There are many things that are notable about this New York Times story, which will occupy a special place in my series: “Exactly which elite, liberal institution does have to live up to the Left’s values?” (Previously covered here and here.)
Though, before I begin, there may be no better way to put it than David Fredosso’s perfect tweet:
The first 2,000 people listed in the Boston telephone directory get their revenge. http://t.co/GlI1ulmDro
— David Freddoso (@freddoso) January 5, 2015
First, I thank the New York Times for covering this as NYT reporters are so very skilled at covering mind-blowingly self-absorbed conflicts between various factions of the upper-class liberal and un-self-aware. It’s basically the beat of the entire NYT staff.
The basics: Harvard faculty were more than happy to make recommendations about reforming health care, which were then adopted in the Affordable Care Act— among them, children on parents’ insurance until 26, comprehensive preventive care, cost-sharing, and the Cadillac tax on high-cost insurance. But living by those recommendations and their attendant costs is a whole other matter.
For years, Harvard’s experts on health economics and policy have advised presidents and Congress on how to provide health benefits to the nation at a reasonable cost. But those remedies will now be applied to the Harvard faculty, and the professors are in an uproar.
Members of the Faculty of Arts and Sciences, the heart of the 378-year-old university, voted overwhelmingly in November to oppose changes that would require them and thousands of other Harvard employees to pay more for health care. The university says the increases are in part a result of the Obama administration’s Affordable Care Act, which many Harvard professors championed.
The faculty vote came too late to stop the cost increases from taking effect this month, and the anger on campus remains focused on questions that are agitating many workplaces: How should the burden of health costs be shared by employers and employees? If employees have to bear more of the cost, will they skimp on medically necessary care, curtail the use of less valuable services, or both?
The message from Harvard to faculty, which one professor declared, “deplorable, deeply regressive, a sign of the corporatization of the university.”
In Harvard’s health care enrollment guide for 2015, the university said it “must respond to the national trend of rising health care costs, including some driven by health care reform,” otherwise known as the Affordable Care Act. The guide said that Harvard faced “added costs” because of provisions in the health care law that extend coverage for children up to age 26, offer free preventive services like mammograms and colonoscopies and, starting in 2018, add a tax on high-cost insurance, known as the Cadillac tax.
A fact buried far down in this story, just paragraphs from the end? Harvard’s premiums are going down. With that nearly unbelievable context, let us unleash the incredible whining of an incredibly privileged set having to live by its own rules.
Just how out of touch are the faculty members of Harvard? A world expert on Virgil and a French history professor are leading the charge against these outrages, which will sound suspiciously like “way better than most health plans I’ve ever had” to normal Americans:
Employees will now pay deductibles and a share of the costs, known as coinsurance, for hospitalization, surgery and certain advanced diagnostic tests. The plan has an annual deductible of $250 per individual and $750 for a family. For a doctor’s office visit, the charge is $20. For most other services, patients will pay 10 percent of the cost until they reach the out-of-pocket limit of $1,500 for an individual and $4,500 for a family.
Previously, Harvard employees paid a portion of insurance premiums and had low out-of-pocket costs when they received care.
Those deductibles are quite low, the co-pay is reasonable, and paying 10 percent of one’s health care costs is not the end of the world. As the article points out, the plans are far more generous than the average Obamacare exchange plan.
The slight increase in costs to these put-upon upper-class intellectuals has led to an internal Harvard wonk-off with mathematicians and economists battling it out with administration over how much costs are really rising in order to avoid having to give over any of their paychecks for this cause:
In response, Harvard professors, including mathematicians and microeconomists, have dissected the university’s data and question whether its health costs have been growing as fast as the university says. Some created spreadsheets and contended that the university’s arguments about the growth of employee health costs were misleading.
The administration has responded by saying it can’t change 2015’s arrangements, as they’re agreed upon far in advance and affected by changes in the health care market. You’d think a bunch of Harvard professors, some of whom helped make those changes, might have anticipated this. What the administration will do is start a fund for employees facing costs of more than 3 percent of their income on health insurance. The national average for spending on health care for families, according to the Bureau of Labor Statistics, is 7 percent.
The administration’s decision-making has been further complicated by the fact that one common method of cutting costs—narrowing doctor choices— would be quite awkward at Harvard. Harvard Med is affiliated with some of the world’s best doctors and expensive hospitals. Cutting them from networks would mean cheaper plans, but would also mean Harvard professors can’t go to Harvard Med docs.
Health care is a finite resource. The only thing that ever reliably created more of a finite resource with corresponding ever-falling prices is the free market. The Ivory Tower is intent on rejecting this particular type of health reform*, and now it has to live by its own prescriptions, which means either higher costs or fewer choices.
Hey, at least they’ll be spared the audits.
*To be fair, cost-sharing is a free-market function that can, indeed, bring down spending levels as consumers are exposed to some of the cost of their decisions in our ludicrous third-party payer system. But when cost-sharing is folded into the preservation and exacerbation of third-party payer, as with Obamacare, without really improving cost transparency won’t get you much upside for the downsides these professors decry. But I am not opposed to the idea, in principle.