Issues for and about America In a Globally Competitive 21^st Century Workforce

Solutions to challenges facing higher education require focused discussion not “crosstalk”

Leaders may agree that higher education in the United States faces major challenges, but views on how to overcome those challenges can be as different as the issues themselves.    Before solving higher education writ large, stakeholders may need to learn how to communicate among themselves. 

In its Campus Commons? report, the latest of a series of higher education publications, Public Agenda refers to discussions involving groups with differing perspectives, concerns, and priorities as “crosstalk.”  Rather than talking across one another, Public Agenda espouses   “purposeful discussion.”  A strategy of open communications among the various higher education stakeholders would, at a minimum, bring to the surface their differences.  Such a discussion would serve to inform the American public about the multiplicity and complexity of challenges facing higher education.  With more open and effective communications, the higher education groups – college presidents, financial officers, faculty, students – can address their differences “talk through their priorities” and move forward to “grapple with realistic solutions.”

Campus Commons?not only reports the findings from interviews with public higher education financial officers and from focus groups with faculty members from two-year and four-year institutions,[1] but synthesizes those from earlier studies of higher education.[2]   Based on an analysis of these findings, several observations are made:  (1) that there appears to be a consensus among the stakeholders that American higher education faces major challenges; (2) that there remain differences regarding the definition of the problem and lack of focus concerning its solutions; (3) that faculty viewpoints are important to the debate and should be included; (4) that there may be a need to further examine faculty views; and (5) that the next phase should be to build on these findings “to develop a framework for productive dialogue and decision making.”

The Campus Commons? Report also contains a section on selected findings from financial officer and faculty interviews, a table summarizing views of the various groups on their understanding of the problem and possible solutions, and an inventory of cost-effectiveness ideas.  Viewpoints range widely.  The public fears that increasing costs of higher education will undermine its access to higher education even as it views such access as a necessity for success. Faculty are concerned that too many students going to college, especially those less well qualified, will contribute to a decline in the quality of higher education.  In between are college and university presidents who view the problem as one of a nexus of rising expenses and decreasing state revenues.  This view is shared by institutional chief financial officers.  Meanwhile, state higher education officials peer out at the issue from the other end of the telescope, seeing too few higher education graduates. 

While the various groups agree on some possible solutions, most notably increased productivity (i.e., doing more with less), they offer a wide range of other solutions.   At one end of the spectrum is the public, which supports measures that protect access to higher education.  The public believes that by increasing efficiency, colleges can educate more students without additional money.  Faculty members, fearing most declining quality, believe that possible solutions lie at the other end of the spectrum, raising standards and limiting access to less qualified candidates.  For the same reason, they also hold diametrically opposite views to state higher education officials who propose more focus on dual enrollment (high school students taking college classes), retention and graduation.  Faculty members believe that more graduates does not equate to better educated persons, and that college classes in high school are not equivalent to those taught in colleges.  By redefining higher education as a public rather than a private good, college and university presidents press for much more funding for higher education.  Institutional chief financial officers are receptive to new ideas being brought into the discussion and suggest several, such as larger classes and distance education.

From these studies a list of ideas emerge related to the issues of cost, quality and access, which form the crux of the challenges facing higher education.   This cost-effectiveness inventory consists of the following: 

• Improving college readiness through a variety of measures including better counseling, improved assessments, and earlier and more effective use of remediation based on the assessments.
• Improving retention for students already in college by, among other things, better tracking high-risk students, enrich first-year programs, assist students to develop mentoring relationships, offer additional support, better design remediation, provide graduation incentives, apply best practices in serving low-income students.
• Creating an integrated P-20 education system that would “overcome barriers” through dual credit systems for high school students, greater coordination between industry and education, creation of centers of excellence, and mechanisms for communication among institutions with similar programs.
• Offering greater differentiation of programs to match the diversity of college students by enhancing technical education, granting college credit for existing experience and knowledge, expanding distance education, refraining from using the term nontraditional students, developing new models of instruction and more relevant curricula to adult learners.
• Using incentives and models from the business world to reward collaboration, to rethink efficiencies in all areas such as textbook purchases, to create incentives for improving student retention and graduation, to outsource non-educational functions such as custodial services and facility maintenance, and increase receptivity to innovative ways of thinking.
• Innovating and applying creativity to address challenges, such as use of technology, new techniques and approaches to instruction, to use of facilities, to financial funding.
• Making greater use of information for the purpose of reaching out to prospective students, especially minority and low-income students by means of targeting information, open-house and career awareness programs, and better communications about the benefits of higher education.
• Offering better assessments and productivity measures by identifying, implementing, and disseminating best practices through the use of better tools for assessing educational outcomes.

A copy of Campus Commons? What Faculty, Financial Officers and Others Think About Controlling College Costs is available on the Public Agenda website:  http://www.publicagenda.org/pages/campus-commons.   The other publications referenced in this report are also available on the Public Agenda website:  http://www.publicagenda.org/.

New OECD Data Show U.S. Continues Below Average in Degree Attainment

The Organization for Economic Cooperation and Development (OECD) released its annual Factbook 2009 recently, containing statistical comparisons for more than 30 member countries.  The organization looks at wide ranging data from population and demographics to suicide rates to water consumption. 

Among the annual data are rates for tertiary, or postsecondary, degree attainment in OECD countries.  The United States ranks fourth out of all OECD countries in ages 25-64 total tertiary degree attainment.  This encompasses what the OECD considers “Type A” degrees – a degree from a traditional university; and “Type B” degrees, which generally refer to shorter, vocationally oriented programs of study which lead to direct career access, such as certificates and degrees from career colleges in the United States.   

However, the new data also show that the U.S. ranks 14^th in terms of total tertiary graduation rates at expected age of graduation (approximately age 24 based on OECD information), trailing countries like Ireland, Italy and Poland and below the OECD average.  The data also indicate a continued downward trend in attainment rates in the U.S., which it has shown in years past.  This is due to the significant increase in the proportion of the adult population attaining postsecondary education in most OECD countries in recent decades. 

Some good news indicates that Americans pursue their degrees later in life, as the U.S. moves up slightly to 11^th in tertiary attainment between ages 25-34, with just over 39% of the population having degrees. 

However, the report finds that some countries are improving markedly in this area. For instance, it states, “comparing the tertiary attainment levels of 25-34 year olds with those of 55-64 year olds indicates that in Korea, there has been an increase in tertiary attainment over the past 30 years of more than 40 percentage points, nearly 30 percentage points higher than the OECD average increase over this period. In contrast, some OECD countries have only seen marginal increases (USA) or even decreases (Germany) over the same period.”

The data bear this out.   While ranking 11^th in the younger group, ages 25-34, in ages 55-64 in tertiary degree attainment U.S. is second. 

Andreas Schleicher, Head of the Indicators and Analysis Division, OECD Directorate for Education, says the long-term prognosis for the U.S. workforce’s higher education attainment looks bleak. 

“When you look at today’s workforce qualification, the U.S. still ranks high,” he says.  “But other countries have caught up and overtaken on Type A degrees.”

Furthermore, the OECD says that the United States does not have a strong presence with Type B, career-oriented degrees either.

“Current graduate output for the United States is about 10% for Type B degrees, while the OECD average is 12%.  Ireland has 27%, Japan 35, Spain 40%.  There are a lot of countries where Type B programs are very popular and have a long tradition,” says Schleicher.  “The U.S. still has a way to go in these degrees as well.” 

Nurse Practitioners Seen as Key to Obama-Era Healthcare Reform

State government and health policy leaders are calling for nurse-managed health centers (NMHCs) to take a prominent role in healthcare reform.  According to the group, health care reform is going to mean that nurse practitioners will play a more front-and-center role in treating patients, especially the more than 46 million Americans who currently lack health care insurance and are underserved by today’s health care system. NMHCs – an innovative delivery model for primary and preventive care, especially for low-income and vulnerable populations – should expand significantly to increase the capacity of the nation’s over-strained health care delivery system, they say. 

“Nurse practitioners are going to be key to healthcare reform in the Obama era,” said University of Miami President Donna Shalala, Chair of the American Academy of Nursing’s Raise the Voice campaign.  The campaign is designed to harness the power of nurses, nurse practitioners and other professionals to provide needed primary health care, health promotion and disease prevention through “disruptive solutions” such as community-based care. That is, care delivered by advanced nurse practitioners and related professionals in a holistic, patient-centered way.

“Nurse practitioners are part of the solution and must be at the table when dealing with healthcare reform.”

Shalala spoke at an event accompanied by Pennsylvania governor Ed Rendel and Executive Director of National Nursing Centers Consortium Tine Hanson-Turton.

“The acute primary care physician (PCP) shortage is going to worsen and we believe that skilled nurses used in the nurse managed care centers can help absorb large numbers of people who are currently uninsured,” she added.

Shalala said that there are currently not enough PCPs in the country and nurse managed health centers can be used for primary and preventive care, and that there are already over 250 centers in action across the U.S.

Governor Edward Rendell of Pennsylvania spoke about the use of NMHCs in his state, asserting that they have increased access to healthcare for consumers and empowered nurses.  While the state once had some very restrictive laws governing the services and treatments nurses could provide, Rendell said the state worked to empower nurses by lifting barriers.  The state government changed 49 regulations and statutes in Pennsylvania so that nurse practitioners could practice.

“State and federal governments need to help nursing schools expand their classes,” Rendell said.  “In six years, we’ve been able to double the number of grads coming out of Pennsylvania nursing schools.” 

“We have nurses running clinics in supermarkets, CVS and Rite Aids, they are open until 9 at night and on weekends.  This is alleviating use of emergency rooms especially for non-life threatening cases, such as a dog bite,” said Rendell.

“When it comes to first responders in healthcare, we need to think outside the box and increase reliance on non-primary care providers,” said Tine Hanson-Turton.

She said there are currently 150,000 nurse practitioners nationwide and each year 4,000 graduate from nursing schools. 

Hanson-Turton called on President Obama to “build a healthcare workforce infrastructure to incorporate more nurse practitioners.”

She called on the government to include nurse practitioners and NMHCs in demonstration projects such as those managed by the Centers for Medicare & Medicaid Services. 

“We have creativity in spending the stimulus funding. We should utilize existing centers – some were started and invested in by the federal government, so it would be a good way to use taxpayers’ dollars.”

She said many nurses have left the profession, and one of the reasons is lack of opportunity to take a leading role.  “This will give us an opportunity to train and retain,” she said. 

Panel Underscores Importance of Two Year Degrees

Does America need a more expansive view of what postsecondary education means and a more expansive view of who has access to and attains a postsecondary education?   Answering these sorts of questions proved the focus of a recent seminar in Washington, DC, conducted by the Center for American Progress.    

Liberal Arts and Science degrees are and will remain an important part of postsecondary education, but so too should be technical and vocational degrees.   It makes no sense, said one of the panelists, Rick Stevens, Senior Vice President of Human Resources and Administration at the Boeing Company, that $60,000 mechanic positions go unfilled in a county transportation facility because Americans view a credential in mechanics as beneath them.  On any given day, 3,000 Boeing employees are in school he said, to increase their skills and knowledge. 

The challenge is not only to educate people on how to use existing technology but to “solve future problems by using technology not yet in use” he added.   To do so, Stevens made several recommendations, including a vision of college as more than the traditional four-year experience, measures of success that are based on output and not a US News and World ranking, reforming education funding so  that more goes to those with the greatest financial need, more hands-on education at the high school level in technical fields, and greater alignment among government, business, and the media to promote this vision of increased social capacity through education.   Summarizing his vision of this broad-based brand of education, Stevens explained that to land two astronauts on the moon, it took a support force of three million people.

Echoing these remarks, Louis Soares, Director of Economic Mobility at the Center for American Progress and panel moderator, pointed to a fundamentally new focus on the relationship between work and education and policy shifts indicative of this change in focus.   Specifically, he commented on the spot light on two-year institutions, which in the past couple of decades have experienced a rapid growth rate in enrollment and degrees conferred.   While his remarks were aimed at community colleges based on a Center for American Progress report, The Other College:  Retention and completion rates among two-year college students, the findings apply to private two year institutions as well.  Students attending these institutions tend to be older, more likely to be working at least part-time, independent, and of a lower socioeconomic background than their four-year college counterparts.  “Students are making rational choices” Soares said, based on data that show that in addition to the primary benefit of higher education of higher earnings, other benefits may include improved health, workplace amenities, and increased civic participation.

