parity

Equality in name only? How Vanderbilt promotes a discriminatory insurance policy (Vanderbilt Hustler Re-post)

While a student, I wrote several articles for Vanderbilt’s campus newspaper, but all of these were lost from the Vanderbilt Hustler website (along with all historic website content) sometime in the summer of 2016. I’m going to try to upload these articles here while I can still find scanned PDFs of the print issues that existed at the time. Unfortunately, the articles’ original links to sources are lost. 

This article did end up prompting a conversation about the tuition insurance policy. Vanderbilt Student Government passed a resolution encouraging a policy change. The Bursar (who was very genial when I met with him about this with the Student Body President) negotiated a new tuition insurance policy that reimburses mental and physical illness equitably, which took effect the following year (2015-2016).

Equality in name only? How Vanderbilt promotes a discriminatory insurance policy

(Published August 27, 2014)

Like many universities, Vanderbilt aspires to promote diversity and inclusion. The university requires its first-year students to discuss racism and the importance of pluralism, and its official policies include a promise to not discriminate in university programs. There is even an Equal Opportunity, Affirmative Action, and Disability Services Department whose “core values include equity, diversity, inclusiveness, accessibility and accommodation.” In light of the university’s seeming commitment to equality, I found it particularly vexing to receive a letter from Vanderbilt, accompanied by a signed note from the bursar, promoting a policy that is patently discriminatory.

Vanderbilt offers a “tuition-insurance” plan issued by A.W.G. Dewar, Inc., which provides reimbursement of education fees should a student withdraw from the university for medical reasons. The plan explicitly specifies that withdrawals caused by “mental health conditions” are given a 60 percent refund while a 100-percent refund is given for “injury and sickness.” The plan also indicates that withdrawals precipitated by addiction or substance abuse receive zero compensation.

On the face of it, the plan suggests either that mental illness is equivalent to three-fifths of a physical illness or that 40 percent of doctor-certified mental illnesses are feigned. Neither of these claims is borne out by any evidence. Rather than aiding a vulnerable student, the plan adds another layer of financial stress to a person likely facing a cascade of problems, possibly impeding his or her return to Vanderbilt.

This practice makes for an incoherent insurance policy, since it provides significantly less coverage for the illnesses most likely to warrant withdrawal. A 2009 study at 10 universities found that having clinical depression was the strongest predictor of withdrawing from college. So giving less coverage for mental illness is rather like having car insurance that provides 40 percent less coverage when your accident involves another car.

Moreover, distinguishing between mental and physical illness to provide unequal service perpetuates stigma against psychiatry and psychiatric illness — the idea that mental illness is “less real” than physical illness, or worse still, that someone is more blameworthy for having a mental illness than a physical one.

The practical implications of this policy are jarring to the point of ineffability. Why should a student suffering from depression because a person raped her receive a 40-percent-reduced reimbursement compared to a per-son struck by the “kissing disease”? Is post-traumatic stress caused by being robbed at gunpoint a less valid reason for withdrawing from college than a football injury?

The policy also violates the spirit, if not the letter, of federal law. In 2008, Congress passed the Mental Health Parity and Addiction Equity Act, which requires equal coverage for mental illness, including substance abuse, in health insurance plans. Hence, as The New York Times writes: “This would probably be illegal if tuition refund policies were deemed health insurance, instead of insurance that just happens to be based solely on your health.”

Since 2010, Vermont has required that colleges in the state provide equal coverage for withdrawal due to mental illness. Prompting the change was a complaint by a University of Vermont student named Sherry Williamson, a registered nurse who suffered from depression. “I couldn’t believe that UVM, which tries to promote diversity and be all-encompassing, would take on a policy that was clearly discriminatory,” Williamson said in an interview.

By choosing to contract with A.W.G. Dewar, Inc. under these terms, Vanderbilt University is complicit in unambiguous discrimination against people with mental illness. This is unacceptable for an institution that claims to be forward-looking and antithetical to the welfare of its students. Renegotiating a nondiscriminatory plan is essential if the university’s commitment to equality is more than skin-deep.