alumni/faculty and even hearing there students getting something
| out of it so it touched my heart I have always had a toxic
| opinion about my teachers. Perhaps this could turn into an
| example for the rest of Americas medical schools in the coming
| decades.
| CobrastanJorji wrote:
| "Asked for comment, the 100+ other universities in the US with
| over $1 billion in endowments looked away, assumed too-casual
| poses, and pretended not to notice the question."
| ProllyInfamous wrote:
| "Nobody would actually _ever_ do _that_... " they'd continue
| onward, gas-lighting you from Truth.
| briffle wrote:
| The private school in my town with a $1B endowment is still one
| of the priciest west of the mississippi, and spent last week
| with no internet, because of a cyber-attack. I guess it mainly
| matters what their priorities are.
| hentrep wrote:
| Kaiser Permanente has something similar for their med school in
| Pasadena. In 2019 they announced free med school tuition for the
| first 5 classes (through 2024). Unsurprisingly this attracts top
| talent, and there don't appear to be any sort of strings attached
| (eg, stay employed with Kaiser for X years once you finish).
|
| Their acceptance rate was 50/11,000 applicants last year (0.45%).
|
| [0] https://www.nbclosangeles.com/news/health-wellness/kaiser-
| pe...
| divbzero wrote:
| The wealth came from David "Sandy" Gottesman's investments, the
| most prominent of which was an early investment in Berkshire
| Hathaway. Gottesman was a friend of Warren Buffett, served on the
| board of Berkshire Hathaway, and also founded his own firm First
| Manhattan.
| proee wrote:
| Couldn't other Universities follow suit? Harvard sits on a $50B
| endowment fund, though maybe these funds are contractually
| obligated toward different causes.
| psychlops wrote:
| How then would Harvard sort students by socioeconomic status?
| legitster wrote:
| Harvard is already free if your family income is less than
| $85,000.
|
| https://college.harvard.edu/admissions/why-harvard/affordabi...
|
| In fact Harvard charges _more_ in tuition just because your
| family is rich!
| proee wrote:
| What if the parent are rich but won't fund their children's
| education? I guess they are SOL?
| legitster wrote:
| I'm not opposed to free tuition, but I kind of question the
| utility of a grant like this.
|
| It's not like there's a requirement here that the doctors are
| going to work in the non-profit sector. It's not going to make
| the field less overworked and toxic. The students at this school
| have the same demographics as every other medical school.
|
| Given that nearly all of the students who graduate from a medical
| program end up in the top 10% of wage earners, this seems like a
| temporary alleviation of financial problems for a very small
| cadre of well-to-do.
|
| I am happy Dr. Gottesman felt such an affinity for her former
| employer, but it kind of strikes me as an ... uncreative(?)
| deployment of a _billion_ dollars.
| DylanDmitri wrote:
| Doctors who graduate without loans have more leverage when
| deciding their next position. They can immediately go for
| research or volunteer work that otherwise wouldn't recoup their
| costs.
| _dark_matter_ wrote:
| My wife is a physician, and of the friends we made when she
| was in medical school, only one went to serve underserved
| populations. A big part of the reason he did so was because
| they would pay off his loans!
|
| So maybe this will actually lose an effective lever at
| getting doctors to serve those populations?
| Solvency wrote:
| Seriously. I wonder if a billion dollars could have been used
| as a small step towards unfucking the byzantine middleman
| parasitic corrupt insurance-centric healthcare system instead.
| toomuchtodo wrote:
| Diminishing returns based on outcomes you can change in
| elections to put reps into Congress who will fix healthcare
| legislation. Sometimes you can, some races/districts you just
| have to wait out demographics.
|
| Michael Bloomberg spent almost $1B trying to become
| president, and didn't even move the needle. That's capital
| inefficient; you want to target spend for maximum outcome
| return. This is a win, enjoy the hope for a moment, it's a
| long slog ahead.
|
| Obligatory https://runforsomething.net/ and always vote PSA.
|
| (scholar of demographics, political science, and dark money)
| burntwater wrote:
| Just thinking through everything this implies. Would it be safe
| to assume this means some people if not entire departments will
| be laid off? Not as much need for financial aid, bursar's office,
| etc.
|
| Overall it's a great thing, a more lean administration and better
| efficiency, but it's a small peek into what would happen if the
| U.S. ever gets single-payer healthcare (as I fully hope we do).
|
| On a different note, if things like this became more common, with
| fewer new doctors having massive debt, that would pull down
| salaries and medical bills. How you view that depends on if
| you're a doctor or a patient.
| molave wrote:
| It'll be similar to how horse drivers reacted when cars became
| popular, or painters with the advent of the camera.
| stevage wrote:
| Sounds like a very interesting experiment in economics is about
| to happen.
| chenxi9649 wrote:
| This entire story is just so heart warming and I don't know if
| the title/discussions right now are doing it justice.
|
| 1. The fact that this donation is 100% going towards tuition. My
| university has a few B's in endowment, but those money are most
| definitely not going towards making the tuition fees lower lol.
| Hopefully this will allow them to select some candidate that are
| struggling the most financially...
|
| 2. The donor being a 93 year old doctor/alumni of that school
| that studied "learning disabilities and developed screening
| protocols".
|
| 3. The money was from her late husband's "whole portfolio of
| Berkshire Hathaway stock". And before he passed, he told her to
| "do whatever you think is right with it" and the article ends
| with her saying "I hope he's smiling and not frowning". Makes me
| cry a little.
| louwrentius wrote:
| This may go against the grain, but I think it only shows that
| billionaires should not exist.
|
| Because I don't think it should be up to an unelected
| individual what to do with this kind of money.
