Within the last month, in response to HUCTW's ongoing proposals to establish the benefit in negotiations with the University, Harvard has announced its intention to convene a new committee, chaired by the Provost and with broad faculty involvement, to consider the question of "domestic partners" coverage further.

HUCTW representatives will take part in the meetings of the Provost's committee enthusiastically, but a troubling question lingers. Why is it that a small but important question concerning the basic fairness of Harvard's health insurance offerings, which has already been studied extensively by a Joint Committee which included a number of Harvard's top administrative and faculty experts on health care issues, needs to be referred to committee for a second time? Again, it is hard not to reach the conclusion that the University's approach to the consideration of complex health care issues is not comprehensive or inclusive, but remains chaotic and confused.

Conclusion

In the end, the overall picture of Harvard's response to the health care challenges on its own campus is one of sporadic, incoherent activity. A significant lack of consultation and full communication on the HealthFlex Blue change is followed by a stunning excess of process in considering "domestic partners" coverage. Lasting, effective structures have not been created for committing the University's resources to finding good answers to difficult questions, even though they are called for in the HUCTW Agreement and by many concerned individuals in the Harvard community.

There is an urgent need for intensive, ongoing attention to health care issues by Harvard's top administrators. At a time when the American health care system is undergoing great evolution and new approaches to national policy could emerge, it is all the more important that the University have a serious mechanism for studying health care on this campus, considering new ideas, collecting and analyzing data, and educating all of Harvard's concerned citizens. The challenges are only going to get more complex.

It is possible to control costs to institutions such as Harvard without limiting coverages or handing down a greater share of costs to staff members. It is critical that we strive to do just that, for the sake of the University and its working people. No one can afford simply to continue as we are. It is also possible to change our definitions of who is included and who is covered, as our understandings change about what kind of families exist among us and need to be supported. Until we do that, an ideal of basic fairness and equal treatment for everyone in the Harvard community will not be achieved.

The time for a new and more serious, inclusive, ongoing approach to the administration of health care policies at Harvard is right now.

Definitions

Co-Payment or Co-Insurance

Many health insurance plans require a patient to pay a portion of the cost for each treatment received. For example, a plan might require a co-payment by the patient of $5 for every doctor's visit or separate treatment.

Cost Containment

At least two different kinds of efforts to control health care costs are referred to under the heading of "cost containment" in current health care policy. Plans designed to yield better coordination between providers and insurers (see "managed care" below) with resulting efficiencies, and changes which limit the amount or kind of care which a health plan covers can both be called cost containment.

Deductible

Many health insurance plans require a patient to pay 100 percent of the cost on a limited amount of health care costs incurred in a given year. For example, a $200 deductible would mean that the first $200 of bills for treatment in a year would have to be paid by the patient. Additional expenses beyond the first $200 would be covered by the plan.

HMO