How Much are Three Letters Worth?


Posted by Debbie Koh

Pursuing a graduate degree is a huge undertaking. At Wagner, getting a Masters of Public Administration typically means an investment of two years’ time (nights studying at Bobst Library you’ll never get back), tuition (roughly $40,000 per year), and any lost wages if you’re not working (opportunity cost).

It’s reasonable to question whether such a significant investment is worth it, especially when considering a public service career. So what convinced me that getting those three letters behind my name was worth the time and resources? I’d say the following areas: networking, experience and skills.

- Networking: No, I don’t mean the jaded, using-other-people’s-connections-to get-ahead kind of networking. I’m talking about being brought into a group of students and alumni who are joined by the desire to use their careers to achieve some sort of social impact. That shared motivation is what drove my day-to-day conversations with other students, helped me conduct information interviews with alumni, and encouraged me to connect with prospective and new students. Sometimes this kind of networking opened doors to career opportunities and sometimes it didn’t, but it helped me decide what made sense to keep pursuing and what to leave behind.

- Experience: Wagner offers a unique opportunity to build up one’s work experience. Being in New York meant that I had access to a huge array of institutions, organizations, and companies. If I wanted to work for a non-profit with US headquarters and overseas offices, or a small consulting firm with local and national clients, I could (and did). Capstone, which remains the highlight of my Wagner experience, provided me with solid experience that I could reference in job interviews and lessons learned that I apply in my current job. Finally, it was inspiring to learn from from the variety of backgrounds that were captured even in a specific program like Health Policy and Management, and from the larger student body.

- Skills: Probably the easiest, most obvious reason the go to graduate school, but it’s still worth noting. Economics, statistics, and finance skills are critical to have but difficult to get outside the classroom. In addition, taking time to become knowledgeable and stay current about one’s field – whether hospital management or international development – often falls prey to the daily demands of the workplace. Graduate school provides the opportunity to study the history, theory and recent developments in one’s practice area. I believe that this is a key component to producing high-quality work in any field.

The affordability and utility of an MPA or any graduate degree will always be a personal choice. It’s impossible to know how my career might be different or whether I would’ve had the same opportunities without attending Wagner. Certainly, no program is perfect – but for me, it was worth it.

Debbie graduated from Wagner in 2010 with her MPA in Health Policy and Management, International Health. She returned to her native California in 2011 and currently works for Venture Strategies Innovations. Follow her on Twitter at @thedebkoh or connect via LinkedIn. All views expressed are her own.


What Will SCOTUS* Do?


Posted by Joel Wittman

After three days of hearing oral arguments on the legality of all, or parts, of the Patient Protection and Affordable Care Act (ACA), the Supreme Court is hopeful of rendering its decision in June.  Based on what we’ve heard so far, it doesn’t bode well for the ACA.  The primary issue of contention is the inclusion of an “insurance mandate” whereby citizens are required to purchase health insurance or pay a penalty.  The mandate seems to be the linchpin of the reform act; without this requirement will insurance premiums skyrocket and will access to health insurance be limited?  This also raises the question of severability.  If the mandate is struck down, will the entire ACA also be invalidated or can parts of it survive?  Will the law’s popular “guarantee issue” and “community rating” provisions survive without the mandate that virtually all Americans must have health insurance?  Guarantee issue prevents insurers from discriminating against people with pre-existing conditions and community rating standardizes insurance premiums for those living in the same area.  The states that have attempted to enact guarantee issue and community rating systems without instituting mandates saw their health reforms fail – insurance premiums skyrocketed, consumers had fewer choices and the number of uninsured went up.

So, what is the insurance industry to do?  Insurers must prepare for a worst-case scenario – a ruling that the individual mandate is unconstitutional, but insurers still must provide policies for all people.  In that situation, insurers say premiums will rise sharply because of people with chronic illnesses and pre-existing conditions, for example, would buy health coverage, but healthy people would not.  Short of persuading Congress to write a new law, the insurers are considering certain contingencies including:

- Penalizing those who enroll outside of short annual windows

- Denying treatment for specific conditions, especially right after a policy is purchased

- Rewarding certain insurance buyers, such as offering much lower premiums for younger and healthier people

- Expanding employers’ role in automatically enrolling employees for health insurance

- Urging credit- rating firms to use health insurance status as a factor in determining individuals’ credit ratings.

There remains, however, a divided opinion about the exclusion or inclusion of the individual mandate in the health reform act.  Some believe that its exclusion will cripple the ACA and all of its proposed benefits, while others contend that the penalty associated with the mandate is not onerous enough to deter individuals from not purchasing health insurance.

Things are never as simple as they seem to be.  The good intention of the current administration to increase access to health insurance coverage for all individuals at affordable pricing may not be good enough to preserve the goals of the ACA.  Do you throw out the baby with the bath water if the entire plan is deemed unconstitutional?  Do you preserve part of plan and try to make the best of the remaining regulations?  Or, do you leave the ACA as is and have the first meaningful health care reform since the Great Society?  Only SCOTUS can let us know.

* Supreme Court of the United States

Joel Wittman is an Adjunct Associate Professor at the Wagner School of Public service of New York University.  He is the proprietor of both Health Care Mergers and Acquisitions and The Wittman Group, two organizations that provide management advisory services to companies in the post-acute health care industry. He can be reached at joel.wittman@verizon.net.