I never saw him coming. We collided at full force, and I fell to the ground in pain. My teammates rushed to see if I was ok. I wasn’t. The football game on hold, participants awaited the Emergency Support Team’s arrival. Turns out several of my teeth had gone through my lower lip. Ouch. Blood all over. Pain throughout. Several friends provided critical assistance and support. Months later, I remain to them indebted. But thanks to the foresight of Washington University administrators, I don’t owe much to those who, at great cost, transported me to the hospital or stitched up my lower lip. I write, then, in support of WU’s mandatory health fee.
Announced in the spring of 2001, the Student Health Insurance Plan immediately ignited a controversy. Students complained loudly, arguing the $420 charge (which has since risen to $450) was a needless expense for those already covered by their parents’ insurance. Burdened by ever-increasing tuition and room and board fees, parents themselves wrote Dr. Laurie Reitman, the Director of Student Health and Counseling Services, in protest. Many expressed their displeasure to deans and professors. Others threatened to withhold donations to the university.
In a Student Life column, Aaron Chait described WU administrators as “clever rascals” determined to sucker him for all he was worth. With no more than the slightest hint of sarcasm or compassion, Chait added: “Where is the ‘financial specialist’ that thought of this asinine scheme so that I can come to his home, steal his VCR, punch his oldest daughter in the ear, hold his newborn’s nose so that he learns to breath through his mouth, and kick his dog?” Conor Waddell did him one better: “A monkey with a tumor could have come up with a better plan.” Dismissing the university’s explanations, he wrote: “Reitman’s arguments make me want to slam my head into a door until my arms don’t work anymore and all I can do is feebly knee the portal into my bleeding skull.” A pleasant experience, I imagine.
Yet after a friend forcefully elbowed my lip into my lower teeth, I reconsidered the administration’s arguments anew. For I too had once opposed the health fee, but under very different circumstances. Back then I was covered by my mom’s employer. The plan was an unnecessary expenditure. Today I am, and at the time of the accident was, insured only through the university. The health plan now saves me money. Last September, the ambulance ride alone would have cost me nearly as much as an entire year’s fee. Twenty-some odd stitches would have run an extra eight or nine hundred dollars.
Aside from individual profit (or loss), however, the health plan is defensible on philosophical and/or religious grounds. Put simply, as human beings, all WU students ought to have basic health insurance. I live in and am active in an on-and off-campus community. I care about my classmates and want them to be healthy. I would prefer that they not lie to the university about lacking coverage, as occurred regularly before the student health plan was made mandatory. If they do not feel well, I ask that they seek treatment, if not for their own sake, then at least for mine. The more people who are ill in my residence hall, the greater the likelihood I, too, will get sick. Two days before an important test, perhaps.
The rationale for a mandatory plan, no waivers allowed, is fairly straightforward. Bulk purchases enable significant discounts. The greater the number of student subscribers, the lower the cost to individual customers and to the community as a whole. Further, group subscription eliminates adverse selection, a phenomenon wherein only unhealthy students signup for care and insurance companies raise rates accordingly.
Some believe the current system is less than completely efficient. In its place, they suggest the health insurance fee be bundled with tuition costs and financial aid packages. This scheme, they argue, would better align needs and resources. Fair enough. What worries me not are arguments about details. What saddens me most are conflicts over principles.
I never saw it coming. Many of my friends talked about equality. Wrote about making sacrifices. Volunteered for causes that aimed to reduce hunger, improve education, and guarantee basic human rights. But when the rubber met the road, when students-or, more often, their parents-were asked to pay a little extra so that all may have basic health insurance, folks balked. At a forum to address complains, Reitman, Conor’s “Czar of Health Services,” was treated with scarcely more respect than some of my friends might show the anti-Christ.
Writing several months after the fact, Alli Gilmore noted in a news story that the “tension [around the health insurance plan] appears to have died down.” I can only hope students and parents haven’t merely muted their criticism, but reconciled their concerns with the principles both claim to espouse.