Another report whose findings were presented by one of the co-authors, Arthur Hauptman, was Cost, Commitment, and Attainment in Higher Education:  An International Comparison.  He arrived at a similar conclusion that the United States diminished world ranking is largely due to its lagging rates in less than four-year educational attainment or what is referred to as sub-bachelor’s degrees and not lack of resources. Using the most recent Organization for Economic Cooperation and Development (OECD) data for 2006, the United States ranked second in attainment rates of bachelor’s degrees for all adults (aged 25-64), compared to 9^th for sub-bachelor’s degrees.  For the youngest group of workers (aged 25-34) the rankings were 6^th and 11^th for bachelor’s and sub-bachelor’s degree attainment, respectively.  On the other hand, the United States ranked first for what was termed “commitment to higher education,” whose measure is resources devoted to higher education (i.e., revenues to institutions as a percentage of GDP).  The top ranking countries in overall educational achievement also ranked high in sub-bachelor’s degree attainment.  Strategies used by OECD countries to increase their educational attainment rates ran the gamut from increasing enrollments in institutions of higher education to reducing the time to earn degrees.  The strategy used by Japan and Korea, ranked second and third in educational attainment, was relying on the private sector to foster growth.  The United States and Spain were also listed as using this particular strategy to increase their attainment rates.

The other panelists in addition to those already mentioned, included Jamie Merisotis, CEO of the Lumina Foundation for Education, Nancy Hoffman, Vice President of Jobs for the Future, and Nisha Patel, Program Officer for Special Initiatives at the Bill and Melinda Gates Foundation.   They all reiterated the importance of associate degrees, increased access for underserved populations, and a re-focus on learning outcomes.  They offered examples of how to expand access and achievement, such as beginning with improved high school performance by reducing dropout rates and better preparing students for college as well as dual enrollment programs.  All agreed that higher education must be made more affordable, particularly for low-income students, by simplifying the financial aid process and increase funding for the most needy. 

A copy of The Other College:  Retention and completion rates among two-year college students, February 2009 is available on the Center for American website:  http://www.americanprogress.org/issues/2009/02/two_year_colleges.html

Cost, Commitment, and Attainment in Higher Education:   An International Comparison, is available on the Jobs for the Future website:  http://www.jff.org/Documents/MOA_report_051909.pdf

New Study Finds Diversity in Graduation Rates at U.S. Colleges

A new report from the American Enterprise Institute, a non-partisan think tank in Washington, D.C., finds that graduation rates among similarly categorized colleges and universities vary immensely in the United States.  On average, fewer than 60 percent of students graduated from four year colleges within six years of matriculation between 2001 and 2007. 

Data for the report were drawn from the Department of Education’s Integrated Postsecondary Education Data System (IPEDS).  The schools were segmented by the AEI researchers into categories based on selectivity, from the “most competitive,” schools which typically admit fewer than 1/3 of applicants and require them to be in the top 10-20% of their graduating class, to “noncompetitive” schools, requiring only evidence of graduation from an accredited high school.

The report showed that on average, the percentage of graduates increases with the selectivity level of a school (about 1 percent of the 1,385 schools in the study are market-funded institutions).  For instance, non-competitive schools produced an average 34.7% graduation rate, less competitive 39.6%, competitive (a category that nearly half of all schools fall into) 48.6%, very competitive 62.3%, highly competitive 75.2% and most competitive 87.8%.  The four lower categories had the widest range of graduation rate, with rates for very competitive schools ranging from above 80% to below 10%, for example.

“We are not suggesting that high graduation rates are invariably a good sign or low graduation rates necessarily a bad one,” the report’s authors write. “The results reported here should be read with such cautions. In particular, we do not want to suggest that modest differences in graduation rates should be overemphasized—that is why we focus on the extremes.”

At a panel discussion analyzing the report findings and hosted by AEI last week, Stephen Joel Trachtenberg, a former president of George Washington University in Washington, D.C. said the report “gives you one stone of a large mosaic.  If information like this drove decisions, nobody would ever drive a motorcycle or buy a pack of cigarettes.” 

His comments seem to point to the cautionary advice the report provides to parents and students making higher education decisions, implying that students should take graduation rates into account when choosing a school. 

Other critics have pointed to the study’s inability to account for other variables that may affect an institution’s graduation rates, such as financial aid given through a school’s endowments or other means, the number of its students who transfer to other colleges, percentage of lower income students or first generation college goers attending schools.

The study includes only a handful of career colleges in its rankings.  In addition to selectivity level, it presents graduation rates for schools by state and top and bottom ranking schools by region of the country.  It also looks at graduation rates for Historically Black Colleges and Universities and Institutions of High Hispanic Enrollment, which the data show lag behind national averages.

The report concludes that the “six-year graduation rates depend on an institution’s students and not just its academic program,” and urges parents, prospective students and guidance counselors to “take a hard look at graduation rates. If the numbers are low, they should make sure there is a good reason. If none is forthcoming, they should look for alternative places to invest their time, their money, and their future.”

Several Educational Pathways Found to Improve Social Mobility

“Now, as never before, the economic well-being of American workers depends on their education and training,” is how a report prepared by the Hudson Institute and CNA for the Bill and Melinda Gates Foundation begins.   Not surprisingly, this study, titled Pathways to Boosting the Earnings of Low-Income Students by Increasing Their Educational Attainment, found that higher levels of postsecondary educational attainment result in higher earnings, and high school preparation and performance positively affect both postsecondary and earnings outcomes.  What was a surprising finding is that certificates, considered the lowest rung of postsecondary educational attainment, can also lead to better earnings, even for those with less than stellar high school academic experiences.  According to the study there exist several pathways to better earnings.  And, opportunities for higher paying jobs are not restricted to high school high achievers from middle and high income groups who earn traditional four-year degrees.   Indeed, one of its concluding statements is that “low-performing [in high school] low-income students substantially benefit by attaining certificates in health-related, professional, and voc-tech fields.”

The other side of the coin is the substantial achievement and outcome gaps among various groups.   This study followed a cohort of 144,545 Florida public school students who entered the 9^th grade in 1996 through high school and into (and out of) Florida public two- and four-year colleges and into the workforce in Florida.  The researchers found that fewer than one out of four low-income high school students attended college compared to a one out of three overall rate of attendance. 

Program selection also matters in terms of earning potential.    As the chart below indicates, health-related programs proved to be a high return course for students with Certificate or Associate Degrees and Bachelor’s degrees.   On the other hand, the average highest annual earnings for those with Certificates or Associate’s degrees in the social sciences or humanities are lower than those without any postsecondary credentials.  “These results clearly show that two-year college credentials in career-related, rather than academic, fields may have the potential to raise earnings,” the study notes.

The study poses a pair of policy options:   “(1) increasing attainment of four-year degrees by high-performing low-income students; and (2) increasing attainment of certificates from two-year colleges by low-performing low-income students.”  The former is achieved by increasing the number of low-income students who perform at higher levels (i.e., achieve higher GPAs) and are college ready.  The latter is achieved by better informing them of the career options available to them. 

Out of five major impediments to increasing attainment of degrees and certificates, the study identifies lack of information about returns from postsecondary education and completion expectations as the primary reasons why more low-performing, low-income students do not enter two-year colleges to obtain certificates in high-return fields.   The other impediments are:  financial (lack of funds or cost of foregone earnings), experiential (lack of high school preparation and work experience), and motivational (lack of interest in pursuing certain careers).  The fifth impediment is institutional is lack of sufficient slots to accommodate employer demand. 

The study states that “the bottom line is …that low-cost informational services would be highly effective in increasing course completion, credential attainment and earnings,” but admits that “we do not know enough about all of the impediments and the cost-effectiveness of different ways to remove them to make definitive recommendations.   Thus, it would be worthwhile to determine the cost-effectiveness of removing informational and other constraints, especially those that prevent low-income students from attending two-year colleges, completing high return courses, and obtaining certificates.  The best evidence would come from demonstration projects that would assess informational and other deficits, deliver high quality assessments and counseling, and then determine how this information affected course selection and credential attainment.”

A copy of Pathways to Boosting the Earnings of Low-Income Students by Increasing Their Educational Attainment, Louis Jacobson and Christine Mokher, The Hudson Institute and CNA, is available on the website:  http://www.hudson.org/files/publications/Gates%2001-07.pdf

Education Critical in Expanding Access to Higher Earning Jobs

As the gap between the top earners and everyone else expands, the importance of “upgrading productivity, skills, and rewards in the service sector is the key challenge” according to a recently released report, Changing the fortunes of America’s workforce:  A human capital challenge, by the McKinsey Global Institute.  The goal of the study is to provide a “comprehensive, well-founded  explanation” for the phenomenon of income dispersion by examining its purported underlying causes, including free trade, outsourcing, immigration, technological change, immigration, and the decline of unions. 

As evidence of the income dispersion the report offers the following statistics:   between 1994 and 2005 household incomes of the top 10 percent of households grew at an average annual rate of 3.3 percent, “while incomes among the bottom 10 percent of households grew at an average of only 1.0 percent a year, and income growth for upper and middle income households was also moderate, at 1.5 percent to 1.7 percent a year.”  Ultimately, the study did not find a discrete or definitive cause of or “silver bullet” remedy to the increasing income dispersion.  Rather, it discerned that the road to not only the recovery from the present economic downturn, but to future economic growth should be for policymakers to focus on human capital.  Specifically, the focus should be on redevelopment of human capital, “not only for students in schools and colleges but across the current workforce.”

A key to understanding income dispersion is labor market institutions, which, according to the report, have been lax to respond to the shift from a manufacturing-based to a service-based economy that increasingly requires advanced skills.   The gist of the report is that for the past decade or so and up to the present, employer demand for certain workers is out of sync with the supply, even the oversupply, of certain other workers, citing that “71 percent of US workers are in jobs for which there is low demand from employers, an oversupply of eligible workers, or both.”  The paucity of in-demand advanced skilled workers drives up their earnings, while the oversupply of workers in ebbing labor markets drives down their earnings. 

McKinsey looked at which “drivers” had a positive or negative impact on incomes on workers in nine industry/occupation “clusters.”   Three types of drivers were identified, each with three components.  Demand drivers influence the demand for labor and include:  skill-biased technological change (SBTC), trade, foreign direct investment and offshoring (TFO), and organizational complexity.  Supply drivers influence the supply of labor and include: immigration, the aging of the workforce, and female labor force participation.  The components of institutional drivers, which refer to the institutional arrangements in the labor market are:  education, performance pay, or what the report termed “the superstar phenomenon,” and deunionization. 

The specific industry/occupation clusters were derived from the Bureau of Labor Statistics and paired industries and occupations based on similar income levels and employment characteristics.   The nine cluster categories were: (1) top earners – managers in high-growth industries and professional service professionals; (2) white collar workers – managers and professionals in a range of industries; (3) artists and farmers – managers in agriculture, mining and energy, educators in recreation, hospitality, and transportation, and entertainers; (4) front-line – core, non-tradable service workers in management, professional services, education and law enforcement; (5) speeding treadmill – core, non-tradable service workers, primarily educators and wholesale and retail sales; (6) automated away – mix or manufacturing production, administrative support, and repetitive manual jobs; (7) classic blue collar – predominantly manufacturing and production occupations; (8) semi-skilled servicers – mainly non-tradable, lower-skill functions in high-growth industries; and (9) low earners – low skill repetitive manual jobs and administrative support jobs. 

While a variety of “drivers” explained why the demand or income of a certain cluster or clusters grew or declined, education was found to be a positive driver for all the clusters.   And looking toward the future, the report states that “education is the most important mediator of future labor and supply and demand.  In light of the growing demand for skills, appropriate education and training plays a critical role in giving workers access to more attractive jobs.  Moreover, a shortage of American workers with the skills to fill the jobs fostered by new technologies and more complex organizations has meant that people with those skills have seen substantial income premiums.”

A copy of the report, Changing the fortunes of America’s workforce:  A human capital challenge, June 2009, is available on the McKinsey & Company, McKinsey Global Institute website: http://www.mckinsey.com/mgi/reports/pdfs/changing_fortunes/Changing_fortunes_of_Americas_workforce.pdf

President’s Council of Economic Advisors Finds Need for More Associates’ and Vocational Degrees

A July report from the President’s Council of Economic Advisors finds that careers requiring postsecondary educational attainment are expected to grow significantly faster than those with lower education requirements such as manufacturing and low-skill jobs.  The report, Preparing the Workers of Today for the Jobs of Tomorrow finds, “the fastest growth among occupations that require an associate’s degree or a post-secondary vocational award.”

While the benefits of a college degree are well documented—higher wages, more job security and in the current environment, significantly lower rates of unemployment—the new report is significant because it underscores the growing trends which play to the   strengths of the career college sector. 

The White House report reviews existing employment data from the Bureau of Labor Statistics and government forecasting to summarize and predict employment trends through 2016, when it states that the economy will resemble that of 2008, but with some important shifts.  Most notably, the healthcare sector will continue to represent a large percentage of employment growth.   Those positions requiring less than a bachelor’s degree will represent much of the growth, such as lab technicians, health information technicians and physical therapy aids.  “Health care support” occupations are projected to grow 48 percent in the years between 2000 and 2016.

Other important growth areas cited in the report include a resurgence in construction and rebuilding as the country moves out of the economic recession, resulting in increased jobs in fields such as electrical work and plumbing.   The Presidential advisors state that environmental-related occupations will expand over the next decade, citing a projected 52 percent growth rate between 2000 and 2016, compared to a 14 percent growth rate in all occupations.

