Ed Webb: What price for student health?

This past spring, Penn's administration announced that nine of Penn's 12 schools would begin paying the health insurance premiums of their fully-funded graduate students. However, as the details of the 2001-2002 Penn Student Insurance Plan slowly emerged, it became clear that many graduate students will actually be worse off under the new arrangement.

This goes without saying for those students who face the prospect of paying premiums 35 percent higher than in previous years. But the premium is only half the story, since the new plan involves a "cost-sharing" scheme implemented in response to what both insurers and administrators have called "over-utilization" on the part of Penn students. As a result, graduate students who suffer from chronic health conditions, who experience an acute health crisis or who have dependents stand to pay a considerable portion of their stipends (many of which are only $12,500 per year) in out-of-pocket expenses.

The new plan requires that students pay 30-40 percent of prescription costs. Further, under the new agreement, Student Health Services -- with only nine physicians and nurse practitioners -- becomes the primary care provider for the 7,000 people covered by the plan (minus those who live outside a 25 mile radius of SHS), not including the estimated 13,000 other students who, though not insured through the PSIP, are expected to make routine use of SHS.

If students need to go outside of SHS -- if they need to see specialists other than a podiatrist, orthopedist or part-time gynecologist, the only two specialists SHS has on staff -- they must pay a $250 deductible and 10 percent of any further charges. They must also pay 10 percent of emergency room costs and 10 percent of all lab test costs -- including any they get done at SHS -- up to a maximum of $2,500 for individual students, $5,000 for students with dependents.

These changes will translate into very real hardships for hundreds of graduate students and their families -- the 10 percent that the administration admits will be disadvantaged under the new plan.

One graduate student suffering from asthma had calculated her medical expenses for the coming year to be over $2,000, prompting her to consider leaving the University; she was eventually forced to ask her graduate chair for extra funding.

Another student with Crohn's disease (an intestinal disorder) expects to pay nearly $1,000 for the prescription medication he needs to prevent an acute attack -- which could still occur and would lead to thousands more in hospital costs. Some students have even resorted to signing their children up for CHIP, a public assistance program providing basic health care to children of low-income families. Of course, given the ever-present possibility of accidents, anyone insured under this plan could face comparably high costs.

The administration's delay in making the details of the plan known has only aggravated an already bad situation. Peter Conn, deputy provost and chairman of the committee responsible for negotiating this plan, acknowledged in a meeting this July that he should have held a meeting with students about health insurance in May. As a result, students have not had a chance to plan ahead for these costs or to seek alternatives.

For example, students who are eligible to have their children insured by CHIP will be applying for this program too late to have their children covered by the time last year's plan expires. (At least Stanford University gave sufficient warning to their students about the possibility of going on public assistance.)

Over the course of the summer, members of Graduate Employees Together-University of Pennsylvania/AFT have collected and distributed information about the new health plan and other options. We are also calling on the administration to set up a fund for students currently facing financial hardship under the new plan, and to re-negotiate as many aspects of the plan as possible over the course of the next year.

We also believe that a union of graduate employees would prevent such poor decisions from being made at all, because the presence of a union would change the way the administration makes decisions that affect all graduate students. We look forward to cooperating with other graduate student groups and the administration to make future decision-making more productive.

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