Today we’d like to introduce you to Dr. Roger Lee Mendoza
First, congratulations, Dr. Roger, for winning the Pearson Award for Excellence in Higher Education. We’d love to learn more about your work and what you’d consider as your major contributions to your field?
I am a professor of business in the College of Business and Economics of California State University in Los Angeles (or Cal State LA). Business or management as a field of study is particularly attractive to me because it teaches us how to consider organizational challenges rationally, and make practical decisions about planning, organizing, staffing, directing, and controlling scarce resources relative to the multiple, competing demands for these resources. In the study of business, the ivory tower meets and works with the real world.
As an applied economist specialized in healthcare business, specifically in finance and insurance geared towards the healthcare industry, I teach students how to frame problems, use data with numbers, and think through tradeoffs and consequences in allocating scarce resources for healthcare. I examine and seek to find systems-based solutions with the objective of making quality healthcare more equitable and affordable for all. I investigate factors that influence the industry’s costs and quality of care, and thus the supply and demand for healthcare; alternative approaches and strategies to healthcare production and delivery; how we can improve how we plan, budget, and monitor healthcare; and the role that stakeholders, especially insurers and other payers, play in healthcare spending.
I would say that my major contributions to my field are in teaching and scholarship. In terms of teaching, I have devised and adapted methods and materials to engage students in ways that they may find practical or real-life value to what they learn in healthcare finance, insurance, and business regulation. Poetry, Taylor Swift songs, comparative dance forms, role-played case work, point-counterpoint debates, flipped classrooms, Jeopardy-style gaming, and computer game simulations are typical, instructional components of the courses I teach. And for these I am fortunate to have been recognized with various awards, including the McGraw-Hill Pathfinder Award for Teaching Excellence, Phi Kappa Phi Love of Learning Award, Cal State LA’s Assessment Ambassador Award, and more recently, the Pearson Prize for Excellence in Higher Education.
My scholarly contributions are mostly through the over 60 juried (or peer-reviewed) studies I have conducted and published, for which I have received grant-funding and awards, including from the Bank of Americas, and several of which I have presented in learned meetings or conferences. My research work has appeared in top-ranked business and economics journals. Much of my pioneering work investigates how healthcare payers respond to financial risks and incentives in terms of healthcare product design and development, market positioning, pricing decisions, and insurance market competition. In this sense, my work evaluates the role of market power in affecting efficiency, value, and distributional outcomes in the production, utilization, and regulation of healthcare goods and services.
My research and publications have equally been helpful in consulting for health insurance, hedge-fund, and law firms. These firms are based in the U.S. and around the world, for instance, the last one from last week was a hedge-fund company from Brisbane, Australia. Much of my industry consulting is in the areas of health insurance design and coverage, testing, and premium pricing and cost-sharing, rather than on the investment side.
Could you tell us more about the Pearson Award for Excellence in Higher Education that you recently won? What message do you think it conveys to learners?
The Pearson award is sponsored by Pearson Education, the world’s leading learning company, providing digital content, assessments, qualifications, and data to nearly 200 countries. The award recognizes and honors faculty nationwide and in any field of study “who uses strategy, knowledge, process, and behaviors to create positive student outcomes.”
Following a six-month search and nomination process starting in July 2023, over 50 out of 615 faculty nominees were shortlisted by January this year. I was nominated by colleagues and students for devising, adapting, and experimenting with instructional methods and materials with the goals of creatively personalizing courseware materials to resonate with students and in a way that they might find “quantitative” courses like mine meaningful and engaging, and also valuable in their personal lives and professional careers. In April this year, I was lucky to be chosen as one of five winners for “exemplary teaching and learning.”
I think the Pearson Award, along with the McGraw Hill Pathfinder Award “for teaching inventiveness and innovation” which I also received as one of three nationwide winners in May 2023, sends a clear message that teaching excellence is just as prized as scholarship, especially at a time when most faculty awards are conferred on original research and publications. By shaping minds and inspiring generations in creative ways, we can help make this world a better place.
Thanks for sharing your insightful work and your many, path-breaking contributions. At this point, maybe you can tell our readers some of your backstory.
I originally came from the Philippines. In high school, I had planned to major in European languages, particularly Spanish which I could speak fluently by age 10, and work in a Philippine embassy in some Spanish-speaking country in Europe or Latin America. Then in my junior year in college, I discovered that I was good with numbers, thanks in large part to two outstanding math professors who inspired me. I also got very interested in economics, grounded as it is in math, particularly while doing graduate work in public administration where we had to choose from three concentrations, one of which was economics/economic development, and for which I had wonderful economics professors who, for some reason, took much interest in guiding my intellectual path in economics. While I eventually specialized in health economics, during the formative years of my graduate work, it was largely an underdeveloped subspecialty. Not a single health economics course was then offered at the University of the Philippines, where my adventure in higher education began. So I ended up writing research papers and my dissertation on economic development, including the privatization and deregulation of government corporations, inspired by the transition from a 16-year dictatorship to redemocratization in the Philippines, for which economic liberalization was critical.
