My time with Americorps and Neighborcare is winding down. With the unofficial start of summer, Memorial Day, behind us, I now look to my future with a hodgepodge of feelings and new adventures.
The Dental Integration project, the brain child of my Americorps service, is going smoothly. We are even considering using this model to contact other patient populations, such as diabetics, overdue mammogram patients, annual exams and pap patient reminders. Shifting these responsibilities from medical and dental providers to administrative staff will greatly affect the productivity of our providers. Although admin staff will have more work...
Speaking of productivity, a new project our organization is attempting is increased productivity, measured in terms of patients visits per day per provider. This is essential considering the major budget cuts that just happened both in Olympia and Washington DC. We must increase the number of patients per providers because a) we are seeing more and more patients, b)we get reimbursed and paid for patients who have appointments with a provider, not a nurse or counselor and c) because we can't really afford to hire new providers to make up for the increased patient load. When I think of the word "productivity," I think of factories; the mass production of goods. I don't think of it in terms of check ups and pap smears, but alas, the medical system is a business afterall. While we are in the business of healing and caring from a non-profit standpoint, there are rent and utilities to pay, employees have to eat and feed their families.
With my Americorps service just about done. I'm looking ahead to my future and I don't think the community health field is for me. I have grown fond of the compassionate people and philosophy behind community health centers; the idea of community-based health and making quality services accesible to immigrants, low-income families and other indigent gourps, but it's emotionally exhausting. With the current budget situation and the current political idealogies that threaten medical services for low-income families, it's heart wrenching to know that with every million dollars cut from social and health service programs, thousand of people will have a lower quality of life. We hear about it all the time in the news, but now, these numbers have faces and the impact is felt on a personal level.
I strongly believe with all my heart that access to health care is a right and essential to improving the quality of life of all immigrants, low-income families and minority groups. And I'm a fighter: I have strong morals and I will fight for them. But I'm exhausted and the community health center movement is fighting a losing battle. A battle where only our patients, who are amongst the neediest of our community, are the ones affected.
You think the suits down in Olympia know first hand what it means to cut health services funding? They are not on the battlefield, day in and day out, watching struggling families make ends meet, desperately looking for jobs and trying to feed their kids. And while in this clinic, in this building, we can only really help with their medical woes, perceived health is so intricately woven with self-worth, motivation, perseverance and other psychological and spiritual attributes that allow individuals to not just live, but THRIVE.
But I guess it's difficult for anyone to thrive in this economic climate. College students, small business owners,recently unemployed breadwinners: it's hard enough to get by, let alone get ahead.
I am an Americorps volunteer at Neighborcare Health, a community health organization based in Seattle. After having relocated from Calfornia to Seattle to pursue a career in public health, I'm overworked and underpaid but livin' it up the Americorps way.
*The opinions on this blog do not reflect that of Americorps, Washington Service Corps or Neighborcare Health. Just Samantha's :)*
*The opinions on this blog do not reflect that of Americorps, Washington Service Corps or Neighborcare Health. Just Samantha's :)*
Thursday, June 2, 2011
Friday, March 4, 2011
Stand with Planned Parenthood...uh, can't I just sit?
Planned Parenthood is the largest reproductive health care organization in the United States and is now on the Federal funding chopping block. Now before we jump to conclusions, let's look at the facts about the services PP actually provides.
Percent of total services:
35% contraception
34% STI/STD testing and treatment
17% cancer testing and screening
10% other women's health procedures, including pregnancy, prenatal, midlife, and infertility
2% to 3% abortion or abortion-related
We may now resume our jumps to conclusions.
PP is an easy target because they publically advocate for reproductive rights. But when less that 3 percent of what they do is actually abortions, this is more a demonstration of newly acquired power by House Republicans rather than actual progress for pro-life advocates. Clearly the issue in cutting Federal support is abortion rights, not the budget. PP received $349.6 million from Federal funding in 2008, and that amount is merely a drop in the bucket when our current deficit is in the trillions.
So why bring up abortion rights now? We have record high rates of unemployment, families are consistently losing their businesses and homes, higher education costs are going much higher and while we are told that things are improving, there seems to be no end to the all the struggles Americans are facing. Abortion is the go-to topic to distract from the more important issues, such as the game of hide-and-go-seek the Democrats in Wisconsin are playing or the little to no impact on military spending in our massive budget crisis. But here's the thing: just because abortion gets used as the shiny object flashing in your eyes doesn't mean it isn't important to discuss. It's just not important to discuss at this time and in this political climate.
