Open Letter to Dean Schreyer about changes in the Student Health Plan
Dear Dean Schreyer,

We are a group of graduate students, including members of Princeton Graduate Students United, writing to you about the deficiencies in the new Student Health Plan (SHP), and the Health Plan Assistance Program (HPAP) that your office administers in order to make up for these deficiencies. We are deeply concerned by the decrease in out-of-network coverage the HPAP seeks to address, and we want to make sure your office can guarantee that no one who uses out-of-network coverage, and nobody who may need to use it in the future, is forced to select a less than optimum service provider for fear of having to pay more in costs. We also want to make sure that nobody faces unexpected costs in the hundreds or thousands of dollars as a result of this change in coverage. A decrease in out-of-network coverage is especially alarming at a time when surprise out-of-network billing is on the rise. According to Aetna, the insurance company that provides insurance to the Princeton community, ⅓ of all Americans have been surprised by an out-of-network bill for medical treatment which they received while unable to withhold consent: either because they were not informed that a component of their care would be performed by an out-of-network provider (e.g. the anesthesiologist for a surgery performed at an in-network hospital), or because the emergency nature of a medical situation did not allow for detailed research by the patient into each individual component of their care (e.g. the patient was unconscious). In a healthcare system that offers few financial protections to patients, it is unfortunate that the university is unwilling to bear slight additional costs in order to cover out-of-network and in-network coverage at the same rate.

As it stands now, the HPAP solution to the new SHP falls short of resolving problems faced by graduate students due to these changes in the following ways:

1. While we appreciate the positive changes that have been made to in-network coverage, we do not think it is right for the university to penalize other graduate students, in effect pitting certain interests against others. The decision to cover out-network resources at a lower rate invariably affects students made vulnerable by substantial adversity, e.g. those with complex medical pictures requiring specialist care and those who require ambulance and emergency services.

2. Without a guarantee that all care costs will be reimbursed up to the 80% coverage level, we must assume that grads and dependents should anticipate that some requests for reimbursement will be denied. This will require people to change care providers in order to afford healthcare, a disruption to continuity of care with demonstrated adverse health effects. It may also lead students to select less appropriate providers for cost reasons. In particular, in the future, graduate students will be forced to narrow down their search for providers to in-network ones, because out-of-network providers will cost thrice as much. No one should be in the position of compromising the quality of their healthcare in this way.

3. The Health Plan Assistance Program requires new disclosures of our health and medical diagnoses and treatments to the graduate school, which raises serious privacy concerns. Just as no employee should have to disclose information about their personal medical picture to their employer in order to receive coverage of health costs, no graduate student should have to disclose this information to a representative of the Graduate School.

4. It is unclear what the grounds are for approval or rejection of applications to the Program. The only criterion for reimbursement from the Program that has been published is that graduate students must prove that they “cannot reasonably access in-network care.” “Reasonably” can mean anything. Without defining the word “reasonably,” this amounts merely to saying that assessment of applications to the Program is at your personal discretion. This introduces budgetary unpredictability for all grads who need to use out-of-network care--at a potentially enormous scale.

Your office can easily solve these problems with:

1. A commitment that you will ensure that in the next Aetna contract both in-network and out-of-network coverage go up to 90%.

2. A commitment to reimburse all grads’ out-of-network care costs to 80% coverage for the duration of the current contract between Aetna and the University

3. Eliminating the requirement that students disclose any medical information to the graduate school in order to receive reimbursement.

Will your office commit to making these changes?


Sincerely,

Paresh Chandra Comparative Literature, G 4
Thomas Davies, Classics G6
Robert Decker, French and Italian, G 6
Liora O'Donnell Goldensher Sociology, G 6
Micah Fletcher, QCB Year 4
Kay Gabriel Classics, G6
Aram Ghoogasian NES, G 1
Jannia Gómez SPO, G3
Skyler Gordon, G2
M Heddaya, Art and Archaeology, G 5
Mari Jarris, Comparative Literature, G4
Sebastian Klinger German, G5
Elias Kleinbock, Comparative Literature, G 5
William Mullaney Comp Lit 3
Vivekananda Nemana, Sociology, G4
Jamie Pelling Near Eastern Studies G4
Felice Physioc, History, G5
Candela Potente, Comparative Literature G5
Aliya Ram (Comparative Literature, G 1)
Sarah Reibstein, Sociology, G5
Leah Reisman Sociology, G6
Marie Sanazaro (Comparative Literature, G 4)
Diba Shokri German, G5
Hrishikesh Somayaji (Chemistry, G 5)
Andreas Strasser (German, G 5)
Tim Alberdingk Thijm CS G2
Sean Toland, German, G7)
Johan Trovik Politics, G5
Hugh Wilson (QCB, G 5)










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