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SiMON FRASER UNIVERSITY
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MEMORANDUM
To
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SENATE ?
From ?
SENATE UNDERGRADUATE ADMISSIONS
BOARD
Subject .... .. ...
REQUIREMENT
INSURANCE
OF
!P.. CA ?
Date.....
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JUNE 22, 1972
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MOTION: ?
"That Senate approve revision of Admission
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Policies relating to Requirement for
Hospital and Medical Insurance Coverage:
1.
That all students be required to have
approved hospital and medical insurance
coverage from the 73-1 semester onward as
a condition of registration.
2.
That subject to the approval of the Board,
non-Canadian students be assessed a fee to
cover the lowest applicable premium for
medical and hospital insurance. The fee
to be refunded or deleted if the student
provides evidence of approved medical and
hospital insurance coverage."
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S-7u#
Hospital and Medical Insurance: A Report
on the difficulties encountered by University
Health Services with recommendations for
consideration by Senate
Prepared for Senate
by
S. Stratton and P. Belton
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Definitions and Summary of Recommendations
B.C. Medical Insurance
An insurance plan provided by a society licenced by the Medical
Services Commission of B.C.. It pays for all services rendered
by medical practitioners that are medically required as provided
under the Canada Medical Care Act.
Anyone resident in B.C. for twelve consecutive months and with an
income less than $1000 may qualify for assistance in paying the
premiums.
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It is the responsibility of every resident to enrol
in the plan and maintain coverage for him or herself and his or
her dependents. There are no restrictions on eligibility.
B.C. Hospital Insurance
A service that pays benefits for in-patient and emergency treatment
at hospitals. Anyone who has resided in B.C. for twelve consecutive
months or landed immigrants who have resided in B.C. for three
consecutive months may qualify for the service. Canadians from
outside B.C. may maintain hospital insurance in their home province
during the twelve month residence requirement. Beneficiaries are
required to pay $1 for each day they receive in-patient benefits
and $2 for each emergency visit. Qualified beneficiaries pay no
premiums.
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sS.U.A.B. Recommends:
I. That all students be required to have approved medical and
hospital insurance (equivalent to that defined above) by the 73-I
semester and thereafter.
2.
That routine procedure for issuing medical and hospital insurance
to non-Canadian.-students each semester be investigated by the Registrar.
3.
That Canadian students should be responsible for their own
Insurance coverage and should be made aware of the consequences of
not having approved medical and hospital insurance.
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INTRODUCTION S.U.A.B. on February 17th 1972 recommended in
principle that all students be required to show proof of approved
hospital and medical insurance coverage as a condition of registration.
This document contains a statement of the problem and a more detailed
proposal for its solution. This document was reviewed by S.U.A.B. on
June 20th 1972 and S.U.A.B.at that time modified its recommendation by
replacing the words "show proof of" with "have." S.U.A.B. discussed
several possible ways of implementing the policy with the Director of
U.H.S. and the Registrar, and concluded unanimously that the policy could
in fact be implemented by the 73I semester. (Appendix II)
THE PROBLEM The number of uninsured patients making use of the University
Health Service continues to rise and if this trend continues, the U.H.S.
will no longer be able to provide them with free treatment. The reason
for this is that the U.H.S. obtains provincial funds only for those
patients registered in the B.C. Medical Insurance Plan.
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It is also
concerned that some students may have to abandon their University
careers owing to the high cost of medical treatment, laboratory charges
and hospital care, which the U.H.S. is unable to supply.
Up to July 1971 students were able to buy inexpensive combined Medical
and Hospital insurance through a University carrier. This company
cancelled the contract and a second insurance company is now issuing a
similar policy but is unwilling to continue providing coverage on a
casual basis to a few individuals who represent a higher-than-average
insurance risk.
WHO WILL BE AFFECTED? S.U.A.B. is primarily concerned for non-Canadian
students in their first three semesters at S.F.U. who, in many-cases,-are
unaware of the cost of-medical and hospital treatment in B.C.. They fall
into two main categories:
I) Those with student visas, who must reside in B.C. for twelve months
to qualify for hospital insurance;
2) Those with landed Immigrant status who must reside in B.C. for three
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months to qualify for hospital insurance.
The majority of these students has no medical or hospital insurance.
There is less concern about Canadian students the majority of whom pays
for, or is covered by parental contributions to the B.C. Medical Insurance
Plan
and
quatUTesfor B.C. Hospital Insurance. S.U.A.B. nevertheless
felt that it would be iniquitous to require insurance of non-Canadian
students only. Thus they recommended that all students should have
approved medical and hospital insurance involving:
3)
Any student without B.C. medical insurance;
4)
Canadians from outside B.C. who have less than twelve months
residence and have not maintained hospital insurance coverage in their
home province.
About 10% of the students registering each semester have residence outside
B.C. although the University has no record of their insured status. Of
the 209 new students registered this semester 4.4% are from outside Canada
and 6% from outside B.C.. The U.H.S. estimates that 15% of the students
they see have no medical or hospital insurance, and despite their
advice and calendar entry only twelve students have purchased insurance
since the plan was introduced.
