A Taste of Their Own Medicine

...But much takes place that is by no definition disinterested, brilliant, or scholarly, and those activities frequently occur in public and make the newspapers...

...With federal money inevitably come attempts at federal control...

...Much disinterested and brilliant scholarship takes place in universities...

...That suggests to me that the fate of the universities ultimately depends upon whether the large intellectual class they house comes to understand the institutions of our society or continues to press for statist, central control in all areas but their own...

...Since it is true that government does not understand universities or the mode of abstract intellectual endeavor, it is important that universities make an effort to understand the nature of bureaucratic government...

...Americans spent $140 billion on health care in 1976, up from $40 billion in 1965, from $73 billion in 1970, up 19% over 1975...

...So it is that when our spokesmen talk of the scholarly ideal, the public thinks it knows better...

...But most of us would recognize the stopping point much sooner.than-would an equally intelligent person whose career is defined entirely by the single principle, and so bureaucracies thrust on past the balance point to produce results that are disastrous to institutions and processes that depend upon a balance of principles...

...In the discussion that followed this and the other talks, a prominent educator-administrator said government had to understand that university faculties were selected on the principle of excellence and that this principle distinguished professors from garbage collectors, whose selection, one gathered, may properly be governed on grounds other than excellence...

...It is not merely that we have failed fully to comprehend the great private institutions of our society--universities, corporations, the free market, and the like-but that we have not understood with any degree of sophistication the limits of government and the inherent and inescapable nature of bureaucratic regulation...

...There is, besides, a pleasure which is nonetheless real, even if perverse, in seeing elitist institutions scream when the remedies they have prescribed for others are applied to them...

...sexual equality...

...What we are witnessing is a more general political phenomenon in which government regulation expands to control the decisional processes of all institutions in the private sector and the effects of overregulation are quite as pernicious for other private institutions and, indeed, for state and local government...

...What may not be evident is why universities in particular have proved so vulnerable and why they have not resisted and do not resist more vigorously and effectively...

...I think both the diagnosis and the prognosis are quite correct...

...And each bureaucracy is specialized by principle...

...While university spokemen talk of the indispensable role of the university as the base for disinterested scholarship and impartial attempts to understand our world, the universities sometimes behave in ways that belie the image...

...As health costs go up dramatically, health benefits increase undramatically, and the result is increasing frustration both among those who pay the bills and among doctors and hospital administrators, who see no way of keeping costs down...

...These trends in ideas about society and government tend to produce what Robert Nisbet calls the twilight of authority, which is a decline in the authority and autonomy of institutions...

...This is not a counsel to despair, or at least it is not intended as such...

...The academic world, speaking generally, has been actively hostile to the claims of other nongovernmental institutions to autonomy in the name of greater efficiency that benefits society...

...It is also refreshing to observe that access is no longer the problem it once was...

...There is in much of the rhetoric coming from university leaders today a defensive note with an unattractive whining undertone, partly, one supposes, because they are aware that they seek an autonomy not granted to others and which many of them have vigorously opposed granting to others...

...None of these things are true...

...Twenty-five years ago, health costs represented 4.5% of GNP, in 1975 they were 8.3 % ; soon the figure will be much higher...

...Their ability to do so is considered their virtue, for we now regulate so many details of a complex society that our elected officials cannot begin to cope with the decisions that must be made...

...But lower-class Americans now visit doctors' offices as often as upper-class ones, and while the poor do not get as good care as the rich (in no country do they do so), they generally get as much care...

...Observe the popularity of S.t...

...That is true in part because of the higher costs government has forced upon the universities, but it would be true in any event because of higher costs and the inability of higher education to take advantage of 20 The Alternative: An American Spectator April 1977 management techniques and mechanization that are available to private industry...

...There was a time, it should be remembered, when it was believed that safety from a powerful state at the service of mass opinion lay in the strength of intermediate institutions, like corporations and universities, that could be relied upon to resist the intrusion of the state...

...It is demonstrable that government has come to believe in its own superior competence and morality and has as a consequence undertaken controls that have made economic markets and social processes work less well than they otherwise would...

...safety...

...Have the universities gained or lost in authority and autonomy in the last decade...

...Not long ago it would have been unthinkable for universities to harbor such turbulence and such destruction o f property and academic standards as we saw during the late 1960s...

...We seem to be courting that danger...

...General movements are influenced by innumerable small victories and losses over details...

...There is, therefore, every reason for educators to make their case publicly, to use such political influence as they can muster over the details of political regulation, and to try to educate the President, the Congress, the courts, and, perhaps most importantly, the federal bureaucracy about the ways in which universities work and the harm that is done to them as organisms by well-intentioned efforts to make them perform in ways that are perceived as fairer...

...Nor is it a counsel to abstain from all but the largest political efforts...

...This is the text of a talk he delivered at a conference on university-state relations, held last December at George Washington University and sponsoredby the University Centers for Rational Alternatives...

...Medicine, of course, is advancing, but few would contend that we are twice as healthy as 25 years ago, even though health expenditures take up almost twice as much of our income proportionally...