Dr. Watson Scott Swail of the Virginia-based Educational Policy Institute says the White House report echoes what his group has found regarding post-secondary education.  “I think we have overblown some of the need for four year education in lieu of what society actually needs,” says Swail.    Swail’s research group finds that less than one quarter of all jobs today require a bachelor’s degree or higher, and he says that we as a society need to be a lot more realistic about higher educational attainment.

Dr. Swail says career colleges have an important role to play in filling the needs of the training the workforce for tomorrow’s jobs.   With their emphasis on career and vocational training and certificates that can be obtained in a shorter period, Swail says the career college sector should continue to grow and be recognized as an option for skills attainment, although its higher than community college tuition costs could remain something of an inhibiting factor.

The President’s Council of Economic Advisors conclude in their report that “there remain important limitations to our education and training system, many stemming from low completion rates, limited accountability, poor coordination among different programs and excessive bureaucratic restrictions on the use of training funds.”

U.S.Students Bested by International Peers in Some International Assessments

The National Center for Education Statistics has issued a new special analysis focusing on the performance of U.S. students in reading, math, and science.  The analysis compares scores of U.S. students with the performance of their peers in other countries that participated in Progress in International Reading Literacy Study (PIRLS), the Program for International Student Assessment (PISA), and the Trends in International Math and Science Study (TIMSS).

The PIRLS assesses the reading skills of 4^th graders, and TIMMS assesses math and science abilities in 4^th and 8^th graders.  PISA assesses the reading, math and science skills of 15-year-old students, and focuses on the OECD-member countries.    Worldwide, about one million students participated in the latest round of international assessments, with about 5,000 U.S. students participating from randomly selected schools across the country in each of the three assessments. 

The report identifies which countries have outperformed the United States in terms of students' average scores and the percentage of students reaching internationally benchmarked performance levels, and which countries have done so consistently. 

In some cases, U.S. students have lost ground on their assessment scores.  In the 2006 PIRLS assessment, the number of countries whose 4^th graders outperformed U.S. 4^th graders jumped from three in 2001 to seven in 2006.  While U.S. scores are staying roughly constant over time, some countries are improving. 

Dr. Stephen Provasnik, one of the analysts at the U.S. Department of Education who produced the report, says this is significant in terms of future capabilities of U.S. workers, in terms of how competitive they are, vis-à-vis international counterparts.

“Do these assessments say we’re getting more competitive with other countries? The answer is no.  While our scores have improved in some instances, the number of countries outperforming the U.S. has increased in reading, math and science,” says Provasnik.  “We’re not keeping up, competitively speaking.” 

In math, U.S. students scored above the TIMSS scale average on the 2007 TIMSS, and U.S. scores were higher than the respective U.S. score in 1995. However, fourth-graders in 8 of the 35 other countries that participated in 2007 (Hong Kong, Singapore, Chinese Taipei, Japan, Kazakhstan, Russian Federation, England, and Latvia) scored above their U.S. peers, on average; and 8th-graders in 5 of the 47 other countries that participated in 2007 (Chinese Taipei, Korea, Singapore, Hong Kong, and Japan) scored above their U.S. peers, on average.

“U.S. students are not doing any worse than before; in fact in math they are doing better, but in other countries students have improved more,” says Provasnik. “We are not improving as fast as other countries, and people can argue over the reasons for this.   But some countries like Germany have reformed their entire education systems based on the results of these assessments.”

The PISA scores paint a more striking picture. 

“In PISA 2006, U.S. 15-year-old students' average mathematics literacy score of 474 was lower than the OECD average of 498, and placed U.S. 15-year-olds in the bottom quarter of participating OECD nations, a relative position unchanged from 2003,” the report’s executive summary states.

Stated another way, students in 23 of the 29 other participating OECD-member countries outperformed their U.S. peers in math literacy. 

The 2006 PISA assessment scores yielded similar results in science.  Students in 16 of the 29 other participating OECD-member countries outperformed their U.S. peers in terms of average scores, putting U.S. students in the bottom third internationally in science scores. 

“TIMSS assesses what kids learn in school; things that are common across all countries, while PISA is a test of their ability to apply knowledge and skills,” says Provasnik.  “PISA contains more functional problems such as you might encounter in everyday life or occupations. In other words, TIMSS is what kids are used to seeing in school, PISA makes them stretch. So while U.S. kids are competitive at what they are taught in school, they are not as competitive, when it comes to applying that knowledge and skills, as many of their peers in the OECD.”

One reason why U.S. students appear to hold their own – although still fall below the top of the scale – in PIRLS and TIMSS assessments is that a broader swath of developed and developing countries are surveyed with these tools.  By contrast, the thirty OECD countries which administer PISA are developed nations, on par with the Unites States in terms of modernization and standard of living. 

Provasnik underscores that when it comes to applying knowledge and skills to tasks outside the classroom that have functional, occupational applications, U.S. students do not look as good as their peers in other developed countries.  Countries that have regularly outperformed the United States?   Korea, Singapore, Hong Kong and Finland stand out in all three subjects.  “Their students are scoring at the top in the world, and are now outperforming the U.S. on all three subjects.” 

Kennedy Leaves Legacy in Building a Competitive U.S. Workforce

Senator Edward Kennedy’s passing last week has been described in the national media as the “end of an era.” He has been praised for his work in support of civil rights, for fighting for equal pay for equal work, for defending the rights for the disabled, and for enabling access to higher education for the disadvantaged. 

As a longtime member and sitting Chairman of the Senate’s Committee on Health, Education, Labor and Pensions (HELP), Kennedy left a legacy which included considerable efforts to improve the workforce competitiveness of the U.S. middle and lower income sectors, with particular emphasis on access to higher education and expanding and safeguarding federal student aid funding.

“No United States senator has committed more of his time and his wisdom to the advancement of American higher education. Thanks to him, students across the spectrum have the opportunity to pursue their ambitions,” said Drew Faust, President of Harvard in December 2008, as the University bestowed an honorary degree to Kennedy.

Of the approximately 300 pieces of public law authored by his office in his 47 years of service, many impacted the landscape of higher education funding and access. 

Kennedy was considered the primary author of the Federal direct loan program and he conceived of and executed the compromise program which allowed students to choose between FFEL and direct loans.   He garnered bipartisan support for the compromise plan by the government, which was enacted by Congress and signed by President Clinton in 1993. 

Kennedy was a champion of raising Pell grant limits to ensure college access and affordability.   “Access to college was a huge issue for Senator Kennedy,” says Will Marshall, President of the liberal Progressive Policy Institute.  “Particularly as college prices rose, often outstripping inflation, he was indefatigable in creating a support system for middle class families and generally low income families through vehicles like Pell grants.” 

More recently in 2007, Senator Kennedy co-authored the College Costs Reduction and Access Act which authorized $23 billion increase  in student aid, the largest amount  since the GI Bill.  When President Bush signed the bill into law, Kennedy applauded the accomplishment, stating, “A college education is more important than ever – important to individual opportunity and important to our nation’s economic health.  This legislation shelters students and their parents from the turbulence in the credit markets so a student’s ability to go to college and pursue the American Dream is not blocked.”

Senators Kennedy and Enzi were also responsible for shepherding through the HELP committee reauthorization of the Higher Education Act in 2008, which took steps to simplify the FAFSA and expanded aid to low income students once again. 

PPI’s Marshall says another area Kennedy championed was national service.  “He was committed to the idea that we should expand opportunities for young people to serve their community and their country; and they should earn a reward to defray college costs for doing so.  Such a reward could be applied to any postsecondary training or professional training,” Marshall says.     

In May 2008, Senator Kennedy also passed the Ensuring Continued Access to Student Loans Act which increased the amount of low-cost federal loans available to students and gave parents of eligible students better access to low-cost federal loans (PLUS loans).

At his confirmation hearings in 2009, then Education Secretary-designate Arne Duncan praised Senator Kennedy’s involvement in passing the America COMPETES Act of 2006.   This bipartisan legislation was intended to help the U.S. remain competitive in the 21^st century global economy by increasing research investment and “strengthening educational opportunities in science, technology, engineering, and mathematics from elementary through graduate school.”

Will Marshall says that the Senator’s passing will leave a gap in general in the Senate, but that there are plenty of Democrats who want to expand access to college. 

“Tax credits and policies aimed at ensuring access for the middle class are a big Democrat focus.   It’s no longer just low income families that are having access problems.  The middle class is getting squeezed,” he says. 

Employer-Sponsored Health Benefits at Risk

Rising costs and the expectation of health care reform could be the perfect storm to change the rules of the game for employer-sponsored health insurance.

The amount of money workers and their employers contribute to family health insurance premiums in 2009 continues to significantly outpace inflation, forcing employers to make tough decisions about which employees are more likely to be offered the benefit.   Will the rising cost of health care coverage give more highly skilled workers a competitive advantage in the marketplace, and allow those workers that are in demand to have more control of their family’s health insurance options? 

A new survey of over 2,000 employers from the Kaiser Family Foundation and the Health Research and Education Trust finds that many U.S. workers will face a deterioration of employer-sponsored health benefits next year. 

The survey found that 40 percent of employers surveyed said they are likely to increase the amount their workers pay out of pocket for doctor visits. Almost as many said they are likely to raise annual deductibles and the amount workers pay for prescription drugs.

Nine percent of employers said they plan to tighten eligibility for health benefits; eight percent said they plan to drop coverage entirely. Forty-one percent of employers said they are "somewhat" or "very" likely to increase the amount employees pay in premiums -- though that would not necessarily mean employees would pay a higher percentage of the premiums. Employers could simply be passing along the same share of the overall increase that they are doing this year.

Report author and Senior Policy Analyst at the Kaiser Family Foundation Bianca DiJulio says it is significant that nine percent of respondents said they will tighten health insurance eligibility guidelines, which could mean restricting eligibility for coverage for certain levels of employees.  

According to Paul Fronstin, Director of the Health Research and Education Program at the Employee Benefits Research Institute, health insurance was historically offered by companies as a way to entice employees.   During World War two, labor was scarce, there were wage controls in effect and companies needed to attract workers using other means, so they turned to offering health coverage.  

“Today’s unemployment is almost 10 percent.   Being competitive in the labor market isn’t as compelling,” Fronstin says.  High unemployment, combined with highly skilled jobs being outsourced overseas and the skyrocketing cost of coverage could cause many U.S. employers to rethink the benefit all together, he says. 

“When health insurance benefits started, health care was cheap,” says Fronstin. “You didn’t have miracle drugs to lower cholesterol, bypass surgery, or MRIs. All the medical miracles that we benefit from today didn’t exist back then.   As a result it didn’t cost a lot.”  

One of the reasons employers never stopped offering health insurance is that there was no viable alternative.   Health reform could change that. 

“It’s the perfect setup to allow employers to get out of the health benefit business.   It will give them options as far as what they can offer,” says Fronstin.  “For the most part they [employers] don’t discriminate.  I think that health reform could push them in that direction.”

Fronstin believes health reform could allow employers to stop offering coverage, and give them more flexibility to attract the kind of workers that they want, either through offering more money or supplemental health care packages.   Much in the way pension plans have given way to 401(k) plans, which are more portable and not tied to a specific employer, health reform could create similar changes in health benefits. 

Experts Consider College for All

On September 17^th the Urban Institute in Washington, DC held a public agenda symposium on the subject of whether it is reasonable or even advisable to encourage all Americans to enroll in higher education. 

The panel discussion was moderated by National Public Radio education correspondent Claudio Sanchez, and included Jean Johnson, Executive Vice President of Public Agenda and head of its Education Insights division; Charles Kolb, President of the Committee for Economic Development; Robert Lerman, Urban Institute fellow in labor and social policy; and Paul Lingenfelter, President of State Higher Education Executive Officers.   Throughout the 90 minute forum, these individuals made presentations discussing the need for major changes in the way students are prepared in K-12 for higher education and the need for millions more students achieving degrees in order for the U.S. to remain globally competitive, as well as advocating different approaches to achieving success, including apprenticeships and career-focused education. 

Jean Johnson presented results from a recent study published by the Public Agenda which found that 75% of the general population strongly believes that no one should be denied a higher education because they don’t have the money for it.   Furthermore, more than half of respondents felt that college is essential to be successful in life.  Public school teachers, however, were found to harbor serious doubts about whether their students should continue on to higher education, with only one-third saying that they believe all students should go to college.  This statistic shows, according to the study, that there is a need for fundamental change in the way students are prepared for postsecondary education.  These changes include improving college readiness by focusing on remediation earlier in the K-12 experience, creating a tighter integration between higher education and K-12 institution, and focusing on innovation and greater use of information to better inform and prepare students for entering college and completing their programs. 

To emphasize the importance of improving college readiness, Paul Lingenfelter noted that for the U.S. to match other leading nations in degree attainment rates, 55% of adults must attain some form of college degree by 2025, but that we will fall 16 million degrees short if there is a failure to increase the current degree completion rate of 37.4% (as of 2005).   In order to raise this rate, Lingenfelter proposes that we must increase high school graduation rates, encourage adults who have some college experience to go back and complete a degree, and support those who have completed high school but have not attended college to do so and obtain a degree.  Lingenfelter emphasizes the importance of these rates not just from a globally competitive perspective, but on the basis that the least educated are the most vulnerable during economic downturns.   He notes that by 2018, 63% of all jobs in the U.S. will require some postsecondary education and training.

