Inadequate health plan needs greater improvements

By Eileen Meyer     4/9/09 7:00pm

Ed. note: This article has been changed from the printed version.In a 2008 study of graduate students on the Rice-subsidized health plan, 97 percent of over 400 respondents were unhappy with the plan coverage and cost. Indeed, a comparison of the plan with other similarly-sized schools in the top 50 US News and World Report rankings shows that our current plan is well behind our competition in almost every way, such as co-pay percentage and out-of-pocket maximum.

Adding insult to injury, over the past two years Rice's insurance provider Aetna made almost three times as much as the industry average for a comparable plan and number of lives insured. And while students are a healthier population to insure, Aetna's profit was worth about 120 years of Rice tuition and board at their current rates.

Students are feeling ripped off, and justly so.

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But that is really only the beginning of the story. Since Rice generously subsidizes graduate student health insurance, the students aren't the only people losing money. With all the budget-consciousness this recession has brought on, how did Rice overlook this one?

The answer was a dirty little nine-letter word: committee.

Alas, the handful of administrators charged with advising and choosing a yearly health insurance plan neither pay for this service nor use the plan themselves. Any student of human nature can probably predict that this leads to less than ideal results, even if the committee had the requisite expertise to compare health plans meant to serve over 1,500 students.

We have no broker for the student plan, and no formal review process. The only qualifications for committee members appear to be that they have been asked to choose the plan in the past, which, given how truly terrible some of these past providers and plans were, is not particularly comforting.

Sir Barnett Cocks, former United Kingdom Clerk of the House of Commons, once quipped, "A committee is a cul-de-sac down which ideas are lured and then quietly strangled." Unfortunately, though perhaps not unpredictably, the process of "choosing" a plan has settled down to the process of accepting, without too much questioning, whatever plan the current provider puts in front of the committee.

The only exceptions to this sad tableau in recent years have required monumental efforts by the students observing the process, taking many hours of effort away from their research to take surveys, call insurance companies, research alternatives and educate ourselves about the real expectations for an insurance plan. The fact that a massive report had to be written to even get students into a meaningful debate about the plan benefits speaks to the real nature of this committee, which sees its duty as one to be dispensed with, as quickly and painlessly as possible. This cannot be considered ideal.

An article referencing a 2008 issue of Business Week suggests that "college administrators are often unfamiliar with the insurance industry and do not negotiate the best deals," further asserting that "the relative health of most college students makes the market very lucrative." Research in the same article showed that while large insurers spend, on average, about 80 percent of premiums on medical care, many college-recommended plans were found to be deficient, spending "well below 70 percent of premiums on care."

Unfortunately, the Rice plan is on pace to be almost twice as bad as quoted here. It is a sad fact about America today that a single accident or illness can bankrupt a person overnight, and it is even sadder to watch it happen to someone who thought they had paid to be protected from that possibility.

The fairly obvious solution is to treat choosing an insurance benefit the way any business would: bring in some competition. After a lengthy report from students outlining this position last December got almost no response from the informal committee, a formal letter was addressed to President Leebron.

Anxiously, we waited to see if our suggestions for a formal committee process, student-paid broker or self-funded plan would be taken seriously. At length, we received a reply which indicated very little would change. Again, the balance swung in favor of the status quo, as it has so many times over the sad history of health insurance for students.

Despite much language in the response indicating approbation for student input and ideas and promises to implement changes, the students advising the committee were treated to an abrupt announcement shortly thereafter that the plan had been chosen for 2009-10, without even the appearance of a discussion. A telephone query about this oddly incongruous behavior was met with a sharply-worded reminder that students have no real right to any vote on the health plan at all, and that our position is merely "advisory." What exactly was the harm in giving students, or their representatives, a choice?

This argument isn't about blaming the administrative committee members, who have been signed up for a thankless job. This isn't about some idealized "right" to health care, or even about what is ethical for Rice to do with its large population of student-employees straddling the poverty line. It's about what's smart.

After all, Rice is a private institution and under no obligation to do anything for graduate students in terms of health benefits, just as it's not obligated to have competitive stipends, good facilities or anything else that might attract top students.

But for all the talk of Rice's vision and unconventional wisdom, it's hard not to get a little cynical when encountering neither in day-to-day dealings with the inertial forces of the status quo. Instead of looking at student initiative as a nuisance to be quashed, Rice administrators might be better served by harnessing that enthusiasm for application to the very real problems students are having. Instead of countering every complaint about the current plan with an excuse and a shrug, maybe a change could be made which benefits both the students and the administration. However, this would require giving students a few real seats at the table, with a real vote in the process, indicating real representation.

It might require actually changing the way we do things.

Recruiting better graduate students to our programs has to be a major pillar in the effort to improve them, and making the health insurance benefits as good as, or even better than, our competition could have real value in that effort. Instead of settling for mediocrity, we could be bucking the trend so noted above. Certainly that would be considered unconventional, and maybe even wise.

Eileen Meyer is a physics graduate student and GSA Community Service Chair.

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