Debate continues on medical costs for injured college athletes

In this photo from Oct. 1, 2005, Alabama trainers work on receiver Tyrone Prothro as quarterback Brodie Croyle pats him on the back after he suffered a broken leg in a game against Florida in Tuscaloosa, Ala. (AP Photo/Rob Carr)

If a college football player is hurt in a game, it would seem to make sense that the school pays his medical expenses, right? As we hear Lee Corso exclaim every Saturday on ESPN's College Gameday, "Not so fast!"

Currently the NCAA requires schools to ensure that every student-athlete has insurance for sports-related injuries. The schools do not necessarily pay for that insurance, however. The athletes' or their parents' insurance often pays for these expenses, and the family often faces paying the deductibles and out-of-pocket medical costs themselves. In the rare circumstances in which an athlete's claims reach $90,000, the NCAA's catastrophic insurance plan covers the costs.

Once an athlete leaves college, the school is not generally required to pay for medical care related to those on-field injuries. Since many athletic scholarships are renewable annually, a coach could revoke a player's scholarship if he gets injured and isn't considered healthy enough to play.

This week, the PAC-12 Conference took the first steps to reform this model. In addition to guaranteeing four-year scholarships for athletes and easing transfers between schools, these changes would ensure that the medical expenses for athletes injured during their college playing days would be covered up to four years after they leave school.

The PAC-12 changes seem to be a huge victory for all college athletes, but it remains to be seen if athletes at schools outside of the power conferences receive these benefits.

Look at the discrepancy in how big and small athletic departments handle their medical costs.

According to The Birmingham News, the University of Alabama covers medical, dental and rehabilitation expenses for its players injured during an official team activity.

When Tyrone Prothro, the former Crimson Tide wide receiver who made one of the most famous catches in college football history, suffered a horrific tibia fracture in 2005 that led to a severe infection, the university paid the medical bills for his 10 surgeries.

Auburn instead pays all expenses not covered by a family's medical insurance. If an athlete does not have insurance, then Auburn puts him on its medical coverage.

According to The Birmingham News, these plans weren't cheap. In the 2010-11 academic year, Alabama paid $1.96 million for medical expenses and insurance. Auburn paid $852,477.

On the other hand, the University of Maine doesn't have an athletic department generating multi-million dollar revenues. The school requires its athletes to pay the first $10,000 in co-pays and deductibles, according to The Portland Press Herald.

College athletic departments do provide medical services that the average person - or even regular college student - wouldn't get. Schools usually grant their athletes regular access to the team doctors for evaluation of injuries. Players also have regular access to athletic trainers for rehab, injury prevention, taping and injury management. These services could cost thousands with private healthcare providers.

The University of Maine paid $296,580 for salaries and benefits for the athletic trainers, $15,000 for physician coverage of its major sports, and $42,637 for supplies such as tape and braces in 2013.

The debate over what universities should cover financially is further complicated by the designation of players as student-athletes and not employees. For example, if a football coach breaks his leg while standing on the sideline as a player barrels into him, his immediate and long-term medical expenses would likely be paid completely by the school through a workers' compensation plan, since the coach is an employee of the university.

If a player on that same team breaks his leg during that same game, his personal insurance would likely have to pay. He would probably have to pay thousands of dollars on his own since he is a student-athlete and not an employee of the school.

Hopefully another change will come from the PAC-12 reforms. Maybe we will see more transparency about schools' handling of medical costs. Parents of high school athletes being recruited to play college sports need to ask what level of medical care and coverage the universities will provide.

Does the school's insurance pay for all medical costs? Does it pay for a second opinion? Does it cover care for long-term complications of an injury years after the athlete leaves school? These are issues that often arise, but I doubt many parents and athletes think about them until after an injury occurs.

I expect these PAC-12 changes will eventually be adopted by all of the larger conferences. These large schools can afford to absorb the medical costs, either paying them completely or after the families' insurance policies have paid. For smaller schools with much smaller athletic department budgets, we will have to wait and see if they can, or will, pay.

Dr. David Geier is an orthopaedic surgeon and sports medicine specialist in Charleston. For more information about football injuries and other sports medicine topics, go to his blog at drdavidgeier.com.