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Friday, September 17, 2010

What's The Worst That Can Happen?

Most people understand that irrespective of how bad things get they can still be thankful for being healthy and happy; "At least you have your health!" as the expression goes. Perhaps it seems odd, then, to suggest that it may actually be worse to be without one's insurance than to be without health.

As a child I rarely (if ever) had concerns with respect to my own health. I was typically happy and had most of my needs and (reasonable) desires met as our family was upper-middle class and my parents were fairly even-handed in their approach to parenting (i.e. fair in accommodating my sister and I so long as we took care of our responsibilities and behaved well). Playing soccer during the fall & baseball in spring and swimming during the summer ultimately meant that physical activity was part of my regular life. Aside from being diagnosed with an ear infection twice and gastroenteritis once I was able to avoid illness and even more serious misfortune (such as the all-too-common broken limb). As a child I was (of course) covered by my dad's health insurance and I only became conscious of the difference between an HMO and a PPO when my dad's employer decided to switch away from Kaiser in the mid-1990's.

Although it seemed somewhat odd to me that I would start having problems after turning 21 such was exactly what I experienced. The first incident occurred while playing basketball during a game of one-on-one with a friend in August of 2001: I found myself to have great difficulty breathing after an asphyxiation sensation and was unable to understand why such a thing would happen (the game was friendly enough and physical coordination, especially the type one would attribute to one's medulla, had never been an issue). Stranger still would be the diagnosis of "exercised-induced asthma" which was written into my chart after a visit to the doctor at the behest of my dad (who viewed the excess saliva production which I was exhibiting to be less a sign of a macho Texan and more indicative of the absence of health).

Over the course of two years I was prescribed Rhinocort, Singulair, Clarinex, Astelin, Albuterol, Flonase, and Advair. I was diagnosed with nose-boggy turbinates, a septal deviation, pediatric allergies to grass and cat dander, a nasal spur, anxiety, depression, gastroesophogal reflux disease (aka GERD), allergic rhinitis, and dyspnea w/exertion (aka exercise-induced asthma). During the course of those two years I visited various doctors offices over 20 times, and underwent an endoscopy, a barium swallow, a head CT scan, a body CT scan, a chest X-ray, a fiber-optic examination of my vocal cords, and had a needle stuck in my arm more times than Iggy Pop.

Perhaps its a philosophical question to ask whether a cancer diagnosis is to be expected after experiencing the same; nevertheless, it was without any particular expectation that on November 20, 2003 (my mom's birthday and two days before my own) I received the news that the previously-taken biopsy of a thyroid nodule on the base of my neck had come back positive and that I had papillary thyroid cancer.

How is it possible that it may actually be worse to be without one's insurance than to be without health? When I graduated from college (in August of 2003) I was forced to find health insurance of my own: the law at the time afforded coverage for individuals who were over 21 under a parent's plan only if the individual was not older than a certain age (23?) and was enrolled as a full-time student. Due the series of (mis?) diagnosis between August 2001 and August 2003 BlueCross/BlueShield (the provider of my father's coverage) rejected my application for individual coverage and my application to Kaiser Permanente contained no self-disclosure of any of the visits which had previously occurred. Although I was covered by Kaiser Permanente when I received my cancer diagnosis (and was thus spared what would most likely have been financial ruin as a result of the subsequent care which was required) my health has been challenged by what is typically a very treatable illness. In some sense the worst part is knowing that the entire ordeal can be attributed to an impetus to re-examine the rules which regulate health insurance coverage for recent graduates rather than taken for what it is (a transgression of human dignity and a failure of humanity).

Thursday, September 16, 2010

It's A World Gone Mad (With MBA's)

I recall that my dad once told me that engineering is the only profession where one works to put one's self out of business; a quick scan of the numbers at the Bureau of Labor & Statistics' website as well as 'census.gov' confirms the general vector of what he was saying.

To frame the numbers in the right context one should note that (of a population of approximately 300 million Americans) approximately 13% (i.e. 40 million people) are between the ages of 25 and 34; of those, 22.8% have a bachelors degree and 8.3% have an advanced degree. What's the breakdown of those degrees? Of the 600,000 graduate degrees conferred in 2006 ~150,000 were business degrees, ~170,000 were education degrees, and ~33,000 were engineering degrees.

