The Nation : Campus Correspondence : College Students Are at the Mercy of Campus Health Centers

While studying for my undergraduate degree in Virginia, a medical problem I had was misdiagnosed and I endured low-quality care at the university health center. When I learned that one of the center’s doctors had called a friend of mine for a date following her gynecological exam, I decided it was time to look elsewhere for serious health care.

Unfortunately, my experience was not exceptional. Budget cuts have forced layoffs of physicians, nurses and other medical specialists at campus health centers across the country. Student claims of misdiagnoses are common.

Many college health centers, further-more, are not government regulated. Although most states require unannounced inspections of hospitals, nursing homes, home-care agencies and ambulatory surgical facilities, campus centers are exempted in 39 states. School administrations provide the only oversight.

Of the estimated 1,650 campus health centers in the United States, about 75 are accredited by either the Assn. for the Accreditation of Ambulatory Healthcare or the Joint Commission on the Accreditation of Health Care Organizations.

These organizations set high standards for centers that offer care comparable to that received in a hospital. But most facilities that specialize in services similar to those provided at walk-in clinics--that is, campus health centers--are neither regulated nor accredited because they supposedly aren’t providing services that could put patients at risk.

In fairness, some students do have access to inexpensive and high-quality care at some universities--especially those with strong medical schools. Otherwise, they have little choice but to visit their campus center when they need care. Students juggling part-time jobs or Pell grants simply cannot afford a trip to a private physician; uninsured students are worse off.

Although President Bill Clinton’s health-reform plan does not address regulation of campus clinics, it does aim for universal coverage, which, if accepted, would at least give students better medi- cal choices. But universal coverage bypasses the problem. Students dealing with health problems for the first time should receive better treatment for their money. They have entrusted their well-being to universities and, in some cases, they are being let down miserably.

Students at the University of Arizona praised their campus’ health center, but 20% annual budget cuts for three consecutive years have taken their toll. Between 1991-1993, Arizona unloaded seven of its 20 full-time physicians and health-care providers.

Rutgers’ health centers sustained annual cuts of 3% to 14% over the last five years. To make up the difference, student fees have been raised, reserves drawn down and hiring for certain positions frozen.

The combination of budget cuts and a system of inconsistent regulation makes for a disastrous situation. While little can be done to staunch dwindling finances, state governments can require that university health centers be regularly inspected. While this would not guarantee improved treatment, it would at least let students know just what sort of treatment they can expect.

Meantime, students need to look out for themselves. If the treatment provided at their health center is untrustworthy, students should seek a second opinion off campus. Lining up a primary-care physician before they need one is also important. Every state and county has a local medical society that can offer referrals.

Students should shop around for health insurance, which is relatively cheap because they are usually healthier than the general population. For students on a tight budget, physicians often will work out a payment plan or even a discount.

These options are hardly ideal, but until state legislators and universities take health care for college students more seriously, there isn’t much choice. It is unfortunate that with all the attention focused on health-care reform, 16 million college students have little reason to believe that any change will come to their campus health centers.*