Pitt debates health care benefits

With possible cuts in state appropriation and the resulting economic problems for the city… With possible cuts in state appropriation and the resulting economic problems for the city and Pitt, the University may be facing some tough decisions in the future, according to Chancellor Mark Nordenberg.

“The Dickens description of the best of times and the worst of times isn’t entirely off mark,” he said.

But, Nordenberg added, the fear induced by any of these problems may be dwarfed by a larger worry – the cost of health care. The concerns become more relevant for the University community since Pitt is currently in health care negotiations. According to Vice Chancellor for Public Affairs Robert Hill, the health care contract is set to run out June 30.

These concerns about the cost of health care and ways of alleviating the burden on consumers were the topic of discussion at the Spring Plenary, which was sponsored by the University Senate.

Nordenberg related the health care problem to the mythic story of Alexander the Great and the Gordian knot, which was unable to be untied. In the end, Alexander was able to conquer the knot through his cunning mind. Nordenberg then invited the keynote speaker, Sherman Folland, associate professor of economics at Oakland University, to step into the role of Alexander helping to untangle the health care insurance knot.

Folland began by admitting that he was unlikely to be the hero of the lecture, as there are few clear-cut solutions to the health care dilemma.

“In fact, what you’ll hear from me may sound unusual to you,” he said.

According to Folland, the problem is not so much an issue of finding some universal solution, but that health care costs are a sheer matter of a steady proportion. If the level of health benefits offered is raised, the amount of money that an employee receives in wages is almost always lowered. That means that lowering health care does not matter very much to the employers offering the benefits – they pay the same either way. Folland sees the employee as paying the cost of health care in the end.

While a university could offer more benefits, there is always a trade-off.

“If you have health benefits greater than other schools, you need not be uncompetitive,” Folland said, adding that instead the salaries of the employees would just be lower.

Pointing out that rich countries usually pay more for health care, Folland said that the high health care costs are a result of the sophisticated technologies available and the consumer’s demand for high quality.

Panel member Nicholas Bircher, associate professor of anesthesiology and critical care medicine, presented the doctor’s point of view in the health care dilemma.

“Physicians’ salaries did change over the 20th century, but the product changed as well,” he said.

In his comments, he presented the health care insurance industry as an unstable and ever-changing industry where the patient is left “like a ping-pong ball in a hurricane.” He urged consumers to shop around and do their homework in looking for health coverage.

Compared with the models that Folland and Bircher presented – relatively small amounts of consumer autonomy in changing the system – the second two panelists focused on the system’s failure and the need for significant change.

Nathan Hershey, professor of health law, began with a question.

“All of us are health care consumers, now who’s pushing us around?”

For Hershey, the answer is a round robin of blame in which everyone points a finger. Hershey believes this spread-out blame resulted in consumer disillusionment. But after citing various examples of fund misuse, Hershey said that it is the insurers who push people around more than anyone.

“Who’s watching out for the consumer?” he said.

As the last panelist, Gordon MacLeod, professor of health services administration, voiced the strongest critiques of the health care system and called for the most radical changes.

“As a professor I have to give the health benefits system a failing grade,” he said.

MacLeod’s statements resulted in applause as he emphasized the need for a nationwide health plan that is both universal and regulated. In the struggle for this plan he called on Pitt and other college faculties to lead the way with “all deliberate speed.”

“Committed faculty members … could inspire the American public to change its course,” he said.

To support his views, MacLeod gave statistics about the quality and costs of health care in the United States as opposed to other developed countries. According to MacLeod, the United States has higher infant mortality rates and shorter longevity than nearly all other developed nations.

The plenary ended with an open discussion where audience members asked questions. Many of the people commenting applauded MacLeod’s idea, while others asked about the future of health care benefits for Pitt employees.

According to Hill, more information about health care options offered to Pitt employees will be available to the public once negotiations are finished.