A Constructivist Study of Graduate Assistants' Healthcare Experiences in a Research University

This constructivist study explores 16 graduate assistants' (GAs) healthcare experiences and uses grounded theory to create a model of graduate assistants' experiences with university-provided healthcare in a large research university. The model is composed of four broad components: (a) systems; (b) access, care and coverage; (c) knowledge, quality and cost; and (d) self. Graduate assistants' needs and expectations constantly negotiate various systems in the model. Expanding upon the limited research regarding graduate student healthcare, this study provides implications for higher education administrators and policy makers. Based on our study findings we argue that it is not sufficient for university administrations to simply provide paid health insurance "options" without robust support systems on campus. Because students are often stressed out, lack time and energy, and find it hard to navigate the complicated systems of profit-driven health care industry, the lack of direct support in graduate students' day-to-day healthcare needs can cause tremendous loss on their success and productivity. Hence, universities have tremendous opportunities to better understand and address their graduate students' real needs so as to add value to institutional success and productivity. Keywords: Graduate Students, Healthcare, Qualitative Research, Union, Constructivism, Higher Education, Student Benefits, Administration, Policy, Learning environmentA telephone call disrupts Rozita (a composite character), a third year doctoral student at a large research university, who is trying to concentrate and finalize an important research report after having graded 72 undergraduate papers. She hasn't slept well and her eye-sight is blurring. She is wearing a pair of eyeglasses; unfortunately, one of the lenses has been broken for the past three days. It's been years since she had her eyes checked, so she is wondering whether to order a new pair of glasses or just have the old one fixed this weekend. It's been a tiring week for her but a sudden flash of smile is visible on Rozita's face as she remembers an important term from her appointment letter: INSURANCE PROGRAM. What this means to her is that healthcare is provided for by the university, and she is pretty sure that anything she may need would be covered - including an eye examination and eyeglasses. "I'll probably have my eyes checked and have a new pair ordered," murmurs Rozita proudly as she reaches her phone to answer the call. What is heard on the phone immediately snatches away the momentary flash of happiness from her face. She finds that the call is machine recorded message from a debt-collection company asking her to pay $450 for some outstanding bills: bills for the deductible and coinsurance from her last hospital visit. She now doubts whether her eye-checkup would be covered. She realizes that her regular dental checkup is overdue by six months. So she wants to line up the dental check up with eye check up to save time. But she wants to make sure it will be covered. She calls the dentist's office to ask if dental checkup is covered by her insurance. After taking note of all the information from Rozita, the dentist's secretary says that coverage depends on many factors including pre-existing conditions but she encourages Rozita to visit the clinic anyway. How to make sense all this? Rozita is not sure at all.There have been few formal studies conducted on the topic of graduate student healthcare (Lenssen, 2010; Markowitz, Gold, & Rice, 1991; Smith, 1995). The largest population in the United States that lacks health insurance is young adults (between the ages of 19 and 29) with 13.2 million (29 percent) lacking coverage in 2007 (Nicholson et al., 2009). There is substantial overlap between the population of uninsured young adults and the population of graduate assistants (GAs), but the specific needs and experiences of GAs - and graduate students more broadly - have not been researched or documented. …