The Future of Healthcare in the U.S.
Despite the national focus on the flaws of the American healthcare system, Art Jones ’67 offered a more nuanced understanding of the topic with his presentation. “The Future of Healthcare in the U.S.: The Good, the Bad and the Ugly,” in which he critically evaluated healthcare through the distinct yet interwoven lenses of science, economics and politics.
Before delving into this complex and multifaceted debate, Jones handed out an extensive bibliography of his sources, encouraged each member of the audience to seek out “multiple sources from multiple views” and emphasized one of the underlying themes of his talk: “Perspective and perception are important.” Indeed, political leaning often influences what constitutes a good healthcare policy.
Jones briefly identified “the good” in our healthcare system: precision medicine. This approach to disease treatment and prevention is extremely individualized, taking into account the variability in each person’s environment, genetics and lifestyle for personalized care. As remarkable as this may sound, “the bad” in U.S. healthcare frequently eclipses precision medicine’s benefits.
It’s no secret that the astronomically high costs of healthcare are continuing to rise, but Jones contextualized this knowledge even further. “We spent $3.2 trillion on healthcare in 2015. We’ll pass the German economy in healthcare expenditures in the next few years,” he explained.
But it gets worse. Not only do we have the most expensive medical care system in the world, but we also are ranked 28th by outcomes, meaning that the U.S. healthcare system provides “worse-than-average outcomes for 15 out of 23 different indicators.”
Jones admits that there is no perfect system, but there is still hope. “How do we control costs? Keep people as healthy as possible with preventative medicine and public health, provide medically necessary services, provide services in the most efficient way possible—don’t duplicate services—and avoid costly mistakes.” While clear steps forward such as these are in sight, Jones noted, “This becomes more difficult as our society becomes more polarized.”
I Play One on TV
“Antique,” by the nature of the word, implies a certain outdatedness. However, in discussing his career as an appraiser of such relics, John Nye ’87 made clear that there is significant demand for such antiquities, and modern inventions such as the internet play a significant role in augmenting the market, offering these artifacts to buyers from around the globe.
Nye specializes in furniture, but opened with a story describing a painting he auctioned at an estate sale, one that initially appeared to be, as he described, “remarkably unremarkable.” The painting in question, which Nye admitted to nearly tripping over in the basement where it had been stored, opened with a modest starting bid of $250. However, this number quickly leapt into four, five and six digit sums, eventually landing on a winning bid of $870,000.
The three bidders who drove the piece into “telephone number prices,” Nye noted, sent in their offers over the phone. Before the winning bidder got off the line, he revealed that the painting, previously unidentifiable, was in fact an original Rembrandt, one in a series of five paintings that the Dutch Master completed as a teenager. While certainly an unexpected twist, Nye explained that the tactic of phone bidding is not uncommon. Rather than attend auctions in person, serious buyers conduct endless hours of research on the internet until they find precisely the right piece. By scouring hundreds of sites and placing bids remotely, buyers are, as Nye suggested, “Taking the regionality out of the regional auction house.”
Nye closed with a brief discussion of his career as
, eliciting a plethora of questions from the audience. As a final piece of advice to the would-be furniture sellers among the crowd, Nye offered his thoughts on preserving antiques, stating candidly, “If you like it, use it.”
A Life In Politics
Former Iowa Governor and former U.S. Secretary of Agriculture Tom Vilsack ’72 provided an insider’s look at Washington, D.C. in the Alumni College “A Life in Politics.” Vilsack solicited questions from the crowded and spent the next hour addressing these queries.
Vilsack discussed his experience as the designated survivor during the 2012 State of the Union Address. After Vilsack was told to miss the speech, he was taken to what he described as an “underground city” before President Obama left for the Capitol to give the speech. For the duration of the address, Vilsack received identical security coverage to the president, and would, were there an attack on the Capitol which exterminated the president and his cabinet, guarantee the continuity of government.
To Vilsack, this responsibility represented the confidence President Obama had in him and his capabilities, a notable endorsement. “If you are going into one of these jobs, you had better hope everyone in your past remembers you the right way,” advised Vilsack, citing as an example Tommy, his now-retired former boss who was called by the FBI during background checks for Vilsack’s 1999 Secretary of Agriculture position. Vilsack had worked with Tommy for a brief period at a Mobil gas station over the summer of 1970.