The number of students enrolled in engineering programs are obviously higher with proportions for engineering students in B.S./M.S./Ph.D. programs reported as 475,000/120,000/29,000; of the students enrolled in engineering majors in 2006 only 115,00 were enrolled at doctorate-granting colleges. In 2006 there were 2,000 electrical engineering Ph.D.'s.; in contrast, there were ~15,500 M.D.'s and ~43,000 J.D.'s that same year.

The Institute for Electrical & Electronics Engineers (IEEE), which is the international professional association for "EE-types" like myself boasts 395,000 members and more than 90,000 student members. In the U.S., "IEEE-types" constitute only 0.25% of the workforce (~370,000 people) in almost equal proportions of electrical and electronics engineers (i.e. 153,00 electrical, 138,000 electronics, and 79,000 computer hardware engineers).

How has the picture for electrical engineers changed over time? In 1971 an electrical engineer could expect to earn ~$11,000/yr. and growth in the number of engineers over the last ten years has been ~6% (the lowest for any of the major engineering disciplines). According to The Economist, the growth in MBA's between '69-'70 and '06-'07 was 600% (21,561 to 150,211).

For additional perspective one should note that there are ~11 million cancer survivors in the U.S. with ~325,000 of those diagnosed at age 15 or younger.

Electrical engineers are a rare breed!

Wednesday, September 15, 2010

How To Stumble Out Of The Gate In The Greatest Race Of Your Life

Do a 1510/1600 SAT I, 760/800 Math IIC 750/800 Writing & 690/800 Chemistry SAT II, a GPA which is greater than 4.0 and a litany of extracurricular activities (J.V. swimming freshman & sophomore year, Model U.N. all four years with co-presidency status senior year, and marching/symphonic band all four years with junior drum major status junior year and drum major status senior year) have anything in common for a college applicant in 1997/1998? Maybe, but they still didn't merit electrical engineering admissions to M.I.T., Rice, & Stanford! Although the courses which I took were as challenging as our high school had to offer (i.e. honors courses in math, science, government, & english senior year and an honors science & honors foreign language course junior year) and my applications noted the courses which I took to supplement the education I received at our local public high school (i.e. the courses at the local community college during summers as well as the class at U.C. Berkeley senior year) the case which I made for admission was apparently not compelling enough: Stanford offered outright rejection (another academic who applied for an engineering admission during the early admission period was accepted), M.I.T. offered a spot on the wait-list which became a rejection a few months later, and Rice offered a spot on the wait-list which would require waiting until at least Spring '99 to confirm.

Although things looked bleak at the time (and for a few years thereafter) the "High School Honors Program (HSHP)" admission which I had received to U.C. Berkeley's L&S College late in my junior year provided some measure of security: my application for transfer to the College of Engineering (COE) was approved and I was able to enroll for the Fall '98 semester. The admission to the E.E.C.S. program was quite an honor as U.C. Berkeley's COE had done away with index scores the year before (when E.E.C.S. admission was rumored to have required a 7700/8000 index, the most of any major in the U.C. system) and had a reputation for being one of the best engineering programs in the nation (if not the world). While being a part of my class's freshman experience was a unique experience and valuable (from the perspective of affording an opportunity at social development which tends to be quite significant in American culture) the position in which I began my U.C. Berkeley experience was by no means ideal.

How can one say that having an HSHP admission (which afforded early, i.e. junior year, confirmation of admission) was not ideal? Well, it's not that the HSHP admission itself was not ideal but rather that the circumstances which were concomitant with the honor weren't consistent with what my qualifications had merited; as such, the HSHP admission (arguably) created additional complications with respect to admissions processes. Given my GPA and standardized tests scores the notion that I would not receive a Regents' & Chancellor's Scholarship was unfathomable; nevertheless, such was my fate both before and after appeal of the decision (a staff member in Sproul Hall hinted that preference for female candidates had been shown but my parents chose not to sue when I was told of the same). Also, one would not necessarily assume that involvement with the HSHP would somehow increase one's risk (or even certainty) for suffering a mistake such as AP credits (in my case a semester's worth) not being transferred to the COE but so also was my fate.