While not disputing the need for a skilled and competitive workforce, Robert Lerman and Charles Kolb questioned whether an academic-only approach is the best way to accomplish this.   Lerman advocated an expansion of apprenticeship programs in order to give practical on-the-job experience while students work towards their degree in their chosen field.  He cited multiple countries, including Australia, Switzerland, and the United Kingdom, where apprenticeships are widely used to provide skills training and make degree attainment easier.  In the United States, the federal government only allocates $25 million per year on apprenticeship programs.  Kolb emphasized that while all people can benefit from postsecondary skills, the overall investment needs to be worth the effort.

In the Q&A session following the panelist presentations, several members of the audience emphasized that a key area of focus on improving degree completion rates, as well as increasing workforce participation, is working on improving student attitudes in areas such as attendance, timeliness, and work ethic.   The panelists didn’t seem to have any specific answers on how to combat these problems, but all agreed that they were linked to the overall goal of improved economic competitiveness.  The issue of college costs was not a main focus in this forum, although it was emphasized as a hindrance to degree completion rates.    The panelists represented their views as part of an evolving debate on how to achieve the best results from a college education at the beginning of the 21^st century. 

Wealth Down; Poverty Up

Disturbing economic news from the Census Bureau:   Between 2007 and 2008, the percentage of Americans below poverty has increased; real median household income and real per capita income have declined; and the number of uninsured Americans has grown.

These are findings of the 2008 annual Current Population Survey (CPS) conducted by the U.S. Census Bureau and reported in the September 2009 issue of Income, Poverty, and Health Insurance Coverage in the United States:  2008.

Coinciding with the recession, real per capita income declined by 3.1 percent for the total population and real median household income declined by 3.6 percent from $52,163 to $50,303 between 2007 and 2008.   Households of all races and Hispanic origin were affected by a decline in real income, albeit by different percentages and different income levels.  The decline experienced by non-Hispanic white households was the lowest (2.6 percent to $55,530) of all groups and the highest for Hispanics, whose income declined by 5.6 percent to $37,913.  Although the decline in income for African-American household was much lower than Asian, 2.6 percent compared to 4.4 percent, their income levels differed substantially, $34,218 and $65,637, respectively.  http://www.census.gov/Press-Release/www/releases/pdf/09_iph_presentation.pdf

As measured by other characteristics, few American households were spared.   The incomes of native- and foreign-born households, including those of naturalized citizens, declined.  Real median earnings of men and women who worked full-time declined, although not equally.    Male earnings declined by 1.0 percent to $46,367, and female earnings declined by 1.9 percent to $35,745.

With the exception of the Northeast, whose income remained unchanged, the real median income of the other three regions – South, Midwest, and West – declined. 

In terms of poverty, itself, in 2008, the official poverty rate increased from 12.5 percent in 2007 to 13.2 percent, which translated to 39.8 million people below poverty.   It has been nearly 50 years since there have been so many people below poverty.  http://www.census.gov/Press-Release/www/releases/pdf/09_iph_presentation.pdf  

The increase in the poverty rate was greatest for children under 18 years of age, from 18.0 percent in 2007 to 19 percent in 2008.   For people between the ages of 18 and 64 the poverty rate increased slightly from 10.9 to 11.7 percent, but remained unchanged for people 65 or older.  While non-Hispanic whites experienced an increase in their poverty rate from 16 million to 17 million, they represented 42.7 percent of the people in poverty but 65.4 percent of the total population.  Increases in the poverty rate occurred for both native and foreign born, inside and outside of principal cities, and in two regions of the country, the Midwest and the West.  For the other two regions the poverty rate was statistically unchanged from 2007 to 2008.

While the percentage of uninsured people remained statistically unchanged between 2007 and 2008, the number of people increased from 45.7 million to 46.3 million.   Both the percentage and number of people covered by private health insurance declined from 67.5 percent to 66.7 percent in 2008 and from 202 million to 201 million, respectively.  Conversely, the percentage and number of people covered by government health insurance, either Medicare or Medicaid, increased from 27.8 percent in 2008 to 29.0 percent in 2007 and 81 million to 85.6 million.  The number and percentage of children under 18 who were uninsured declined from 8.1 million to 7.3 million, representing 11.0 percent and 9.9 percent, respectively, which was the lowest rate since statistics have been compiled in 1987. http://www.census.gov/PressRelease/www/releases/pdf/09_iph_presentation.pdf

The Current Population Survey for 2008 was conducted in March 2009 of a sample representing the national civilian non-institutionalized population.   Members of the armed forces living either on or off base are included if at least one civilian adult lives in the household.

A copy of the report is available on the census bureau website: http://www.census.gov/prod/2009pubs/p60-236.pdf

Hot Jobs in the City: Push for Urban Renewal May Create Jobs

The Obama administration is initiating a revival of America’s urban centers by coordinating federal funding and local innovation which it says will transform cities into new, thriving centers of renewal and jobs.  To spearhead the effort, in April 2009 the White House announced the appointment of the White House Director of Urban Affairs, Adolfo Carrion, the first person to hold the position.

At a July roundtable on urban issues hosted by the White House, President Obama announced the first interagency review of how government invests in urban and metropolitan areas in the last thirty years.   The review will be conducted jointly by the Office of Management and Budget, the Domestic Policy Council, the National Economic Council and the Office of Urban Affairs. 

This cross-agency approach to urban policy is consistent with the administration’s efforts to break down siloed approaches and replace them with a holistic review which takes into account all aspects of metropolitan area needs. The White House will also take into account needs of entire regions – cities, suburbs and exurbs, in its urban development policies.

Revitalizing cities was an integral piece in the American Recovery and Reinvestment Act (ARRA) funding, signed into law February.   Over $13 billion was earmarked for projects administered by the U.S. Department of Housing and Urban Development, which has jurisdiction over government-controlled housing in many of the nation’s cities and urban areas.  HUD announced in May that it is making $100 million of that funding available to rid public housing of dangerous lead paint, for example. 

Much of the ARRA funding directed at HUD has an urban feel to it.   For example the “Green Retrofit” program will allow for window replacements and systems upgrades in multi-family buildings to make them more efficient.   While some may call these green jobs, others may see them as traditional brick and mortar construction trades.  However, the Green Retrofit could also fund things like upgraded roofing and solar-powered water heater installation, the department says. 

Harry Holzer, an economist at Georgetown University and the Urban Institute, and former Chief Economist at the U.S. Department of Labor, looks at the long term policy strategy of revitalizing America’s cities as an unknown.

“Some cities have been thriving in the last ten or 15 years.   They’ve adapted well to the international economy, and they tend to be mostly the highly educated cities.  But that wasn’t driven by policy.  Maybe a little bit, but most happened independent of policy,” says Holzer. 

The cities that were heavily dependent on manufacturing, which has since left, and haven’t replaced those jobs are suffering more, and there are some differences today in the jobs found in cities as opposed to suburban and rural areas, Holzer says. Cities tend to have a greater concentration of some service jobs, both at the high and low ends of the skills spectrum.   There are more restaurants, hospitals and law firms, for example, which require service skills. 

Holzer agrees with the White House plan to expand traditional urban policy to a more metropolitan approach, rather than strictly looking at the needs of the inner city. 

“You want to ensure that whatever jobs and skills training are available in the suburbs would be available in the city too,” says Holzer.   And, he adds, the suburbs aren’t all the same.

“One urban strategy would be ensuring that people in the city have access to good jobs and opportunity.   But people also need to get the skills and you need to have job placement.  Are one-stops [job placement centers] in cities going to help people get jobs in the suburbs, for example, if that’s where the better jobs are? There needs to be coordination.”

Holzer says the talk of green jobs and infrastructure jobs spurred by the ARRA are likely to be similar in the cities and outside of them.   However, construction jobs in cities may be less residential, more bridges and roads, for example. 

“The short term issue is going to be bringing any jobs to anyone, anywhere – replacing the ones we’re losing in the recession, then we will have the luxury of thinking about which jobs are going to which places,” says Holzer.   “It is hard to revitalize cities.  It’s hard to change the mix.” 

Still, the White House plan is an ambitious one, and one that Holzer says may benefit those mid-sized cities struggling to replace a manufacturing base that has evaporated in recent decades.

It Takes Cooperation and Coordination to Build a Healthcare IT Workforce

A  CEO Roundtable on building the health IT workforce, conducted last week on Capitol Hill, made clear that healthcare related technology gains require people skills for the most sought after outcomes, and it will take a concerted effort by the government, healthcare providers, and educators to make this match happen.  

Produced by CCA and TechAmerica, the roundtable forecast a “perfect storm” of challenges facing these groups in building the health IT workforce.   On the healthcare side, the United States is experiencing an increasingly aging population that is putting more demands on the healthcare system and a concomitant gap in the healthcare workforce, due to the retirement of healthcare workers.    On the IT side, speakers  indicated a shortage of IT workers in the aftermath of the IT bubble bursting a decade ago.  Then there’s the economy that continues to bleed jobs rather than generate new ones. 

Still, it is not all bad news.   In fact, according to the most current Bureau of Labor Statistics projections, healthcare and IT professions make up 15 of the 20 fastest growing occupations and three of every ten new jobs that will be created.   Roundtable participants indicated that a fully implemented healthcare IT system would improve quality, provide wider access, and reduce costs of healthcare, and this view is   shared by most American adults according to a poll released at the event.   One estimate of the cost savings of a fully implemented healthcare IT system is $88 billion over the next ten years.

The roundtable brought together representatives of the executive and legislative branches of the federal government as well as CEOs of healthcare provider systems, educational institutions, and healthcare information technology-focused associations.   Claire Shipman, Senior National Correspondent for ABC News, facilitated the event.  Featured speakers were:     Aneesh Chopra, Assistant to the President and Chief Technology Officer, Executive Office of the President; W. Stephen Love, CEO, Dallas Fort Worth Hospital Council; Linda Kloss, CEO, American Health Information Management Society; JoAnn Klinedinst, VP, Health Information and Management Systems Society; Harris Miller, President and CEO, CCA; Phil Bond, President, TechAmerica; Art Keiser, Chancellor, Keiser University; Duncan Anderson, President and CEO, Education Affiliates; and Geoffrey Brown, CIO, Inova Health Systems.

Putting into perspective the key role of a skilled healthcare IT workforce to the achievement of the healthcare IT revolution, Harris Miller, CEO and President of CCA recited a remark made former Representative Connie Morella (R-MD) when asked how things had changed since she no longer served in the U.S. Congress:   “Now I sit in the back of the car and it doesn’t go anywhere.” “Having technology without a workforce is like sitting in the back of the car, you don’t go where you need to go,” said Miller.  There was a consensus that promotion of innovations in healthcare IT has to go hand-in-hand with efforts to attract the necessary number of people and to develop appropriate training and education programs.

Progress is being made.   Chopra said that the Administration is committed to harnessing technology to develop strategies to promote data exchange and other innovations in healthcare delivery, including provision of an adequate workforce.  The other panelists provided illustrations of this, such as creation of regional extension centers, incentives for innovation, and convening a healthcare IT standards committee focused on promoting the idea of “meaningful use” of technology rather than simply its acquisition.  Without meaningful use, technology serves as a paperweight, Chopra said, recalling a popular cell phone commercial. 

The Roundtable also include remarks by Rep. Allyson Schwartz (D-PA), who introduced the E-prescription legislation, and said congressional action will not stop there.    It is well understood, Representative Schwartz added that the current healthcare system is fragmented and not as effective as it should be and to make it more effective through healthcare IT, it will take a workforce made up of different levels from those who design the software to those who implement it.   Incentives,  she said, are needed to make this happen.  Part of the stimulus package Congress appropriated includes $19 billion for healthcare information technology. 

One panelist described health IT as having three dimensions: an adequate specialized HIT workforce of persons skilled in using and managing healthcare information technology, IT competency for all health care provides, and IT literacy of healthcare consumers but stressed that building a specialized healthcare IT workforce is pivotal. There were many aspects of building a healthcare IT workforce that were discussed, such as making people aware that there is a need for an HIT workforce, and that there are a variety of jobs available with which the public may not be familiar. The government has a role to play by providing incentives through programs such as the Work Investment Act program, which enables state and local officials to establish broad-based labor market systems using federal job training funds for adults, dislocated workers and youth.   Healthcare providers and schools must also do their part in getting the message out.

Several concerns also were voiced about barriers to building the workforce, such as protectionist policies of certain healthcare professional groups that limit the number of new entrants into the profession as well as new programs and state-based licensing policies.   There seemed to be consensus, however, that these concerns should not stifle or impede what Chopra referred to as the movement to capture the imagination about the use of technology. 

CCA and TechAmerica will be conducting a second CEO Roundtable focused on healthcare IT in Austin, Texas on November 17.