SOLUTIONS ?
The following possibilities have been considered:
A)
Persuade students to take out their own insurance;
B)
Charge uninsured students for services provided by the U.H.S.;
C)
Obtain funds from the Board of Governors and/or Student Societies
for the cost of medical treatment by the U.H.S.;
D)
Obtain funds from the Board and/or Student Society to purchase
insurance for those students who are not covered;
E)
Require approved medical and hospital insurance as a condition
of registration.
Of these possibilities A) has been implemented, without success for the
last twelve months and B) and C) do not solve the problem of laboratory
and hospital costs. Only D) and E) provide a solution to all aspects of
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the problem stated above. As the majority -- some 80% -- of our
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students are covered by family or personal contributions to the
B.C.
Medical Plan, possibility D) appears to be unjust. The cost of
university-wide medical and hospital insurance would be high, perhaps $40,000
initially.
DISCUSSION
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The following questions emerge if policy E) is implemented:?
I) Is the policy consistent with the philosophy of admitting students
solely on their academic qualifications? The University presently
requires students, as a condition of registration, to pay Student Society
dues and Tuition fees and no waiver mechanism exists to permit students
to register without such payment. Enforcement of such a policy might
save others from financial ruin.
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It would ultimately benefit all students
who are not resident In
B.C.
by reducing insurance rates as a result
of greater participation. The policy would also have a humanistic
justification, particularly for non-Canadian students. These students
are, for the most part, unaware of the serious financial difficulties
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which may arise as a result of illness or accident in the province of
B.C.. Students would become familiar with the medical and hospital
insurance coverage they hold prior to an emergency situation and would be
aware of the services for which they are eligible.
2) To what degree should the University enforce such a policy?
a)
Introduce some waiver mechanisms;
b)
Prohibit students from registering without insurance if they
are ineligible for B.C. Hospital insurance;
c)
Prohibit students from registering without both medical and
hospital insurance.
The degree of enforcement might influence
i) enrollment
ii)
the policies and procedures used in our present
preregistration system.
Most universities in Canada require either a medical examination or
medical insurance for their students. Full enforcement of policy E) is
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unlikely to affect enrollment significantly. ?
Full
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enforcement
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is
the simplest to ?
incorporate into our preregistration system.
At ?
its meeting of June 20th, ?
S.U.A.B. ?
was nevertheless ?
in favour of
a procedure that would allow the University to grant waivers to students
on the grounds of conscience or religious belief.
3) ?
What would be the financial
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effect of ?
implementing this system?
a) ?
To the University:
Cost would vary according to the detail
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of the procedure. ?
It
would probably be
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less
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if the majority of paperwork were handled by
the U.H.S.. ?
Printing, ?
mailing and part-time assistance would probably
cost less than $5,000 per year.
b) ?
To the student:
Students with no medical
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insurance would have to pay premiums
of between $6 for a single student with
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12 months residence and no income
to $150 per year for a married
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, student with one or more children. ?
Students
with no hospital ?
insurance, or with no hospital
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or medical
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insurance would
have to pay group medical
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and hospital ?
insurance premiums ?
(at present only
a combined policy
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Is available).
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The premiums range from approximately
$16 per semester to $70 per year for a single student and double those
amounts for family coverage.
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As a rough estimate, between
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100 and 500
students might be expected to have no hospital or medical
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insurance ?
in
one semester.
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5.
Appendix I PROPOSED MOTION
TO SENATE
Revision of Admission Policies -- Reqqirement for Hospital and Medical
Insurance Coverage
MOTION
I)
That all students be required to have approved hospital and
medical insurance coverage from the 73-I semester onward as a
condition of registration.
II)
That subject to the approval of the Board, non-Canadian students
be assessed a fee to cover the lowest applicable premium for
medical and hospital insurance. The fee to be refunded or
deleted if the student provides evidence of approved medical and
hospital insurance coverage.
Financial reasons make it impossible for an increasing number of uninsured
students to obtain free medical treatment from the University Health
Service.
Students up to now have been able to purchase inexpensive insurance
coverage from the University's Carriers but numbers are now so small
that the company is unwilling to continue these policies.
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6.
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Appendix II PROCEDURES
Several possible procedures for implementing this policy were
discussed by S.U.A.B. on June 20th 1972.
As the main concern of U.H.S. is for non-Canadian students, it was
recommended that the Registrar should investigate a procedure whereby
such students are automatically billed at each preregistration for the
lowest applicable rate of group Hospital and Medical insurance.
It was further recommended that the Registrar should investigate a
procedure whereby all students, first, are made aware that it is their
responsibility to have hospital and medical insurance and, secondly,
made aware of the consequences of having no medical or hospital insurance.
Presumably in the latter case such students might be required to obtain
insurance, to pay for medical treatment or to withdraw from the University.
The University should accept no moral or financial responsibility for
students without medical or hospital insurance.
Other than this S.U.A.B. was concerned that the procedure should be as
simple as possible and to rely, apart from spot checking by U.H.S.,
largely on the word of the student.
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