THE ANTHRAX scare has brought a new word into the American consciousness: Cipro. Even though most Americans are learning about its capabilities, they don't consider who will pay for those expensive prescriptions.
Yet the question of how to provide adequate care at a reasonable cost arises every day and in mundane places like the University. Student Health has proposed bringing specialists in house to lower the cost of student health care. This idea deserves consideration by administration and students.
Twelve physicians work at Student Health full time, with a supplementary staff of trainees from the Medical School and nurse practitioners. All three groups see students who make appointments, though students who make emergency appointments usually see trainees because physicians are booked for ongoing care. Though the experience sometimes is frustrating, it's a lot easier than trying to find a primary care physician covered by a student's insurance plan.
Obviously, though, this service costs money. Although budget money is allotted, all students pay through their student fees, $292 per student this year. Though this pales in comparison to out-of-state tuition, it does represent a sizable chunk of our student fees, and so students should pay attention to how it's used.
Student Health focuses most of its resources on the ability to treat students within the realm of general family practice medicine. This doesn't mean, however, that these are the only ailments students come in with. Therefore, it is often necessary to refer students to specialists.
These referrals generally are to the University hospital. The hospital is close enough for students to have convenient access, and the close relationship between Student Health and the Medical School provides a ready pool of specialists from which to draw.
Yet this does not mean that going to the hospital is an inexpensive option for students. For students on the QualChoice health insurance plan - and whatever successor is chosen for next year - visits are reimbursed at the full rate because Student Health is a primary care provider, and the University hospital is on the reimbursable list.
However, the majority of students here do not have QualChoice because they are on a family plan. With fee-for-service insurance becoming rarer, students cannot assume their visits to specialists will be covered fully. This is because many plans require specialist referrals to go through an authorized primary care physician for reimbursement. Also, even if students can go directly to the specialists, the doctors may not be on the approved list. Either way, students must either go through the inconvenience of seeing a Charlottesville physician or pay a high out-of-pocket cost.
To help with this problem, Student Health has proposed bringing doctors in-house to handle the two most common referrals, orthopedics and dermatology. With an average of 30 to 40 referrals a month for each, a part-time specialist would have enough work to justify coming here. These services would be treated as any other Student Health visit, thus sharply reducing out-of-pocket cost.
Student Health Director James Turner investigated the issue earlier this year and found an orthopedist willing to come two half-days a month for $30,000 a year. Even if all the cost came from student fees, this would result in an increase of less than $2 a student. Turner believes he also could find a dermatologist for a similar amount. Recent renovations to Student Health mean that the facilities already exist to accommodate the extra physicians.
However, the budget office turned down the request. The exact reason is uncertain, but Turner thinks it probably is for the understandable reason that the administration wants to hold student fees down and did not have time to investigate the larger picture. Yet a raise in cost of around $3 per student is a small percentage of the $292 we already pay and much cheaper than visiting a specialist.
One could also argue that Student Health wasn't established to provide specialty service. However, the University already provides gynecology and mental health services. Both provide fairly simple services, like annual Pap smears and therapy to help deal with the stresses of college life. Both save students money from going to specialists elsewhere. It makes sense to bring in other specialists that share these criteria.
Bringing in orthopedic and dermatological specialists represents a cost-effective way to deliver students quality health care. As it becomes harder to hold down costs in areas such as prescription drugs, we need to be in the business of finding cost-effective methods of care where we can. Saving money on health care isn't as hot an issue as anthrax, but for most of us it's more important in everyday life.
(Elizabeth Managan's column appears Wednesdays in The Cavalier Daily. She can be reached at emanagan@cavalierdaily.com.)
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