Inevitably, this discussion of government turned to President Trump, addressing the causes for the Democratic Party’s failure in the 2016 election, and the skepticism of some of the Trump administration. Vilsack believes the Democratic Party failed to present a broad enough economic message to attract rural American voters, leaving them vulnerable to Trump’s messages.
Vilsack stressed the importance of pacing when executing change in government, using the Obama administration as an example of a system which does “too much, too fast, too soon.” Though Obama may have been overly ambitious, Vilsack predicts the opposite for Trump, who he does not believe will serve his full four-year term. “Government is not a business. You cannot try to run government like a big business,” said Vilsack.
Finally, Vilsack predicted the problem he foresees polarizing future politics, the issue of whether health care policy and food policy is a right or a privilege. Though the future of government appears complicated, Vilsack has found a sort of silver lining: “I think the new administration is going to help with the partisan divide,” he said, to laughs from the audience.
Solar at Home
With an obvious passion for helping bring clean, renewable energy to interested homeowners, Doc Bagley ’77 provided a comprehensive and engaging overview of solar options during his Friday presentation, “Solar at Home.” Bagley, who has worked in the industry for more than 16 years, began his presentation by explaining that enough sunlight reaches the earth’s surface every 88 minutes to meet the world’s power requirements for a year. “It is imperative that we continue to focus on healthier, more sustainable forms of energy,” he said.
Bagley launched into all the details that a homeowner would need to consider in deciding to switch to solar power. His capacity audience of attentive “students” asked frequent questions as he reviewed costs, mounting systems, sizes, durability, utility company power exchanges, rates, tax credits, helpful websites, financing, major vendors, and how Google Earth is employed in determining solar energy availability.
The Greatest Philanthropist in the World
The Class of 1967 kicked off their Alumni Colleges with Professor Robert Paquette’s presentation: “The Greatest Philanthropist in the World” in which he told the story of Gerrit Smith, a member of Hamilton’s Class of 1818 and a leading abolitionist and philanthropist in America.
For many audience members who had completed their formal education 50 years ago, the way in which Paquette provided a thorough understanding of Gerrit Smith’s role in the abolitionist movement was a delightful surprise. Paquette expertly incorporated a diverse range of sources to share an extraordinary amount of knowledge. He complemented his own evaluation of Smith with newspaper articles, portraits, letters, modern-day photographs and handouts for the audience to illuminate largely unknown anecdotes, facts and interpretations.
But for members of the Hamilton community who already knew Paquette, his ability to present critical analysis with enthusiasm, clarity and wit should come as no surprise. Paquette, who began teaching American history at the College in 1994, has earned many prestigious awards for his extensive research on the history of slavery.
As one example of many, “Gerrit gave hundreds of thousands of acres he owned in the Adirondacks to foster a community of poor African Americans from New York City to achieve land-owning status because only with a certain amount of property could they vote.” Later, he provided funds for a blacksmith who made pipes in order to arm slaves. In short, Paquette said, “Much is owed to the philanthropy of Gerrit Smith.”
Just as he intertwined a wide variety of sources in his presentation, Paquette also tied Smith’s narrative to the lives of other key players in the abolitionist movement, such as Hamilton College’s first president, Azel Backus, Beriah Green, John Brown and Frederick Douglass. His college education and relationship to Hamilton, however, also shaped Smith’s life-long of philanthropy and abolitionism. “The education that Gerrit got at Hamilton College served him very well,” he stated, resulting in his impressive moral and historical legacy.
Write What You Know, Make Up the Rest
After graduating from Kirkland College with a degree in fine arts, Susan Bickford ’72 moved across the country, settling in Silicon Valley to forge a career as an executive at a technology company. Approximately 10 years ago, however, Bickford found her interest in the world of computer graphics and animation begin to wane, inspiring a renewed attempt at fiction writing. Though still employed as an independent consultant, Bickford has allowed writing to become her primary focus; her debut novel, A Short Time to Die, came out earlier this year.