...The matters are now so complex that congressional oversight is defeated, and indeed the effort to follow the bureaucracy is now so far beyond the politicians' capacities that Congress has created enormous staff bureaucracies of its own to watch the other bureaucracies...

...The question why they have not is well beyond my topic, but it may be worth examining briefly some of the specific reasons why universities have proved both dociie and vulnerable to political and bureaucratic encroachments...

...Universities are thus seen not entirely as bases of dispassionate analysis but also in large measure as inculcators of political values, and political values of one type...

...Scientific knowledge, nutrition and public health, and pharmaceuticals have so advanced that today the major causes of premature death are accidents and diseases related somewhat Adam Meyerson is managing editor of The Alternative...

...The first and foremost expectation of government with respect The Alternative: An American Spectator April 1977 21 t o universities, the expectation that should override all others, is that they continue as independent institutions...

...It is, moreover, apparent to everyone that university faculties-particularly in the social sciences, humanities, and in the professional schools having relation to public policy--are, to greater or lesser degree, politicized...

...The Carter Administration has sensibly decided that before it makes any proposal for national health insurance it had better do something about medical costs...

...We may argue the wisdom of each of these decisions separately, but we have lost, in large measure through our own efforts, the indispensable presumption that the decision maker should be the institution concerned rather than the government...

...I was struck not only by the persistence of the claim to university uniqueness but to the apparent use of garbage collection as a metaphor for the activities of the rest of the society.] [] THE PUBLIC POLICY by Adam Meyerson Can Government Keep Health Costs Down...

...Thus the Department of Health, Education and Welfare is proposing an agency to regulate hospital budgets, and will most likely make many similar suggestions before the year is out...

...And for those diseases that still elude prevention, we can usually alleviate the pain...

...Universities and higher education, for example, are not more complex than corporations and the economic marketplace, and the case against the politicization of the former is really no stronger than the case against the politicization of the latter...

...Estimates of the major NHI plans before Congress range from $3 billion to $13 billion in 22 The Alternative: An American Spectator April 1977...

...The message to the public was that the universities themselves were not really serious about the values of intellectual excellence and independence they professed...

...The problem of cost is especially severe for government, which now accounts for over 40% of health expenditures...

...Faculties and administrations frequently seemed to compete to see which could give in to irrational and anti-intellecrual demands more rapidly...

...Bureaucracies produce more laws than Congress does...

...like the inhabitants .of almost every Western nation, enjoy superb care...

...Growing numbers of scholars and academic administrators sense that the state has seriously overstepped the area of its legitimate concern in higher education, and that much worse is in prospect...

...One incessantly sued college president reports that his mother now refers to him as "my son, the defendant...

...and there is no particular reason why government should not use its grant money to influence curricula so that the large numbers of students the universities and colleges now take may find "education" more entertaining and less arduous...

...That it is a general movement affecting all institutions seems equally clear...

...Have political parties gained or lost...

...The difficulty is that when we discuss the claims and expectations of government with respect to higher education we are bound to take account of the political-intellectual atmosphere in which government frames those claims and expectations...

...It is not very surprising, then, that regulations are imposed upon the society which, taken one by one as legislative proposals, would not have the slightest chance of enactment by Congress or of escaping a veto by the President...

...But it is certainly true that the academic branch of the intellectual community has strongly supported political control of the other institutions of our society, programs of affirmative action that turned out to be quotas, governmental direction Of institutional purposes, and so forth...

...I don't know how many times I have heard that sentiment expressed in government...

...The most cursory look around shows that...

...Why should anyone expect that government would suddenly become more modest about its righteousness and abilities when it turned to higher education...

...racial equality...

...We tend to create a new bureaucracy for every principle we wish to enforce...

...Have the major Robert H. Bork, formerly Solicitor General of the United States, is a Resident Scholar at the Amemcan Enterprise Institute...

...The case may be hopeless...

...Federal Medicare and Medicaid costs are going up from $36 billion in 1976 to a much higher figure this year, and without some drastic change in our medical system national health insurance would add substantially to government costs...

...Indeed, the autonomy and self-governing capacities of universities are now so little thought of that not only legislatures and federal agencies but courts are willing as never before in our history to scrutinize every exercise of discretion...

...And well it might, for cost is the problem of American medicine today...

...It is customary, almost obligatory in Washington, to lay the decline of governmental institutions to Watergate or Vietnam, but it clearly began before either of those events had any substantial impact upon public opinion, and those occurrences would account for the unpopularity of only a few major institutions...

...It is as though over the past few years the American institutional landscape has been flattened...

...We will certainly share a common fate...

...The quality of health care, it is refreshing to observe, is not at issue...

...clean environment...

...And though the worst of those times are over, it is clear that the university communities have not by any means completely restored their standards, that their morale has been damaged, perhaps permanently, and that some continue to be unable to respond with authority to fresh disruptions, particularly if they come from the left...

...That this is occurring is undeniable...

...The causes of the phenomenon are no doubt quite complex, but the fact remains that the faculties of many of our most prestigious universities are perceived and, worse, are perceived correctly, as well to the left of the national political spectrum...