Isn't it funny that the whole issue around Planned Parenthood is protecting babies but that all too easily we tend to throw the baby out with the bathwater?Cutting all funding to PP because 3% of their services is in providing abortion resources is unfair, especially considering that no government money directly funds said abortions. Yeah, PP accepts Federal grants given the stipulation that none of that money goes towards abortions and yet here we are trying to pull all Federal funding. Abortions are funded by private donors and for-fee services, so it's difficult to understand why people keep screaming that the government is funding abortions. I guess, in a way, it is indirectly...
Abortions are a topic that make me very uncomfortable. I can speak freely and openly about a lot of things, but abortion is one thing I can't speak objectively about. It is very much a personal values issue and our religious and spiritual views are deeply intertwined into ideas of family and respect for life. As a practicing Catholic who embraces and respects the right to life, I cannot condone nor support the act of killing an embryo. However, the reality is that not everyone in the US is a practicing Catholic who respects life, and to push my values strictly influenced by religon onto others is unreasonable. I may hold religious values and this country may have been founded by religious values, but we are secularized government. Proposing legislation based on religious beliefs *cough*PROP 8*cough*DOMA*cough* should have no place in our country, as it represents a form of religious oppression.
That last paragraph looks good in print, but more difficult to do in real life. Since the proposed funding cuts to PP, there have been advocates petitioning and accepting donations for PP at various street corners and businesses throughout Seattle, and everytime I am approached by them I blow them off. Hell no am I going to sign that! They kill babies! I think to myself as I walk past them. It's one thing to say you support a secularized government, and quite another to get me to donate, volunteer and sign petitions to keep PP in business.
So where exactly do I stand on this issue? Well, I can't necessarily stand with PP, but I could just sit. Sit and hope that funding will be restored and those who are morally unopposed to abortions will continue to receive the necessary services they wish to obtain. I will sit and hope that birth control will be available to all those men and women who need them, thereby preventing the need to consider an abortion. I will sit and hope that people who need reproductive cancer screenings and STI tests will continue to get them. But that's all I am willing to do for Planned Parenthood.
Percent of total services:
35% contraception
34% STI/STD testing and treatment
17% cancer testing and screening
10% other women's health procedures, including pregnancy, prenatal, midlife, and infertility
2% to 3% abortion or abortion-related
We may now resume our jumps to conclusions.
PP is an easy target because they publically advocate for reproductive rights. But when less that 3 percent of what they do is actually abortions, this is more a demonstration of newly acquired power by House Republicans rather than actual progress for pro-life advocates. Clearly the issue in cutting Federal support is abortion rights, not the budget. PP received $349.6 million from Federal funding in 2008, and that amount is merely a drop in the bucket when our current deficit is in the trillions.
So why bring up abortion rights now? We have record high rates of unemployment, families are consistently losing their businesses and homes, higher education costs are going much higher and while we are told that things are improving, there seems to be no end to the all the struggles Americans are facing. Abortion is the go-to topic to distract from the more important issues, such as the game of hide-and-go-seek the Democrats in Wisconsin are playing or the little to no impact on military spending in our massive budget crisis. But here's the thing: just because abortion gets used as the shiny object flashing in your eyes doesn't mean it isn't important to discuss. It's just not important to discuss at this time and in this political climate.
Isn't it funny that the whole issue around Planned Parenthood is protecting babies but that all too easily we tend to throw the baby out with the bathwater?Cutting all funding to PP because 3% of their services is in providing abortion resources is unfair, especially considering that no government money directly funds said abortions. Yeah, PP accepts Federal grants given the stipulation that none of that money goes towards abortions and yet here we are trying to pull all Federal funding. Abortions are funded by private donors and for-fee services, so it's difficult to understand why people keep screaming that the government is funding abortions. I guess, in a way, it is indirectly...
Abortions are a topic that make me very uncomfortable. I can speak freely and openly about a lot of things, but abortion is one thing I can't speak objectively about. It is very much a personal values issue and our religious and spiritual views are deeply intertwined into ideas of family and respect for life. As a practicing Catholic who embraces and respects the right to life, I cannot condone nor support the act of killing an embryo. However, the reality is that not everyone in the US is a practicing Catholic who respects life, and to push my values strictly influenced by religon onto others is unreasonable. I may hold religious values and this country may have been founded by religious values, but we are secularized government. Proposing legislation based on religious beliefs *cough*PROP 8*cough*DOMA*cough* should have no place in our country, as it represents a form of religious oppression.
