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Out-of-state insurance out of reach

September 18, 2008

A recent change in the complex insurance configuration at UW-River Falls has caused difficulties for faculty and staff who sought medical treatment outside the state of Wisconsin.

Part of the problem results from the complicated insurance structure that is currently in place, Faculty Senate chair and chemistry professor David Rainville said. The insurance plan that is used by the University works on a series of three tiers that range from highest to lowest cost. The tiers are made up of three different insurance providers. On the top tier is Humana West which has the highest cost, Anthem is on the second tier and on the third tier is standard insurance.

Until recently, out-of-state treatment options were available on the second and third tiers of the insurance plan, but within the past year, the-out-of-state option was only made available as an addition to the third tier. The recent change in the plan has had a detrimental effect because it limits the choice of health insurance available and it costs a lot more money.

When out-of-state care was made available only to the third tier of the plan, a large group of faculty and staff were affected. More people were affected at UWRF than any other institution in the state, Rainville said.

This past year, the issue of out-of-state care was presented to the Wisconsin State Legislature. The issue was passed by the State Assembly, but later failed in the Senate.

Economics professor Jacqueline Brux has been negatively affected by problems with her health insurance. She has had issues for the past three years and dealing with her medical insurance had been a traumatic experience, Brux said in an email interview.

This past summer Brux was diagnosed with Graves’ Disease, which she said is “a serious illness involving a hyper-active thyroid.” She was diagnosed with the condition at the beginning of the summer and months passed before she was able to see a doctor.

“I was diagnosed at the beginning of the summer, but because my insurance required me to see an endocrinologist in Wisconsin, I was forced to wait the entire summer until there was an opening with a Wisconsin endocrinologist.” Brux said. “This is wrong.” 

Brux also referred to a film called “Sick Around the World,” which shows the differences in the health care systems of the United States and other countries such as Taiwan and Great Britain. She said that the film points out that in these other countries the health care systems appear to be more user friendly. The patients in these other countries can get the medical attention they need without so much trouble and without high costs of health care coverage.

Brux said that the health insurance system in the United States is one of the instances in which the government is not acting in the best interests of the people.

“I feel like every day I listen to someone’s story and I end up saying, ‘our country doesn’t take care of its people.’ This is true- it doesn’t. Health care is one of the most important examples,” she said. “We deserve better.”