Bickford returned to Hamilton to discuss her writing process and sources of inspiration for an Alumni College, “Write What You Know, Make Up the Rest.” Though she began her career in writing rather recently, the idea for A Short Time to Die has been percolating in Bickford since she was a teen. During her freshman year of high school, two members of Bickford’s class were brutally murdered, and their assailant never found. Years later, the tragic incident inspired Bickford to create Marly, the protagonist of A Short Time to Die, a young woman in mortal danger who must fight to get away.
While visiting a former Kirkland professor, Bickford, who was then in the process of completing the first draft of her soon-to-be book, gave the preliminary chapters of the novel, previously titled Charon Springs, to her professor. “Tell me what’s wrong, not how to fix it,” said Bickford of collaborative editing. After review, the professor suggested Bickford read the work of Alice Munro, an author whose work is imbued with a strong sense of place. As would a student, Bickford researched Munro, and worked to apply Munro’s spatial tactics to her own expanding work.
Despite having taken a multi-decade hiatus from writing, Bickford, using the skills shaped during her time at Kirkland College, was able to successfully reenter the craft, publishing, after nearly two years of work, her first novel. “If you’re a good communicator, you can make it in any business,” Bickford said. She is currently working on her second novel.
Modeled on the “Ted” series, the “Alex” talk is a short-form speaking series, giving the speaker approximately 10 minutes to deliver a message that is both highly individual yet also universally relevant. Five Class of 1992 alumni joined forces in the Barrett Lab Theatre, each giving short presentations on their areas of expertise.
spoke about his work with augmented reality at the MIT Media Lab. Unlike virtual reality which places the participant in a totally new visual space, augmented reality digitally overlays electronic information onto the seen world, placing in real space things invisible to the naked eye. Werner noted that augmented reality is still in the development stage but predicts it will be at the forefront of the next wave of computing, having already proven its usefulness in medicine, education and retail.
Next, Brian Chiappinelli presented “Investing for Impact: Your (Investment) Role In a Sustainable Economy.” Chiappinelli advocated for the widespread employment of ESG investing, a philosophical approach to equity investing in which environmental, social, and governance factors are considered to determine the ethical impact of an investment. In the move toward a more sustainable economy, Chiappinelli urges the modern consumer to do more with less.
In keeping with the theme of philosophy, the next speaker, Susie Price, discussed the process of mourning, and the many forms it takes. After her husband, Travis, died of cancer, Price was left to grapple with this new, unsought absence in her life. It was during this time, while surfing, that Price came to an important realization: that one must first let go in order to gain control.
Pia Fenimore, a pediatrician, spoke next, comparing various child health statistics to determine what sort of role Generation X is playing as parents. When it comes to the life expectancy, high risk behavior, and graduation rates of their children, members of the Class of 1992, in general, are more effective as parents than their own were. But in terms of happiness, Gen X is failing, an issue Fenimore explored further.
Finally, Jim Rushton provided some “cool M&Ms,” pieces of advice gathered throughout the course of his career in sports radio and marketing. Rushton tracked the course of his career from college graduation to present day, describing each stage, and the learning that accompanied it.
Healthcare In America
In a talk moderated by Scott Allocco ’82, four medical professionals from the Class of 1982 discussed the transition from Obamacare to Trump care, focusing throughout on the influence of the opioid epidemic. Allocco opened with a brief overview of the current U.S. healthcare system in order to put the post-Trump change into context, outlining systems such as Medicare and Medicaid. “As you all know, healthcare reform is really easy,” Allocco said jokingly. The panel also included Anthony Manson, a digital healthcare strategist, John Chatas, an anesthesiologist and pain specialist, and Marina Goldman, a nurse practitioner.
The group discussed the repercussions of Trump care, and the future of healthcare following a return to a free market system. With the institution of Obamacare, it became illegal for healthcare companies nationally to discriminate against patients with preexisting conditions. Companies could no longer cherry pick healthy customers and refuse access to the sick. Soon, however, changes brought on by Trump may cause the system to revert to its discriminatory roots.
The conversation then moved to the topic of the opioid crisis, raising the question of whether opioid addiction should be considered a preexisting condition or not. After Pharma companies instituted the smile scale of pain, patients became universally more aware of their pain, which led to an increase in pain medication prescriptions. This would, as Allocco and his peers suggested, point to some culpability on the part of the drug industry, which fed the U.S. population opioids without properly advertising their dangerous qualities, for the rise in addiction.