Solutions to challenges facing higher education require focused discussion not “crosstalk”

Leaders may agree that higher education in the United States faces major challenges, but views on how to overcome those challenges can be as different as the issues themselves.    Before solving higher education writ large, stakeholders may need to learn how to communicate among themselves. 

In its Campus Commons? report, the latest of a series of higher education publications, Public Agenda refers to discussions involving groups with differing perspectives, concerns, and priorities as “crosstalk.”  Rather than talking across one another, Public Agenda espouses   “purposeful discussion.”  A strategy of open communications among the various higher education stakeholders would, at a minimum, bring to the surface their differences.  Such a discussion would serve to inform the American public about the multiplicity and complexity of challenges facing higher education.  With more open and effective communications, the higher education groups – college presidents, financial officers, faculty, students – can address their differences “talk through their priorities” and move forward to “grapple with realistic solutions.”

Campus Commons?not only reports the findings from interviews with public higher education financial officers and from focus groups with faculty members from two-year and four-year institutions,[1] but synthesizes those from earlier studies of higher education.[2]   Based on an analysis of these findings, several observations are made:  (1) that there appears to be a consensus among the stakeholders that American higher education faces major challenges; (2) that there remain differences regarding the definition of the problem and lack of focus concerning its solutions; (3) that faculty viewpoints are important to the debate and should be included; (4) that there may be a need to further examine faculty views; and (5) that the next phase should be to build on these findings “to develop a framework for productive dialogue and decision making.”

The Campus Commons? Report also contains a section on selected findings from financial officer and faculty interviews, a table summarizing views of the various groups on their understanding of the problem and possible solutions, and an inventory of cost-effectiveness ideas.  Viewpoints range widely.  The public fears that increasing costs of higher education will undermine its access to higher education even as it views such access as a necessity for success. Faculty are concerned that too many students going to college, especially those less well qualified, will contribute to a decline in the quality of higher education.  In between are college and university presidents who view the problem as one of a nexus of rising expenses and decreasing state revenues.  This view is shared by institutional chief financial officers.  Meanwhile, state higher education officials peer out at the issue from the other end of the telescope, seeing too few higher education graduates. 

While the various groups agree on some possible solutions, most notably increased productivity (i.e., doing more with less), they offer a wide range of other solutions.   At one end of the spectrum is the public, which supports measures that protect access to higher education.  The public believes that by increasing efficiency, colleges can educate more students without additional money.  Faculty members, fearing most declining quality, believe that possible solutions lie at the other end of the spectrum, raising standards and limiting access to less qualified candidates.  For the same reason, they also hold diametrically opposite views to state higher education officials who propose more focus on dual enrollment (high school students taking college classes), retention and graduation.  Faculty members believe that more graduates does not equate to better educated persons, and that college classes in high school are not equivalent to those taught in colleges.  By redefining higher education as a public rather than a private good, college and university presidents press for much more funding for higher education.  Institutional chief financial officers are receptive to new ideas being brought into the discussion and suggest several, such as larger classes and distance education.

From these studies a list of ideas emerge related to the issues of cost, quality and access, which form the crux of the challenges facing higher education.   This cost-effectiveness inventory consists of the following: 

• Improving college readiness through a variety of measures including better counseling, improved assessments, and earlier and more effective use of remediation based on the assessments.
• Improving retention for students already in college by, among other things, better tracking high-risk students, enrich first-year programs, assist students to develop mentoring relationships, offer additional support, better design remediation, provide graduation incentives, apply best practices in serving low-income students.
• Creating an integrated P-20 education system that would “overcome barriers” through dual credit systems for high school students, greater coordination between industry and education, creation of centers of excellence, and mechanisms for communication among institutions with similar programs.
• Offering greater differentiation of programs to match the diversity of college students by enhancing technical education, granting college credit for existing experience and knowledge, expanding distance education, refraining from using the term nontraditional students, developing new models of instruction and more relevant curricula to adult learners.
• Using incentives and models from the business world to reward collaboration, to rethink efficiencies in all areas such as textbook purchases, to create incentives for improving student retention and graduation, to outsource non-educational functions such as custodial services and facility maintenance, and increase receptivity to innovative ways of thinking.
• Innovating and applying creativity to address challenges, such as use of technology, new techniques and approaches to instruction, to use of facilities, to financial funding.
• Making greater use of information for the purpose of reaching out to prospective students, especially minority and low-income students by means of targeting information, open-house and career awareness programs, and better communications about the benefits of higher education.
• Offering better assessments and productivity measures by identifying, implementing, and disseminating best practices through the use of better tools for assessing educational outcomes.

A copy of Campus Commons? What Faculty, Financial Officers and Others Think About Controlling College Costs is available on the Public Agenda website:  http://www.publicagenda.org/pages/campus-commons.   The other publications referenced in this report are also available on the Public Agenda website:  http://www.publicagenda.org/.

New OECD Data Show U.S. Continues Below Average in Degree Attainment

The Organization for Economic Cooperation and Development (OECD) released its annual Factbook 2009 recently, containing statistical comparisons for more than 30 member countries.  The organization looks at wide ranging data from population and demographics to suicide rates to water consumption. 

Among the annual data are rates for tertiary, or postsecondary, degree attainment in OECD countries.  The United States ranks fourth out of all OECD countries in ages 25-64 total tertiary degree attainment.  This encompasses what the OECD considers “Type A” degrees – a degree from a traditional university; and “Type B” degrees, which generally refer to shorter, vocationally oriented programs of study which lead to direct career access, such as certificates and degrees from career colleges in the United States.   

However, the new data also show that the U.S. ranks 14^th in terms of total tertiary graduation rates at expected age of graduation (approximately age 24 based on OECD information), trailing countries like Ireland, Italy and Poland and below the OECD average.  The data also indicate a continued downward trend in attainment rates in the U.S., which it has shown in years past.  This is due to the significant increase in the proportion of the adult population attaining postsecondary education in most OECD countries in recent decades. 

Some good news indicates that Americans pursue their degrees later in life, as the U.S. moves up slightly to 11^th in tertiary attainment between ages 25-34, with just over 39% of the population having degrees. 

However, the report finds that some countries are improving markedly in this area. For instance, it states, “comparing the tertiary attainment levels of 25-34 year olds with those of 55-64 year olds indicates that in Korea, there has been an increase in tertiary attainment over the past 30 years of more than 40 percentage points, nearly 30 percentage points higher than the OECD average increase over this period. In contrast, some OECD countries have only seen marginal increases (USA) or even decreases (Germany) over the same period.”

The data bear this out.   While ranking 11^th in the younger group, ages 25-34, in ages 55-64 in tertiary degree attainment U.S. is second. 

Andreas Schleicher, Head of the Indicators and Analysis Division, OECD Directorate for Education, says the long-term prognosis for the U.S. workforce’s higher education attainment looks bleak. 

“When you look at today’s workforce qualification, the U.S. still ranks high,” he says.  “But other countries have caught up and overtaken on Type A degrees.”

Furthermore, the OECD says that the United States does not have a strong presence with Type B, career-oriented degrees either.

“Current graduate output for the United States is about 10% for Type B degrees, while the OECD average is 12%.  Ireland has 27%, Japan 35, Spain 40%.  There are a lot of countries where Type B programs are very popular and have a long tradition,” says Schleicher.  “The U.S. still has a way to go in these degrees as well.” 

Nurse Practitioners Seen as Key to Obama-Era Healthcare Reform

State government and health policy leaders are calling for nurse-managed health centers (NMHCs) to take a prominent role in healthcare reform.  According to the group, health care reform is going to mean that nurse practitioners will play a more front-and-center role in treating patients, especially the more than 46 million Americans who currently lack health care insurance and are underserved by today’s health care system. NMHCs – an innovative delivery model for primary and preventive care, especially for low-income and vulnerable populations – should expand significantly to increase the capacity of the nation’s over-strained health care delivery system, they say. 

“Nurse practitioners are going to be key to healthcare reform in the Obama era,” said University of Miami President Donna Shalala, Chair of the American Academy of Nursing’s Raise the Voice campaign.  The campaign is designed to harness the power of nurses, nurse practitioners and other professionals to provide needed primary health care, health promotion and disease prevention through “disruptive solutions” such as community-based care. That is, care delivered by advanced nurse practitioners and related professionals in a holistic, patient-centered way.

“Nurse practitioners are part of the solution and must be at the table when dealing with healthcare reform.”

Shalala spoke at an event accompanied by Pennsylvania governor Ed Rendel and Executive Director of National Nursing Centers Consortium Tine Hanson-Turton.

“The acute primary care physician (PCP) shortage is going to worsen and we believe that skilled nurses used in the nurse managed care centers can help absorb large numbers of people who are currently uninsured,” she added.

Shalala said that there are currently not enough PCPs in the country and nurse managed health centers can be used for primary and preventive care, and that there are already over 250 centers in action across the U.S.

Governor Edward Rendell of Pennsylvania spoke about the use of NMHCs in his state, asserting that they have increased access to healthcare for consumers and empowered nurses.  While the state once had some very restrictive laws governing the services and treatments nurses could provide, Rendell said the state worked to empower nurses by lifting barriers.  The state government changed 49 regulations and statutes in Pennsylvania so that nurse practitioners could practice.

“State and federal governments need to help nursing schools expand their classes,” Rendell said.  “In six years, we’ve been able to double the number of grads coming out of Pennsylvania nursing schools.” 

“We have nurses running clinics in supermarkets, CVS and Rite Aids, they are open until 9 at night and on weekends.  This is alleviating use of emergency rooms especially for non-life threatening cases, such as a dog bite,” said Rendell.

“When it comes to first responders in healthcare, we need to think outside the box and increase reliance on non-primary care providers,” said Tine Hanson-Turton.

She said there are currently 150,000 nurse practitioners nationwide and each year 4,000 graduate from nursing schools. 

Hanson-Turton called on President Obama to “build a healthcare workforce infrastructure to incorporate more nurse practitioners.”

She called on the government to include nurse practitioners and NMHCs in demonstration projects such as those managed by the Centers for Medicare & Medicaid Services. 

“We have creativity in spending the stimulus funding. We should utilize existing centers – some were started and invested in by the federal government, so it would be a good way to use taxpayers’ dollars.”

She said many nurses have left the profession, and one of the reasons is lack of opportunity to take a leading role.  “This will give us an opportunity to train and retain,” she said. 

Panel Underscores Importance of Two Year Degrees

Does America need a more expansive view of what postsecondary education means and a more expansive view of who has access to and attains a postsecondary education?   Answering these sorts of questions proved the focus of a recent seminar in Washington, DC, conducted by the Center for American Progress.    

Liberal Arts and Science degrees are and will remain an important part of postsecondary education, but so too should be technical and vocational degrees.   It makes no sense, said one of the panelists, Rick Stevens, Senior Vice President of Human Resources and Administration at the Boeing Company, that $60,000 mechanic positions go unfilled in a county transportation facility because Americans view a credential in mechanics as beneath them.  On any given day, 3,000 Boeing employees are in school he said, to increase their skills and knowledge. 

The challenge is not only to educate people on how to use existing technology but to “solve future problems by using technology not yet in use” he added.   To do so, Stevens made several recommendations, including a vision of college as more than the traditional four-year experience, measures of success that are based on output and not a US News and World ranking, reforming education funding so  that more goes to those with the greatest financial need, more hands-on education at the high school level in technical fields, and greater alignment among government, business, and the media to promote this vision of increased social capacity through education.   Summarizing his vision of this broad-based brand of education, Stevens explained that to land two astronauts on the moon, it took a support force of three million people.

Echoing these remarks, Louis Soares, Director of Economic Mobility at the Center for American Progress and panel moderator, pointed to a fundamentally new focus on the relationship between work and education and policy shifts indicative of this change in focus.   Specifically, he commented on the spot light on two-year institutions, which in the past couple of decades have experienced a rapid growth rate in enrollment and degrees conferred.   While his remarks were aimed at community colleges based on a Center for American Progress report, The Other College:  Retention and completion rates among two-year college students, the findings apply to private two year institutions as well.  Students attending these institutions tend to be older, more likely to be working at least part-time, independent, and of a lower socioeconomic background than their four-year college counterparts.  “Students are making rational choices” Soares said, based on data that show that in addition to the primary benefit of higher education of higher earnings, other benefits may include improved health, workplace amenities, and increased civic participation.

Another report whose findings were presented by one of the co-authors, Arthur Hauptman, was Cost, Commitment, and Attainment in Higher Education:  An International Comparison.  He arrived at a similar conclusion that the United States diminished world ranking is largely due to its lagging rates in less than four-year educational attainment or what is referred to as sub-bachelor’s degrees and not lack of resources. Using the most recent Organization for Economic Cooperation and Development (OECD) data for 2006, the United States ranked second in attainment rates of bachelor’s degrees for all adults (aged 25-64), compared to 9^th for sub-bachelor’s degrees.  For the youngest group of workers (aged 25-34) the rankings were 6^th and 11^th for bachelor’s and sub-bachelor’s degree attainment, respectively.  On the other hand, the United States ranked first for what was termed “commitment to higher education,” whose measure is resources devoted to higher education (i.e., revenues to institutions as a percentage of GDP).  The top ranking countries in overall educational achievement also ranked high in sub-bachelor’s degree attainment.  Strategies used by OECD countries to increase their educational attainment rates ran the gamut from increasing enrollments in institutions of higher education to reducing the time to earn degrees.  The strategy used by Japan and Korea, ranked second and third in educational attainment, was relying on the private sector to foster growth.  The United States and Spain were also listed as using this particular strategy to increase their attainment rates.

