Tuesday, March 30, 2010

The Benefits of Health Care

As those of you who read this column regularly know, I'm not one given to posting my initial response to events. I prefer to let things percolate for a bit and try to flesh out all the implications. The recently passed health care legislation in the United States is no different. First of all, I would like to congratulate the US Congress for their work. They have made the health system much more fair, and took a stab at trying to slow the growth of costs, something that will benefit all in the long term. Universal health care is something we have enjoyed in Canada now for many decades. In recent years this has proved to be a boon for private industry; they do not need to spend as much out of pocket providing coverage for their employees located here as for those in the US.

Thus, this provides an excellent place to talk a little bit about the benefits that one might expect working as a postdoc or undertaking a PhD. In Canada, things are pretty simple: with few exceptions postdocs and PhD students are left to fend for themselves. In the US there is more variation. Typically, as university employees (RAs and TAs), PhD students and postdocs are entitled to some basic health care, subject to reasonable co-pays ($5-25 for a doctor's visit, $100+ for emergency rooms, in-network). In many ways this replicates the Canadian health care system, so long as you remain a student in good standing and continue to work a certain minimum number of hours per week. Rare indeed is the postdoc or PhD that covers regular preventative care, such as dental visits, or provides it to spouses and that goes for both countries.

While this all sounds good, make no mistake, as Robert Heinlein once said "There ain't no such thing as a free lunch." (TANSTAAFL) If you work in the US, the cost of providing benefits with a position is passed on to you in the form of lower salary then you might earn otherwise. In fact, I have heard of positions that have a "marriage penalty" of sorts in which a pay cut is the price of adding a spouse to a coverage plan. These losses can be significant, totaling thousands of dollars over the course of a year.

Still, the situation is more complicated. For cultural reasons, Postdocs and PhD students in the USA tend to make significantly more then their Canadian counterparts (for instance, US$25k is not an unusual 1/2-time Science RA/TA, whereas the most lucrative NSERC PGS-D pays only C$21k and does not come with a tuition waiver, like the US counterpart; likewise US postdocs typically start around $50k and go up from there, whereas C$40 is much more common here), even factoring in the higher cost of providing benefits. Thus any reductions in cost associated with the new legislation will only widen this gap and make US Positions more attractive.

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