That last paragraph looks good in print, but more difficult to do in real life. Since the proposed funding cuts to PP, there have been advocates petitioning and accepting donations for PP at various street corners and businesses throughout Seattle, and everytime I am approached by them I blow them off. Hell no am I going to sign that! They kill babies! I think to myself as I walk past them. It's one thing to say you support a secularized government, and quite another to get me to donate, volunteer and sign petitions to keep PP in business.
So where exactly do I stand on this issue? Well, I can't necessarily stand with PP, but I could just sit. Sit and hope that funding will be restored and those who are morally unopposed to abortions will continue to receive the necessary services they wish to obtain. I will sit and hope that birth control will be available to all those men and women who need them, thereby preventing the need to consider an abortion. I will sit and hope that people who need reproductive cancer screenings and STI tests will continue to get them. But that's all I am willing to do for Planned Parenthood.
Thursday, February 17, 2011
Reading Rainbow theme song, you lied.
It has been suggested by congress last week to eliminate Americorps funding, in addition to several other programs, to try to curb federal spending. A new budget will be proposed in a few weeks and could possibly interrupt my Americorps service. A mild panic has flooded me over the past weekend after opening up to the possibility of losing my job with no fault of my own, yet again.
After graduating from college, I spent a year searching for a job relevant to my education, experiences and interests, but worked as a fill-in substitute teacher in the meanwhile. At last I was hired at a Fresno branch of a national non-profit organization that I love and admire, only to be let go 3 days later when my background check did not got through. My supervisor called me in to his office privately, told me the background did not go through and asked me to take my things and leave the building immediately. He told me he would hold the position for me until this got cleared up since he believed this to be an error. Confused and hurt, I left and began investigating why a woman who passed the Deparment of Justice and FBI's background checks to work as a public school substitute teacher could not pass the background for office work at a NPO.
Heres what happened:
A few years earlier my identity was stolen by a woman in Sanger,CA and used my identity when arrested for committing a felony. During her trial they corrected the identity to her true name and had an additional charge of "providing false identity to a police officer." I had first known about it when began to receive collection notices from Fresno County Superior Court in the mail while I lived in Davis. After going to Fresno County Superior Court, I was told the issue would be cleared up since the person of interest was not me. This was November 2006, fast foward to April 2010 and once again Fresno Superior Court has failed me.
Having no prior exposure to the court system, I blindly navigated my way from person to person, being transferred to all sorts of people trying to figure everything out. Eventually I had to go to the Reedley court house, get documents from them and fax them to the background company to clear it up. Exactly 2 weeks after being let go, everything was cleared up and I was anxious to get my job back as promised by my supervisor. I called him, excited to announce I could start work as soon as tomorrow only to be told he has filled the position. Douche bag. So I went back to substitute teaching, which paid much better anyways. But the powerlessness I felt after this horrible experience has remained.
Americorps allowed me to work in the field of my interest, using my skills and education to serve a non-profit organization and a population that needs me. Yes, Neighborcare Health needs me, they identified me as a person with the skills and background that would benefit their organization and their patients. And I benefit because I am working towards my goals and working for an organzation that matches my values system, even if working for only a fraction of the salary regular employees receive. Yes, I am overworked and yes, I am horribly underpaid considering I moved from out-of-state to a high cost-of-living city. But I love the work I do at Neighborcare, I am good at it and I am personally fulfilled. I have a sense of personal value, power and control through the chaos of life. The thought that I may once again lose control of my life at no fault of my own, even if only in losing my job, is terrifying.
My generation is the "You can do anything you set your mind to" generation. We grew up having our minds filled with hope and possiblities to succeed, that with hard work and a college education, you can go anywhere and do anything! Maybe this was true, during the economic boom of the 1990's when Clinton was in office, unemployment was at an all time low, the housing market was booming and our country was had real wealth (defined in my terms as in manageable debt and competitive in a global economy). The realities of graduating from college in 2009, the worst economic environment since the Great Depression, were far different from the land of milk and honey promised to us by our grade school teachers. No milk nor honey, it is dog-eat-dog in the job market and a giant pitbull had just bite my head off.
I think this video exmpliefies all the lies we were brainwashed with in our youth.
