University Times

L E T T E R S

Comprehensive subscribers: Protest closed formulary change

To the editor:

I wonder if Pitt employees who currently have the Highmark Comprehensive health insurance plan understand what the proposed change to a "closed formulary" means.

According to the University Times (Feb. 18, 1999), it means that your doctor "must choose from among a list of accepted drugs for a given health problem. Otherwise, the insurer won't pay anything toward the prescription." It is essential to understand that this is not a requirement that you use generic drugs, although in many cases it will lead to that. Rather, it means that the insurance plan can veto your doctor's choice of drugs.

This limitation is being imposed to cut costs — not an unreasonable goal in the abstract. But those of us who select the Comprehensive plan do so because we highly value freedom of choice in health care and are willing to pay for it. If we had wanted limitations of freedom of choice in exchange for lower health care costs, which is what closed formulary imposes, we could have joined a managed care plan a long time ago.

If you agree with me that you'd rather retain freedom of choice and pay more for it, please write immediately to Ronald Frisch, associate vice chancellor for Human Resources, and Herb Chesler, co-chair of the University Senate benefits and welfare committee, protesting this change and asking for it to be rescinded.

Alan Meisel

Professor, Law and Bioethics

and

Director

Center for Bioethics and Health Law

____________________

Same-sex partner health benefits: Another viewpoint

To the editor:

Dr. Barbara Sargent-Baur's letter in the March 4 issue of the University Times urging the Board of Trustees not to offer health benefits to same-sex domestic partners prompts me to tell my personal story to the University community.

My partner and I have been devoted to each other for eight years and we are parenting her three children. Since we have been together, her children have received the dedicated attention of two parents who love and cherish each other. Our children all test as gifted and we are very proud of all their accomplishments. We are parents who make certain that our children are involved in extracurricular activities such as Boy Scouts, community soccer teams and school organizations. We are also parents who are modeling positive adult behavior to our children through active participation in community organizations and our church.

Sadly, our family has several medical challenges with which to cope. My partner has suffered for eight years with a recurring illness that does not allow her to work and required that she drop her chosen profession. Her state of satisfactory health is only delicately maintained with several daily medications. Our oldest child suffers from severe asthma in addition to a recurring illness of her own, both of which require daily prescriptions. Our middle and youngest children have two neurological disorders that also require two daily medications each. In addition, I have developed health problems in recent years requiring daily prescriptions.

While I receive good health insurance benefits as an individual Pitt employee and our children receive some health benefits from the plan in which their father is enrolled through his employer, the gaps in health coverage for the whole family have presented us with a potential financial catastrophe. Health coverage for the children is limited by the requirement that we meet an annual $200 deductible per child. In addition, coverage of their prescriptions is limited. While my partner does have the Medicare card available to all individuals on federal disability, she does not qualify for a prescription card. We must pay out-of-pocket for her numerous medications. As a result, our family's monthly bill for prescription drugs is over $500! The impact on our family's budget is obvious.

To state, as Dr. Barbara Sargent-Baur does, that we same-sex partners are "unwilling to make the long-term commitment of marriage" is to talk nonsense! My partner and I have done the only thing the laws of the land permit us to do. We registered as domestic partners when a previous enlightened Pitt administration offered us the opportunity. Same-sex partners face exactly the same difficulties of growing into adulthood that heterosexual, married partners do. Same-sex partners face exactly the same partnering and child-rearing responsibilities that heterosexual, married partners do. Same-sex partners create the same loving families that heterosexual, married partners do. Same-sex partners do, however, shoulder a larger burden than do heterosexual married partners. We have the life-long burden of facing discriminatory laws, practices and attitudes of the institutions and individuals who have taken it upon themselves to define the "norm."

Many members of the academic community disagree with the Board of Trustees' discriminatory practices and think, as I do, board members should fully embrace diversity in all its glory — a concept the University claims to support. We must do everything in our power to urge the board to extend the same level of health benefits to all University employees AND their families. And they must do it now!

Ray Anne Lockard

Head Librarian

Frick Fine Arts Library

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Provost outlines advantages to alternative use of stadium site

To the editor:

The Facilities Plan, which was reviewed by various groups within the University during the '96-'97 academic year and embraced by the Board of Trustees' property and facilities committee in May 1997, places a very high priority on providing our students with the best possible campus environment and on attracting our undergraduates to reside on campus. Implementing this plan poses a significant challenge to the Pittsburgh campus because of the scarcity of land in Oakland, the many competing demands on the available land, and the expectations of our neighbors. Within these constraints we must seek to provide our students with appropriate housing and recreational facilities, while making the best possible use of each building we own or operate.

If the University and the Pittsburgh Steelers agree to share the football facility which the Steelers plan to build on the North Side, it would become possible to implement many aspects of the Facilities Plan in a very attractive fashion. The convocation center could be brought down into a much more central location on the campus, connecting this major new facility with daily campus life and locating within the facility a major student recreation center which could not have been included if the center were placed in its previously proposed location. This convocation center and recreation facility, which would occupy approximately half the stadium site, would face a green area of campus stretching all the way to the Chemistry Building behind the buildings which front on O'Hara Street. Much needed space for more residence halls could be found in this attractive area of green hillside, simultaneously solving our shortage of residence hall space and providing a focus of out-of-class campus life which complements the two existing centers of student life in the Forbes Quadrangle area and the Student Union area. This new center for the social life of the students would be the first to have a traditional campus ambiance.

