The Laurie Hamre Center for Health & Wellness (HWC) is a precious resource on campus. It’s the only place where students can get medical attention, no matter what their health insurance is, even if it takes time to schedule an appointment outside of walk-ins. It’s a phenomenal asset when you have little time to go to an off-campus healthcare provider. Everyone, whether you have Macalester’s insurance or not, can access these resources. But for students off the insurance plan, accessing information on how to pay for health services is difficult. There are issues in transparency that we might not notice otherwise, but can be a serious issue for the students who choose to use it.
I became aware of the lack in clarity last month. Like other study abroad hopefuls, I was in need of a physical for my program. For students not on the Macalester insurance, a physical is $100 and gets billed to your account. I’d known ahead of time that there was a fee — it’s outlined on the HWC website — but many of my friends didn’t learn this until they scheduled the appointment. The fee is listed at the bottom of the medical services Frequently Asked Questions page.
For many prospective patients, having a fee located at the bottom of the FAQ is not ideal. But for me, this was only the beginning. I realized that the physical fee was one of two publicly available charges, the other of which being for emergency contraceptives ($15). There’s a wide variety of services offered at the HWC; I understand not wanting to list every laboratory test on the page. What worries me, however, is that charges for some of the basic immunizations are not listed. Some students might need to get vaccinated for something before they go abroad, or simply update their records. The tetanus shot should be renewed every seven years, after all.
But the lack of transparency goes further than small fees and charges. Up until quite recently, the Insurance and Billing page did not highlight issues that non-Macalester insurance students should’ve been aware of. I didn’t know, for example, that not paying a charge within a timely fashion would incur interest on my student account. Much like the physical fee, that detail was left at the bottom of the Insurance and Billing page. The ever-ambiguous “charges may apply” was everywhere, too, though never expressly stating what charges might be. The vague nature of the page wasn’t helped by the fact that physicals, which had a charge listed on one other page, lacked the fee information. Making that kind of billing information more openly available to students can start by citing the fee in more than one spot so it’s easier to find.
The current iteration of the page is an improvement. After redoing their website this summer, the HWC staff realized the insurance page was not what they wanted it to be. I spoke with Denise Ward, the associate dean of the HWC, and learned she fully intends on fixing the page so it’s more accessible for students. Changes have already begun, highlighting the interest issue and a step by step process for getting insurance reimbursements.
I still believe that there are other avenues for improvement; during my conversation with Ward, we talked about the feasibility of listing medical charges online. Having some of these smaller, more common fees available online can prepare students for what’s ahead of them. If the goal of the HWC is to serve as a health resource for the Macalester community, the first step is helping students understand how much things might cost before they get the procedure.
Yes, this is a luxury we don’t get once we start dealing with professional healthcare providers. As one HWC employee put it, “That’s not how it works in the real world.” Outside of Macalester, finding providers that work with your insurance is an excruciating ordeal; it’s even worse if you don’t have any.
As an institution that values the safety of our students, I don’t believe we should be mimicking “the real world” when that means copying a broken healthcare system. It’s exciting to see that the HWC agrees and is working to improve how they disseminate information. The actions of one college health center is indeed a small part of the puzzle, but I believe that if there’s an opportunity to change, we should take it.