The other panelists in addition to those already mentioned, included Jamie Merisotis, CEO of the Lumina Foundation for Education, Nancy Hoffman, Vice President of Jobs for the Future, and Nisha Patel, Program Officer for Special Initiatives at the Bill and Melinda Gates Foundation.   They all reiterated the importance of associate degrees, increased access for underserved populations, and a re-focus on learning outcomes.  They offered examples of how to expand access and achievement, such as beginning with improved high school performance by reducing dropout rates and better preparing students for college as well as dual enrollment programs.  All agreed that higher education must be made more affordable, particularly for low-income students, by simplifying the financial aid process and increase funding for the most needy. 

A copy of The Other College:  Retention and completion rates among two-year college students, February 2009 is available on the Center for American website:  http://www.americanprogress.org/issues/2009/02/two_year_colleges.html

Cost, Commitment, and Attainment in Higher Education:   An International Comparison, is available on the Jobs for the Future website:  http://www.jff.org/Documents/MOA_report_051909.pdf

New Study Finds Diversity in Graduation Rates at U.S. Colleges

A new report from the American Enterprise Institute, a non-partisan think tank in Washington, D.C., finds that graduation rates among similarly categorized colleges and universities vary immensely in the United States.  On average, fewer than 60 percent of students graduated from four year colleges within six years of matriculation between 2001 and 2007. 

Data for the report were drawn from the Department of Education’s Integrated Postsecondary Education Data System (IPEDS).  The schools were segmented by the AEI researchers into categories based on selectivity, from the “most competitive,” schools which typically admit fewer than 1/3 of applicants and require them to be in the top 10-20% of their graduating class, to “noncompetitive” schools, requiring only evidence of graduation from an accredited high school.

The report showed that on average, the percentage of graduates increases with the selectivity level of a school (about 1 percent of the 1,385 schools in the study are market-funded institutions).  For instance, non-competitive schools produced an average 34.7% graduation rate, less competitive 39.6%, competitive (a category that nearly half of all schools fall into) 48.6%, very competitive 62.3%, highly competitive 75.2% and most competitive 87.8%.  The four lower categories had the widest range of graduation rate, with rates for very competitive schools ranging from above 80% to below 10%, for example.

“We are not suggesting that high graduation rates are invariably a good sign or low graduation rates necessarily a bad one,” the report’s authors write. “The results reported here should be read with such cautions. In particular, we do not want to suggest that modest differences in graduation rates should be overemphasized—that is why we focus on the extremes.”

At a panel discussion analyzing the report findings and hosted by AEI last week, Stephen Joel Trachtenberg, a former president of George Washington University in Washington, D.C. said the report “gives you one stone of a large mosaic.  If information like this drove decisions, nobody would ever drive a motorcycle or buy a pack of cigarettes.” 

His comments seem to point to the cautionary advice the report provides to parents and students making higher education decisions, implying that students should take graduation rates into account when choosing a school. 

Other critics have pointed to the study’s inability to account for other variables that may affect an institution’s graduation rates, such as financial aid given through a school’s endowments or other means, the number of its students who transfer to other colleges, percentage of lower income students or first generation college goers attending schools.

The study includes only a handful of career colleges in its rankings.  In addition to selectivity level, it presents graduation rates for schools by state and top and bottom ranking schools by region of the country.  It also looks at graduation rates for Historically Black Colleges and Universities and Institutions of High Hispanic Enrollment, which the data show lag behind national averages.

The report concludes that the “six-year graduation rates depend on an institution’s students and not just its academic program,” and urges parents, prospective students and guidance counselors to “take a hard look at graduation rates. If the numbers are low, they should make sure there is a good reason. If none is forthcoming, they should look for alternative places to invest their time, their money, and their future.”

Several Educational Pathways Found to Improve Social Mobility

“Now, as never before, the economic well-being of American workers depends on their education and training,” is how a report prepared by the Hudson Institute and CNA for the Bill and Melinda Gates Foundation begins.   Not surprisingly, this study, titled Pathways to Boosting the Earnings of Low-Income Students by Increasing Their Educational Attainment, found that higher levels of postsecondary educational attainment result in higher earnings, and high school preparation and performance positively affect both postsecondary and earnings outcomes.  What was a surprising finding is that certificates, considered the lowest rung of postsecondary educational attainment, can also lead to better earnings, even for those with less than stellar high school academic experiences.  According to the study there exist several pathways to better earnings.  And, opportunities for higher paying jobs are not restricted to high school high achievers from middle and high income groups who earn traditional four-year degrees.   Indeed, one of its concluding statements is that “low-performing [in high school] low-income students substantially benefit by attaining certificates in health-related, professional, and voc-tech fields.”

The other side of the coin is the substantial achievement and outcome gaps among various groups.   This study followed a cohort of 144,545 Florida public school students who entered the 9^th grade in 1996 through high school and into (and out of) Florida public two- and four-year colleges and into the workforce in Florida.  The researchers found that fewer than one out of four low-income high school students attended college compared to a one out of three overall rate of attendance. 

Program selection also matters in terms of earning potential.    As the chart below indicates, health-related programs proved to be a high return course for students with Certificate or Associate Degrees and Bachelor’s degrees.   On the other hand, the average highest annual earnings for those with Certificates or Associate’s degrees in the social sciences or humanities are lower than those without any postsecondary credentials.  “These results clearly show that two-year college credentials in career-related, rather than academic, fields may have the potential to raise earnings,” the study notes.

The study poses a pair of policy options:   “(1) increasing attainment of four-year degrees by high-performing low-income students; and (2) increasing attainment of certificates from two-year colleges by low-performing low-income students.”  The former is achieved by increasing the number of low-income students who perform at higher levels (i.e., achieve higher GPAs) and are college ready.  The latter is achieved by better informing them of the career options available to them. 

Out of five major impediments to increasing attainment of degrees and certificates, the study identifies lack of information about returns from postsecondary education and completion expectations as the primary reasons why more low-performing, low-income students do not enter two-year colleges to obtain certificates in high-return fields.   The other impediments are:  financial (lack of funds or cost of foregone earnings), experiential (lack of high school preparation and work experience), and motivational (lack of interest in pursuing certain careers).  The fifth impediment is institutional is lack of sufficient slots to accommodate employer demand. 

The study states that “the bottom line is …that low-cost informational services would be highly effective in increasing course completion, credential attainment and earnings,” but admits that “we do not know enough about all of the impediments and the cost-effectiveness of different ways to remove them to make definitive recommendations.   Thus, it would be worthwhile to determine the cost-effectiveness of removing informational and other constraints, especially those that prevent low-income students from attending two-year colleges, completing high return courses, and obtaining certificates.  The best evidence would come from demonstration projects that would assess informational and other deficits, deliver high quality assessments and counseling, and then determine how this information affected course selection and credential attainment.”

A copy of Pathways to Boosting the Earnings of Low-Income Students by Increasing Their Educational Attainment, Louis Jacobson and Christine Mokher, The Hudson Institute and CNA, is available on the website:  http://www.hudson.org/files/publications/Gates%2001-07.pdf

Education Critical in Expanding Access to Higher Earning Jobs

As the gap between the top earners and everyone else expands, the importance of “upgrading productivity, skills, and rewards in the service sector is the key challenge” according to a recently released report, Changing the fortunes of America’s workforce:  A human capital challenge, by the McKinsey Global Institute.  The goal of the study is to provide a “comprehensive, well-founded  explanation” for the phenomenon of income dispersion by examining its purported underlying causes, including free trade, outsourcing, immigration, technological change, immigration, and the decline of unions. 

As evidence of the income dispersion the report offers the following statistics:   between 1994 and 2005 household incomes of the top 10 percent of households grew at an average annual rate of 3.3 percent, “while incomes among the bottom 10 percent of households grew at an average of only 1.0 percent a year, and income growth for upper and middle income households was also moderate, at 1.5 percent to 1.7 percent a year.”  Ultimately, the study did not find a discrete or definitive cause of or “silver bullet” remedy to the increasing income dispersion.  Rather, it discerned that the road to not only the recovery from the present economic downturn, but to future economic growth should be for policymakers to focus on human capital.  Specifically, the focus should be on redevelopment of human capital, “not only for students in schools and colleges but across the current workforce.”

A key to understanding income dispersion is labor market institutions, which, according to the report, have been lax to respond to the shift from a manufacturing-based to a service-based economy that increasingly requires advanced skills.   The gist of the report is that for the past decade or so and up to the present, employer demand for certain workers is out of sync with the supply, even the oversupply, of certain other workers, citing that “71 percent of US workers are in jobs for which there is low demand from employers, an oversupply of eligible workers, or both.”  The paucity of in-demand advanced skilled workers drives up their earnings, while the oversupply of workers in ebbing labor markets drives down their earnings. 

McKinsey looked at which “drivers” had a positive or negative impact on incomes on workers in nine industry/occupation “clusters.”   Three types of drivers were identified, each with three components.  Demand drivers influence the demand for labor and include:  skill-biased technological change (SBTC), trade, foreign direct investment and offshoring (TFO), and organizational complexity.  Supply drivers influence the supply of labor and include: immigration, the aging of the workforce, and female labor force participation.  The components of institutional drivers, which refer to the institutional arrangements in the labor market are:  education, performance pay, or what the report termed “the superstar phenomenon,” and deunionization. 

The specific industry/occupation clusters were derived from the Bureau of Labor Statistics and paired industries and occupations based on similar income levels and employment characteristics.   The nine cluster categories were: (1) top earners – managers in high-growth industries and professional service professionals; (2) white collar workers – managers and professionals in a range of industries; (3) artists and farmers – managers in agriculture, mining and energy, educators in recreation, hospitality, and transportation, and entertainers; (4) front-line – core, non-tradable service workers in management, professional services, education and law enforcement; (5) speeding treadmill – core, non-tradable service workers, primarily educators and wholesale and retail sales; (6) automated away – mix or manufacturing production, administrative support, and repetitive manual jobs; (7) classic blue collar – predominantly manufacturing and production occupations; (8) semi-skilled servicers – mainly non-tradable, lower-skill functions in high-growth industries; and (9) low earners – low skill repetitive manual jobs and administrative support jobs. 

While a variety of “drivers” explained why the demand or income of a certain cluster or clusters grew or declined, education was found to be a positive driver for all the clusters.   And looking toward the future, the report states that “education is the most important mediator of future labor and supply and demand.  In light of the growing demand for skills, appropriate education and training plays a critical role in giving workers access to more attractive jobs.  Moreover, a shortage of American workers with the skills to fill the jobs fostered by new technologies and more complex organizations has meant that people with those skills have seen substantial income premiums.”

A copy of the report, Changing the fortunes of America’s workforce:  A human capital challenge, June 2009, is available on the McKinsey & Company, McKinsey Global Institute website: http://www.mckinsey.com/mgi/reports/pdfs/changing_fortunes/Changing_fortunes_of_Americas_workforce.pdf

President’s Council of Economic Advisors Finds Need for More Associates’ and Vocational Degrees

A July report from the President’s Council of Economic Advisors finds that careers requiring postsecondary educational attainment are expected to grow significantly faster than those with lower education requirements such as manufacturing and low-skill jobs.  The report, Preparing the Workers of Today for the Jobs of Tomorrow finds, “the fastest growth among occupations that require an associate’s degree or a post-secondary vocational award.”

While the benefits of a college degree are well documented—higher wages, more job security and in the current environment, significantly lower rates of unemployment—the new report is significant because it underscores the growing trends which play to the   strengths of the career college sector. 

The White House report reviews existing employment data from the Bureau of Labor Statistics and government forecasting to summarize and predict employment trends through 2016, when it states that the economy will resemble that of 2008, but with some important shifts.  Most notably, the healthcare sector will continue to represent a large percentage of employment growth.   Those positions requiring less than a bachelor’s degree will represent much of the growth, such as lab technicians, health information technicians and physical therapy aids.  “Health care support” occupations are projected to grow 48 percent in the years between 2000 and 2016.

Other important growth areas cited in the report include a resurgence in construction and rebuilding as the country moves out of the economic recession, resulting in increased jobs in fields such as electrical work and plumbing.   The Presidential advisors state that environmental-related occupations will expand over the next decade, citing a projected 52 percent growth rate between 2000 and 2016, compared to a 14 percent growth rate in all occupations.

