How Much for Hygiene?

The University-wide committee that set out to investigate the Hygiene Department a year ago has come up with a set of worthy recommendations, but its five graduate student members frankly admit that they haven't accompished what they set out to do--find out "whether the Hygiene Department is giving the best possible service for the fee charged." This failure is due to the peculiar nature of University expense accounting; to discover what happens to the student's $15, the committee would have had to examine every invoice and voucher for a year of Hygiene Department operation, a task which even the U. S. Government auditors, who looked at the books when the University held war-time Army and Navy contracts, found difficult.

But although incomplete, the report is sound. The committee did study the income and operation of the department and gathered a quantity of material on the health services of other colleges. On the basis of this study the group makes its recommendations. The Department should examine several of them carefully.

For instance:

1. The first recommendation calls for the omission of some extra fees beyond the $15 per term charge. The fact that patients at Stillman must pay more than the $15, for medicine, special services, and after-hour calls, has always been a chief source of complaint. The committee would make up this loss of revenue by economics in the department. But they miss the stronger argument that the department showed a balance of more than $100,000 in 1946-47, the year they studied. This figure suggests that some of these irritating fees could be abolished.

2. The committee puts in a welcome word for the commuter who consults his own physician regularly, and asks that he should not be required to contribute $15 a term to support a Hygiene Department that he never uses. The intricacies of University accounting cannot guarantee that the $100,000 is a concrete balance, but even the committee's figures, which ignore this profit, support the notion that such an amnesty for commuters would not push the department into the red.

Unfortunately, the committee has hardly touched on a question that appears to contain the major solution to the Hygiene Department's difficulties. With Stillman and Holyoke Street only twenty minutes from the Harvard Medical School, a more effective liaison between the two University medical organizations would pay financial as well as professional dividends. College and graduate students are still shunted out daily to private specialists, while full staffs of specialists in University employ are right across the Charles. The report slides by the significant fact that at Chicago and Pennsylvania the student fees are less than Harvard's and still pay for the services of specialists attached to University hospital or medical school.

Closer cooperation with the Medical School might also bring about economies in the management of Stillman Infirmary. In 1946-47 more than $141,000 out of a total expenditure of $423,000 went to maintain a large, year-round staff at Stillman. Ninety percent of the time, more than half of Stillman's beds are empty, and seldom is the whole staff busy. As the committee points out, the large staff is a worthwhile form of insurance against epidemics that should not be given up. But the Hygiene Department has given no conclusive reasons why the permanent staff at Stillman could not be reduced, while Med School internes filled in during the rare emergencies. Chicago and Pennsylvania have managed to slice the costs of health protection by a similar use of medical staffers whose main job is not the care of students.

With the costs of education continuing to rise, it is more than ever the responsibility of every University department to eliminate waste expenditures and give the student the most for his money. The Hygiene committee has done all that a part-time student group can do. The Hygiene administrators know that the student body can go no farther. It is up to the Department to cure its own ills.