After graduating from college, I spent a year searching for a job relevant to my education, experiences and interests, but worked as a fill-in substitute teacher in the meanwhile. At last I was hired at a Fresno branch of a national non-profit organization that I love and admire, only to be let go 3 days later when my background check did not got through. My supervisor called me in to his office privately, told me the background did not go through and asked me to take my things and leave the building immediately. He told me he would hold the position for me until this got cleared up since he believed this to be an error. Confused and hurt, I left and began investigating why a woman who passed the Deparment of Justice and FBI's background checks to work as a public school substitute teacher could not pass the background for office work at a NPO.
Heres what happened:
A few years earlier my identity was stolen by a woman in Sanger,CA and used my identity when arrested for committing a felony. During her trial they corrected the identity to her true name and had an additional charge of "providing false identity to a police officer." I had first known about it when began to receive collection notices from Fresno County Superior Court in the mail while I lived in Davis. After going to Fresno County Superior Court, I was told the issue would be cleared up since the person of interest was not me. This was November 2006, fast foward to April 2010 and once again Fresno Superior Court has failed me.
Having no prior exposure to the court system, I blindly navigated my way from person to person, being transferred to all sorts of people trying to figure everything out. Eventually I had to go to the Reedley court house, get documents from them and fax them to the background company to clear it up. Exactly 2 weeks after being let go, everything was cleared up and I was anxious to get my job back as promised by my supervisor. I called him, excited to announce I could start work as soon as tomorrow only to be told he has filled the position. Douche bag. So I went back to substitute teaching, which paid much better anyways. But the powerlessness I felt after this horrible experience has remained.
Americorps allowed me to work in the field of my interest, using my skills and education to serve a non-profit organization and a population that needs me. Yes, Neighborcare Health needs me, they identified me as a person with the skills and background that would benefit their organization and their patients. And I benefit because I am working towards my goals and working for an organzation that matches my values system, even if working for only a fraction of the salary regular employees receive. Yes, I am overworked and yes, I am horribly underpaid considering I moved from out-of-state to a high cost-of-living city. But I love the work I do at Neighborcare, I am good at it and I am personally fulfilled. I have a sense of personal value, power and control through the chaos of life. The thought that I may once again lose control of my life at no fault of my own, even if only in losing my job, is terrifying.
My generation is the "You can do anything you set your mind to" generation. We grew up having our minds filled with hope and possiblities to succeed, that with hard work and a college education, you can go anywhere and do anything! Maybe this was true, during the economic boom of the 1990's when Clinton was in office, unemployment was at an all time low, the housing market was booming and our country was had real wealth (defined in my terms as in manageable debt and competitive in a global economy). The realities of graduating from college in 2009, the worst economic environment since the Great Depression, were far different from the land of milk and honey promised to us by our grade school teachers. No milk nor honey, it is dog-eat-dog in the job market and a giant pitbull had just bite my head off.
I think this video exmpliefies all the lies we were brainwashed with in our youth.
Monday, February 7, 2011
Mmm girl, you just gave me a cavity cause you SOOOO SWEET!
For the past 3 months or so, my Americorps partner and I have been working on a project to find an easier way to co-integrate medical and dental patients within our clinics. Although often housed in the same building, the medical clinic and the dental clinic were seen as separate entities with two different patient populations. We were working to find a way to link them up better on the administrative end, a task that requires staff from every level to be re-trained in one way or another. And finally, after months of research we presented our preliminary findings.
This first presentation came at a crucial time for the dental clinics. State funding for adult dental services has been cut as of January 1, meaning no dental reimbursements for medical coupon, or Medicare, patients. This is a huge hit for the dental clinics budget and in order to stay afloat, a new patient population needs to be exploi...I mean, reached out to. As I mentioned in my very first AmeriCorpse blog post, Idealism Waning, there are two populations that the State has reliable funding for: children and pregnant women. We have been focusing our integration project on children who are currently medical patients but are not dental patients in Neighborcare. Over half of the children seen in medical have no or unknown dental provider. We are their medical home and now we want to be their dental home too.
But isn't it funny how so many children come in to see a doctor regularly but so few come in to see a dentist? Many families only get insurance coverage for medical only or if they do get dental insurance it's a limited, high deductible plan. That could be a reason why so few of our children patients actually see a dentist. But many (maybe even most)children in Neighborcare are covered by Medicare, so all their primary medical and dental are free of charge, why isn't our dental clinic flooded with patients? After all, the dental clinic is only on the second floor and we have an elevator...
