Big Pharma Disease Mongering?

Can’t say I’m surprised by this.  Related to that, if you work in an academic setting, you'll find plenty of students who suddenly are able to find a health care professional to diagnose them with a "learning disability" requiring "accommodation" (and medication - amphetamine stimulants - in many cases) once they fail some classes.  Interestingly, the same students who were straight-A students as college undergraduates mysteriously develop a "learning disability" in their early-mid 20s (or later) once they have problems with difficult courses in some sort of post-graduate education.

The pharmaceutical industry’s image has been significantly damaged in recent years as the public discovered the role its aggressive marketing played in fueling the opioid epidemic. But the American people are still largely in the dark about what may be pharma’s most effective tactic for pushing drugs — marketing diseases.

There’s a substantial body of medical literature dating back to the early ’90s about the practice known as “disease mongering.” Pharmaceutical companies regularly pathologize everyday experiences, convince doctors that they are serious problems, tell a hypochondriacal public it needs help and offers the cure: a new drug. Against the onslaught of billions of dollars in marketing campaigns each year, however, researchers’ warnings about these tactics have gone largely unheeded…

 …“Marketing for a drug can start seven to 10 years before they go on the market. Because it’s illegal to promote a drug before it goes on the market, what they’re promoting is the disease. That’s not illegal to do because there’s no regulation on creating diseases,” Fugh-Berman told Yahoo News.

Lisa Schwartz and Steven Woloshin, co-directors of the Center for Medicine and Media at Dartmouth Institute for Health Policy and Clinical Practice, said disease-awareness campaigns may seem caring or educational but are often just marketing in disguise. The campaigns often follow three basic steps: lower the bar for diagnosis, raise the stakes so people want to get tested and spin the evidence about a drug’s benefits and risks. These steps were seen in campaigns on testosterone deficiency, bipolar disorder and restless leg syndrome…

…Fugh-Berman recalled taking an online test with her coworkers at PharmedOut, a group she directs at Georgetown that exposes pharmaceutical marketing and promotes evidence-based prescribing. The test on pseudobulbar affect (PBA), which manifests when specific brain damage leads to laughing or crying that is inappropriate and unconnected to a person’s emotions, suggested that normal human expressions could be signs of PBA with questions like “Do you ever find things funny that other people don’t find funny?” and “Do you cry easily?”

“Almost every woman failed. Only one woman passed. Most of the men failed, but more of them passed. I would say that anyone who passed the test I was actually worried about,” Fugh-Berman said…

… “I feel that there are people involved in creating new diseases and promoting drugs that aren’t really needed who are pretty amoral. Their measurement of success for themselves is strictly sales,” Pearson said. “There are good-spirited and good-hearted people in companies who are proud of developing something that provides help to some people — and then their marketing department gets ahold of it and turns it into something else.”

Rising Collge Tuition

Related to this post, we read this article about rising college tuition and what you can do about it.  Note the part about “amenities.”  Providing such fluff is not only an incentive to draw students in, it is also a justification for the rapidly proliferating administrative parasites.  After all, why does a college or university require 10,000 deans (slight exaggeration) and more “student affairs” personnel than there are grains of sand on a beach (another very slight exaggeration)?  To provide those “amenities” and “enrich the student experience.”  It’s not only the “student experience” that is getting “enriched,” that’s for sure.  And the article touches upon another issue: education inflation; today, a college degree is required for jobs that in the past required only a high school diploma.  Eventually, one will need a PhD, MD, or JD for even the most mundane entry-level job, and then even that won’t be enough.

The cornerstone article may be useful to you, so take a look.

Why Not Adjunct Administrators?

At left, is that an academic administrator? 

By http://phil.cdc.gov/PHIL_Images/20031208/87d4bff74e41427cb278526bd9cbe76a/5260_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=776561

Following up on this and also on this, I ask: why not have adjunct administrators?  Well, other people have already written about this.  See this summary:

Rather than fill universities with adjunct instructors, why not replace them with adjunct administrators?

Most of the growth of university costs comes from administrative bloat. Non-faculty staff has grown at more than twice the rate of instructors – you know, the people who are the ostensible reason a university exists. As tenured professors retire, administrators kill those tenure lines and replace them permanently with part timers. Administrators do this so they can gorge on a higher salary while demanding more from the refugee ration-packet salary of academics. Think I am not being generous? Some administrators earn $300,000 a year to fundraise for new football stadium skyboxes. Vice Presidents at the University of Maryland saw their salaries increase by 50 percent between 1998 and 2003, as faculty positions were slashed. All the while adjuncts try to get by with the help of Medicaid or food stamps.

Worse of all, administrators isolate themselves from students behind security doors but meddle more and more in faculty and student lives.

Indeed.  A problem is that hiring and “cost-cutting” decisions are made by administrators themselves. Guess whose positions they have an incentive to protect?

Rent-seeking behavior, anyone?

The same principles apply as to why we have outsourcing and H-1B job replacement for workers, but not for management (or lawyers, economists, politicians, mass media, etc.). Economically, it's always easier for administration (of all types) to focus on the mote in the worker's eye than the beam in their own.

