Notes on UHS and Student Health Care April 2004 (revised Nov 2004) These notes outline some of the concerns with the current funding of student health services on the UC Berkeley campus. They are compiled by T. Madon, based on conversations with Steve Lustig, the Associate Vice Chancellor and Director of University Health Services. Background University Health Services is currently funded in part by the Registration fee (approx. 42% of the UHS budget comes from this source) and also by fees for service (e.g. non-routine exams, pharmacy, lab work, etc). However, because the proportion of the Reg Fee devoted to UHS tends to fluctuate from year to year (depending on the overall fiscal state of the University...) it turns out that UHS funding is not tied to enrollment. And as with the recent discussion of classroom technology (and UC Berkeley's decline in this area), it has been noted that Berkeley has fallen far behind in its support of student health over the past several years. Let's review some statistics and trends:
How Student Health Impacts the UC Aside from the statistics above, which point to a chronic de-funding of student health services over the past 10 years, it should be noted that maintenance of the status quo at the Tang Center is a danger to students (1) and also to the prestige of the University (2). (1) Risk to Students: Reducing students' access to essential support services—particularly those that cannot be obtained independently, like health services—clearly puts our students at risk. Not just the risk of failing a class, but also the risks of undiagnosed alcohol and drug abuse, withdrawal from school, suicide, untreated depression, risky sexual behavior, etc. And unlike our admission policies, which are controversial, student health represents a liability that the university can and must fix. Health services should probably be the LAST student service to absorb cuts. So why was UHS one of the first units to take a 20% cut last year, at the first signs of an economic downturn? (2) Risk to the University: Some members of the Berkeley faculty have expressed concern that our students are less engaged and lively than in years past. I would suggest that this results (in part) from students' loss of access to the essential services and support that maintain mental health and well-being. It is not necessarily true that the "quality" or "fitness" of our students has declined, or that we are admitting students who are at greater risk and who therefore cannot participate or perform as fully. Instead, perhaps the continuous erosion of student support over the past 10 years (along with growth in competition, workload, and expectations) has compromised the climate of our campus, making it less conducive to academic success. So, it is in the faculty's best interest to prioritize the health (particularly mental health) of the student population, since it improves academic performance, retention, throughput, student participation, etc. A decline in the perceived quality of the student body hurts our faculty recruitment efforts. Why SHIP increases do not go to UHS SHIP reimburses students for outside services (including emergency services) that are not easily provided in-house at the Tang Center. It also reimburses UHS for specialty services and visits that are billed to insurance. In general, SHIP revenues do not go directly to UHS-- instead, UHS bills insurance, and then receives reimbursement from SHIP (just like a hospital). SHIP reimbursements also go to Sutter Health (a local outside health care provider) and other players in the bay area healthcare industry whenever a student uses services at a medical center or hospital outside Tang. The Tang Center's referrals to outside providers (like Sutter & Alta Bates) for standard health care concerns (like student counseling or routine x-rays) tend to drive student health insurance premiums up, because outside providers are generally much more expensive than doctors who work at UHS. It's cheaper and more efficient to provide services at Tang. And students prefer the convenience of on-campus healthcare. Also-- keep in mind that for graduate students, it's the Grad Division, dept. block grants, lab grants, and research contracts that pay health insurance premiums (e.g. for students working as GSIs and GSRs). So grad depts (and faculty researchers) end up bearing the rising costs of healthcare. It makes more sense for students (and/or the university, in the case of graduate students) to pay for a campus health service fee instead of paying ever-increasng insurance company premiums (SHIP). But students would have to vote for any new campus-based "service" fee. The Idea of a Separate Student Health Services Fee Some background on the Tang center: Currently, the Vice Chancellors assign some percentage of the $365 reg fee to University Health Services (these funds account for about 42% of the Tang Center's operating expenses). But the assigned percentage fluctuates year-to-year, depending on the health of the overall university budget-- in lean years, reg fee funds are often diverted to other university programs, to fill in the gaps. So a health services fee that is *separate* from the reg fee would provide a fixed, enrollment-driven income to the Tang Center-- so that we don't have to cut physicians, nurses, psychologists, and psychiatrists every time the university experiences a budget crunch. It would also pay for more on-campus services (and more access), would reduce our dependence on "outside" referrals, and would ultimately lower (or at least steady) the Student Health Insurance Program premium (which has risen 20-30% per year for the last few years). A campus-based health fee sounds like a win-win situation, but students would need to be educated on potential benefits before they'd agree to vote for an increase in campus-based fees. (Note that the Reg Fee could not be discounted by an amount equal to the new health service fee). Perhaps education on the importance of paying for adequate on-campus health care is a campus-wide issue with which the Chancellor could help. |