...Growing regulation is incompatible with that expectation and the public case can surely be made by the most articulate group in our society...

...they must, if they wish not merely to survive but to survive as vital and autonomous intellectual centers, make the case against any additional regulation and seek to roll back much that now exists...

...The result is not congressional oversight but bureaucratic oversight...

...Authority is deeply resented in any form, and the universities, long perceived as elitist and authoritarian establishments, are natural targets for those riding a new surge of egalitarianism and populism...

...But it would be possible for universities to rally more effective political opposition to control, at least to minimize and contain it, had they not damaged their own images so badly in the recent past...

...At some point every principle becomes too expensive in terms of other values to be pushed further...

...The dominant strains of opinion at the moment appear to be egalitarian and legalistic, joined, rather ominously, to a simplistic view of the society and its possibilities for improvement...

...Everybody is quoting Tocqueville these days, and I would refrain were he not so pertinent, even though in this context he also.appears so mistaken...

...The answer is clear in every case: they have lost authority, autonomy, prestige, and power, they have done so precipitously, and the trend promises to continue...

...I would not be misunderstood...

...I make these points not because I take a gloomy pleasure in saying that the universities asked for it, though it is in some measure true that I do and they did, but because I think the universities' fate inseparable from that of the rest of society...

...What is not correct, and what I have heard in the pronouncements of university presidents, is the thought that the federal government makes a unique kind of error when it undertakes to regulate universities, or that universities are so different and more subtly complex than other institutions that regulation is bound to be uniquely destructive when applied to them...

...The result is not only that many today take pleasure in the plight of academics forced to swallow their own medicine, but also that the public philosophy of dispersed authority has been undermined and ridiculed by intellectuals who now invoke it for their own benefit...

...No single principle is fit to live with...

...It is also apparent that political conclusions are often presented dogmatically and as though they were the result of scholarship, even when it is plain that they are not...

...Universities also did incalculable damage to their public reputations hy their reactions to assaults during the time of student turmoil...

...Cost, however, is irritating everyone...

...Institutions so perceived are obviously in much poorer position to resist governmental regulation on the grounds that their scholarly independence must not be compromised...

...But the phenomenon is far more widespread...

...The opinions formed then persist...

...Hayakawa for standing against disruptions and imagine what were the feelings of the public about those university presidents and faculties who cbose to run with the student radicals and to match their rhetoric as a mode of appeasement...

...The claims and expectations of government with respect to all institutions, of which universities are merely a subset, grow out of this moralism and the belief that law can effectively guarantee fairness in every relationship...

...Bureaucrats are as well-intentioned a group as I have ever seen, but they move according to bureaucratic imperatives of which they are not even aware...

...Once all the resources and institutions of a society are seen as assets to be used by government to satisfy politically defined wants, there is no particular reason why government should not decide it wants short-run scientific results for immediate application rather than basic research...

...It is simply unreasonable to suppose that general political and social trends will affect every institution other than the university...

...Should they continue to fail to do so, not only the universities but all of society will be the losers...

...My dominant impression of the peril of our time, and of the time that stretches ten or twenty or thirty years ahead of us, is that expressed by Walter Bagehot: "The characteristic danger of great nations, like the Romans and the English, which have a long history of continuous creation, is that they may at last fail from not comprehending the great institutions which they have created...

...That is a firm rule of government, and no one need be shocked by it...

...These considerations suggest to me that universities cannot simply rely upon educating the bureaucracies...

...On the contrary, modern medicine is one of the great achievements of Western man, and the majority of Americans...

...Aristocratic countries, he said, abound in powerful individuals who cannot easily be oppressed and "such persons restrain a government within general habits of moderation and reserve...

...If the society does not understand higher education and research and their needs, it is also true that universities have too little troubled to understand other institutions and their needs...

...corporations gained or lost...

...It would help if the universities were publicly more assertive...

...Democracies contain no such persons, but their role, Tocqueville thought, may be assumed by great private corporations and associations, each of which "is a powerful and enlightened member of the community, which cannot be disposed of at pleasure or oppressed without remonstrance, and which, by defending its own rights against the encroachments of the government, saves the common liberties of the country...

...It should not come as a surprise if that invocation is met with a smile...

...That means every such organization has one principle: health...

...The first reason, of course, is simply that as never before higher education is dependent upon federal money...

...Thanks to Medicare, Medicaid, and private insurance, most people have the financial wherewithal for medical care when they need it, Gaps in access remain: 10-15% of Americans are uncovered by any insurance, a higher proportion of children are uncovered, and millions have no protection against catastrophic medical bills...

...to preventable human behavior (e.g., cancer...

...Q . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . Q . . . . . QJ . . . . . . . . 4 ~ . . . . . . . ~ . . . . ~ Q ~ O ~ Robert H. Bork A Taste of Their Own Medicine Can universities escape the regulation they prescribe for all other institutions ? It is instructive that colleges and universities have recently become so concerned about the intrusion of the federal government into what they had thought were their private concerns...

...whatever...

...In our time the great private corporations and associations have not played the role assigned them...