With the advent of MOOCs, and other low-cost opportunities for online education, there has been ongoing debate about the tension between costs and quality. OHSU, like many universities is working hard to provide a quality, rigorous academic experience to students on campus, through hybrid courses and through online courses. In this article Reihan Salam makes the argument that costs impact quality in online courses. “One way of thinking about higher education, and education more broadly, is that once you get past the students who are the most prepared and most eager to learn, you have to apply increasing amounts of both help and hassle. That is, you need to offer personal attention and tutoring as well as discipline and structure, all of which are labor-intensive in the extreme.” Well said!