Lessons For The Insurance World

Lessons For The Insurance World

---

Jay Himmelstein’s compelling Narrative Matters essay about his niece’s illness and the limits of her student health insurance program presents important lessons for those of us working to ensure adequate economic access to necessary and appropriate health care for college and university students.

Because it is the colleges and universities that decide both their institutional requirements for students to have adequate coverage and the level of benefits for the university-sponsored plan (including plan limits, coinsurance, and deductibles), I sent Himmelstein’s essay to more than fifty campus student health leaders. In my cover note I wrote: "If there are lessons here for the insurance world, they are two: (1) Voluntary plans are problematic because of risk selection, and (2) plan limits for this basically healthy population might harm only a few people, but their physical suffering will be significantly compounded by economic worries, and they might forgo necessary care."

I received extremely positive responses from many of these student health leaders. As evidence of how important Himmelstein’s essay is, let me quote from one of the responses: "It is a very a timely article for us as our university administration and graduate school are currently looking at ways to reduce the cost of student health insurance.... I am afraid they are going to suggest reducing or limiting the benefits of our excellent plan, meaning that what I read in this essay could very well happen to one of our students. I am going to distribute copies of this essay it to our Student Health Insurance Advisory Committee. Thanks for sending it."

In turn, I say thanks to Health Affairs and Himmelstein for this important—and clearly timely—essay.

Stephen C. Caulfield
The Chickering Group, an Aetna Company, Cambridge, Massachusetts