Casey Humbyrd: Health plan strong despite expense

Health care in the United States has reached a near breaking point. Improvements have enabled us to better and extend the quality of life. And the decision to do more predicts health care cost increases of 12-15 percent nationally per year.

The Delaware Valley is no exception, as increases in malpractice insurance for physicians are passed along as higher fees for patients. Health care as business is a statement contradictory to our humanity -- how do we place a dollar value on a life?

At the same time, President Bush's budget cuts Medicare payments by 5 percent, weekend bus trips to Canada are being organized to help senior citizens obtain cheaper prescription drugs and the movie John Q. swept the box office its opening weekend.

With these contentious and problematic issues in mind, I worked to get myself appointed to the Student Health Insurance Advisory Committee, which develops the university health insurance plan for 7,300 students -- approximately 1,500 undergraduate and 5,800 graduate students.

SHIAC has met nearly every Monday night since October. The only incentive for individuals working on this committee has been a passion for student welfare and a mediocre dinner, much more the former than the latter.

As the Student Health Insurance Plan is unveiled today in The Daily Pennsylvanian, I wanted to publicly support not only to the plan, but also the process that led to this plan.

SHIAC was made up of faculty members, administrators and students with student representation proportional to the plan's constituency. All members began the year distinctly aware of the dissatisfaction with the 2001-2002 plan -- which featured a premium increase and decrease in benefits. All members received (and on my part, read) every complaint sent by e-mail to the committee. As in past years, the goal of the committee is to obtain an acceptably low cost insurance plan with adequate benefits for the needs of the student population.

The process began by soliciting student feedback as to the 2001-2002 plan, followed by committee development of an ideal plan, along with benefits that could be "tweaked" to reduce premium cost.

Next, the committee received proposals from three companies -- Chickering/Aetna, Mega Life and Keystone-Independence Blue Cross.

Finally, we debated as to the optimal design and unanimously decided to remain with Chickering/Aetna under a modified plan.

While the final vote was unanimous, the process as a whole was not strictly governed by consensus. For the first time in my life, I often found myself arguing the positions of my constituents, rather than my own. My parents still provide my coverage under a private plan, however, most of the students on the plan pay their health insurance through student loans. I felt a strong responsibility to argue for restricting any increases in premium beyond the bare minimum of $200 (15 percent of last year's $1,350 plan).

On one memorable evening, a committee member said the insurance plan should be adequate to help a student "if they get hit by a bus." At a minimum, the plan must prevent a student from incurring insurmountable debt in the event of catastrophic illness or injury.

However, reading e-mail from students who owe thousands of dollars in health care bills for prescription drugs, hospital stays and unexpected surgeries, we all determined that healthcare should not only be a safety net, but also a security blanket, encouraging necessary utilization. Personally, I was forced to reconsider my cap of $200 in order to allow for a plan that would be both.

The final plan responds to the major areas of complaints. The annual deductible has been lowered by $150, the annual out-of-pocket maximum has decreased $1,000 and the prescription drug benefit has been shifted from co-insurance to $10 co-pay for generic drugs and $20 for brand names.

Additionally, coverage has been expanded for hospitalization, surgical expenses, office visits, lab and x-ray charges and emergency room care. The total additional cost for this increase in benefits is $127 more than the 2001-2002 plan would cost in the 2002-2003 school year without any changes.

The inherent danger of a representative, democratic committee that works to please everyone is that the best you may accomplish is a shared discontent among all constituencies. The balancing act that has become the business of health care is a necessarily frustrating one, but the experience of SHIAC has been nothing short of rewarding.

And to those undergraduates who feel discontented, I can only echo Anne Hankey, chairwoman of the Nominations and Elections Committee, which appoints students to SHIAC, "If you have a concern, make your voice heard. Committee applications are available online at dolphin.upenn.edu/~nec and are due April 1." I graduate May 13 -- time to let your voice be heard.

Casey Humbyrd is a senior Biology and Urban Studies major from East Greenwich, R.I., and a member of the Student Health Insurance Advisory Committee.

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