An Unhealthy Change

In September, the Harvard University Group Health Program (HUGHP) cut benefits for retired Harvard employees. Now, those close to retirement and still on the plan have the unenviable task of finding another healthcare provider before Harvard takes away their coverage. Indeed, just last month, University Health Services (UHS) warned older employees still on the HUGHP plan to make alternative arrangements before they retire.

When the University sacrifices the health of its workers because of the bottom line, the Harvard community suffers, and we are increasingly concerned that Harvard is inching closer to cutting off even more health benefits.

Yet Harvard is not alone. In recent years, vertiginous rises in costs have caused many large employers to scale back or eliminate their workers’ health insurance options. A report released by the National Coalition on Health Care last May predicted the average monthly health insurance premium for family coverage would soar into the four-figure range by 2006. Meanwhile, in Medicare managed-care plans—which account for two of the alternatives suggested by UHS Director David S. Rosenthal ’59 in last month’s warning letter—82 percent of patients were required to make copayments in 2003, up from 4.3 percent in 1999. That medicine has become fiscally exacting for employers as well as those covered is a gross understatement.

But much more real than even the University’s anxiety about its health budget is the possibility of future modifications to Harvard healthcare. What makes HUGHP’s recent move surprising and regrettable is the message it sends to employees: that their health insurance benefits are subject to drastic change. And while retired patients who choose to switch to BlueCross BlueShield’s MedEx supplement (rather than one of the Medicare-managed plans) will continue to receive care from UHS, the perturbing question of whether Harvard’s medical resources will always be available to them is inescapable.

Rosenthal’s letter is much more than a reminder that HUGHP will no longer cover retirees. It is also a reminder that Harvard is not above treating its employees according to the results of cold cost-benefit analyses. Unlike many other large employers, whose business is limited to making money, Harvard is in an ideal position to provide its workers with better health coverage than a look at the prices might support. It would seem less critical for the University to minimize risks to its balance sheet than risks to its former employees’ health.

It is fortunate that the circumstances of the change allow Harvard retirees to elect to keep UHS as their primary provider. But deep concern on the part of employees is well-founded. No end is in sight to the extraordinary surge in health care costs; the University could conceivably cease funding MedEx at some later date and close the doors of UHS to its retired faculty and staff. Nothing short of a guarantee to the contrary will do for reassurance.