Capitation. Gatekeepers. Health Alliances. The terminology of President Clinton's health care plan seems hostile and uninviting, but the plans' goals are simple -- universal access to primary health care for everyone -- even college students.
Clinton's plan intends to change the way health care is provided and paid for and everyone at Dartmouth -- students, faculty, and employees will be affected.
Worried about the rising costs of health care and the growing number of uninsured Americans, Clinton made reforming the health care system a major part of his campaign platform last year.
The White House recently released the plan that First Lady Hillary Clinton and a team of experts have been working on since the President's inauguration last January.
Although the plan is sure to be revised in upcoming battles with Congress, the original version offers a glimpse into the solution that Clinton has for the nations' health care problem and how that will affect Dartmouth students and employees.
Clinton proposes to provide health insurance to all Americans by mandating that companies pay for employees' health insurance. The government will help by subsidizing the cost of insurance for the unemployed and part-time workers. The plan will also create
regional "health alliances."
The health alliances, previously named "health-insurance-purchasing cooperatives," will purchase insurance in bulk from major insurance companies, and will then sell a variety of health care plans to individuals at a lower cost. All Americans not covered through their employers, including people without jobs, will be part of a health alliance.
Clinton's plan also proposes to use federal regulation to cap health care spending.
Students, employees, and faculty at the College will all be affected by Clinton's plans.
First, Clinton's proposal may change the way many students' health care needs are paid for.
According to Dr. Jack Turco, director of College Health Services, the services provided by Dick's House and the DHMC will not change noticeably, but the behind-the-scenes payment for health care would change.
Currently, primary care for everyday health problems is provided to students at Dick's House. Students do not have to pay for each visit to Dick's House, because tuition helps cover any health care needs they might have.
This will not change according to Turco. "[Clinton's plan] is going to have a relatively small effect on what we do [at Dick's House]," he said.
Students who need more extensive health care than can be provided at Dick's House, are referred to the Dartmouth-Hitchcock Medical Center, which either bills insurance carriers directly for any treatment or bills the student, who, in turn, submits the claim to an insurance company.
All Dartmouth students are required to have some form of health insurance, either as part of the Dartmouth Student Group Health Plan or through a personal or family insurance company. The College health plan costs $945 for the 1993-94 academic year.
Every undergraduate and graduate student is eligible for the plan. According to Yolanda Baumgartner, the administrator for business affairs at Dick's House, 40 percent of students are insured under the DSGHP.
Turco said that the Clinton plan will not affect students directly, but may reduce the costs of third party insurance.
Parents of students may be able to get more and cheaper insurance from their companies, thus reducing the need for Dartmouth to supply its own insurance coverage plan.
Turco said that if that is the case, the College will need to look closely at the DSGHP and make some "business decisions" about the plan.
"If fewer and fewer students need to buy into our plan it would make our plan more difficult to continue," he said.
But, according to Turco, Clinton's plan is mainly geared towards the uninsured and will not really impact much on Dartmouth students.
"We theoretically do not have any of those individuals. In a way we mandate students to have a health insurance plan already."
"I doubt right now [Clinton's plan] will make a difference for students," he added.
Clinton's health plan will likely have the greatest effect on students right after they graduate. Recent grads who are covered by the DSGHP, do not have any other health insurance and don't get insurance as a graduation present, would have no health coverage between the time they graduate and either get a job or get health insurance through a graduate school.
Employees and faculty of the College will also be affected by the new health care proposal.
As a medium-sized employer, the College will be required to pay 80 percent of insurance premiums for its employees.
But, Roger Brock, the College's director of human resources, said he does not foresee any change to the current medical plan provided by the College to employees in the near future.
"At this point we're sticking with our current Blue Cross-Blue Shield plan," he said.
The College's current plan is a "flexible benefits plan" according to Brock. College employees choose medical, dental, long-term disability, and life insurance plans from a list of options provided by the College. The College gives employees money based on their salary to pay for the various packages.
According to Brock, the insurance plan that the College offers to employees is renewed every January and Clinton's health package will not have any effect on next year's plan.
"The plan for 1994 is already cast," Brock said. "The government will have nothing in place before we sign up in January.
Expenditures for the 3,000 College employees and faculty total $10 million, Brock said.
Brock said the College will "take a wait and see attitude" on the health care plan and will reconsider its current health care package when the final details of Clinton's plan are accepted.
Turco said it is premature to make any changes in the current health care plan at the College because Clinton's proposal is not yet finalized, and no one knows how the plan will eventually turn out.
"I don't think that anybody has a crystal ball," Turco said. "Everybody is trying to influence the way people think of the plan, but only part of that is fact, the other part is speculation."