|
| This money could likely have been spent more effectively.
| nolongerthere wrote:
| Because our elected officials have been shown to be fantastic
| stewards of our money?
|
| Said no one ever.
|
| The truth is that this is a fantastic use of the money and no
| politician would ever have used it more effectively.
| cqqxo4zV46cp wrote:
| You've got the cause and effect the wrong way around.
| digging wrote:
| > Because our elected officials have been shown to be
| fantastic stewards of our money?
|
| Compared to the billionaires who currently steward our
| money? Absolutely. For example, I just flushed a toilet and
| I'll never have to think about that shit again, except
| perhaps to marvel at how it may one day fertilize shade
| trees in my city.
| silverquiet wrote:
| Those who champion federalism will often say that they
| believe that government power should be spread as widely as
| possible; that local control is best because it gives power
| to those closest to the problems. I see no reason why that
| should be limited to government; a billion dollars is a lot
| of power for one person to wield.
| nolongerthere wrote:
| So you're essentially arguing for absolute socialism, no
| one owns anything, and your neighbors decide what you get
| to eat?
| digging wrote:
| Probably getting too political here but I fully agree. The
| fact that this is such a remarkable story is a sign of how
| rare it is.
| bombcar wrote:
| True, elected officials could have bought a stealth jet for
| that kind of dosh!
| ajkjk wrote:
| That argument doesn't really work in a world where you don't
| really see anyone except other private interests spending
| money in more agreeable ways.
| layer8 wrote:
| I agree with your first two paragraphs, but not with your
| last, coming from a country where college tuition is free.
| chenxi9649 wrote:
| I don't necessarily disagree with the notion that no
| individual should hold "THAT" much power. But I haven't
| read/heard of a way of implementation that actually sounds
| like it can work. Since most of the asset is in stock, does
| one tax ie - Mr. Bezos on his Amazon stock? Would Amazon
| shareholders want that?
| 000ooo000 wrote:
| >Because I don't think it should be up to an unelected
| individual what to do with this kind of money.
|
| Take that to its logical conclusion: where is the line? Are
| you not allowed to donate $50 to a charity of your choosing
| because The Government knows better? There's plenty of
| reasons to hate billionaires but this one doesn't seem sound.
| emmelaich wrote:
| Eliminates tuition _fees_.
|
| These language shortcuts can be confusing for those of us not in
| the USA.
| mistrial9 wrote:
| American Medical Association - fifty years of artificial
| constraint on the supply of M.D. s
| Scoundreller wrote:
| Does the US let you forego capital gains taxes on unrealized
| gains when you donate stock, along with whatever benefit you get
| from donating money?
|
| As a salaryman, I wish I got to donate pre-tax amounts! I get
| some credits, but if your income is high enough, it doesn't even
| cover the taxes already paid.
| gnicholas wrote:
| Yes. You deduct the FMV, not the basis. There are some limits
| on deductions, especially when giving to foundations you
| control. But you can be sure that the donor has been well-
| advised on matching up this enormous deduction with similarly-
| sized realization events (i.e., selling other assets and
| generating taxable gains).
| JumpCrisscross wrote:
| > _I wish I got to donate pre-tax amounts_
|
| "When you donate stock to charity, you'll generally take a tax
| deduction for the full fair market value" [1].
|
| [1] https://www.fidelitycharitable.org/giving-account/what-
| you-c...
| akashshah87 wrote:
| Yes, donating stock means you avoid capital gains. But even
| more relevant in this case is that she likely inherited the
| Berkshire stock from her husband which also resets the cost
| basis which means she wouldn't have had to pay capital gains
| even if she had sold the portfolio instead of donating.
| takinola wrote:
| Yes, donating stocks does not trigger a taxable event (YMMV,
| consult your tax attorney, etc). Not sure if it is possible to
| figure out how to donate pre-tax income (vs pre-tax gains). If
| you do, please share your knowledge.
| toomuchtodo wrote:
| https://www.irs.gov/taxtopics/tc506
|
| https://www.irs.gov/instructions/i1040sca (Control-F "Gifts to
| Charity")
| giogadi wrote:
| We actually already have many loan forgiveness programs for
| doctors - for example, they can choose to work at an understaffed
| clinic in a historically underserved area of the country and get
| huge amounts of their loans forgiven, on top of making a big
| salary. A lot of these clinics fully depend on this pipeline of
| doctors needing loan forgiveness. I'm not saying that this an
| ideal situation, but the loans can sorta encourage many doctors
| to practice where they are most needed.
| dantheman wrote:
| Loan forgiveness like other tax incentives merely distort the
| market. Just pay the doctors what it costs to get them there,
| we are probably over paying by giving loan forgiveness.
| VincentEvans wrote:
| - 1B in donations at 5% APR conservatively invested will yield
| 50M every year.
|
| - At yearly tuition rate of 59K the earned interest is enough to
| pay for 850 students without drawing down the invested principal.
|
| - Albert Einstein college of medicine admits about 150 freshmen
| every year and medical school is 4 years long. So at any given
| time there are 600 students studying medicine at this school.
|
| It seems to me that simply earned interest on this donation
| should be enough to allow students to attend this school free of
| tuition indefinitely.
| anonym29 wrote:
| It's enough not only for that, but to gradually expand the
| number of students they can afford to admit tuition-free into
| the future (strictly on interest), as well, should the desire
| to do so ever arise.
| bombcar wrote:
| Or another way to look at it, you only need $50m a year to be
| the "equivalent" of a billion dollar endowment, and $50m a year
| is the budget of a smallish county.
| johanneskanybal wrote:
| Very us focused, why would you pay for university if you qualify?
| What else could be more in your country's interest?
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