Mike Bloomberg, the media mogul and former New York City mayor, has given Johns Hopkins University US$1 billion to eliminate tuition for most its current and future medical students, the school and Bloomberg Philanthropies announced on July 8, 2024. The gift will also expand financial aid for students studying several other fields at Bloomberg’s alma mater. He graduated from the university in 1964.

Emily Schwartz Greco, The Conversation’s Philanthropy and Nonprofits Editor, spoke with Amir Pasic about this gift and its significance. Pasic is the dean of the Indiana University Lilly Family School of Philanthropy, the world’s first school devoted to research and teaching about philanthropy.

Is this a big deal?

I consider it a milestone in terms of its size, even if it’s smaller than the $1.8 billion Bloomberg gave Hopkins in 2018 to fund scholarships for its undergraduate students.

It also matters because it’s part of a pattern. Earlier this year, Ruth Gottesman gave $1 billion to the Albert Einstein College of Medicine that will also make tuition free for students. Both gifts will make a medical education much more accessible.

And this is a moment of crisis in higher education: Student loan debt is too high, too many students aren’t able to complete their degrees, trust in colleges and universities is declining and too few men and first-generation students are getting degrees.

Do you think it will help increase access to health care?

It’s hard to tell.

Many health experts want to see government policies changed to make health care education more accessible across the board, rather than at just a few universities. But if more leading medical schools start changing in this way, it could ripple through the system and make a difference.

It’s going to be incumbent on medical schools getting big gifts to make tuition free to show that these donations are benefiting the public and not simply producing more physicians who make a lot of money by primarily treating privileged people.

To deliver on the promise, I believe they will need to prove that significant numbers of their graduates are committed to the public purpose of the profession.

That would mean more doctors engaged in primary care and community care in low-income neighborhoods, and more pediatricians. When med students need to take out large loans, they may end up in cosmetic surgery or treating wealthy people with golf injuries rather than attending to needs that are more glaring. Such burdensome debt loads won’t be the case any longer at Hopkins.

Nothing I saw in the gift compels those students to actually make that choice once they graduate. But the goal is that the school will recruit more people from low-income communities and free up more physicians to pursue the public aspect of their calling to serve people with the highest needs.

The med schools will bear a responsibility to create a culture that encourages and expects their alumni to go into those spaces and perhaps even looks down upon those who simply go into high-paid areas of the profession. Just waiving tuition – which costs about $65,000 annually for four years – and doing business as usual won’t make a difference.

Is it wise for Bloomberg to give so much to his alma mater?

There have been a lot of critiques that too much money is going to a few privileged institutions that attract a disproportionate amount of philanthropic funding.

What kind of effect are you achieving when you invest so much in one institution when the problems that we’re facing are quite systemic? How many more people could be reached with that same investment in, say, community colleges, and the public universities that don’t usually get philanthropic gifts at this level?

You can say that making systemic change requires you to distribute resources or target places that are most in need. But Bloomberg Philanthropies has made the case that the leading institutions that attract some of the most prepared and most exceptional candidates have a particular role to play, and it hopes others will follow its lead.

Bloomberg isn’t just giving back to his alma mater and giving back to a place that did great things for him, individually. He’s also enunciating a hope that it will create an example for other donors to follow. Whether that ambition will be effective or not, we don’t know.

Sometimes we look at philanthropy as if it were purely public funding, or the equivalent of a policy endeavor. At the end of the day, we have to remember that this is Bloomberg’s own money. He’s free to make whatever decisions he wants.

I think it’s important to realize that he has his own theory of change – that elite institutions will bring the kind of change that our society needs. You may disagree with that and think that he should fund institutions that serve many more students and will propel upward in society.

But it does appear that Johns Hopkins’ student body has become much more diverse over the past decade.

Is the timing significant, given some of the doubts about higher ed’s value?

This gift is in some ways more typical of higher education giving before a number of major donors got upset over the campus turbulence that began after the Oct. 7, 2023, attacks on Israel.

Many people are asking what the purpose of philanthropy is for colleges and universities and trying to compel them to use their endowments for what they consider to be better purposes despite restrictions on the use of those funds.

Students will be eligible for free tuition only if their families make less than $300,000 a year. What do you think about that?

Some schools have taken a different approach by ending tuition for everyone, such as the Princeton School of Public and International Affairs, Cooper Union and the Cleveland Clinic Lerner College of Medicine.

I think only ending tuition for people who are more likely to need the help and limiting free living expenses to those in households earning less than $175,000 is reasonable.

Otherwise, Johns Hopkins could potentially squander funds on students who could easily pay and whose access and experience would not be curtailed if they had to pay for medical school without any financial aid.

Amir Pasic is a Senior Fellow at the Foreign Policy Institute at Johns Hopkins University's School of Advanced International Studies. He also holds a master’s degree in international relations from Johns Hopkins University and is a former Johns Hopkins University employee.