Harvard Researches Health Plan for Staff

Harvard is considering offering a maverick, long-term health insurance plan, which, if adopted, could provide nursing home and hospital care for faculty and staff, University administrators said yesterday.

Under such a policy, University employees would pay insurance fees to an in-house program that would cover a yet unspecified amount of medical care for patients needing such services for extended periods of time. As universities across the country look into offering long-term care insurance plans, Harvard's research in the area is expected to serve as a model for similar programs.

Financial Vice President Thomas O'Brien, the main force behind Harvard's health-care planning, said yesterday that he has been spending 25 percent of his time "deciding how to go about the design of a plan and share information with other colleges."

A $225,000 grant from the Carnegie Foundation is funding O'Brien's travels to Washington, where he said he has been meeting with members of the trade organizations of higher education officials.

With the new policy, Harvard aims to provide affordable nursing home care to employees. While 10 percent of people older than 65 will spend a year or more in a nursing home, health care costs are climbing, and only people who need services end up paying for them, said O'Brien.

"It's infinitely cheaper to offer health care insurance on a group basis than on an individual basis, which would have prohibitive premium costs," said Claire Sheahan, spokesman for TIAACREF, the New York-based insurance company that provides pension systems for universities nationwide. Individual coverage could cost hundreds of dollars each year, compared to an employer provided plan that would run only a few dollars a month, said Sheahan.

"[Long-term health insurance] is very badly needed as the population ages. We can't make Congress adopt a plan, so we will do it through institutions," said Ernst Benjamin, co-chairman of the pension issues committee of the umbrella organization for higher education in Washington. Benjamin, who also heads the American Association of University Professors, said such policies have not existed at universities until now, but "Harvard will provide academic leadership" in the area.

Insurance companies are now banding together with university representatives to develop health care plans. TIAA-CREF recently sent a letter to 3800 universities to "start them thinking about the issues" of long-term medical insurance, said Sheahan.

In general, when universities enter the health-care arena, they spend only as much as they take in from participating employees, Benjamin said. Under plans being investigated, Harvard and other universities would not be "writing a blank check" for runaway nursing home costs, he said.

"The trade-off between cost and coverage" willdecide how many services Harvard would offer,O'Brien said.

"The biggest challenge facing employers todayin health insurance is reconciling costcontainment and preserving high-quality care,"said Sheahan.

Harvard's program could provide anything fromsolely catastrophic coverage to immediate,comprehensive health care. But because the plan isnow in its preliminary research stage, no costfigures or details are yet available. Universityadministrators will determine within a yearwhether the plan is feasible, said O'Brien.

Some older faculty members who would beeligible for insurance coverage said that they areglad to see Harvard looking into such a program.

"I'm always in favor of improving health care,"said John Kenneth Galbraith, Walburg Professor ofEconomics Emeritus. "It sounds like something wellworth investigating."

But Trumbull Professor of American HistoryDonald H. Fleming said his current coverage issufficient. "I wish to choose my own hospital andmy own program," said Fleming. "Most schemesentail reducing your choice of hospital and Iwould never allow for that.