If an arrangement with the Steelers makes it possible for us to create this new center of campus life, there will be many issues of program planning which will appropriately involve faculty and student input, just as the formulation of the Facilities Plan involved faculty and student input during the '96-'97 academic year. The program of facilities and activities in the recreational center, procedures for the scheduling of concerts in the convocation center, the selection of possible academic themes for the residence halls, processes for setting the mix of residence halls and fraternity houses, the planning of attractive means to transport our students to the football games, and issues connected with the scheduling of recreational and athletics use of the extensive complex of fields at the top of the hill all come easily to mind. The crucial issue for the immediate future, heavy on my mind as one charged with implementing the Facilities Plan, is that we seize the opportunity to make creative use of the 10-acre stadium site should it become available.

Provost James Maher

*********

Executive vice chancellor discusses Henson law suit

To the editor:

One of the stereotypical ploys of the litigating lawyer is often described in the following way. If the law is on your side, argue the law. If the facts are on your side, argue the facts. And if your case is weak on both those fronts, find some way to divert attention from its lack of merit. That tactical approach has been central to the public relations efforts surrounding the case brought by Deborah Henson, a former employee, against the University of Pittsburgh.

Both the facts presented by the Henson case and the law governing her claim are straightforward. The University makes health insurance coverage available to all of its employees, whatever their sexual orientation. Coverage also is available to an employee's spouse and to his or her children. However, it is not available to a "domestic partner," whether of the opposite sex or of the same sex. Coverage criteria such as these, according to the great weight of legal authority, are non-discriminatory.

In fact, the lines drawn by the University are both lawful and customary. Essentially the same lines are drawn by well over 90 percent of the institutions of higher education in America — including every college and university in the Pittsburgh area and every state-owned or state-related college or university in Pennsylvania. Essentially the same lines are drawn by the vast majority of American businesses — including, to the best of our knowledge, almost all of the businesses that call this region home. Essentially the same lines are drawn by the City of Pittsburgh in its own employment relations.

In certain key respects, that fact alone vividly reveals the weakness of Ms. Henson's claims. She contends that a section of the city code requires the University — and, by extension, all city employers — to extend health insurance coverage to same-sex domestic partners.

However, if that was true, the city's own benefits program would fail to satisfy the requirements of city law. And in recent weeks, some of the very members of City Council who championed the code provisions on which Ms. Henson attempts to rely have publicly stated that the law enacted never was intended to compel the result she now seeks.

Ms. Henson's claims also run afoul of numerous provisions of the controlling state law. However, despite public contentions to the contrary, the University has not, at any point in any of its submissions, sought either to invalidate existing law or to undermine established rights. Instead, our use of these governing state law provisions has been purely defensive and targeted to achieve a single goal — the dismissal of the unwarranted and unsupportable claims asserted by Ms. Henson in the action that she initiated.

For example, Ms. Henson's most basic quarrel is with the Pennsylvania law that restricts marriage to a relationship "between one man and one woman," thus drawing a clear legal distinction between spouses and domestic partners. In discussing that provision, we rely even more specifically on the legislative history raising the concern that legalizing same-sex marriages would unwisely place another unfunded mandate on the business community, the precise issue presented by Ms. Henson's case. Similarly, in formally advising the Human Relations Commission what it must already know — that the authorizing state law does not include "sexual orientation" as a protected category, we rely specifically on language of the state act that exempts from its scope the terms or conditions of any bona fide or employee insurance plan. In citing those provisions as well as sections of the state's Home Rule Act and the Unfair Insurance Practices Act, what we request is a finding that the remedy sought by Henson is not available to her and what we seek is dismissal of the claims wrongfully asserted against the University. At no point do we request that the code itself be overturned or that accepted protections under it be eliminated.

It is true, of course, that precedents developed in this case could become the basis for broader legal challenges to existing protections in future actions. That risk is present whenever litigation is used as a tool for social change. Naturally, the risk looms much larger when the particular case being litigated is weak.

Crusaders for other causes long recognized that cases to be used to drive social change must be selected carefully or more may be put at risk than can likely be gained. In recent years, in fact, civil rights activists have worked aggressively to avoid dispositive legal decisions in highly visible cases, even when resolution was on less-than-optimal terms, because they feared the long-term consequences that a formal decision might bring.

That such risks are presented by this case is apparent from the loud and overstated public relations campaign that has been launched by Ms. Henson and her representatives. Unfortunately, that same sense of reality seems not to have influenced their legal strategy. If the erosion of rights that they purport to fear ultimately comes to pass, that will have been the direct product of their use of a weak case to raise the contested issues.

Jerome Cochran

Executive Vice Chancellor

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Comprehensive subscribers: Protest closed formulary change

To the editor:

I wonder if Pitt employees who currently have the Highmark Comprehensive health insurance plan understand what the proposed change to a "closed formulary" means.

According to the University Times (Feb. 18, 1999), it means that your doctor "must choose from among a list of accepted drugs for a given health problem. Otherwise, the insurer won't pay anything toward the prescription." It is essential to understand that this is not a requirement that you use generic drugs, although in many cases it will lead to that. Rather, it means that the insurance plan can veto your doctor's choice of drugs.

This limitation is being imposed to cut costs — not an unreasonable goal in the abstract. But those of us who select the Comprehensive plan do so because we highly value freedom of choice in health care and are willing to pay for it. If we had wanted limitations of freedom of choice in exchange for lower health care costs, which is what closed formulary imposes, we could have joined a managed care plan a long time ago.

If you agree with me that you'd rather retain freedom of choice and pay more for it, please write immediately to Ronald Frisch, associate vice chancellor for Human Resources, and Herb Chesler, co-chair of the University Senate benefits and welfare committee, protesting this change and asking for it to be rescinded.

Alan Meisel

Professor, Law and Bioethics

and

Director

Center for Bioethics and Health Law