Student Insurance: Who Pays?

THIS fall, almost 60,000 students at institutes of higher education in Massacusetts were forced to become guinea pigs in the state's experiment with universal health care. Worse yet, they are being forced to pay a handful of private insurance companies for the privilege. In most cases, they are paying for it with financial aid funds provided by the taxpayers and intended for things such as tuition and books.

There is absolutely nothing wrong with trying to ensure that all students have adequate medical insurance. But there is something dreadfully wrong with the way that the state of Massachusetts is going about it.

The pool of uninsured students affected by the new student health insurance program represents a little less than 15 percent of the total number of college and university students in the state. Under the new regulations, those students are required to pay anywhere between $200 and $600 per year in premiums, with an average cost of $270. Students cannot register for classes this fall unless they have health coverage. Although most schools accept "equivalent coverage" as a substitute for the plans mandated by the state, a few schools, notably Curry, Dean and Hellenic College, require that all students sign up for the state's plan, regardless of other coverage that they may have.

UNINSURED students--those not covered by either a parent's health insurance or a policy of their own--are more likely to come from lower-income families who qualify for state and federal financial aid. The good news for these students is that they are allowed to use their financial aid dollars to pay for the required health insurance.

The bad news is that they don't get any extra financial aid to compensate them for the additional expense. With their already tight budgets strained even further by the new regulations, these students face some difficult decisions--such as how to afford both health insurance and books.

That's bad news for the taxpayers as well. The financial aid dollars that were earmarked for the education of youth are now pouring into the coffers of a few private insurance companies.

But what if these students were uninsured and became sick or injured? For some, the anwer would be Medicaid. Any full-time student under 21 years old with less than $2000 in assets and less than $483 in mothly income is eligible for Medicaid assistance. If the state has been woefully negligent in publicizing that fact, perhaps it's because Massachusetts is already several hundred million dollars delinquent on it's Medicaid obligations. Or perhaps it's because Medicaid dollars don't go to insurance companies.

THE student health insurance program is ultimately doomed to fail because, just like the Catastrophic Health Care Act, it is at best an attempt to apply a Band-aid remedy to a national health care crisis.

The costs of health care are so enormous that any plan that attempts to extend benefits to only a small portion of the population will result either in placing an unfair financial burden on that portion, as was the case with the Catastrophic Health Care Act, or in the misuse of funds intended for other purposes, as is the case with the student health insurance program.

Only the creation of a national health care system, perhaps modeled after the Canadian system, will bring costs under control and create a system that is truly equitable, universal, efficient and free at the time of delivery.

In a recent poll, three out of five Americans expressed admiration for the Canadian system. Poll after poll shows that Americans are ready to support a national health care program. So where are our leaders on this issue?

And where are the students? They are being forced to spend their Pell grants and scholarships on expensive private health insurance. If ever there were an issue for the 1990s, an issue that combines social consciousness with a healthy dose of self-interest, it is the issue of creating a national health care system.

David A. Danielson, a 1965 graduate of the Harvard School of Public Health, is executive director of the Committee for a National Health Program.