Health care and/for the post-academic
In honor of the passage of health care reform by the House of Representatives (yes, I’m a big ol’ liberal!), I wanted to address how health insurance can be a day-to-day issue that affects grad students and, especially, post-academics without full-time employment. I’m only aware of how the health insurance system works (or rather worked when I was a grad student) at UC Irvine, but the experiences I’m recounting that are my own and of people I know might reflect those of others elsewhere. Some of memories are a little fuzzy, but I do remember how precarious things can be for grad students with nothing lined up after the Ph.D or M.A.
Health insurance for grad students can be quite good, at least if you’re a student in good standing and have no reason to take any time off or leaves of absence. At UCI, health insurance came along with our fees and tuition, which were covered by the institution as long as we were on fellowship or teaching; there’s this whole thing about the school basically paying itself (at least that’s how I understand it) that always seemed to be absurd bureaucratic accounting. Our health insurance covered a lot of things, including primary care, counseling, dental, and vision. We had a big health center on campus, though it could take a while to get an appointment. One notable blind spot to grad student health insurance was that it didn’t offer family dependent coverage.
The problems with health coverage would come later on for students who were running out of teaching and funding towards the end of the Ph.D. process. It’s part of a chain reaction of anxiety that could become a vicious circle:
* You are trying to work on your dissertation, but you find out that you have lost funding.
* Not only do you have to find some kind of job to sustain yourself, you also have to figure out a way to pay fees and tuition, unless you can get a leave of absence.
* Part of the funding you’ve lost for fees and tuition is what pays for your health insurance. You have to pay for the insurance out -of-pocket.
* Figuring out how to get a job that doesn’t get in the way of your studies, pay for your daily expenses, not to mention fees, tuition, and health care, do exactly that–get in the way of your studies.
* Because you’re probably working more hours and it’s harder and more stressful to find gainful employment outside of the grad teaching system, it takes longer for you to finish your Ph.D. Then you devote more time to worrying about paying for fees, tuition, and insurance. All-in-all, things go bad all at once, and health insurance is part of that picture, though maybe a small one–unless you get sick.
Fast forward to finally finishing that Ph.D. and going on the job market. If you’re lucky–and good, let’s not forget to mention that–you can line up a job while you’re putting the finishing touches on your dissertation, so you can time when it is you file your paperwork for your Ph.D. But say you aren’t set up as you complete the Ph.D. You’re probably thinking about ways you can hang on until next year’s job market opens up, which means you’re looking for lecturing work if you can get it. Benefits, like health insurance, can be hard to come by as part-time labor, especially if you are being hired at a rate below which you cannot get on a reasonable plan. Also, you apparently aren’t eligible for COBRA either, since you aren’t coming off an employee plan and it’s expensive to begin with.
I’m told that every lecturer at UCI can get some kind of health care, but below being a 50% employee, the coverage you get is basically for catastrophic care with a very high deductible. And with the budget crisis in the UCs (and probably most state universities), it’s hard to get to that 50% threshhold. I don’t ever think I got there when I was teaching 3 classes a year as a lecturer.
I’m no expert on these things, but I’d think that health care reform, s0 long as it provides good, affordable or subsidized coverage, is something that will benefit part-time academic labor or someone leaving academia with no immediate long-term job prospects. Again, health care is probably not the #1 concern of a possible post-academic–unless s/he is sick or has a family member who is sick–but it’s something that can be a nagging issue piled on top of a bunch of other nagging issues. What experiences have you had with health care and health insurance, as a grad student or an employed academic or a post-academic or a hamster worlder?
Photograph of Speaker of the House Nancy Pelosi meeting with President Barack Obama from Wikimedia Commons, courtesy of the Office of the Speaker of the House, public domain.
on March 22, 2010 on 10:49 am
There is some good news about COBRA in that the payments are partially subsidized at the moment. That might help some people who are caught in the middle at the moment.
As a hamster worlder, I always wondered why health insurance had to be tethered to my workplace. Employers can change plans whenever they want. In the aftermath of the dot-com bust, when so many companies were merging, I worked for one company that changed insurers three times. This is really tough if you want to stick with your primary care physician, and it makes it hard to keep your medical records together as you change from whatever PCP the insurance gives you.
I know single-payer tends to freak everyone out except the Canadians and Dennis Kucinich, but I am hoping that some of the recent reform helps to de-link health insurance from the workplace, at least for continuity’s sake.