College’s Responsibility Ends

By BILL PENNINGTON

Published: April 4, 2013

http://www.nytimes.com/2013/04/05/sports/ncaabasketball/broken-leg-renews-focus-on-college-athletes-health-insurance.html?ref=health&_r=0

Jeff Haynes/Reuters

• The injured player was Kevin Ware, a sophomore guard for Louisville, playing in the N.C.A.A. tournament.

• He was taken to a hospital and had surgery to repair compound fractures of his tibia.

• Louisville officials said the university had a secondary policy on its varsity athletes, ensuring that Ware, who also has his family’s primary insurance, will incur no out-of-pocket expenses in his rehabilitation.

After Louisville?

• But Ware is likely to be personally responsible for any health care expenses related to the injury after he leaves Louisville.

• Injuries sustained in college athletics that linger or develop into chronic conditions are generally not covered by a university’s or the N.C.A.A.’s medical insurance once an athlete has left college.

Another Example

• Bob DeMars, played four years as a defensive lineman for Southern California, from 1998 to 2001. He tore the posterior cruciate ligament in each knee while playing for the Trojans. He also sustained a serious neck injury and separated both shoulders.

• “I wake up with a lot of things bothering me sometimes, and my knees are unstable,” said DeMars, 33, a filmmaker and part-time teacher. “If my knee goes out because I don’t have a P.C.L. and my anterior cruciate ligament tears and I’m hobbled for the rest of my life, I hope Southern Cal helps me pick up the pieces. But they don’t have to.

• “College athletes aren’t employees, so there’s no workmen’s compensation. They tell us we’re student-athletes because it’s not a job. But it sure is a business, and it’s not a nonprofit.”

If Claims Get Big

• If Ware’s medical claims exceed $90,000, he will also qualify for the N.C.A.A.’s catastrophic insurance program, which has some continuing coverage under certain conditions. The N.C.A.A. has additional supplemental insurance for injuries that occur during championships events.

• But not all colleges generate as much revenue through athletics as Louisville does; the university took in more than $40 million through its basketball program alone last year. Many colleges outside the N.C.A.A.’s top athletic tier do not offer comprehensive secondary policies to their varsity athletes. The N.C.A.A. requires an institution only to certify that each athlete has some kind of primary medical insurance, which is usually a family policy.

The Economics – Risk Pooling

• David Dranoff, Health Economist at Northwestern: “… if an athlete’s parents don’t have a policy, then the college offers them the same policy they offer regular students. That is usually a group policy that’s not particularly generous and not tailored to the kinds of injuries that occur in sports, which often require specialized surgeries, long rehabilitations and expensive tests” like magnetic resonance imaging tests.

• “So the colleges treat the athletes like regular students,” he continued, “when they’re routinely exposed to much more hazardous conditions where injury is common.”