Check out the lastest viewpoint written about the problems of health care delivery, insurance, and
funding at the University Text provided below too.
As students we get the amazing opportunity to think, to write, to
study, to argue, and live what has been called the "life of the mind." Some
of us pay dearly to be here, some of us are paid handsomely to be here,
some of us are the partners and children of students here. But no matter
how we find ourselves here, a fundamental right to be healthy binds us
together as a university community. While healthcare fights to take top
billing in the ongoing presidential race, the issue has never been more
vital and more pressing here at the University of Chicago.
In the first week of March, the Student Health Insurance Review Committee
(SHIRC) presented their recommendation of health insurance providers to the
campus community at a serious of town hall meetings. The discussions were
informative, occasionally tense, and illustrative of just how important
health insurance provision and funding is for everyone at the university.
This point was made especially by members of Save our Student Health
Insurance (SOS)HI, a student group dedicated health care issues, but by
virtually every other student present as well.
The University requires all students to carry health insurance coverage. To
this end, they provide an option for us to buy into a group plan. For many,
especially international students, the families of students, and persons
with pre-existing conditions, this is the only insurance available to us.
It is literally a life line. This plan, however, is not only rather
expensive (easily a quarter or third of a graduate students annual income),
but has been bordering on the laughable in terms of coverage over recent
years.
Following the dismantling of a self-insured system administered and funded
by the University in the face of dramatically rising costs, the University
has gone about finding an outside insurance provider to meet the student
population's needs of health insurance. This is no easy task, and SHIRC has
taken on the impossible and thankless task of selecting a provider and a
plan that provides necessary coverage at an affordable price. That
committee is constrained, however, by not only the nation wide increases in
health care costs, but by an administrative constraint placed on their
mission: they cannot directly address questions of how students are
expected to pay for the very coverage they are required to carry.
The University's decentralized bureaucracy has made it de-facto policy to
split questions of provision and funding. The excellent presentations this
past week at the town hall meetings tried to concern themselves solely with
the provision of health insurance. The recommendation detailed 1) the
insurance company being recommended to the University as its provider and
2) the benefits that may or may not be included in that plan to determine a
final premium price. These are deeply important issues, yes, but for those
of us live on fixed incomes determined largely by the university, for those
of us who pay dearly in tuition fees already, for those of us who rely on
their partner's student status to get coverage, concerns about provision
and benefits cannot be separated from the question of how are we to pay for
that coverage? It should not be surprising that the question which came up
again and again during these town hall meetings was "How are we supposed to
pay for this?
The University, the College, our Divisions, and our Departments need to
hear from us that we can't talk about health insurance without talking
about funding. Questions about specific kinds of coverage are important,
but when the price of basic health insurance puts many of us below the
poverty line ($9,573 a single childless person, according to the 2003 US
Census figures), then it should not be surprising that we are concerned
less with the differences between basic and comprehensive plans, between
the pros and cons of out of pocket expenses, deductibles, or out-patient
surgery allotments, but with the simple price tag. Until the University
addresses basic questions of funding, questions of provision pale in
comparison.
The degree to which we think of ourselves as a community of colleagues,
scholars, and friends is a defining characteristic of what makes this
university so amazing. If we let ourselves be atomistic agents, then we
undermine not only our own ability to function as a group, but we undermine
the very closeness and solidarity that makes this university so
exceptional.
o matter what your own funding status is, no matter what insurance policy
you carry, fighting for affordable health care is deeply important to each
of us, to our departmental communities, and the university as a whole. We
are all lucky enough to live the "life of the mind" or something close to
it. The most basic prerequisite for that life, however, is our health, not
only individually, but collectively. We owe it to ourselves and to our
community to ensure that each of us has adequate and affordable health
care. The University administration owes us some real options for how to
get there.
The work of the SHIRC (http://shirc.uchicago.edu/) is to be commended.
