University President Mary Sue Coleman and Hillary Clinton have a lot in common. Both are powerful female leaders in traditionally male-dominated fields. Both have conveniently shifting principles. If Clinton becomes our 44th president, both will have been the first female president of their respective institutions.
But they have another thing in common: Both are ardent supporters of universal health care.
Clinton headed the disastrous Task Force on National Health Care Reform in 1994. Coleman co-chaired the Institute of Medicine’s Committee on the Consequences of Uninsurance. As a Democratic presidential candidate, Clinton is practically required to be a voice for the uninsured. Coleman had her own moment in the national spotlight as a proponent of universal health care when she presented a report to Congress on behalf of the Institute of Medicine in 2004. She said, “The committee believes this is an urgent problem – work must begin immediately. There is no justifiable excuse for delay.”
However, there’s one big difference between Clinton and Coleman: Clinton can back up her rhetoric. Granted, one is a U.S. presidential frontrunner and the other is a university president. However, Clinton has used her political clout in a strong effort to cover the estimated 47-50 million uninsured Americans – an effort that was maybe a little too strong when she was First Lady – while Coleman just spit out a lofty public statement about how someone else should do something.
Coleman is exactly right, though: There is no excuse for the federal government to drag its feet in ensuring that every American is insured. But Coleman and the University have the power to start small in the meantime by mandating that students who want to attend the University have health insurance.
An estimated one-third of America’s uninsured is between the ages of 18 and 24. A 2005 survey of students at the University’s Ann Arbor campus found that 5.6 percent of undergraduate and 10.5 percent of graduate students were uninsured. Considering that there were roughly 25,500 undergraduate and 14,500 graduate students enrolled in the fall 2005 semester, that means about 2,950 students were uninsured.
While international students are required to either prove they have coverage during their time in the United States or buy a University-sponsored plan, the University doesn’t require the same of domestic students. The University offers the Domestic Student Health Insurance Plan for American students, but the premium starts at an overwhelming $2,183 a year, a figure that has more than tripled in actual-value cost since the plan began in 1997 at $678.
According to Karen Klever, supervisor of the University Health Service Managed Care/Student Insurance Office, UHS notes “a direct correlation between the decrease in membership and increases in the insurance premiums.”
For many students, who are young and healthy, the choice is obvious: Avoid the exorbitant premiums by going without health insurance. But the costs could be enormous. Trips to the emergency room can cost thousands of dollars, money that has to come from somewhere. While the University doesn’t charge University hospital bills to student accounts, if students are stuck with tuition and medical bills without the money to pay both, it’s a tough choice to make. Many choose to drop out in order to pay the medical expenses.
If the University wants a solution, mandatory health insurance is all the rage. Similar to laws that mandate car insurance for all drivers, by forcing everyone to have health insurance and subsidizing the insurance for low-income people, these requirements expand the pool of healthy contributors, reducing average costs. Further, by encouraging primary care instead of emergency care, unpaid hospital expenses plummet. Make everyone pitch in and you insure everyone, while cutting average costs.
While states like Massachusetts, California and even Michigan are just getting in the game, universities have been doing this for a while. In a 2003 New York Times article, a health care consultant estimated that 25 percent of public universities and 90 percent of private universities require proof of health insurance in order to enroll.
Matthew Sullivan of The Chickering Group Inc., the insurance company running the University’s policy, explained to me that while insurance rates vary depending on a number of factors, mandating insurance has certainly reduced premiums for students. According to its website, Florida State University, which recently started requiring all incoming freshmen to show proof of health insurance, has a policy with a premium that starts at $1,440 a year.
Seemingly, the added bonus of mandating health insurance for students is that it can be figured into college expenses, allowing financial aid to cover the costs. According to The Chickering Group’s website, Title IV of the 2004 Reauthorization of the Higher Education Act allows students to use financial aid to pay health insurance costs, an incentive for students to buy insurance. Not only would mandating health insurance reduce costs, it could help cover some of those costs too.
According to Klever, “The issue of requiring health insurance for student’s attending the Ann Arbor Campus is currently being reviewed.” As Coleman said four years ago, though, there is no justifiable excuse for delay.
Gary Graca is an associate editorial page editor. He can be reached at gmgraca@umich.edu.