Why would such mistakes matter? As it turns out being a Regents' & Chancellor's Scholar entitled one to a few privileges which made the freshman experience just a little bit more livable, namely housing preference (which in my case would have meant not being housed in the dorm complex furthest from campus) as well as class enrollment preference (which wasn't so bad since the AP credit went missing for four semesters thus forcing the disorientation which came with enrolling in the 8AM offering of more than one required course). The course exam database which Regents' & Chancellor's Scholars are able to access might also have come in handy but given the fact that much of my first two years were spent struggling due to not having matching math and physics courses (e.g. Math 53 and Physics 7B) it's not clear what type of a difference such material could have made; after all, struggling with discomfort due to a distaste for dorm food and a schedule which doesn't quite suit one's preference doesn't make for the best precursor to success for the fifteen weeks which typically account for 1/2 of one's grade in a given course.

What type of difference do such experiences make? Ultimately not much, which is to say they don't make a positive impact in any regard. When one's graduation comes against the backdrop of a $1T loss of market capitalization in one's intended sector of employment (i.e. telecom) as well as implosion of a "bubble" in associated sectors (i.e. dot-com's) employability matters and it's very difficult to distinguish one's self to one's professors in upper-division courses when one is struggling to solidify one's foundation & footing.

When did some of these small perturbations in initial conditions finally come to a head? After doing a co-op in Spring '02 (in the hopes of compensating for an abysmal job market and struggling economy), resuming my coursework in Fall '02 and completing my last requirement (E190, technical communications) in the Summer of 2003 I was informed by the dean (after my having sent a letter of appeal) that I would be unable to use the Campus Career Center's On-Campus Recruiting (OCR) facility to find a job. Although fall semester use of OCR had been extended to spring & summer graduates in previous years the dean informed me that a decision had been made to not extend the same courtesy in 2002 due to improvement in the economy. Having to ask the dean to ensure that I received credit for my third attempt at course credit for Math 55 (after a failure to receive a response to the correspondence sent to my advisor before my enrollment posing a question with respect to the same) was simply icing on the U.C. Berkeley cake at that point. The milk (a denied request for a ninth semester) would only turn to sour cream six years later when I audited two upper-division E.E.C.S. courses and realized that success was indeed possible given a measure of circumstance which was amenable.

Where did the experience leave me? Hmmm... probably not at a point which one would call the best stochastic realization of what could have been a very simple process. Being unemployed for 14 months after graduation, getting diagnosed with thyroid cancer three months after being conferred with my degree, and having a transcript stained with letters which looked very different from the ones I had received on my high school transcript just a few years before was not what I had intended for myself. Ultimately finding work with IBM was pretty good... but realizing that I was on the wrong side of a Chinese wall at the research facility which stretched back in time all the way back to when I was barely ineligible to participate in the eXtreme Blue program was not. Getting a chance to attend graduate school at UH Manoa was also pretty good... but having the transcript of the academic experience reflect a regression of my previous experience is not.

Incidentally, since the time I graduated a number of changes have been wrought to the obstacles which I encountered in my experience at U.C. Berkeley:
  • Food at Unit 3 has improved significantly and is now considering premier as far as college dining goes
  • Math 55 is no longer the only discrete mathematics course which can fulfill graduation requirements (a new course, EECS 70, has been created)
  • The COE offers a five-year combined B.S./M.S. E.E.C.S. degree program
  • OCR eligibility has been extended to alumni who enroll in Alumni Advantage
  • My advisor (Linda Segars) retired
Who else should be so lucky?


Edits:

20100916@2205PST - Corrected "How can one say that having an HSHP admission (which afforded early, i.e. junior year confirmation, of admission) was not ideal?" to "How can one say that having an HSHP admission (which afforded early, i.e. junior year, confirmation of admission) was not ideal?
20100916@2205PST - Corrected "Ultimately finding work with IBM was pretty good... but realizing that I was on the wrong side of a Chinese wall at the research facility which stretched all the way back to when I was barely ineligible to participate in the eXtreme Blue program was not." to "Ultimately finding work with IBM was pretty good... but realizing that I was on the wrong side of a Chinese wall at the research facility which stretched back in time all the way to when I was barely ineligible to participate in the eXtreme Blue program was not.