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Attachment - Letter to Healthcare Taskforce from Faculty Council

Attachment - Letter to Healthcare Taskforce from Faculty Council

January 16, 2014

To the Penn State University Task Force on Healthcare:

The Faculty Council of the College of Education provides this public commentary on the healthcare issue that began with the “Take Care of Your Health” initiative. In response to President Rodney Erickson’s invitation to prepare commentary and consultation, the College of Education’s Faculty Council—an elected body of faculty representatives with the purpose of facilitating effective shared governance within the College—solicited comments and concerns from faculty and staff. A public town hall was held (October 9, 2013), members of the community were invited to provide comments to their representatives privately and via email, and online to the draft of this statement. A good-faith effort was made to synthesize the collected feedback into this statement of our community’s principles and values that the Faculty Council believes are essential to protect in Penn State’s healthcare policies, as well as possible options that may be ethically considered to address the University’s fiscal considerations.

On behalf of all the faculty and staff who shared comments and concerns, the College of Education Faculty Council wishes to affirm that healthcare benefits provided by the University are a public good for many families in our community that must be based in transparency, fair treatment, equality, consent, and choice. The healthcare benefits vision represented by the “Take Care of Your Health Initiative” violates these basic rights, undermines the “shared risk pool” that is the entire purpose of insurance, and threatens the sense of trust between the University administration and its employees essential to Penn State’s stability and future vitality. Policies like those envisioned by “Take Care of Your Health” divide rather than unite and result in an adversarial employment climate. We found a hesitance among some staff and untenured or non-tenured faculty to make public comments that aren’t anonymous out of fear of potential retribution—which reflects how the actions of the University administration have eroded trust.

Penn State’s healthcare policies must treat all employees and their families fairly. This core principle is violated by the coercive and arbitrary $100/month penalty, without appeal, that the “Take Care of Your Health” initiative attempted to impose. We believe that any seizure of pay (or reduction of an individual’s benefits) by the University as employer without due process through an impartial appellate body threatens common standards of fairness and protection against arbitrary abuse. Due process and access to appeal become even more morally imperative when the University as employer seeks to coerce employee dependents too—even those not employed by the University. There is concern that if the University administration can coerce spouses and domestic partners that it could decide in the future to coerce employees’ children too.

Penn State’s healthcare policies must respect the principle of equality. This core principle is violated by the discriminatory and arbitrary $100/month penalty for employees with spouses or domestic partners who could receive any health coverage, even inferior and unaffordable, elsewhere. Differential treatment of employees based on the status of their spouses or domestic partners threatens the equality of all employees and hurts the most financially vulnerable employee households.

This principle is also violated by the arbitrary $75/month against smokers. Differentiation of employees into favored and disfavored classes based on personal lifestyle practices that are unrelated to job performance and not illegal threatens personal liberties, separation between work and private lives, and basic human dignity. Targeting employees who smoke is arbitrary because it is unclear that smoking presents a greater threat to health or expense than many other habits that are potentially dangerous or costly. What are the limits to other private behaviors the University can choose to penalize in the future? Profiling employees based on personal characteristics unrelated to their job performance threatens the Penn State commitment against all forms of discrimination.

Penn State’s healthcare policies must respect the principle of consent and choice. This core principle is violated by punitive coercion of health practices, tests, or treatments—such as compulsory physicals and blood screening coerced by a $100/month penalty. It is further violated by punitive coercion to surrender personal medical data to the University or a third-party vendor like the WebMD survey and the ICH biometric screening. These unethical policies are a threat to the basic right to privacy and control over our own bodies. Mandatory or compulsory surrender of personal health data to an employer or any third party threatens the basic right to medical privacy guaranteed by law. The use or transfer of personal employee data by the University as employer (or a third-party vendor contracted by the University) without voluntary, informed consent is a threat to the most fundamental ethics of a research community and commitment to an ethical culture. Additionally, access to choice in healthcare is important. There is concern that the University’s continuing partnership with Highmark may disrupt employees’ access to Geisinger, the largest provider of full medical services in the area relied on by many employees—especially those with children needing pediatric care.

By permanently withdrawing the “Take Care of Your Health” initiative and abandoning the coercive and arbitrary measures it represented, Penn State can restore trust between its administration and employees. An adversarial climate of conflict is ultimately more costly to the University in lost efficiency and productivity than any long-term putative savings promised by the “Wellness” industry. To move forward, Penn State must restore trust and address the fear expressed by some faculty and staff that protest or appeal might be responded to with threat of termination, denial of tenure, or even veiled remarks to seek employment elsewhere if unhappy at Penn State. A University environment in which employees, particularly those employed atwill, feel afraid to publically protest against potential abuses or to seek redress through the system for fear of retribution threatens the essential mission of higher education to free inquiry and debate of ideas.

Recognizing that rising healthcare costs have fiscal implications for the University, there are possible cost-control measures that do not threaten the principles of fairness, equality, consent, and choice. Measures that subdivide the employee shared risk pool into favored and disfavored groups, target particular employees or households for discrimination, or coerce employees into surrendering their medical privacy and choice over their own bodies are unethical. Instead, the University needs to consider the range of possible measures that would be ethical:

• Transforming Penn State campuses into more healthful environments—such as completely
Smoke-Free Zones

• Contributing to costs to employees to support wellness practices (e.g., low-cost healthy lunch
options, membership fees to health clubs/facilities either on campus or in the community)

• Offering reasonable financial incentives for voluntary health behaviors supported by valid research—such as voluntary smoking cessation or weight management programs

• Increasing the premium contributions or deductibles of all employees to the shared risk pool at a rate commeasure with actual inflation—not an arbitrary amount like “$100/month”

• Altering the amounts of benefits for all participants in the risk pool

• Offering employee incentives for reducing costly medical procedures or overused services

• Changing or renegotiating with medical networks or health insurance providers

However, all ethical measures would require the University to be more transparent about its fiscal condition and liabilities and to commit to using critically reviewed research to inform evidence-based policies on benefits. When the University administration simply insists it cannot afford employee benefit costs without providing transparent information, trust is jeopardized—especially as employees see the University able to spend large sums of money on other projects (like paying $100 to employees who had to submit to “Take Care of Your Health” or the “Penn State Lives Here” publicity campaign). We call on the Task Force to use the expert researchers Penn State has on its faculty to provide and review research germane to the issue, openly and transparently.

In conclusion, the Faculty Council of the College of Education believes that respecting transparency, fair treatment, equality, consent, and choice in future benefits policies will restore trust and heal our Penn State community. We extend thanks to the President, to the University Senate, and to the members of the Task Force for giving units the opportunity to offer public commentary on the issue. Your time and consideration are greatly appreciated.