Our current health system greatly influences our persception of health values, and the current model has diverged dental health from overall health by creating separate insurance systems. So we the consumers agree that they should be separate; we agree with the status quo that the mouth is in fact not part of our bodies and that bacteria invading our tooth enamel is not as important than bacteria invading our tissues. This is why the State chose to cut adult dental services: Dental is not viewed as essential care.
But luckily, those wiley ol' lawmakers knew to keep those cute and cuddly little humans covered, well, at least for now. It turns out that the first few years of life are the some of the most important in oral health. Infants are first introduced to the decay-causing bacteria from their caretaker, typically their Mom. This bacteria spreads from person to person, then in their tiny little mouths and causes their tiny baby teeth to rot. Milk and other sweet beverages are not the cause of decay, but they create the perfect environment for the bacteria to proliferate and spread. Tooth decay is an infectious disease.
Unlike STIs, we can't just wrap the baby up in latex to prevent the spread of infection. The culprit of the spreading is actually Mom and her poor oral hygiene habits. Mom teaches baby her poor oral hygiene habits and baby grows into child with poorer oral hygiene habits. Then child becomes adult, has baby and the circle repeats. Let's break this cycle and teach Mom how important oral hygiene is! Oh wait, but dental hygiene is "non essential," so nevermind.
Nevermind, oh well, too bad, ce la vie. Budget cuts suck.
This first presentation came at a crucial time for the dental clinics. State funding for adult dental services has been cut as of January 1, meaning no dental reimbursements for medical coupon, or Medicare, patients. This is a huge hit for the dental clinics budget and in order to stay afloat, a new patient population needs to be exploi...I mean, reached out to. As I mentioned in my very first AmeriCorpse blog post, Idealism Waning, there are two populations that the State has reliable funding for: children and pregnant women. We have been focusing our integration project on children who are currently medical patients but are not dental patients in Neighborcare. Over half of the children seen in medical have no or unknown dental provider. We are their medical home and now we want to be their dental home too.
But isn't it funny how so many children come in to see a doctor regularly but so few come in to see a dentist? Many families only get insurance coverage for medical only or if they do get dental insurance it's a limited, high deductible plan. That could be a reason why so few of our children patients actually see a dentist. But many (maybe even most)children in Neighborcare are covered by Medicare, so all their primary medical and dental are free of charge, why isn't our dental clinic flooded with patients? After all, the dental clinic is only on the second floor and we have an elevator...
Our current health system greatly influences our persception of health values, and the current model has diverged dental health from overall health by creating separate insurance systems. So we the consumers agree that they should be separate; we agree with the status quo that the mouth is in fact not part of our bodies and that bacteria invading our tooth enamel is not as important than bacteria invading our tissues. This is why the State chose to cut adult dental services: Dental is not viewed as essential care.
But luckily, those wiley ol' lawmakers knew to keep those cute and cuddly little humans covered, well, at least for now. It turns out that the first few years of life are the some of the most important in oral health. Infants are first introduced to the decay-causing bacteria from their caretaker, typically their Mom. This bacteria spreads from person to person, then in their tiny little mouths and causes their tiny baby teeth to rot. Milk and other sweet beverages are not the cause of decay, but they create the perfect environment for the bacteria to proliferate and spread. Tooth decay is an infectious disease.
Unlike STIs, we can't just wrap the baby up in latex to prevent the spread of infection. The culprit of the spreading is actually Mom and her poor oral hygiene habits. Mom teaches baby her poor oral hygiene habits and baby grows into child with poorer oral hygiene habits. Then child becomes adult, has baby and the circle repeats. Let's break this cycle and teach Mom how important oral hygiene is! Oh wait, but dental hygiene is "non essential," so nevermind.
Nevermind, oh well, too bad, ce la vie. Budget cuts suck.
Friday, January 21, 2011
The Waiting Game
After months of work on my grad school application for the Masters in Public Health at the University of Washington Dept. of Epidemiology, all material has been submitted and now I wait. I wait for a response from the department, waiting to know if they value personal merit over a higher GPA, waiting to know what August 2011 will look like for me, just waiting...and patience is one of my weaker virtues.