Dr. Watson Scott Swail of the Virginia-based Educational Policy Institute says the White House report echoes what his group has found regarding post-secondary education.  “I think we have overblown some of the need for four year education in lieu of what society actually needs,” says Swail.    Swail’s research group finds that less than one quarter of all jobs today require a bachelor’s degree or higher, and he says that we as a society need to be a lot more realistic about higher educational attainment.

Dr. Swail says career colleges have an important role to play in filling the needs of the training the workforce for tomorrow’s jobs.   With their emphasis on career and vocational training and certificates that can be obtained in a shorter period, Swail says the career college sector should continue to grow and be recognized as an option for skills attainment, although its higher than community college tuition costs could remain something of an inhibiting factor.

The President’s Council of Economic Advisors conclude in their report that “there remain important limitations to our education and training system, many stemming from low completion rates, limited accountability, poor coordination among different programs and excessive bureaucratic restrictions on the use of training funds.”

U.S.Students Bested by International Peers in Some International Assessments

The National Center for Education Statistics has issued a new special analysis focusing on the performance of U.S. students in reading, math, and science.  The analysis compares scores of U.S. students with the performance of their peers in other countries that participated in Progress in International Reading Literacy Study (PIRLS), the Program for International Student Assessment (PISA), and the Trends in International Math and Science Study (TIMSS).

The PIRLS assesses the reading skills of 4^th graders, and TIMMS assesses math and science abilities in 4^th and 8^th graders.  PISA assesses the reading, math and science skills of 15-year-old students, and focuses on the OECD-member countries.    Worldwide, about one million students participated in the latest round of international assessments, with about 5,000 U.S. students participating from randomly selected schools across the country in each of the three assessments. 

The report identifies which countries have outperformed the United States in terms of students' average scores and the percentage of students reaching internationally benchmarked performance levels, and which countries have done so consistently. 

In some cases, U.S. students have lost ground on their assessment scores.  In the 2006 PIRLS assessment, the number of countries whose 4^th graders outperformed U.S. 4^th graders jumped from three in 2001 to seven in 2006.  While U.S. scores are staying roughly constant over time, some countries are improving. 

Dr. Stephen Provasnik, one of the analysts at the U.S. Department of Education who produced the report, says this is significant in terms of future capabilities of U.S. workers, in terms of how competitive they are, vis-à-vis international counterparts.

“Do these assessments say we’re getting more competitive with other countries? The answer is no.  While our scores have improved in some instances, the number of countries outperforming the U.S. has increased in reading, math and science,” says Provasnik.  “We’re not keeping up, competitively speaking.” 

In math, U.S. students scored above the TIMSS scale average on the 2007 TIMSS, and U.S. scores were higher than the respective U.S. score in 1995. However, fourth-graders in 8 of the 35 other countries that participated in 2007 (Hong Kong, Singapore, Chinese Taipei, Japan, Kazakhstan, Russian Federation, England, and Latvia) scored above their U.S. peers, on average; and 8th-graders in 5 of the 47 other countries that participated in 2007 (Chinese Taipei, Korea, Singapore, Hong Kong, and Japan) scored above their U.S. peers, on average.

“U.S. students are not doing any worse than before; in fact in math they are doing better, but in other countries students have improved more,” says Provasnik. “We are not improving as fast as other countries, and people can argue over the reasons for this.   But some countries like Germany have reformed their entire education systems based on the results of these assessments.”

The PISA scores paint a more striking picture. 

“In PISA 2006, U.S. 15-year-old students' average mathematics literacy score of 474 was lower than the OECD average of 498, and placed U.S. 15-year-olds in the bottom quarter of participating OECD nations, a relative position unchanged from 2003,” the report’s executive summary states.

Stated another way, students in 23 of the 29 other participating OECD-member countries outperformed their U.S. peers in math literacy. 

The 2006 PISA assessment scores yielded similar results in science.  Students in 16 of the 29 other participating OECD-member countries outperformed their U.S. peers in terms of average scores, putting U.S. students in the bottom third internationally in science scores. 

“TIMSS assesses what kids learn in school; things that are common across all countries, while PISA is a test of their ability to apply knowledge and skills,” says Provasnik.  “PISA contains more functional problems such as you might encounter in everyday life or occupations. In other words, TIMSS is what kids are used to seeing in school, PISA makes them stretch. So while U.S. kids are competitive at what they are taught in school, they are not as competitive, when it comes to applying that knowledge and skills, as many of their peers in the OECD.”

One reason why U.S. students appear to hold their own – although still fall below the top of the scale – in PIRLS and TIMSS assessments is that a broader swath of developed and developing countries are surveyed with these tools.  By contrast, the thirty OECD countries which administer PISA are developed nations, on par with the Unites States in terms of modernization and standard of living. 

Provasnik underscores that when it comes to applying knowledge and skills to tasks outside the classroom that have functional, occupational applications, U.S. students do not look as good as their peers in other developed countries.  Countries that have regularly outperformed the United States?   Korea, Singapore, Hong Kong and Finland stand out in all three subjects.  “Their students are scoring at the top in the world, and are now outperforming the U.S. on all three subjects.” 

Kennedy Leaves Legacy in Building a Competitive U.S. Workforce

Senator Edward Kennedy’s passing last week has been described in the national media as the “end of an era.” He has been praised for his work in support of civil rights, for fighting for equal pay for equal work, for defending the rights for the disabled, and for enabling access to higher education for the disadvantaged. 

As a longtime member and sitting Chairman of the Senate’s Committee on Health, Education, Labor and Pensions (HELP), Kennedy left a legacy which included considerable efforts to improve the workforce competitiveness of the U.S. middle and lower income sectors, with particular emphasis on access to higher education and expanding and safeguarding federal student aid funding.

“No United States senator has committed more of his time and his wisdom to the advancement of American higher education. Thanks to him, students across the spectrum have the opportunity to pursue their ambitions,” said Drew Faust, President of Harvard in December 2008, as the University bestowed an honorary degree to Kennedy.

Of the approximately 300 pieces of public law authored by his office in his 47 years of service, many impacted the landscape of higher education funding and access. 

Kennedy was considered the primary author of the Federal direct loan program and he conceived of and executed the compromise program which allowed students to choose between FFEL and direct loans.   He garnered bipartisan support for the compromise plan by the government, which was enacted by Congress and signed by President Clinton in 1993. 

Kennedy was a champion of raising Pell grant limits to ensure college access and affordability.   “Access to college was a huge issue for Senator Kennedy,” says Will Marshall, President of the liberal Progressive Policy Institute.  “Particularly as college prices rose, often outstripping inflation, he was indefatigable in creating a support system for middle class families and generally low income families through vehicles like Pell grants.” 

More recently in 2007, Senator Kennedy co-authored the College Costs Reduction and Access Act which authorized $23 billion increase  in student aid, the largest amount  since the GI Bill.  When President Bush signed the bill into law, Kennedy applauded the accomplishment, stating, “A college education is more important than ever – important to individual opportunity and important to our nation’s economic health.  This legislation shelters students and their parents from the turbulence in the credit markets so a student’s ability to go to college and pursue the American Dream is not blocked.”

Senators Kennedy and Enzi were also responsible for shepherding through the HELP committee reauthorization of the Higher Education Act in 2008, which took steps to simplify the FAFSA and expanded aid to low income students once again. 

PPI’s Marshall says another area Kennedy championed was national service.  “He was committed to the idea that we should expand opportunities for young people to serve their community and their country; and they should earn a reward to defray college costs for doing so.  Such a reward could be applied to any postsecondary training or professional training,” Marshall says.     

In May 2008, Senator Kennedy also passed the Ensuring Continued Access to Student Loans Act which increased the amount of low-cost federal loans available to students and gave parents of eligible students better access to low-cost federal loans (PLUS loans).

At his confirmation hearings in 2009, then Education Secretary-designate Arne Duncan praised Senator Kennedy’s involvement in passing the America COMPETES Act of 2006.   This bipartisan legislation was intended to help the U.S. remain competitive in the 21^st century global economy by increasing research investment and “strengthening educational opportunities in science, technology, engineering, and mathematics from elementary through graduate school.”

Will Marshall says that the Senator’s passing will leave a gap in general in the Senate, but that there are plenty of Democrats who want to expand access to college. 

“Tax credits and policies aimed at ensuring access for the middle class are a big Democrat focus.   It’s no longer just low income families that are having access problems.  The middle class is getting squeezed,” he says. 

Employer-Sponsored Health Benefits at Risk

Rising costs and the expectation of health care reform could be the perfect storm to change the rules of the game for employer-sponsored health insurance.

The amount of money workers and their employers contribute to family health insurance premiums in 2009 continues to significantly outpace inflation, forcing employers to make tough decisions about which employees are more likely to be offered the benefit.   Will the rising cost of health care coverage give more highly skilled workers a competitive advantage in the marketplace, and allow those workers that are in demand to have more control of their family’s health insurance options? 

A new survey of over 2,000 employers from the Kaiser Family Foundation and the Health Research and Education Trust finds that many U.S. workers will face a deterioration of employer-sponsored health benefits next year. 

The survey found that 40 percent of employers surveyed said they are likely to increase the amount their workers pay out of pocket for doctor visits. Almost as many said they are likely to raise annual deductibles and the amount workers pay for prescription drugs.

Nine percent of employers said they plan to tighten eligibility for health benefits; eight percent said they plan to drop coverage entirely. Forty-one percent of employers said they are "somewhat" or "very" likely to increase the amount employees pay in premiums -- though that would not necessarily mean employees would pay a higher percentage of the premiums. Employers could simply be passing along the same share of the overall increase that they are doing this year.

Report author and Senior Policy Analyst at the Kaiser Family Foundation Bianca DiJulio says it is significant that nine percent of respondents said they will tighten health insurance eligibility guidelines, which could mean restricting eligibility for coverage for certain levels of employees.  

According to Paul Fronstin, Director of the Health Research and Education Program at the Employee Benefits Research Institute, health insurance was historically offered by companies as a way to entice employees.   During World War two, labor was scarce, there were wage controls in effect and companies needed to attract workers using other means, so they turned to offering health coverage.  

“Today’s unemployment is almost 10 percent.   Being competitive in the labor market isn’t as compelling,” Fronstin says.  High unemployment, combined with highly skilled jobs being outsourced overseas and the skyrocketing cost of coverage could cause many U.S. employers to rethink the benefit all together, he says. 

“When health insurance benefits started, health care was cheap,” says Fronstin. “You didn’t have miracle drugs to lower cholesterol, bypass surgery, or MRIs. All the medical miracles that we benefit from today didn’t exist back then.   As a result it didn’t cost a lot.”  

One of the reasons employers never stopped offering health insurance is that there was no viable alternative.   Health reform could change that. 

“It’s the perfect setup to allow employers to get out of the health benefit business.   It will give them options as far as what they can offer,” says Fronstin.  “For the most part they [employers] don’t discriminate.  I think that health reform could push them in that direction.”

Fronstin believes health reform could allow employers to stop offering coverage, and give them more flexibility to attract the kind of workers that they want, either through offering more money or supplemental health care packages.   Much in the way pension plans have given way to 401(k) plans, which are more portable and not tied to a specific employer, health reform could create similar changes in health benefits. 

Experts Consider College for All

On September 17^th the Urban Institute in Washington, DC held a public agenda symposium on the subject of whether it is reasonable or even advisable to encourage all Americans to enroll in higher education. 

The panel discussion was moderated by National Public Radio education correspondent Claudio Sanchez, and included Jean Johnson, Executive Vice President of Public Agenda and head of its Education Insights division; Charles Kolb, President of the Committee for Economic Development; Robert Lerman, Urban Institute fellow in labor and social policy; and Paul Lingenfelter, President of State Higher Education Executive Officers.   Throughout the 90 minute forum, these individuals made presentations discussing the need for major changes in the way students are prepared in K-12 for higher education and the need for millions more students achieving degrees in order for the U.S. to remain globally competitive, as well as advocating different approaches to achieving success, including apprenticeships and career-focused education. 

Jean Johnson presented results from a recent study published by the Public Agenda which found that 75% of the general population strongly believes that no one should be denied a higher education because they don’t have the money for it.   Furthermore, more than half of respondents felt that college is essential to be successful in life.  Public school teachers, however, were found to harbor serious doubts about whether their students should continue on to higher education, with only one-third saying that they believe all students should go to college.  This statistic shows, according to the study, that there is a need for fundamental change in the way students are prepared for postsecondary education.  These changes include improving college readiness by focusing on remediation earlier in the K-12 experience, creating a tighter integration between higher education and K-12 institution, and focusing on innovation and greater use of information to better inform and prepare students for entering college and completing their programs. 

To emphasize the importance of improving college readiness, Paul Lingenfelter noted that for the U.S. to match other leading nations in degree attainment rates, 55% of adults must attain some form of college degree by 2025, but that we will fall 16 million degrees short if there is a failure to increase the current degree completion rate of 37.4% (as of 2005).   In order to raise this rate, Lingenfelter proposes that we must increase high school graduation rates, encourage adults who have some college experience to go back and complete a degree, and support those who have completed high school but have not attended college to do so and obtain a degree.  Lingenfelter emphasizes the importance of these rates not just from a globally competitive perspective, but on the basis that the least educated are the most vulnerable during economic downturns.   He notes that by 2018, 63% of all jobs in the U.S. will require some postsecondary education and training.

