Vaden Defends Changes

Stanford’s Cardinal Care health plan will look significantly different beginning Sept. 1. The announcement, made by Vaden Health Center in early February, has left many students wondering what impact the changes will have.

For those students with alternative health care plans, a revamped Cardinal Care will not have an impact unless it proves a viable competitor to those current plans.  There are, however, many current and new Cardinal Care users who will feel an impact.

In an open letter to the Stanford Community, Dr. Ira Friedman, Director of Vaden Health Center, outlined the changes to the health plan. Included in the changes, international students will be required to purchase Cardinal Care, whereas they previously had the option to purchase insurance from an alternative provider – an option American students will retain.  Additionally, transgender surgical treatments will be covered under the plan.

Regarding the mandate for international students to purchase Cardinal Care, Dr. Friedman’s letter reads, “Most international students are already covered by Cardinal Care. Those who are not often find themselves facing the unfortunate consequences of inadequate coverage when they need off-campus health care. This is particularly true for mental health treatment. Cardinal Care will now provide a safety net for those students.”

But much of the international student community is actively protesting the mandate.  Immediately after Vaden published Dr. Friedman’s letter, a petition against the provision circulated the campus.  The petition currently has over 500 signatures, most of whom are graduate students. It reads, “A significant number of international students have insurance plans available to them in their home countries that provide comparable or better coverage than Cardinal Care at significantly lower rates.”

Under the new Cardinal Care plan, the 12-month annual cost will fall by $128 to $3,072.  The petition sites the potential for $2,000 in annual savings through some European health plans over Cardinal Care.

One issue concerning young adults and their health care preferences is particularly reminiscent of the larger national debate.  The petition states, “As responsible adults who have made informed choices in selecting our alternate insurance coverage, it is our strong belief that being forced to enroll in Cardinal Care instead is patronizing at best.”  On the national level and now at Stanford, individuals continue to question what level of choice they will have in selecting their health coverage.

But for the signers of the petition, the provision is simply too inconsistent.  The petitioners write, “[I]f universal coverage is really the goal, it is unclear to us why international students are being singled out with this policy, while domestic students remain free to choose whatever coverage they deem adequate.”

When asked why the provision targets only international students and not all students, all of whom could potentially be under-insured, Dr. Friedman wrote in an email, “In our experience, this problem of under-insurance occurs much more often among international students, and that has long been a source of particular concern for us.”

And in his open letter, Dr. Friedman cited another area of concern for Vaden officials – transgender surgical treatments under the plan.  He used one sentence at the end of the letter to announce that Vaden is “pleased to be able to include [transgender surgical treatment] coverage in 2010-11.”

The Cardinal Care 2010 FAQ is nearly as brief in its explanation as to why Cardinal Care will include transgender surgical treatment coverage.  It states, “Students have made a compelling argument to include a benefit for transgender surgical procedures.”

When asked what that argument was, Dr. Friedman replied, “The argument for ending the exclusion is that, in the context of other treatment, surgery can be effective and appropriate treatment for a transgender person.”  Transgender *non-surgical *treatments have been covered under Cardinal Care for some time.

It is doubtful that the number of students undergoing surgery will be high.  Regarding the actuarial projections used, Dr. Friedman said, “I don’t have a single number. Our actuaries did projections in terms of probabilities. Most likely the number of claims will be very small.”

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