Higher Ed and Healthcare Woes: What We’re Doing Wrong (and Other Countries Are Doing Right)

It’s been a summer full of bad news in education in the United States.

Drastic state budget cuts, shrinking endowments, unprecedented need for financial aid to struggling families—these obstacles to earning a degree have been well-documented in the news and blogs these past three months. There’s a lot of hand-wringing all the way around and a great deal of angst regarding the future of higher ed as we know it.

So, it was both heartening and disturbing to return to Buenos Aires, Argentina (where I live) and read a rather nonchalant headline in the local newspaper about how Argentina will be opening over a dozen new universities in the next two years. Here, in this country that is still climbing its way back from the utter decimation of its economy less than a decade ago, there is a renewed interest in investing in education. Despite the setbacks caused by the recent global financial meltdown, the Argentine government recognizes the need to make education accessible to more students in order to stimulate the economy and create a better quality of life for its citizenry.

But what’s so striking about this news is not that education is a priority here—it’s that most universities are free or at very low cost to students. It’s free for students to attend the most respected university in the country, Universidad de Buenos Aires (UBA). It does take longer to graduate—six years is common for an undergrad—but students schedule their classes in blocks that allow them to work in their field at the same time, meaning that they graduate with relevant experience as well as a diploma. The other obvious difference is the facilities: Argentine students don’t attend universities in country-club settings. Most university buildings are nondescript and students tend to live at home or in no-frills apartments rather than in sparkling dorms with access to sky-lit dining halls and state-of-art fitness centers.

But there is serious learning going on. And a student can go on to earn an advanced degree in law, architecture, business, psychology, etc. at very little cost. One can even go to medical school for next to nothing. As the United States struggles with the issue of healthcare reform, other countries around the world have a systemic head start–and it has little to do with affordable insurance options for patients.

It’s a simple supply-and-demand situation. Here in Argentina, there is not such a strict admissions policy for medical school. Those who really want to go to medical school can do so. The filtering takes place in the rigorous program itself. Rather than picking only the very top students for admission, they let a big pool of applicants begin. There are many who don’t make it to the finish line, obviously, but it’s not because they weren’t allowed to start.

Because medical school is free or very low cost in other countries compared to the options in the United States, nations like Argentina can train a lot of doctors and other professionals each year. (Buenos Aires has the highest number of psychologists per capita than any city in the world.) When there are more doctors per capita and less demand per doctor, there is more access and more time spent per patient.

Of course, this also means that becoming a doctor abroad rarely leads to the high incomes physicians in the States have come to expect. Then again, they don’t have a mountain of student loans to repay, nor do they have to shell out big-time for insurance policies to protect them from lawsuits. The system doesn’t allow for huge pay-outs to those who sue, so this level of insurance is unnecessary.

Whether you see these as pluses or minuses depends on your perspective. If the goal is to have access to well-trained and committed medical personnel and adequate facilities at low cost to patients, many other countries have an advantage. If the goal is to have an elite corps of medical personnel who are likely to make a great deal of money and keep access limited at high cost to patients and/or insurance companies, the U.S. system works like a charm.

When we search for solutions to our healthcare woes or our education challenges, we need only look at how other countries are investing in ways that give patients and students access to excellent and affordable services. In the U.S., we focus on patching together insurance policies for patients rather than dealing with the root problem: making sure that there are plenty of outstanding doctors who are willing and able to charge less and still have a good income and lifestyle, and offering plenty of low-cost healthcare options. And we do the same in education—we look at funding more financial aid for students rather than getting at the heart of the issue: training more teachers and providing affordable and accessible education options.

I hope the decision-makers for both education and healthcare reform read the headlines around the world and see the possibilities for positive change.