Dismantling academia, part II: the parasites

This post is a sequel of my research on how the U.S. academia is being demolished.

As we have already established, according to major school administrators around the country (including the former president of Stanford University), the major reason for the high college tuition is the overblown salaries of the faculty.

The solution? Remove faculty from the equation – or at least keep them at the bare minimum. Instead of full time faculty with benefits, the higher education institutions should employ adjunct faculty and teaching assistants without benefits.

Whereas these declarations have been made public only recently, the process of switching to adjuncts has been undergoing for decades. The adjunct faculty are now the majority of the higher education instructors in the U.S.

More than 50% of all faculty appointments are part-time.  According the Association of American Association of University Professors: 
 
“This includes positions that may be classified by the institution as adjuncts, part-time lecturers, or graduate assistantships.

Many faculty in so-called “part-time” positions actually teach the equivalent of a full-time course load.

Over one-fifth of part-time appointments are held by graduate student employees, whose chances of obtaining tenure-track positions in the future are increasingly uncertain.

To support themselves, part-time faculty often commute between institutions and prepare courses on a grueling timetable, making enormous sacrifices to maintain interaction with their students.
 
Since faculty classified as part-time are typically paid by the course, without benefits, many college teachers lack access to health insurance and retirement plans” 
 
According to online records, an adjunct professor is paid $3,500 for an entire course. So, why would anyone take on this type of work that is so exacting, requires so much effort and investment of time? 

I just watched a documentary about poverty in America, and one of the featured guys was explaining that as a head busboy he was making approximately $11,000-12,000/year. This income probably does not include tips distributed among the service staff. So, instead of teaching four huge courses in nine months, why not work as a busboy or barista in Starbucks?

It might be that in some places around the country, adjuncts are paid a bit higher for a full load of teaching. Thus, according to this website, the median pay for adjunct professors is $30,000/year; whereas the average salary for all secondary / higher education lecturers / associate / assistant professors is $65,140. Obviously, our administration can save good amount of money by switching to adjunct teachers.

Are there any consequences?

According to online research, this trend damages student learning (the adjuncts do not even have offices in the colleges), faculty governance, and academic freedom (the protection of tenure is gone, so if you are not tenured, and even worse - you are an adjunct, watch your mouth and keep your opinions to yourself).

Meanwhile, no one has tried to compare the salaries of the adjunct educators to these of the administrators. But here they are, I could not find one administrator position that is paid less than $45,000. Most salaries are six figures. 

Most of the administrator positions in the past were created to help faculty fulfill their functions as educators. Today, faculty serve the administrators.  And the administrators are self-propagating.  By the way, these are the defining characteristics of any parasite, look it up in a biology textbook:

"an organism that lives in or on another organism (its host) and benefits by deriving nutrients at the host's expense"

Dismantling Administration

 Representative of a typical administrator. By Source, Fair use, https://en.wikipedia.org/w/index.php?curid=19854440

Related to this, take a look at this article. I’ll reproduce some parts of it, and then link to another article, and then make some comments at the end.

The number of non-academic administrative and professional employees at U.S. colleges and universities has more than doubled in the last 25 years, vastly outpacing the growth in the number of students or faculty, according to an analysis of federal figures. 

The disproportionate increase in the number of university staffers who neither teach nor conduct research has continued unabated in more recent years… 

…Universities have added these administrators and professional employees even as they’ve substantially shifted classroom teaching duties from full-time faculty to less-expensive part-time adjunct faculty and teaching assistants, the figures show… 

…Part-time faculty and teaching assistants now account for half of instructional staffs at colleges and universities, up from one-third in 1987, the figures show. 

During the same period, the number of administrators and professional staff has more than doubled. That’s a rate of increase more than twice as fast as the growth in the number of students. 

It’s not possible to tell exactly how much the rise in administrators and professional employees has contributed to the increase in the cost of tuition and fees… 

…But critics say the unrelenting addition of administrators and professional staffs can’t help but to have driven this steep increase. 

At the very least, they say, the continued hiring of nonacademic employees belies university presidents’ insistence that they are doing everything they can to improve efficiency and hold down costs. 

“It’s a lie. It’s a lie. It’s a lie,” said Richard Vedder, an economist and director of the Center for College Affordability and Productivity. 

“I wouldn’t buy a used car from a university president,” said Vedder. “They’ll say, ‘We’re making moves to cut costs,’ and mention something about energy-efficient lightbulbs, and ignore the new assistant to the assistant to the associate vice provost they just hired.”… 

...The ratio of nonacademic employees to faculty has also doubled. There are now two nonacademic employees at public and two and a half at private universities and colleges for every one full-time, tenure-track member of the faculty. 

Centralization has been promoted as a way to reduce costs, but Vedder points out that it has not appeared to reduce the rate of hiring of administrators and professional staffs on campus—or of incessant spikes in tuition… 

…“It’s almost Orwellian,” said Vedder. “They’ll say, ‘We’ll save money if we centralize.’ Then they hire a provost or associate provost or an assistant business manager in charge of shared services, and then that person hires an assistant, and you end up with more people than you started with.” 

