<p>Were any health benefits cut or lessened in some way during this renegotiation with BCBSNC? For example, even with the parity laws now in place, many aspects of MH or psych testing benefits are being covertly limited (longer list of non covered diagnoses, significant cuts in reimbursement rates or hours authorized, etc). Even with the increase in cost to the student, the insu company often gives, but takeths away.</p>
<p>SBR, it’s a last resort treatment actually. Doctors are apprehensive about doing it and there is a lot of red tape to go through to be approved. Between the psychological evaluations and all that, it takes well over a year to go from start to finish so OperaDad, no, they can’t be on it for just a semester.</p>
<p>I doubt students are lined up for sex change surgery. This move was made for other reasons.
- A PR move to let LGBT know they are welcome at Duke.
- Bangwagon jumping. It’s cool to be LGBT now. If you “come out” you are a hero. The LGBT community is now “a hook” for many colleges seeking greater diversity.
- Many elite universities believe it’s their “social responsibility” to make up for wrongs against URM from prior generations. There are data to suggest URM and low income students benefit the most from an elite university.</p>
<p>I think I have to disagree with your #3, bud. Ever since Grutter v. Bollinger (2003), affirmative action has been talked about in terms of how a more diverse class enhances the education of the class as a whole, rather than that the USA needs to right its past wrongs by letting in URMs.
Of course going to Duke becomes a more intellectually stimulating experience when a given student is exposed to more of the LGBT population, students from a range of socio-economic backgrounds, etc!</p>
<p>baddriver, I think that what bud mentioned means that going to an elite university benefits those who are from lower socioeconomic status more than others. It’s kinda the idea that this high class university opens doors to the moving up the social ladder.</p>
<p>Why do you automatically assume that URMs are lower on the social ladder? As a whole they are, but quite a few well off URMs get in just because of their skin color. </p>
<p>If this were actually Duke’s goal, they would give lower socioeconomic people a boost and not people with certain skin colors.</p>
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<p>Most of the psychological evaluations will be covered by normal insurance (adjustment disorder). When that is done with, the student can then get the Cadillac plan for the SBR. So, it can be one semester.</p>
<p>Whoa there, SBR is not the acronym for gender(sex) reassignment surgery lol. This SBR is perfectly OK with his junk.</p>
<p>Frankly I think the college years have enough going on w/o someone deciding it’s the right time to even undergo a procedure like that. Watch–you’ll have a former student who had the surgery done one day sue in our sue-happy/blame society.</p>
<p>Orion, the post said “There are data to suggest URM and low income students benefit the most from an elite university”. I was responding to the low income students part more than the URM (hate that term) part.</p>
<p>Agree with Beachmom. College is a time of great change as students leave home and must adjust to moving into adulthood. New friends, new freedom, a new world where they are learning about themselves. An argument can be made that it’s unethical and malpractice to take a young adult and perform life altering surgery on them at this stage in their life.</p>
<p>So a legal adult isn’t allowed to choose what to do to their own body because they’re not let’s say 30 with a well established life? People are supposed to wait to correct nature’s mistake? They’re supposed to be depressed? Honestly, only about 1% of people who get the surgery regret it. And it’s so much red tape to have to go through to “prove” you don’t identify with your biological sex that it’s not funny. Doing it on a whim wouldn’t really happen…</p>
<p>I think what Beachmom and bud123 is trying to say is that college students may not have the support system in place from friends, relatives, and family to cope with such drastic changes. This is a valid concern that even physicians and healthcare professionals can under-appreciate. Medical treatments especially in the field of psychiatry are not merely about the treatments themselves and a patient does not live in a vacuum. In general, while some treatments may be efficacious on paper, the requirement for patient compliance, long term follow up care, and the active involvement of family and social support may be quite high. The absence of these elements and the addition of what is already a stressful environment may render the therapy ineffective at best and even detrimental in some cases. Physicians and policymakers have a responsibility to consider all these things when devising a treatment plan or policy and this may entail substituting other therapies that do not so burden the patient and thus can assure at least an acceptable level of therapeutic success.</p>
<p>Edit:</p>
<p>I should also mention that in addressing the concerns above:</p>
<p>Yes, a legal adult has the right to make his/her own healthcare decisions. However, this right is necessarily constrained by the fact that the cost of these decisions is paid by the insurance company in this case. If the adult is to pay for treatment entirely out of pocket, then no one would be able to object to his/her decisions. But the insurance company has fiduciary responsibility to many parties, not just the patient:</p>
<p>1) A for-profit insurance company has a duty to shareholders to maximize profit</p>
<p>2) A group insurance plan with pooled risk has a duty to all subscribers to minimize risk</p>
<p>3) An insurance plan has the duty of maximizing the health of its subscribers</p>
<p>Any of these goals may conflict and constrain an individual’s freedom to make his/her own decisions regarding healthcare.</p>