The sleepy cul-de-sac behind my childhood home in Alaska sat at the bottom of a long hill. One summer, with my scooter in tow, I would climb to the top of the hill and race down, reaching 10, 15 or even 20 miles per hour before I made it to the bottom. I felt like the King of the Cul-de-Sac. One Sunday afternoon, with the breeze of the hill wisping through my helmet, I took my hand off one of the handle bars to adjust my sleeve. Instead of stoically keeping my balance like the regal nine-year-old I was, I fell. Hard. My lips and knees were scraped raw, and a tooth was ground down by the asphalt. My parents rushed me to the emergency room, where my wounds were washed and I received a CT scan and several X-rays. Later that week, I went to my local pediatrician for a follow-up — and another X-ray — and my dentist, who gave me a filling for my chipped tooth. Thanks to Medicaid, we paid about 20 dollars out of pocket for these services — and that was just for gas.
Had this happened while I was on Dartmouth’s health insurance, I would have likely paid hundreds, if not thousands, of dollars for these services — leaving me hung out to dry.
The College requires all students to have health insurance that meets a “certain level” — namely comprehensive coverage in the Hanover area — according to the Dartmouth College Health Service website. The Dartmouth Student Group Health Plan offered by the College meets those minimum standards. This academic year, the premium for the plan is $4,163, half of which is waived for students receiving need-based financial aid. After receiving insurance, preventative services at Dick’s House are free to students, while students are responsible for a $250 deductible for in-network services and $500 for out-of-network services. After that, DSGHP will cover up to 90% of non-emergency services.
This system disadvantages many of the students it seeks to benefit. Low-income students who are fortunate enough to have only simple medical needs — nothing more than a cold here or there — may have to pay close to $2,100 for the premium and maybe a couple deductibles for their prescriptions. That, in itself, is cost-prohibitive. For students with more complex medical situations, the amount they pay — and struggle to cough up — grows. Many of these students may have been on Medicaid, but public health insurance rarely transfers across state lines. Additionally, New Hampshire’s eligibility rules prohibit students who are only in New Hampshire for school from receiving Medicaid, leaving most low-income students at Dartmouth ineligible.
DSGHP has enough issues in covered services, and much more when considering its glaring lack of dental insurance. Students have access to the Basix Dental Savings Program, which can lower the costs of dental services — but only marginally. The two Hanover dentists that signed up for the Basix program only offer discounts of 10% and 20%, forcing students to pay the remaining 80% or 90% out of pocket. The benefits of the program are better if students go to West Lebanon or Lebanon, but the cost savings are still negligible when students don’t have reliable transportation or cannot pay upwards of $100 for preventative or emergency dental care. No other portion of the DSGHP covers dental insurance, compelling students to forgo regular dental care and preventative screenings.
To alleviate the health burdens the College’s current health insurance apparatus places on students, more comprehensive versions of the DSGHP must be made available, and full coverage should be easily accessible to eligible students. In particular, students with need-based financial aid — especially those with full-ride scholarships — should not be held responsible for any portion of their health insurance packages, including the premium, deductible and copays. Moreover, all necessary medical expenses should be covered under that plan, including dental coverage. This may seem like a big ask — especially when so many private health insurance plans do not cover dental insurance — but if the State of Alaska can do it, so can Dartmouth.
If I had Dartmouth’s insurance the summer of my scooter accident, I would never have gone to the hospital because of the prohibitive cost, putting me at risk of an undetected concussion, untreated infection or worse. At a school among the richest universities in the country, no student should have to choose between their health and their wallets. For example, students should be able to get a dental cleaning at noon and dinner at 5. A student’s health comes well before their personal and academic success. If Dartmouth is serious about maintaining both, it must commit to providing affordable, comprehensive healthcare for all its students.