Groups like Save our Student Health Insurance
(/soshi.htm) and any other student organizations
are vital if we are to press the University to take health insurance
funding seriously and to ensure the basic right to healthcare for every
student, scholar, worker, parent, child, and human being connected to this
amazing institution.
The U. of C. owns and runs one of the largest teaching hospitals in the mid-West. You may have noticed it on your way to the Student Health Center. For accounting purposes, however, the UC hospital is technically considered independent of the university, despite the name and the fact
that all the doctors on the staff receive full faculty status (allowing them to vote, along with the actual teaching faculty, in university elections and policy decisions). The distinction between hospital and university operations is a legal fiction (devised to improve the university's bond-credit rating), which is at the heart of all the recent rhetoric about "rising costs" TOO the university (i.e., you). Maintaining this fiction is itself very expensive: the recently instituted "student health fee" is a direct result of the increasingly elaborate, bureaucratic boundary work instituted by the U. of C. to isolate its students (the university) from its doctors (the hospital complex). And that fee is just the tip of the iceberg.
Many of us have shared the experience of having to get a "referral" from the Student Health Center to a doctor WITHIN THE UNIVERSITY OF CHICAGO HOSPITAL SYSTEM (or perhaps being told upon arriving at a scheduled appointment with some UC doctor that 1) their visit would not be covered, 2) they needed to pay some enormous "appointment fee" before the doctor would see hem, 3) that that particular clinic or department of the hospital did not take/had never heard of U of C Student Health Insurance, 4) they needed to obtain a referral from the Stud. Hlth. Cntr. for the appointment that the Stud. Hlth. Cntr. had made with them, 5) all of the above). This means that the university is going to great lengths to pretend that the Student Health Center is not in fact an office within the hospital, so that it can bill ITSELF (i.e., you) for services that it is itself providing, at RETAIL (i.e., inflated) rates. I'm sure this looks great on their books, and that the university ensures that it does by retaining the best auditing/consulting services available. But the rising cost of maintaining this arrangement has little to do with the price of antibiotics or syringes--i.e., health care itself.
It has much more to do with the reams of pink, yellow and white paper-trails, double-billing, third- and fourth-party payers, the multiplication of bureaucracies (university, hospital, Student Health Center, in-house insurance coordinators, independent insurance coordinators, independent claims services, outside insurance "providers" [to pay for services provided internally, but with separate, independent billing arrangements]), etc
I feel personally offended when I receive letters from the university claiming that "in the face of the rising costs of health care" the administration has no choice but to gouge its students even more deeply this year.
In the four + years that I've been at the U of C, the University, through various avatars, has consistently and increasingly restricted my access to ITS OWN
health care system. In the few times I've required medical attention, not only had the insurance procedures changed since the previous time (becoming with each change more arcane--quadruplicate carbon copies AND a separate computer system for students??), but the doctors and nurses I talk to HAVE NO IDEA HOW THE SYSTEM WORKS FOR UC STUDENTS (this has caused more than one SNAFU in my case). This kind of endemic confusion (obfuscation?) inevitably costs a lot of money to sort out. For example, I was recently required to create a physical paper-trail of "referrals" to a series of doctors appointments that my attending physician at the Student Health Care Center made for me (related to a bike accident) with different specialists in the hospital WEEKS AFTER they took place (and the bills started coming in), because of some medico-clerical miscommunication (my doctor not only didn't know how the
+referral system worked, she didn't know what services were and were not covered by the student policy--and was shocked to find out that various exams and treatments she routinely sent me to get were not covered). Aside from the hours and hours (days) I spent traipsing around the hospital getting signatures and dropping off forms, imagine the hives of behind-the-scenes activity necessary to process and "correct" all the bookkeeping my case must have generated. Is this the most cost effective way for the U of C to bill itself for the health care provided by the U of C hospital to U of C students?
Perhaps we ought to suggest to the administration that internally out-sourcing health care coverage to its hospital is not a very nice thing to inflict on its students. Wouldn't a more direct, open, relationship between students and the medical faculty and staff be healthier and
cheaper?