I studied at the University of the Philippines, McGill University, and the University of Pennsylvania. I also spent a six-week summer term to study financial economics at the University of London, at its Imperial College which is now a separate academic institution in England. Scholarships, fellowships, research grants, and other competitive awards allowed me to complete my studies in these countries.
By the time I joined academia after finishing graduate school in the mid-1990s, health economics was blooming as an economics subspecialty, no longer lumped under the umbrella of welfare or social economics. Healthcare budgets and expenditures, particularly in prescription drugs and medical technology, were rising fast in many industrialized countries led by the U.S. The biopharmaceutical and medtech sectors had turned into lucrative, multi-national businesses. Many diseases were also spreading globally, with SARS (severe acute respiratory syndrome) becoming the first pandemic of the 21st century, its outbreak not just shocking the world but reminding us just how globally interconnected we are in terms of disease or illness, as SARS spread swiftly from continent to continent. Swine flu became a global pandemic within just a few months in 2009, while avian or bird flu offered a pandemic threat. Around this time the World Bank established its health team to fund research and program initiatives aimed at confronting challenges to healthcare systems globally, including those resulting from lack of universal health coverage, epidemics and pandemics, climate change, aging populations, and the growing burden of lifestyle diseases.
Amid all these developments, many more business schools began offering a concentration or option in healthcare management, especially within their MBA or MS programs. Enrollments in these programs were increasing. I started asking and studying many of the same questions that confronted health economists in the 1990s and early in this century: How do we put a value on health? What factors, including economic or financial factors, influence health, besides healthcare? What influences the supply and demand for health care? And what accounts for the counterintuitiveness of certain healthcare management outcomes, including, for example, the behaviors of providers and payers in contrast to patients and other healthcare consumers.
By then, I had decided to shift to and specialize in healthcare economics and management. I taught them in two other universities in the Philadelphia metro area prior to 2019, joined an actuarial firm there while continuously teaching part-time, and then relocated to Los Angeles to join Cal State LA on a full-time basis in 2019, offering finance, insurance, and regulation courses in the healthcare industry. I have been quite prodigious in publishing in these subjects over the last two decades. Throughout my career, I have been privileged to work in corporate, government, and not-for-profit institutions, including in a consulting capacity to insurance, hedge-fund, and law firms, as noted earlier.
I also find healthcare economics and management useful in extra-curricular activities, including in my capacity as faculty adviser to various student associations on campus, in coaching our intercollegiate case competition teams, and as an officer of two international honor societies. And I do not seem to have lost my flair for languages after all these years. I remain fluent in four languages and have traveled to 41 countries, affording me the opportunity to speak them to the extent possible. I just love the experience!
Can you also talk to us a bit about the challenges and lessons you’ve learned along the way, and from which our readers might gain more insights?. Looking back, would you say it’s been easy or smooth in retrospect?
I would say generally smooth, but certainly not without my own, fair share of challenges and fears.
I am inquisitive by nature. And I like working with numbers to prove or disprove stuff. And economics teaches us how to solve problems using numbers generated from empirical data, meaning factual information that is verifiable by observation and experimental procedure, rather than theory or pure logic. It is that intellectual rigor of economics that I believe makes it a powerhouse within the academy and very relevant to problem-solving and decision-making in the real world, including in our personal lives. I see that in healthcare management: when I teach healthcare finance and insurance and consult for government and private firms, as well as during my full-time stint in corporate insurance and employee benefits.
The challenges I encountered along the way, and still periodically encounter, are two-fold. Because the application of economics to healthcare management and related issues often involves rigorous mathematical analysis, I find there is often that unconscious temptation to think of or create overly complex models of what we investigate, and use unrealistic assumptions in doing so. For example, modeling how healthcare price inflation can be contained or regulated might be based on the unrealistic assumption that providers and payers will not resort to backdoor strategies, like cost-shifting or cost-cutting to the potential detriment of healthcare quality and effectiveness. Those ceteris paribus (“all other things being equal”) assumptions could produce or lead us to outcomes that do not align with real-world observations — one thing I often worry about.
