Wednesday, November 05, 2014

On election day, a unamimous vote

It didn't make the national news, but the Harvard Faculty of Arts and Sciences voted unanimously to request the school's administration to withdraw its proposed changes to the faculty and non-union staff health plan.  Recall that I wrote about some of the issues a few days ago.

Even though I also saw flaws in the proposal, there was a troubling aspect to this vote in an environment that is supposed to encourage rigorous debate and discourse: Whenever you see a unanimous vote at the FAS, you have to worry that the vote became more about the politically correct thing to do. Indeed, the description felt like a throwback to the demonstrations in the '60s.

“It was a great moment for faculty, total dissent,” History professor Carter J. Eckert said after the meeting. “It was a complete rejection on the part of the faculty.”

Although English professor Deidre S. Lynch said she would not describe the discussion as “angry,” she said after the meeting that “a lot of us felt as if the committee that decided the benefits condescended to us.”

The meeting drew noticeably greater numbers than is usual, with many attendees sitting on the floor.

“I don’t come every time, but this time I came for this reason,” said Romance Languages and Literature professor Francesco Erspamer.

Lewis said she was “heartened” by the high attendance at the meeting, noting that professors currently on sabbatical were present.

Wow, even those on sabbatical.


nonlocal MD said...

The descriptions of the meeting indicate that even Harvard profs revert to typical dissatisfied employee behavior when it affects them directly.This faculty reminds me of most meetings of doctors I used to attend. The academic elite tends to lose touch with reality and can turn nasty when crossed.

Forgive me for saying that outsiders find an amusing irony in the fact that Harvard employees are being, shall we say, disadvantaged by their own colleagues on the medical side, and by Harvard's overall failure to deal with the high costs of its own entities. That is the root cause of the problem, not 'condescension'.

Barry Carol said...

As Harvard’s health insurance costs continue to escalate, in significant part due to the market power of its own affiliated hospitals, I wonder if the FAS thinks Harvard can just continue to pass these cost increases along to students and their families by increasing tuition faster than the general inflation rate forever. It would be interesting to hear what the university’s economics professors think about that, especially since I haven’t heard about any willingness to accept smaller wage increases in order to keep the more generous health insurance plan.

Charlotte said...

It took 55 meetings to come up with the new plan, and it was rejected unanimously. Does anyone know what is going on?

Anonymous said...

It is only "fair" that everyone pay equally if everyone uses expensive hospitals equally. They don't.

If you live in Newton you are likely to use the very high-priced and amenity-rich Newton-Wellesley Hospital; if you live in Dorchester you likely use Carney hospital, a hospital that is paid far less. If employees who use Carney are paying the same premium contribution and flat co-pay to use a cheaper hospital, then they are in fact cross-subsidizing those who use Newton Wellesley. That seems regressive to me.

With hospital and physician payment levels varying so dramatically from community to community, costs are regressively socialized if you don't align the premium, co-insurance or co-pay with the cost of the care. This would enable employees who live in Newton to decide if they want to pay more, or drive to a lower cost hospital such as BI-Needham.
The concern isn't whether the junior faculty who live in Newton are unfairly treated by paying more if they use a high cost hospital, the concern should be for the junior faculty or support staff who live in Somerville and are paying for a hospital they never even use through their premium contributions and "flat-tax" cost-sharing arrangements. The people who don't use high-priced hospitals have been paying double digit premium hikes for years that have nothing to do with the providers they use. Lower cost providers have barely gotten inflationary increases for the past decade-- yet consumers who use them have been hit with huge rate hikes year after year while their hospitals have been starved of the capital investments they need.

If this entrenched "flat-tax" approach persists, it will only be a matter of time before lower cost hospitals and physicians will decide to raise their prices too since they are never going to get additional volume in exchange for their greater value (lower costs and excellent quality). Why should any lower cost hospital price one dollar below the highest cost competitors if consumers are forever insulated from any incremental costs associated with their choices? Without this kind of consumer activation and cost-sharing, there is no hope that a high-value provider can win market share to boost revenue so they can make the needed investments to keep their programs competitive. It simply isn't viable for them to keep discounting against an ever stronger and wealthier competitor who is losing virtually no volume because there are no price sensitive consumers.

Barry Carol said...

The reason the less expensive hospitals don’t raise their prices is because they can’t. They can’t because they don’t have the market power that Partners has.

There should be plenty of patients in the Boston region that are increasingly sensitive to costs because they have a high deductible, tiered network or narrow network health insurance plan. They may choose to go to the less expensive facilities to save money on coinsurance or co-pays or they may be forced to go because their network excludes some or all of the Partners hospitals.

Just because the Harvard employees will remain largely insulated from the cost of going to the more expensive hospitals doesn’t mean that everyone else in the Boston region is too.