While not disputing the need for a skilled and competitive workforce, Robert Lerman and Charles Kolb questioned whether an academic-only approach is the best way to accomplish this.   Lerman advocated an expansion of apprenticeship programs in order to give practical on-the-job experience while students work towards their degree in their chosen field.  He cited multiple countries, including Australia, Switzerland, and the United Kingdom, where apprenticeships are widely used to provide skills training and make degree attainment easier.  In the United States, the federal government only allocates $25 million per year on apprenticeship programs.  Kolb emphasized that while all people can benefit from postsecondary skills, the overall investment needs to be worth the effort.

In the Q&A session following the panelist presentations, several members of the audience emphasized that a key area of focus on improving degree completion rates, as well as increasing workforce participation, is working on improving student attitudes in areas such as attendance, timeliness, and work ethic.   The panelists didn’t seem to have any specific answers on how to combat these problems, but all agreed that they were linked to the overall goal of improved economic competitiveness.  The issue of college costs was not a main focus in this forum, although it was emphasized as a hindrance to degree completion rates.    The panelists represented their views as part of an evolving debate on how to achieve the best results from a college education at the beginning of the 21^st century. 

Wealth Down; Poverty Up

Disturbing economic news from the Census Bureau:   Between 2007 and 2008, the percentage of Americans below poverty has increased; real median household income and real per capita income have declined; and the number of uninsured Americans has grown.

These are findings of the 2008 annual Current Population Survey (CPS) conducted by the U.S. Census Bureau and reported in the September 2009 issue of Income, Poverty, and Health Insurance Coverage in the United States:  2008.

Coinciding with the recession, real per capita income declined by 3.1 percent for the total population and real median household income declined by 3.6 percent from $52,163 to $50,303 between 2007 and 2008.   Households of all races and Hispanic origin were affected by a decline in real income, albeit by different percentages and different income levels.  The decline experienced by non-Hispanic white households was the lowest (2.6 percent to $55,530) of all groups and the highest for Hispanics, whose income declined by 5.6 percent to $37,913.  Although the decline in income for African-American household was much lower than Asian, 2.6 percent compared to 4.4 percent, their income levels differed substantially, $34,218 and $65,637, respectively.  http://www.census.gov/Press-Release/www/releases/pdf/09_iph_presentation.pdf

As measured by other characteristics, few American households were spared.   The incomes of native- and foreign-born households, including those of naturalized citizens, declined.  Real median earnings of men and women who worked full-time declined, although not equally.    Male earnings declined by 1.0 percent to $46,367, and female earnings declined by 1.9 percent to $35,745.

With the exception of the Northeast, whose income remained unchanged, the real median income of the other three regions – South, Midwest, and West – declined. 

In terms of poverty, itself, in 2008, the official poverty rate increased from 12.5 percent in 2007 to 13.2 percent, which translated to 39.8 million people below poverty.   It has been nearly 50 years since there have been so many people below poverty.  http://www.census.gov/Press-Release/www/releases/pdf/09_iph_presentation.pdf  

The increase in the poverty rate was greatest for children under 18 years of age, from 18.0 percent in 2007 to 19 percent in 2008.   For people between the ages of 18 and 64 the poverty rate increased slightly from 10.9 to 11.7 percent, but remained unchanged for people 65 or older.  While non-Hispanic whites experienced an increase in their poverty rate from 16 million to 17 million, they represented 42.7 percent of the people in poverty but 65.4 percent of the total population.  Increases in the poverty rate occurred for both native and foreign born, inside and outside of principal cities, and in two regions of the country, the Midwest and the West.  For the other two regions the poverty rate was statistically unchanged from 2007 to 2008.

While the percentage of uninsured people remained statistically unchanged between 2007 and 2008, the number of people increased from 45.7 million to 46.3 million.   Both the percentage and number of people covered by private health insurance declined from 67.5 percent to 66.7 percent in 2008 and from 202 million to 201 million, respectively.  Conversely, the percentage and number of people covered by government health insurance, either Medicare or Medicaid, increased from 27.8 percent in 2008 to 29.0 percent in 2007 and 81 million to 85.6 million.  The number and percentage of children under 18 who were uninsured declined from 8.1 million to 7.3 million, representing 11.0 percent and 9.9 percent, respectively, which was the lowest rate since statistics have been compiled in 1987. http://www.census.gov/PressRelease/www/releases/pdf/09_iph_presentation.pdf

The Current Population Survey for 2008 was conducted in March 2009 of a sample representing the national civilian non-institutionalized population.   Members of the armed forces living either on or off base are included if at least one civilian adult lives in the household.

A copy of the report is available on the census bureau website: http://www.census.gov/prod/2009pubs/p60-236.pdf

Hot Jobs in the City: Push for Urban Renewal May Create Jobs

The Obama administration is initiating a revival of America’s urban centers by coordinating federal funding and local innovation which it says will transform cities into new, thriving centers of renewal and jobs.  To spearhead the effort, in April 2009 the White House announced the appointment of the White House Director of Urban Affairs, Adolfo Carrion, the first person to hold the position.

At a July roundtable on urban issues hosted by the White House, President Obama announced the first interagency review of how government invests in urban and metropolitan areas in the last thirty years.   The review will be conducted jointly by the Office of Management and Budget, the Domestic Policy Council, the National Economic Council and the Office of Urban Affairs. 

This cross-agency approach to urban policy is consistent with the administration’s efforts to break down siloed approaches and replace them with a holistic review which takes into account all aspects of metropolitan area needs. The White House will also take into account needs of entire regions – cities, suburbs and exurbs, in its urban development policies.

Revitalizing cities was an integral piece in the American Recovery and Reinvestment Act (ARRA) funding, signed into law February.   Over $13 billion was earmarked for projects administered by the U.S. Department of Housing and Urban Development, which has jurisdiction over government-controlled housing in many of the nation’s cities and urban areas.  HUD announced in May that it is making $100 million of that funding available to rid public housing of dangerous lead paint, for example. 

Much of the ARRA funding directed at HUD has an urban feel to it.   For example the “Green Retrofit” program will allow for window replacements and systems upgrades in multi-family buildings to make them more efficient.   While some may call these green jobs, others may see them as traditional brick and mortar construction trades.  However, the Green Retrofit could also fund things like upgraded roofing and solar-powered water heater installation, the department says. 

Harry Holzer, an economist at Georgetown University and the Urban Institute, and former Chief Economist at the U.S. Department of Labor, looks at the long term policy strategy of revitalizing America’s cities as an unknown.

“Some cities have been thriving in the last ten or 15 years.   They’ve adapted well to the international economy, and they tend to be mostly the highly educated cities.  But that wasn’t driven by policy.  Maybe a little bit, but most happened independent of policy,” says Holzer. 

The cities that were heavily dependent on manufacturing, which has since left, and haven’t replaced those jobs are suffering more, and there are some differences today in the jobs found in cities as opposed to suburban and rural areas, Holzer says. Cities tend to have a greater concentration of some service jobs, both at the high and low ends of the skills spectrum.   There are more restaurants, hospitals and law firms, for example, which require service skills. 

Holzer agrees with the White House plan to expand traditional urban policy to a more metropolitan approach, rather than strictly looking at the needs of the inner city. 

“You want to ensure that whatever jobs and skills training are available in the suburbs would be available in the city too,” says Holzer.   And, he adds, the suburbs aren’t all the same.

“One urban strategy would be ensuring that people in the city have access to good jobs and opportunity.   But people also need to get the skills and you need to have job placement.  Are one-stops [job placement centers] in cities going to help people get jobs in the suburbs, for example, if that’s where the better jobs are? There needs to be coordination.”

Holzer says the talk of green jobs and infrastructure jobs spurred by the ARRA are likely to be similar in the cities and outside of them.   However, construction jobs in cities may be less residential, more bridges and roads, for example. 

“The short term issue is going to be bringing any jobs to anyone, anywhere – replacing the ones we’re losing in the recession, then we will have the luxury of thinking about which jobs are going to which places,” says Holzer.   “It is hard to revitalize cities.  It’s hard to change the mix.” 

Still, the White House plan is an ambitious one, and one that Holzer says may benefit those mid-sized cities struggling to replace a manufacturing base that has evaporated in recent decades.

It Takes Cooperation and Coordination to Build a Healthcare IT Workforce

A  CEO Roundtable on building the health IT workforce, conducted last week on Capitol Hill, made clear that healthcare related technology gains require people skills for the most sought after outcomes, and it will take a concerted effort by the government, healthcare providers, and educators to make this match happen.  

Produced by CCA and TechAmerica, the roundtable forecast a “perfect storm” of challenges facing these groups in building the health IT workforce.   On the healthcare side, the United States is experiencing an increasingly aging population that is putting more demands on the healthcare system and a concomitant gap in the healthcare workforce, due to the retirement of healthcare workers.    On the IT side, speakers  indicated a shortage of IT workers in the aftermath of the IT bubble bursting a decade ago.  Then there’s the economy that continues to bleed jobs rather than generate new ones. 

Still, it is not all bad news.   In fact, according to the most current Bureau of Labor Statistics projections, healthcare and IT professions make up 15 of the 20 fastest growing occupations and three of every ten new jobs that will be created.   Roundtable participants indicated that a fully implemented healthcare IT system would improve quality, provide wider access, and reduce costs of healthcare, and this view is   shared by most American adults according to a poll released at the event.   One estimate of the cost savings of a fully implemented healthcare IT system is $88 billion over the next ten years.

The roundtable brought together representatives of the executive and legislative branches of the federal government as well as CEOs of healthcare provider systems, educational institutions, and healthcare information technology-focused associations.   Claire Shipman, Senior National Correspondent for ABC News, facilitated the event.  Featured speakers were:     Aneesh Chopra, Assistant to the President and Chief Technology Officer, Executive Office of the President; W. Stephen Love, CEO, Dallas Fort Worth Hospital Council; Linda Kloss, CEO, American Health Information Management Society; JoAnn Klinedinst, VP, Health Information and Management Systems Society; Harris Miller, President and CEO, CCA; Phil Bond, President, TechAmerica; Art Keiser, Chancellor, Keiser University; Duncan Anderson, President and CEO, Education Affiliates; and Geoffrey Brown, CIO, Inova Health Systems.

Putting into perspective the key role of a skilled healthcare IT workforce to the achievement of the healthcare IT revolution, Harris Miller, CEO and President of CCA recited a remark made former Representative Connie Morella (R-MD) when asked how things had changed since she no longer served in the U.S. Congress:   “Now I sit in the back of the car and it doesn’t go anywhere.” “Having technology without a workforce is like sitting in the back of the car, you don’t go where you need to go,” said Miller.  There was a consensus that promotion of innovations in healthcare IT has to go hand-in-hand with efforts to attract the necessary number of people and to develop appropriate training and education programs.

Progress is being made.   Chopra said that the Administration is committed to harnessing technology to develop strategies to promote data exchange and other innovations in healthcare delivery, including provision of an adequate workforce.  The other panelists provided illustrations of this, such as creation of regional extension centers, incentives for innovation, and convening a healthcare IT standards committee focused on promoting the idea of “meaningful use” of technology rather than simply its acquisition.  Without meaningful use, technology serves as a paperweight, Chopra said, recalling a popular cell phone commercial. 

The Roundtable also include remarks by Rep. Allyson Schwartz (D-PA), who introduced the E-prescription legislation, and said congressional action will not stop there.    It is well understood, Representative Schwartz added that the current healthcare system is fragmented and not as effective as it should be and to make it more effective through healthcare IT, it will take a workforce made up of different levels from those who design the software to those who implement it.   Incentives,  she said, are needed to make this happen.  Part of the stimulus package Congress appropriated includes $19 billion for healthcare information technology. 

One panelist described health IT as having three dimensions: an adequate specialized HIT workforce of persons skilled in using and managing healthcare information technology, IT competency for all health care provides, and IT literacy of healthcare consumers but stressed that building a specialized healthcare IT workforce is pivotal. There were many aspects of building a healthcare IT workforce that were discussed, such as making people aware that there is a need for an HIT workforce, and that there are a variety of jobs available with which the public may not be familiar. The government has a role to play by providing incentives through programs such as the Work Investment Act program, which enables state and local officials to establish broad-based labor market systems using federal job training funds for adults, dislocated workers and youth.   Healthcare providers and schools must also do their part in getting the message out.

Several concerns also were voiced about barriers to building the workforce, such as protectionist policies of certain healthcare professional groups that limit the number of new entrants into the profession as well as new programs and state-based licensing policies.   There seemed to be consensus, however, that these concerns should not stifle or impede what Chopra referred to as the movement to capture the imagination about the use of technology. 

CCA and TechAmerica will be conducting a second CEO Roundtable focused on healthcare IT in Austin, Texas on November 17.