Mike Baiocchi | Having a say in your health insurance

The Student Health Insurance Advisory Committee (SHIAC) has started its annual assessment of the Penn Student Insurance Plan (PSIP). This is my second year as part of SHIAC and I'm excited, because we have a couple of long-term projects in development and we have another good group of people this year to help us move these projects forward.

That's the good news.

Here's the bad: Penn's health-insurance situation is just like the rest of America's health-insurance situation. Nationally, plans have been seeing double-digit increases in premium rates for health plans - and PSIP rates have been near that. On top of those increases many of the health-care issues you hear the presidential candidates discussing during the debates are the same issues that impact our health plan - adequacy, equity, accessibility and cost control.

Cost control is our most visible goal. The cost of care is going up, so it's a constant balance between what we pay up front in the form of premium and what we pay on the back end in the form of deductibles and co-pays. Getting that balance right requires input from the student body. For example, what is the right trade-off between premium and deductible?

In addition to controlling the cost of the plan, SHIAC's other main focus is to balance students' competing interests. It's not obvious at first pass, but various groups on campus have different, and often conflicting, interests when it comes to insurance. Here's a simplistic (though still somewhat useful) rundown of students' interests:

1. Masters' degree students and professional students want low insurance premiums because they have to pay for the entire premium out of pocket.

2. Ph.D. students want low deductibles and low co-pays (essentially a comprehensive plan) because their departments pay the premium for much of their time studying here.

3. Students with families want an affordable plan with access for their dependents.

4. PSIP isn't as pressing an issue for the undergraduate population because many are insured through their parents' plans (though some do use PSIP) - they are primarily interested in the services offered by the student-health center.

It's not easy finding the right balance to these issues. What works for one group could be exactly wrong for another. The only way we can resolve issues like this is to reach out to the student community and get feedback as to how important these issues are to you.

Here's an example: One of the most passionate issues this year and last has been providing the human papillomavirus vaccination.

There's not much debate on this issue: This vaccine is good. The decision-making process surrounding whether or not to cover it as a benefit for the 2007-2008 plan year was complicated and I can't do it justice in this article - but here is a quick summary. The HPV vaccine had just hit the market at the time we had to make our decision. Because of its "newness" the cost/benefit (mostly the cost, in the form of proposed increase in premium) was not clear and SHIAC adopted the reasonable (and perhaps a bit conservative) wait-and-see approach.

Waiting one year has given us, and our insurer (Aetna/Chickering), a better understanding of the costs. Are we going to revisit this issue this year? Absolutely. We've received several e-mails from students inquiring about adding coverage for the HPV vaccine and we have already begun discussions on the committee. This is the kind of feedback we need.

So, here's why I'm writing: We need to hear from you. What do you want your health insurance to be? What issues are important to you? Everyone in his or her right mind wants lower premiums and better benefits. But considering we are constrained by economic realities, what's most important to you and what are you prepared to give up in order to get it?

We want your input. You can reach us at shiac@pobox.upenn.edu. This e-mail gets checked regularly and all mail sent to this account is printed out and discussed at our meetings. We have SHIAC representatives on both GAPSA and the UA so you can find us there as well. Over the next few weeks we will be fielding a survey to segments of the student population.

Get a hold of us and let us know what you're thinking. We look forward to hearing from you.

Mike Baiocchi is a second-year Statistics Ph.D. candidate in the Wharton School. His e-mail address is mbaiocch@wharton.upenn.edu

Please note All comments are eligible for publication in The Daily Pennsylvanian.