By: Monica Kao
I’ll be the first to admit that, when it comes to the inner workings of health care and its ongoing reform, I know far less than I actually should. This is despite having taken HMP 130: Contemporary Challenges in Health Care just last semester. It’s not that I don’t understand the importance of the topic–I realize that the policy changes being debated right now will affect me (and the things that I do in my future career) on a daily basis–but frankly, health care reform is complicated and incredibly overwhelming. Reading about it can be boring and confusing–disheartening, even. It’s easy to be ignorant about health insurance and policy, just like it’s easy to be ignorant about a lot of things that make us feel uncomfortable. But this piece about health insurance was hard to ignore. A seventeen-year-old girl in need of a liver transplant died not because of a lack of available organs or substandard care, but because her insurance company refused to pay. To add insult to injury, the insurance company took extreme measures to protect its image (a spy at a funeral, what?) and to discredit the negative media attention that resulted. Hey, call me naïve, but I had always thought that health insurance was in place to help us–to defray the costs of medical procedures and the like–and so it’s incredibly jarring to read stories like Nataline’s, or others about rescission. Where is the justice in a practice that involves looking for ridiculous loopholes to justify canceling someone’s policy retroactively? Victims of rescission, who rely upon insurers to help them through their time of need and poor health, are saddled with medical debt and even more problems than they had before they decided to seek medical care.
The truth is that health care and health insurance is a matter of social justice. For-profit insurance companies know that the people least likely to fight policy rescissions and to take legal action against them are the ones who don’t know what their rights are, who can’t afford to seek legal counsel, and who don’t know who to turn to. In other words, the least educated, the poor, and the marginalized. Sound familiar, public health students? These insurance companies are knowingly targeting those populations that will allow them to get away with what they’re doing–which, in case it hasn’t been made clear enough, is profiting at the expense of other people’s health or even at the expense of their lives. It’s morally reprehensible, and yet all of us allow it to happen because it’s easy for us to be ignorant about complicated policies that may not even seem relevant to us right now. The overhaul of the health care system will affect all Americans; young or old, rich or poor, healthy or sick. And so in the context of health care policy, who makes up the community? We do. All of us. We as public health students, as SLU students, as men and women for others–we express such concern for the condition of others all around the world, for reducing health disparities and building health equity, for improving the quality of life; yet, Nataline’s story demonstrates that there are examples of social injustice within our own community. As public health students, health care policy should matter to us, and it should matter a lot. As I’ve already admitted, I am neither familiar nor comfortable with the politics of health care, but I do recognize that public health is greatly reliant on health care policy and I know that I won’t be able to take the easy route for much longer. Someday, these reforms will catch up with us and although I hope that all of my readers are lucky enough to enjoy impeccable health for the remainder of their lives, there’s always the possibility that we might have to learn their true meaning the hard way. If we expect our community to help us defend our rights and to keep our medical debts from dragging us into bankruptcy, we must also accept responsibility for our community. Most of us will never be policymakers, but all of us are stakeholders in the changes being made, and we have a responsibility to be informed ones at that. I’m resolving to try and learn more about health care reform, and although I might regret this later, I encourage you to hold me to it. Ask me what I’ve read or learned recently, or better yet, tell me what you think.