“In medical school, we were all taught to treat pain to zero. We are realizing now that this may not be the best system,” Chatas said to nods of approval from his peers. The bulk of the opioid issue, Chatas believes, stems from inadequate training and a fundamental misunderstanding about the misuse of medication. Physicians naively place too much trust in their patients, prescribing unhealthy quantities of dangerous medication without properly screening the recipient for misuse or performing a necessary psychiatric evaluation.
Academic Freedom on Campus
Despite a filled auditorium, Henry Kaufman ’67 seamlessly transformed his presentation, “Academic Freedom on Campus in the 21st Century,” into a thoughtful and incisive conversation with the audience. His discussion of free speech on college campuses encouraged free speech from attendees, many of whom had not set foot on campus for 50 years.
For more than three decades, Kaufman has been regarded as a national leader in publishing and media law. His current practice focuses on a range of First Amendment legal issues and often takes institutions of higher education as clients, making him an ideal speaker for this topic. Over a decade ago, he used his First Amendment expertise to counsel Hamilton’s former President Joan Stewart and the Board of Trustees regarding the Ward Churchill controversy. With his overview and evaluation of the past 50 years of academic freedom controversies which persist as points of national debate, Kaufman once again used his extensive legal experience to benefit the College.
“I’m going to challenge you and myself,” Kaufman said. “What would we say to President Wippman about how we should deal with the next academic freedom crisis at Hamilton?”
From this starting point, Kaufman spoke to members of the audience with transparency and insight: “My point of view is that we should decide [how to approach academic freedom] in advance rather than waiting and cleaning up a disaster after.” Furthermore, he explained, “I love the right to protest. I don’t love what we call in the trade ‘the heckler’s veto’. Is there a conversation or exchange of ideas that is so beyond the pale that it deserves to be suppressed—and be suppressed by those who are most upset?”
Kaufman then complicated the debate further. “I have a question for all of you: how do you marry the principles of diversity and free speech on campuses in general and at Hamilton in particular?” This seems to be one of the greatest contentions in present-day academic freedom controversies, prompting audience members to chime in with their own comments, questions and suggestions.
“I haven’t given you a solution,” Kaufman said, instead concluding his discussion with a crisp, compelling aphorism: “Freedom of speech sets everyone free.”
The History and Future of Cybersecurity
“Is a hackerpocalypse preventable or inevitable?” Ward Urban ’82, P’18 asked in his presentation, “The History and Future of Cybersecurity.” In answering this opening question, Urban provided a disquieting glimpse of the current cybersecurity threats facing everyone in cyberspace.
Cyberspace, Urban explained, “is an all encompassing environment that we live in today.” When we’re connected to networks via the Internet—which occurs frequently—we’re in cyberspace. He continued, “We’re going to be even more connected and dependent. The problem is that we’re going to be very vulnerable. There are a lot of benefits of this, but that could all be compromised and is being compromised.”
Cyberhacks, which can take myriad forms like malware, ransomware, network attacks and more, threaten network confidentiality, availability and integrity. Starting with an overview of the history of hackers’ cyberattacks from 1986 to 2016, Urban demonstrated the frequency of cyberattacks and the degree to which they harm consumers and businesses. “Cyber risks are growing and widespread,” he noted. Indeed, over 4.2 billion cyber incidents were reported last year alone.
The harm from such incidents are on the rise, too. Urban cited that the total costs of global cybercrime from stolen money, intellectual property and data, as well as damaged or destroyed productivity, files and reputation, are predicted to increase up to $6 trillion a year by 2021, according to Cybersecurity Ventures.
“This isn’t meant to be discouraging, but sobering,” Urban assured audience members. Despite this dire situation, with its high stakes and constantly evolving technology, Urban is “optimistic that the good guys will win” in the cyberwar. According to him, preventing a hackerpocalypse will depend on collaboration between the government and private sectors to invest in cybersecurity products and services. Given such investments and cooperation between the public and private sectors, Urban concluded, “the advantage should be to the good ‘white hat’ actors against the ‘black hat’ hackers.”