Editor’s note: This article was initially published in The Daily Gazette, Swarthmore’s online, daily newspaper founded in Fall 1996. As of Fall 2018, the DG has merged with The Phoenix. See the about page to read more about the DG.
Starting this November, the Worth Health Center will charge students ten dollars to test for HIV. In the past, HIV testing has been free for students; however, amidst concerns over Worth’s fiscal budget, the health center has decided to mitigate costs with this HIV testing fee.
Beth Kotarski, Worth’s new health director, explains that the budget is not an unlimited quantity and Worth is looking to maximizing services to the most number of students. “We do 8000 visits every year and a substantial part of our budget goes to a very few number of students. We’re looking at how to best spread out the resources that we have. My goal is to provide most services to the most number of students equitably.”
Subsidizing these health costs with a $10 fee would help free up monetary resources for other services. Kotarski would like to focus on enhancing services that are more widespread and benefit the entire student population. Worth hopes to maintain services like free gynecology care, inexpensive birth control, regular cold clinics, and free overnight stays.
Furthermore, rising healthcare costs play a factor in this new policy. Each year, approximately 150 students take the HIV test and it costs approximately thirty dollars to perform each test. In addition to lab costs, Swarthmore has to pay a proficiency test to the state of Pennsylvania. Since the lab tests are performed here on the college campus Pennsylvania law charges Worth several hundred dollars each year to regulate and standardize our laboratories.
For students with financial need or other personal concerns, the Worth Health Center will cover their costs. For other STD tests like Chlamydia and gonorrhea, the fee is five dollars each and students usually use their insurance to cover the cost. However, with the HIV test, Kotarski recommends that Swatties pay out-of-pocket because costs are higher for insurance-covered HIV tests.
This new policy instigated some controversy amongst Swatties over fears that the fee may deter students from testing. While students with financial need are covered, the ten dollar fee may prevent others from taking the test on a regular basis. Regular testing for sexually active individuals is every 6 months.
Kara Peterman ’09 is a Sexual Health Counselor, but cautioned that her opinions don’t represent the opinions of the group as a whole. Peterman explains, “While $10 isn’t a significant amount, I believe that it would make students think twice about getting tested regularly…while we are trying to encourage people to simply get tested, it is also important to emphasize regular testing.”
Eric Glickman ’10 predicts that while this new policy will not make a huge change in the number of students taking the HIV test, there might be a small decline. Glickman is also a sexual health counselor but warns that his opinions aren’t reflective of the group as a whole. He believes that while concerned students are willing to pay the fee, others “will now probably wait longer or until they assess their situation as more risky [before getting] the tests because they have to pay for it.”
In response to these concerns, Kotarski argues that a ten dollar fee is not a huge financial burden for those who can afford it. Her primary concern is to provide these on-site services to the students.
She believes that Worth’s new HIV policy is relatively inexpensive and promotes accessibility to testing for sexually transmitted diseases. In contrast to other colleges, Swarthmore charges a relatively low price for STD testing. Bryn Mawr College charges twenty dollars, Haverford College charges 72 dollars, and the University of Pennsylvania charges the student’s insurance company fees.
Since this policy is still new to Swarthmore, there is no evidence yet of these possible deterrent effects. Only time will determine if this new policy will make a large impact at Swarthmore.
Despite the tensions and controversy surrounding Worth’s new HIV policy, it is important to keep in mind that both advocates and opponents of the policy have the same goal: to promote sexual healthiness and general wellness in the Swarthmore community.
As Glickman ’10 aptly expresses, “I really encourage students to continue getting the tests, whether it means requesting financial assistance from Worth, or paying ten or twenty dollars. Peace of mind, one’s health, and that of one’s sexual partners is worth more than twenty dollars.”
Beth Kotarski, Worth’s new health director, explains… " a substantial part of our budget goes to a very few number of students."
I'd be curious to hear more about that, who puts the biggest burden on the budget, how their health or behavioral characteristics differ from the norm, and cost-control strategies that maximize equity of budget expenditure per student.
I think that the benefits that come from pooling resources have nothing to do with "maximiz[ing] equity of budget expenditure per student." The equity part comes in when different amounts are spent on students who, by chance, have different health conditions. For example, it is equitable if someone who has high needs for medical care uses a high amount of resources, yet contributes to financing of the services the same as another student. Public goods, as I'm sure you know, have some problems balancing incentive for conservation and cost-cutting, but health care (i imagine) isn't something students use when they shouldn't just because it is free: "ooo, free aspirin, let me take 20!"
I guess you comment, econ, just got me worried about blaming people who regularly take HIV tests or use other Worth services more than others. If I misinterpreted what you meant, excuse me, but I still think my point was worth mentioning.
While I htink that hte cost we would pay for testing is a lot less compared to other schools, I'd like to know how this helps defray the overall cost of testing. If only a few people take the tests, and then students with financial needs are covered, how much income is this actually generating to reduce the overall cost of the test?