In higher education, “Everyone now is a chief,” he said. “And there are a lot fewer Indians.” 

And if that is not enough, how about this: 

By contrast, a major factor driving increasing costs is the constant expansion of university administration. According to the Department of Education data, administrative positions at colleges and universities grew by 60 percent between 1993 and 2009, which Bloomberg reported was 10 times the rate of growth of tenured faculty positions. 

Even more strikingly, an analysis by a professor at California Polytechnic University, Pomona, found that, while the total number of full-time faculty members in the C.S.U. system grew from 11,614 to 12,019 between 1975 and 2008, the total number of administrators grew from 3,800 to 12,183 — a 221 percent increase. 

As a faculty member, I can attest to this. Faculty are downsized concurrently with a relentless expansion of administration and staff. Faculty are held accountable to how they spend every microsecond of their workday, and at the same time incompetent administrators have lower and lower responsibility and accountability as they rise in the academic hierarchy. 

The more administrators talk about “tight budgets” and “cost cutting measures”, the more administration and staff they hire, the more expensive out-of-state meetings they attend, the more of their buddies are invited to come and “train the faculty,” and the more fluff and nonsense they waste money on. Much of what administrators do is self-serving: they use the authority of their positions to the advantage of administration (of which they are part) at the expense of faculty and, above all, students (who have to pay, via tuition, for this bloated administrative infrastructure). 

What about the excuse that all these administrators are required because of the expansion of regulations? Guess what – more self-serving behavior. Who do you think are making up all these regulations? Academic administrators working for government and for accreditation agencies. Where do these people come from? Look at the situation in which people switch back and forth between government positions and corporate lobbyists – it is the same principle in academia. It’s the same general pool of parasitic, self-serving administrators that fill the academic administrative posts and also fill the positions in government and accreditation agencies dreaming up more regulations to justify even more administrative hiring. 

What about the “demands of students and their families?” If only those students and families understood how little the students actually benefit from a school having more Deans, Vice Deans, Associate Deans, Assistant Deans, Presidents, Vice Presidents and all of their respective staffs! That’s just another excuse…have you noticed that American academic performance continues to decline despite our expansion of ever-more administration to “help” “students and their families?” In the end, the administrators are not really helping the “students and their families” – they are helping themselves. And why are students ill-prepared for college in the first place (one excuse often cited for hiring more administration)? One reason is that these scenarios play out at the public school level as well; anyone who has a child in American public schools understand how much time is wasted with non-academic fluff at the expense of a rock-solid education.

If all of this administration could be justified by the fact that American education was a well-oiled machine that would be one thing. But that’s not the case. The administrators ultimately cause problems requiring hiring even more administration to fix. Work creating even more work, a feedback loop that will continue until colleges end up having more administration and staff than they do students (faculty have already been out-numbered long ago). It’s like a metastatic cancer and it can only end up by killing off the host. 

Solution? Faculty and students need to form an alliance to promote the best interests of their institutions and the students who attend those institutions against the self-serving behavior of runaway administration. A stand needs to be made or the student-faculty foundation is going to crumble under the weight of the gigantic administrative superstructure, whose sheer mass is much-too-much to handle.

Dismantling academia, part I

Whereas our identities will not be revealed until we are employed, it is not a secret that we hold academic jobs. My husband and I teach and do research. We interact with students every day. We try to impart useful skills and any piece of knowledge we have to our next generations.

However, academia, as we know it, is dying. It is disintegrating right in front of our eyes, and even we are unwilling participants in this process.

How is this happening?

First, there is very little money for research. If you are not highly published and high-visibility researcher today, you are lost. Your research ideas will never see the light, they will never be tested. Maybe in 20 or 30 years from now someone else will come up with the same ideas or may be not.  Countless sparks of creativity are lost today, every day.

Second, teaching in person is over. We will move all instructional material online.

Have you watched The 2015 Atwell Lecture: Stanford President John L. Hennessy? The talk focuses on the future of higher education, and follows the predictions of the honorable president. 

According to him, the students will enjoy short instructional modules of mixed media online and mini-quizzes. This online format may or may not be combined with flipped classroom activities. These are activities, in which students participate on their own - discussions of various scenarios, solving problems, creating small groups to analyze cases. 

This does not sound bad, right? However, when the president of Stanford states that all of these activities could be led by teaching assistants and adjunct faculty to save money, the predictions become sordid. 

The main reason to make these changes? Decrease tuition. Again - this sounds good (especially if you have a child headed for college). However, think about the fact that tuition has increased in the past 20 years, but the ratio faculty:students has not changed. Where does the tuition money go? The money goes to the ever-expanding administration in our schools.

The same administration is disassembling the academia, in order to decrease the payment to faculty, but not their own overblown administrative salaries.

Think about the impact: no academic jobs, no research, no real interaction between highly intelligent faculty and inquisitive students. 

Would the U.S. remain a leader in higher education?

PS
My husband decided to continue this topic in another post. 
I also decided to write PART II on Dismantling academia.

More thoughts and information on college tuition could be found here.