As a political liberal – and proud of it, thank you very much – I believe that it's immoral for a wealthy country to leave tens of millions of its own without health insurance.
That said, I find myself in the weird position of making decisions that effectively deny some people coverage. And I'm not even talking about adjuncts, a topic that has been amply covered here and elsewhere.
I'm talking about students.
Every single semester I get students registering late, or trying not to get dropped, making the argument that they need the class to stay on their parents' health insurance.
This strikes me as somewhat less drastic than the old “I need a C or I'll get drafted” of Vietnam days, but still disconcerting. Given the number of students with chronic conditions – whether it be asthma, or ADHD, or diabetes, or whatever – a cavalier “well,who cares, they're young and healthy” really doesn't cut it. Besides, having young and healthy people paying into the insurance pool (whether directly or indirectly) actually lowers costs for the rest of us.
A fair number of health insurance plans, I'm told, will cover dependents in their late teens and early twenties, as long as they have 'full-time student' status. In concrete terms, that means they need to be registered for at least twelve credits.
Some students (and, presumably, parents) have figured out that it's cheaper to pay tuition for an extra class or two than to try to buy individual coverage. (This is particularly true at cc tuition levels, and even more so when they can get financial aid for the tuition.) So they do, often with little or no intention of taking the actual course (or of taking it seriously). I've had multiple conversations with students at the last possible moment to register, desperately looking for an available slot in any course at all – they really don't care – just to hit that magic “12” number. They're working part-time at low-paying jobs that don't offer insurance; they'd rather come here part time, too. But the material incentives strongly favor full-time status. I get more of these awkward conversations when the midterm warnings go out, telling students that they'll be dropped for non-attendance. They don't dispute the fact of non-attendance; instead they make a humanitarian plea not to effectively deny them health insurance.
Yuck, yuck, yuck.
Reason #396 to support single-payer health care: it would decouple 'full-time student' status from health insurance. I don't want people making academic decisions – whether it's students or me personally – based on health insurance. I don't want to choose between upholding our academic standards and cutting off some kid from the medical care he needs.
I've never knowingly been a party to insurance fraud. If the student didn't follow the rules for registering, I don't make exceptions based on my willingness to divert some miniscule fraction of an HMO's profits. But I've certainly seen students register, um, let's go with halfheartedly.
As an open-admissions college, there's no way to prevent that. Most students register online anyway, so even if I wanted to be a one-man Attitude Police, I couldn't. (And folks seeking health insurance certainly have no monopoly on shaky attitudes.)
But there's something fundamentally wrong with a system that rewards people taking that extra class just to get the insurance. I don't entirely blame them for doing it – they've found a loophole in a ridiculously unfair system – but it certainly distorts what we're trying to do. These folks show up in our attrition numbers, our outcomes assessments, and our (non)-graduation rates, all of which get blamed on us. And they get lower GPA's than they probably ought, simply from spreading themselves unrealistically thin.
Other than supporting single-payer, I don't have a clean answer to this one. This probably isn't as common at the elite schools, given their tuition levels, so it mostly escapes media notice. But in my neck of the academic woods, this is very real, and very messed up.