Secondly, I sometimes find it challenging to condense so much empirical information into a limited window of time and convey it in layman’s terms in conversing with non-economists and even with professionals and leaders in business and industry, for instance, as a consultant. That is probably why some people jokingly say that when you ask two economists the same question, you get three answers. That is to say that the complexity of information we need to share with others, especially outside of our field, and in a way that makes practical and valuable sense to them, can get lost in translation and lend to varying interpretations of the solutions we propose. Hence, the three answers.
On a more personal note, I think adjusting to a new, a foreign environment is always challenging to most of us, as it was for me, having resided in four countries, and having to relocate to three states within the U.S. alone. Coping with the seasons, especially late autumn and the winters, finding your way around while settling in, and having to establish or reestablish your network of support at each move doubtless create obstacles or struggles, at least initially. But I think I was adventurous enough to discover ways and means to adjust or overcome them in due time.
Given your industry consulting and research work which federal agencies and the U.S. Congress have also cited, where do you see the U.S. healthcare industry going over the next 5-10 years? Any major shifts, changes, trends?
There is much interest in healthcare both as an academic subject and as an important business or industry for many reasons.
Healthcare now constitutes over 18 percent of the U.S. economy, which translates to $0.18 of every dollar of national income going to healthcare expenditures, so we care about where those $0.18 go. And that amount is projected to grow slightly more, as healthcare spending continues to outpace the growth of the U.S. economy or real GDP growth.
Secondly, the U.S. government, especially at the federal level, has not only become an active or dominant healthcare regulator under the Affordable Care Act (ACA) of 2010 and healthcare reform. It has become the single largest payer of healthcare expenditures. The tax and other policy implications of these are I think pretty apparent. For instance, there is much discussion these days that Social Security may no longer offer Medicare for people retiring in less than 10 years due to rising medical and healthcare costs and changing US demographics, such as population aging, unless we increase eligibility requirements, reduce benefits, and/or increase taxes. While I do not think we will ever go with “healthcare for all” like in Europe or Canada, these challenges to our national healthcare system make entitlement payments (particularly Medicare and Medicaid) a legislative reform priority for years to come.
Third, there is no gainsaying that healthcare is central to our concept of well-being, especially in the interconnected world we live in today, as we saw with SARS 20 years ago and covid-19 more recently. As one economist aptly said, “without health, what do we have?” These have, in turn, raised many more interesting micro and macro economic and managerial questions. Fortunately, I think we are better positioned now to address them compared to only two decades ago, as a result of the availability of many large, administrative databases where economists could mine vital information with the help of more sophisticated computer technology and software programs.
With respect to prevailing trends, healthcare prices and spending in the U.S. remain the highest of any industrial country in the world. And I must point out that that is not because Americans utilize more healthcare or achieve better healthcare outcomes. Rather, it is because, unlike in European countries and Canada, there is no price control or regulation, no universal healthcare, and limited government intervention in the U.S., all of which many policy-makers believe contains “big government” and should underpin a market economy premised on the principle, “from each according to their ability, to each according to their reward.”
Hence, physician salaries in the U.S. are at least two-and-a half times higher than their Canadian or European counterparts. Skyrocketing prescription drug prices here far surpass U.S. inflation. Patent exclusivity for drugs and medical devices increase and can often corner profits. And third-parties like health insurers and PBMs (pharmaceutical benefit managers) abound and financially thrive in the American healthcare landscape. These middle entities have contributed to the high cost of drugs in the U.S. and have encouraged employer self-insurance among large firms, the banding together of small firms and the self-employed to form association health plans, and consumer-directed health plans and arrangements.
But there also some positives from the market (or profit-based) orientation of the U.S. healthcare system. Most medical advances, including ground-breaking treatments, originate from this country (just count the Nobel and other top prizes predominantly awarded to American scientific discoveries). The U.S. ranks first in science and technology worldwide, thanks to our renowned research universities and robust biotechnology industry, both key sources of healthcare innovation. The U.S. is considered the most profitable market for pharmaceutical companies. Every major foreign medtech company has ties to the U.S. market. Finally, growth in aggregate demand for healthcare goods and services produced by these heavily R&D-invested sectors is expected to continue in the coming years, generating more professional and skilled jobs for American workers who are needed to provide them.
Contact Info:
- Instagram: https://www.instagram.com/mhhighered/reel/C2QFxwhu2u4/
- Twitter: https://x.com/CalStateLA/status/1780283944279384144
- Youtube: https://www.youtube.com/watch?v=lEZdb_d7-xo
- Other: https://www.mheducation.com/news-insights/blog/can-games-poetry-and-pop-music-help-students-learn-healthcare-finance.html
Image Credits
Classroom photo credit: Laura Lopez. The rest are the interviewee’s photos.
