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As the clock struck seven on the evening of April 8, 2005, it was, for most people in Manhattan’s financial district, a typical Friday. Senior and junior employees had already gone home for the weekend and office traffic had slowed to a crawl. As I sat in my cubicle on the 19th floor of Goldman Sachs’ headquarters at 85 Broad Street, however, I had no intention of going anywhere. At two o’clock in the afternoon, I had gone out for a quick lunch with two of my co-workers and a flash of total clairvoyance had overtaken me. I was an analyst in Goldman Sachs’ healthcare banking group, and my area of expertise was the managed care sector. On most days, my responsibilities focused on offering acquisition and financing advice to the world’s largest healthcare providers. Today, however, I wanted to help autoworkers.
Earlier in the morning, I had read an article in the New York Times about the plight of General Motors employees in trying to keep their jobs and their benefits packages. General Motors’ pension obligations, negotiated decades before the era of spiraling healthcare expenses, had soared in current and projected cost. Consulting sharks advised General Motors that slashing costs, employees and benefits was the only way to solve problems. I thought it unconscionable that innocent workers would lose their jobs, insurance and pensions and that their families might also suffer. I vowed to come up with a better solution to the problem and thought about nothing but General Motors during the day’s remaining free time.
Finally, at lunch, a potential solution arrived. Why not create a synthetic investment security that mirrored, in its performance, increases in healthcare costs? This synthetic security could be used as an investment hedge against the pensions of General Motors, reducing increases in pensions to zero for the foreseeable future. Goldman would sell the security to General Motors, and then hedge its exposure to the security by taking a buy position in the same security so that its risk would also be zero. I madly grabbed a cocktail napkin and wrote down a cursory sketch of the entire idea so that it would be fresh in my mind when I returned to my desk. I spent the rest of the weekend converting the idea from a chicken-scratch sketch to a two-page, concise explanation of the idea that senior bankers could understand. I was sure that they, too, would love the idea and quickly take the pages to General Motors for consideration. The senior bankers, however, had far less initial enthusiasm for the pages than I had imagined.
Some bankers rejected my idea on the grounds that a true zero-risk scenario could not be achieved for all parties involved. All of them agreed that the idea was too complicated and would not be widely understood by necessary parties. I was a little disheartened, but did not give up. I arranged for meetings with all eight of the vice-presidents and partners at Goldman Sachs who covered General Motors and I sat with each of them, sometimes individually and sometimes in groups, until every single banker understood the idea and appreciated its value. Eventually my idea received the attention of the chairman of investment banking and the head of the financing group at our firm. They were astounded that a junior analyst had done work of the type usually produced by bankers with ten years greater seniority. I was called into a meeting with both of them and received the news that my idea had been approved for presentation to the client. It had taken me three months to educate the General Motors team about my idea and gain their approval.
Our meeting took place three weeks later at the General Motors building on Fifth Avenue. Eventually, General Motors rejected the idea, saying that while it was correct in calculation and valuable in ideological worth, adopting an investment concept that bypassed the unions in favor of solving a problem through Wall Street would cost inestimable political capital. And, unsurprisingly, like most to whom I have briefly explained the idea, they also thought it was too complicated. On that day, however, I was nonetheless in my glory. Not only did the idea that I had sketched on a cocktail napkin receive consideration from one of the world’s largest corporations, but we had just concluded a meeting where the participants included John Devine, CFO of General Motors, and three senior vice-presidents of General Motors. They listened intently for 45 minutes to an idea designed to save their company from pension problems, imagined and developed not by a partner at Goldman Sachs, but by an investment banking analyst who had received his bachelor’s degree twelve months earlier.
My idea for bringing about a direct solution to the problems at General Motors did not succeed, but the effort was not in vain. Several weeks after our meeting with John Devine, General Motors used the hedging idea as a major bargaining chip and convinced the United Auto Workers to take a fair deal, giving workers reasonable protection of their health benefits and pensions. Of greater personal importance, I realized that my ideas, even as an analyst in a 20,000 employee corporation, could reach some of the most important decision makers in our nation and effect great change. The General Motors experience reenergized my desire to help fix our national problems with healthcare quality and availability. In reflecting on the entire process, what I found most surprising and new was the deep impact that my idea had produced. What my co-workers were surprised to discover was that my interest in our broken healthcare system and finding methods for fixing it traced back to my childhood.
I have always viewed our nation’s healthcare crisis as an out of control epidemic watched with great pain, especially for someone who, like me, is born into a family of professionals predominantly in the medical field. I watched a healthcare system rich in mutual comfort for doctors and patients turn into a disaster of mismanaged costs and power struggles. How are over 40 million Americans uninsured, with many others receiving only partial coverage as premiums also continue to rise? How can the healthcare providers in our nation improve, providing reasonable coverage to more of our citizens without a meaningful sacrifice in service quality? I did not have sufficient answers to these questions, and I realized that working towards their solutions on Wall Street was an inefficient path marked by great resistance. I left banking because I wanted to do more in acting on the behalf of others and because the time for further education and training to achieve my goal had arrived.
I come to New York University Law School with an application and a desire to continue the journey I started as a teenager distressed with our crumbling system of healthcare management and delivery. I apply to New York University as my sole and logical choice, a long-formulated decision made similarly to my lone health policy application to New York University’s Wagner School. Just as my research several years ago revealed that The Wagner School was regarded by most as the strongest program nationally in health policy, New York University proves to be unique in its education of tax law, fortified by excellent coursework in constitutional and healthcare law. I want to strengthen my knowledge in these areas because they are vital tools in understanding the management, regulation, taxation, pensions and reserves within corporations and healthcare organizations. I can take these skills back into the worlds of public service and business, the environments in which much of the substantial change in the healthcare industry takes place.
A potential cure for our deteriorating healthcare system is practitioners with experience from the business, public sector and legal worlds, armed with the knowledge, the education and the heart to bring inspiration and solutions back to the medical community. I could help fashion these solutions as the manager of a healthcare providing agency and through a commitment to changing national healthcare policy. My aim is to focus on fixing the operation of managed care organizations, drug providers and government participation in healthcare through more informed leadership of, and guidance to, lawmakers, doctors, academics and citizens. There is no better tool to arm me in this challenge than combining my acceptance at New York University’s Wagner School for an M.P.A. in Health Policy and Management, which I am starting in September of 2006, with an understanding of the law at New York University. From grasping the workings of the core legal system and tax law to coursework in insurance and other healthcare law, I want to have the ability to often turn to myself when a complicated legal question arises rather than immediately calling a specialist. I desire an education that is both broad, but also specialized through taking classes such as pensions and benefits, cost analyses of the healthcare system and examinations of healthcare law.
The timing for this opportunity is truly one-of-a-kind and fleeting. I only have one chance to file this application for a joint J.D. / M.P.A., before my first year in the Wagner School’s health policy and management program is completed. In taking on the coursework of policy and law at the same time, I can achieve a balance of disciplines and a surplus of combined learning. This approach is an opportunity that I can never replicate again at any other time or school in my life, and that is why completing this application fills me with such excitement and hope. New York University can allow me to take not just one, but two steps closer to my aim of improving the healthcare system, fueling the optimism I have always held that we can make medicine a more effective, efficient and equal institution for our shared society. |
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发表于 2006-12-30 07:01:00
