Have to say, the middle management at the university certainly are consistent – never failing to drive home one inexhaustible message to students: ‘Show us the money!’
In late 2011 we saw more raising of fees, followed swiftly by the raising of the Student Service Levy, and finally the topic of today’s rant: the introduction of a user-fee at the University Health Services. From student-friendly to money-maker, the University Health Services will now charge enrolled students $12 per visit.
AUSA voiced clear opposition to the introduction of fees at the Students’ Affairs Committee meeting in 2011 where the fees were first discussed. After said opposition, student input would have been viewed as a hindrance, running counter to the profit-driven scheme of Campus Life (The so-called “Service Division” that is funded through your levies and controls the healthcare system at university), and was thus disregarded. And with limited (if any) input from students in the decision making, the $12 fee was backhandedly put in place without any fuss. This flagrant disregard for transparency and student input in decision-making by certain factions in the university’s management show us that their priority is not student welfare but bald profit.
So hang on, if charging user-fees for access to health care services is the purported solution, what exactly was the problem to begin with? The likely answers are that fees are a means to mobilising money for the rising demand for health services, or perhaps that they will improve efficiency by moderating and containing costs. And while this logic may be sound when it comes to businesses, health care is a different ball game and requires a completely different approach.
Let us dispel the myths surrounding the introduction of fees for health services. Because user-fees do not reduce cost, they could simply displace the burden to hospitals (where health care is free and waiting times are already ridiculous), or cause sick students to forego treatment all together and increase inequity overall for those most vulnerable.
MYTH 1: “THE UNIVERSITY DOESN’T HAVE THE MONEY TO SUBSIDISE FREE HEALTH CARE.”
One word: nonsense. There is plenty of money to go around. Each and every student has to pay the compulsory Student Services Levy (SSL), a whopping $689 a year, which is the highest SSL fee in the country! So instead of the levy going towards McCutcheon’s ridiculous plans to renovate every inch of the university to attract potential consumers, I mean, students, we could be channelling it towards a much more worthy service, like that of the University Health Services.
And lest we forget, our fees went up by 4% last year, only to see our services cut and McCutcheon getting another pay rise (taking his personal wages to around $800,000 per year!). If there really isn’t enough money to go around, the property development wouldn’t be happening and neither would the pay rise. C’mon McCutcheon, whose back have you got?
If this is about cost control, focusing on patient behaviour rather than that of the providers (doctors) has been proven to have little real success. Not only are the providers a more powerful determinant of healthcare costs, as they make decisions on behalf of patients in terms of diagnosis and treatment, but it has been found that changes in provider payment mechanisms is a more powerful way of influencing their behaviour and working toward reducing service costs.
MYTH 2: “IT TAKES AGES TO GET AN APPOINTMENT BECAUSE IT’S FREE. TOO MANY BLUDGERS BLUDGIN’!”
The idea is that by introducing a user fee, the waiting times will decrease as students are less likely to book unnecessary appointments once they have to foot the bill. While this may lead to a reduction in appointments, it runs the risk of causing students who genuinely need access to free health care to forego treatment they legitimately require, as they simply cannot afford it. There have already been reports of staff turning sick students away – is that the type of environment we want to encourage at our university?
The immediate knee-jerk ‘blame students, not management’ reaction is beyond me. Management have been reducing staff for years, so maybe, just maybe, the waiting times are long because the university has failed to supply the adequate resources and staff that are needed. Ponder that…
MYTH 3: “WHY SHOULD I BE SUBSIDISING HEALTHCARE FOR OTHER PEOPLE THROUGH MY SSL, EVEN WHEN I’M NOT ENROLLED AT THE UNI HEALTH SERVICES?”
In the real world, you already subsidise a lot of things for other people – it’s called paying your taxes, buddy. If you don’t like taxes, find a libertarian safe haven to live out the rest of your self-serving days. Better yet, stop paying them, and see what happens then! Besides wouldn’t you prefer your money went to something more worthwhile than hideously-coloured windows for the new Arts 1 building? I definitely would.
MYTH 4: “WHAT’S ALL THE FUSS ABOUT? $12 IS NOT THAT MUCH!”
Well, you’re right. $12 is not a heck of a lot, for some people. For others, that amount of money can make or break their week
Simply put, introducing a user-fee, even as marginal as Campus Life purports the $12 fee to be, will have a profound effect on access to health services for certain groups, particularly Maori, Pacific and female students (for sexual health services). Shifting the financial burden from risk-sharing population-based models (i.e. free healthcare for all) to individuals shifts the financial burden onto poorer students. Why? Well, poor students are more likely to get sick more often, which is mainly due to their poor diets (healthy food is more expensive) and their poor living and working conditions. For example, living in a damp and mouldy household directly correlates to experiencing higher rates of respiratory illnesses, e.g. severe asthma, and lower immunity in general. They are also more sensitive to health care prices than wealthier students because they’re, uh, poorer.
User-fee introduction as a policy instrument is uninspired to say the least. With plenty of evidence to say that it has limited success and potentially serious effects in terms of equity, you’d really question whether or not Campus Life had done their homework on the issue first.
WHAT CAN YOU DO ABOUT THIS?