The second point, however, is much more concerning for both sides. While the state of Massachusetts still has one of the best healthcare laws in the country, rising costs is the main concern for employers. And because this trend is expected to continue in the foreseeable future, employers are shifting more and more of the burden to the employees. Clearly, this hits workers in the lower income brackets more than any other ones. When your annual income is close to the minimum living wage, a deductible or a copay for each doctor’s visit can be unaffordable. So this is why a jump in the co-pay for a doctor’s visit from $40 to $100, as Harvard has proposed, can be unaffordable. This is an issue close to my heart because I have been working on a startup at HBS in this area. Over the past 7 months I have helped hundreds of patients struggling with their medical bills, and a few of them had the same issues that the Harvard cafeteria staff is struggling with. A $60 copay difference might not sound like a lot of money for many of us, but most people can’t afford to pay it. You don’t exactly have money to spare when your annual salary is $31,000 and you have a multi-person household, with children who have to go to the doctor multiple days a year. And there seems to be a clear indication that people that have to pay more out of pocket tend to avoid going to the doctor altogether, which can lead to much more severe conditions later. So while we understand Harvard’s position, especially in a year of poor endowment results, it is hard not to empathize with the cafeteria staff. We hope that the two parties reach an agreement soon. In the meantime, all we need to do is be a little patient and have an understanding that these issues are complicated on both sides.
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Iulia Iliut (HBS '17) is the co-founder of BillCrew, an employee benefit that helps employees deal with and reduce medical bills.
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