The Healthcare Hypocrisy
By: Michelle Patten
Tags: Insurance, University, Medicine, Healthcare

I was once one of the many pre-med students milling about my university campus, hoping to “change the world” by traveling to third-world countries providing much-needed medical care. But there was something critically wrong about that dream, and not just that my interests were very far elsewhere. I’m not saying that the world has no place for these people. We do need doctors who go out and serve those around the world in need. But we also need to address the critical issues in both policy and practice present in our American healthcare system. Particularly those present in the cases of chronic illness.

About a year ago, ironically just a week after I decided that the medical field was not going to be my future, I was exposed to the various intricacies of insurance policies, medical specialists, and diagnostic testing after the onset of some mystery illness. And after a year, including 5 hospital visits, 8 different doctors, an out-of-pocket bill larger than that of my college tuition, and few answers, I see the issues in this field that I was previously oblivious to.

Living in a capitalist society, acquiring a service almost certainly requires some sort of monetary exchange. While this is a problem within healthcare in and of itself, there is no sense in arguing that health care providers shouldn’t receive a salary, as they provide a valuable service that deserves compensation. The real issue lies in the fact that we don’t directly pay our practitioners, surgeons, anesthesiologists, and other medical professionals for their services. We conduct all business through a middle man: our insurance agency. Insurers themselves do not provide healthcare. They are for-profit organizations taking advantage of the fact that most cannot afford medical care in the case of emergencies without them. But insurance companies don’t run with the benefit of the consumer in mind, unlike doctors who may truly wish to see their patients improve. Insurance companies want your money.

I am not arguing that there can be no commercial aspect to our rights. But the commercial aspect should not get in the way of our rights. Borrowing an analogy from a Huffington Post opinion piece, the way our healthcare system is run is akin to if there were some sort of intermediary in our food purchasing. If we had to pay someone separate who then designates what sorts of foods we have access to and were denied access too. And this separate entity could deny food any time they deem it a financial burden on their part. This is exactly what happens within healthcare. And is our health not a right just as food should be?

The fact that people from other countries are shocked to hear that we have to pay for services such as ambulance fees should be a clue that there is something wrong with how the United States runs things. For example, last year I went into the Student Health Center, and they believed I was having a heart attack. Four times I had to turn down their request to send me to the ER in an ambulance, not because I thought the medical care wasn’t necessary, but because I didn’t want to pay the cost of an ambulance ride. And I am lucky enough to have been conscious and able to deny that “service” and acquire another ride. But for those who are involved in some major accident, and are whisked off to the hospital in an ambulance instead of an Uber, they are often charged thousands of dollars that they simply cannot afford.

And even after finding a ride as an alternative to the ambulance, I opted to go to urgent care rather than the ER, because of the difference between a $40 copay and a $400 copay. And when urgent care referred me to the ER, I instead went back to my dorm room, ate dinner, and went to bed. This was not the first, nor the last time that I neglected the recommended medical treatment due to financial burdens. And I’m not even from a low-income household as many people seeking medical treatment are. Yet I still fall into the category of the 30% of all Americans and 40% of women who have an unmet healthcare need because of cost.

We pretty frequently hear stories such as the EpiPen scandal, where they became overwhelmingly expensive, to the point where many in need of them could not afford them. And still ended up purchasing them due to the necessity. Or the rising prices if insulin, which is necessary for the lives of all 1.25 million Americans with Type 1 diabetes. Or of an insurance company denying a life-saving treatment to a child with cancer. But the issue is even more pervasive throughout society, affecting every person in the country. In 2018, the average cost of healthcare for a family of four was $28,000. And with the median household income hovering around $60,000 in the United States, that is nearly half of a family’s income going toward medical expenses each year. So for anybody with greater than average medical expenses (such as myself) or with lower income, this is creating a significant problem. And chances are, if either of these are the case for a specific household, there are other compounding financial factors as well. Americans should not fear going to a doctor because of the rampant, unexplained charges.

Not only is healthcare and insurance a significant financial burden, but it poses a significant logistical burden as well. This summer, my neurologist ran some bloodwork testing me for various genetic disorders that may have been causing some of my issues. My insurance company denied their claim, deeming this testing “unnecessary”, while up until less than a month prior, it was standard to approve that testing. This led to a month of failed appeals with insurance, meaning it took a month longer than I was expecting to get results. And even after all that time, my appeals weren’t even granted, and I had to pay for a simple blood test out-of-pocket. And while this testing was deemed “unnecessary”, it happened to be the first test that actually gave us any sort of headway.

And making sure you are covered under insurance is a hassle in and of itself. I am currently under my father’s health insurance, meaning that my coverage relies on the company my father works for. Last week, my father’s company stated that they are changing insurance providers at the beginning of December. So I had to look up all of my doctors to see if they are still in-network, and if not, I would have to shift all of my appointments to new doctors, which would set us months behind in the progress we are finally making. Turns out, my new insurance policy doesn’t cover any doctors in the state of Texas. So until I can get on student health insurance at the beginning of next semester, I am uninsured. And for a college student with chronic illness, that’s a significant issue.

While there are certainly further issues in medical and insurance policy that I have neglected to cover, issues in medical practice are also of particular concern, especially for those of various minority groups. When I walk into the waiting room of my neurologist, oncologist, hematologist, and cardiologist, I am always the youngest person in the room. Nobody expects a 19-year-old to have issues requiring this sort of attention. My anesthesiologist, while performing a lumbar puncture in September, stated, “We almost never have to do these on people your age. Thus it’s harder to differentiate the various layers to make sure we are in the right spot.” And indeed, they ended up going too deep into my back, causing issues landing me in the ER three days later. When mentioning my symptoms to my cardiologist, he stated, “Well, this sounds like a stroke, but considering you’re a 19-year-old female, it’s not that urgent.” Turns out it was indeed a stroke, but didn’t get diagnosed until 4 months later and near-permanent nerve issues resulted. And often when I have an appointment scheduled months in advance, this appointment gets cancelled to make room for someone older, who they can more easily diagnose and treat. But just because I’m younger, and these issues don’t make a lot of sense, doesn’t mean that they aren’t life threatening or having a significant impact on my life. Yet I still get disregarded. And this is the case for many youths with chronic illness: we are told that because we “shouldn’t” have these illnesses at this age, we then don’t. Which isn’t the case.

Not only that, but with the medical system being so divided between its different departments, so many things take longer in practice than they actually should due to lack of communication. I have lost track of the number of times that something has been missed because my neurologist neglected to share some tidbit of information with my general practitioner, or that my hematologist has been unaware of the significant pain that I am in constantly because none of my other doctors felt to mention it. And with so much information being passed around without some coherent way of collating all of it, there are many symptoms of mine that the doctors have completely forgotten about addressing at this point.

So here I am, having spent way more out-of-pocket for my medical expenses than any college kid really has the money for, losing feeling in the right side of my body because I didn’t want to pay for the ER after having a stroke, rescheduling all of my December appointments because I am currently uninsured, waiting three months for an appointment with my next specialist because I am a 19-year-old female who isn’t a priority, and suffering from pain and other symptoms that nobody cares to pay attention to. There’s a problem in our healthcare system if any of these are the case. There’s definitely a problem considering all of these are in play, with no solution in sight to any of them.

*This article originally published with AMP at UT Dallas in December 2019*