Viewpoint: School-Sponsored Health Insurance: Planning for a New Reality: If College Health Services Are to Survive, Planners Must Adapt to a Changing Healthcare Environment

By Liang, Bryan A. | Planning for Higher Education, April-June 2010 | Go to article overview

Viewpoint: School-Sponsored Health Insurance: Planning for a New Reality: If College Health Services Are to Survive, Planners Must Adapt to a Changing Healthcare Environment


Liang, Bryan A., Planning for Higher Education


Introduction

President Clinton's attempted health reform 16 years ago included efforts to address college health services. As President Obama now tackles health care, it is an opportune time to review the state of college and university health programs and the effects of reform on them and their future. The bottom line: if college health programs are to survive, market forces and regulation will require a change from the current strategy of managed care avoidance, increased fees, limited service, and expensive programs. College and university planners must take stock and adapt to a changing health care environment if they are to fulfill the needs of their students and their institutions.

The Historical Context

In 1993, during the height of the Clinton health care reform debate, college and university health programs were at a crossroads. Campus health center funding was being cut significantly, with a decrease in overall institutional support from 45 percent to 16 percent between 1987 and 1990. Student fees were raised in response, with revenues almost doubling from 34 percent to 63 percent of the health services budget during this same period (Brindis and Reyes 1997).

Predictably, students and their families demanded change. In fact, a Journal of American College Health article (Brindis and Reyes 1997, 11 41) asked how college health programs could continue this strategy when "students and families argue that, because they already have HMO coverage or some other insurance plan, they should not have to pay for a second, college health fee" Parental frustrations grew further when they recognized they were actually paying three times--to keep their child on their insurance, for the health fee, and for additional expenses such as laboratory tests uncovered by campus plans (Liang, forthcoming). The article's authors argued that "billing the managed care program for services might be more manageable and cost effective," while the argument against billing insurers was typically based on administrative concerns (Brindis and Reyes 1997, [paragraph] 47).

In his reform efforts, President Clinton considered this same concept. With the growing importance of managed care came a proposal to provide employers with incentives to pay a combined student insurance plan/health services fee directly to school health plans to cover student beneficiary health needs.

Although this integration of managed care into college and university health programs was innovative, it failed when the Clinton plan failed. Ever since, managed care has grown exponentially; the integration of it into student health programs seems logical if not inevitable.

The Reform Context

Yet today, only a minority of campuses have found a way to do this, despite a U.S. Government Accountability Office (2008) report noting that two-thirds to three-quarters of students carry insurance either through a parent's employer-sponsored managed care plan or on their own. Managed care is here to stay, and nearly everyone in the United States uses it. However, the status quo of 1993 still exists on campus--parents and students continue to pay up to three times for campus health care. To add insult to injury, those who refuse school-based insurance may pay up to five times the amount for services on campus compared with those who enroll in the school plan (Liang, forthcoming). Further, the GAO report found that school-based plans have low coverage ceilings, have "interior" caps for particular sets of services that further reduce coverage, and simply offer little for the money compared with similarly-situated managed care plans available in the community.

So while President Clinton's reforms--albeit unsuccessfully--attempted to address college and university health, what do President Obama's reform efforts do? At one level--perhaps most compelling--students could remain on their parent's health insurance plan until age 27. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Viewpoint: School-Sponsored Health Insurance: Planning for a New Reality: If College Health Services Are to Survive, Planners Must Adapt to a Changing Healthcare Environment
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.