For example, after graduating with my BS in 2009 I moved back home to Fresno to look for a solid job until I started grad school. I had a top-notch education, solid work experience and excellent recommendations and I am bilingual, so needless to say I felt confident I would secure something relevant to my career interests in public health. After a year of fruitless interviews, on-call substitute teaching and happy-peppy aerobics instructing,(and living with my parents, AGH!) I had had enough. I was wasting away in a city that defines "brain drain" like no other place in the world. Others would have kept waiting and applying for jobs, hoping to get into the company their uncle works for or getting hooked up with a retail job from a friend, but frankly, I didn't bust my behind to get my bachelors degree in genetics so that I could work at Starbucks or Forever 21. I was impatient and didn't want to waste any more of my youth and energy in a place where my talents weren't appreciated. My lack of patience brought me to a thriving city with many opportunities in my chosen profession, score!
Granted, this move came at some personal expense since I left behind everything and everyone I knew. I took a leap of faith that so far has been working out really great but could have easily gone sour. Not everyone has the audacity (or recklessness, stupidity, imprudence) that I had to move 1000 miles away to pursue my dream of saving the world one vaccine and aspirin at a time, but when I speak to friends who are in the same place I was last year, I tell them to get the heck out of Fresno. If our education and skills are of no good to the industries and economy of California's Central Valley, pack your bags, make the sign of the cross and find your success elsewhere. The job market in the Central Valley isn't just magically going to improve overnight and success in times of crisis comes to those who are willing to go after it.
Americorps presented me with an opportunity that was just perfect for me, a career of service in public health, and while I may whine a lot about the economy or how little our stipend may be, this is exactly what I wanted. I wanted to be in Seattle and I want to go to grad school at UW, so at this point all my ducks are in a row and all I can do is wait...and I hate that.
For example, after graduating with my BS in 2009 I moved back home to Fresno to look for a solid job until I started grad school. I had a top-notch education, solid work experience and excellent recommendations and I am bilingual, so needless to say I felt confident I would secure something relevant to my career interests in public health. After a year of fruitless interviews, on-call substitute teaching and happy-peppy aerobics instructing,(and living with my parents, AGH!) I had had enough. I was wasting away in a city that defines "brain drain" like no other place in the world. Others would have kept waiting and applying for jobs, hoping to get into the company their uncle works for or getting hooked up with a retail job from a friend, but frankly, I didn't bust my behind to get my bachelors degree in genetics so that I could work at Starbucks or Forever 21. I was impatient and didn't want to waste any more of my youth and energy in a place where my talents weren't appreciated. My lack of patience brought me to a thriving city with many opportunities in my chosen profession, score!
Granted, this move came at some personal expense since I left behind everything and everyone I knew. I took a leap of faith that so far has been working out really great but could have easily gone sour. Not everyone has the audacity (or recklessness, stupidity, imprudence) that I had to move 1000 miles away to pursue my dream of saving the world one vaccine and aspirin at a time, but when I speak to friends who are in the same place I was last year, I tell them to get the heck out of Fresno. If our education and skills are of no good to the industries and economy of California's Central Valley, pack your bags, make the sign of the cross and find your success elsewhere. The job market in the Central Valley isn't just magically going to improve overnight and success in times of crisis comes to those who are willing to go after it.
Americorps presented me with an opportunity that was just perfect for me, a career of service in public health, and while I may whine a lot about the economy or how little our stipend may be, this is exactly what I wanted. I wanted to be in Seattle and I want to go to grad school at UW, so at this point all my ducks are in a row and all I can do is wait...and I hate that.
Friday, January 7, 2011
Welcome to your clinic, may I take your order?
It was October 2008, I was doing my primary care rotation at a suburban clinic in Xoxocotlan (endearingly called Xoxo, "ho-ho") a small town outside of Oaxaca, the capital city of the Mexican state by the same name. It's a public medical clinic, called a centro de salud, and I spent 2 weeks here, most of which were spent in the consultation room with the uncomfortably touchy, sexual-harassment-lawsuit-waiting-to-happen doctor, but I also shadowed at the vaccination clinic, the nutritionist and the nurses station. It's your average primary care clinic, fairly well equipped, well staffed and on par with the average primary care clinics I know of the in the US. This clinic is nothing special or out of the ordinary in any sense, but it was here were I discovered an important concept of health values.
Read my Xoxo blog post (and other Oaxaca posts)
http://samantha-in-oaxaca.blogspot.com/2008/10/honeymoons-over-back-to-reality.html
It must have been a nurse who uttered those words that shook my soul to the core, because we all know doctors are too self-consumed to share such wisdom. We were checking a patient in when she asked the elderly patient to pay for her visit. Unfamiliar with the insurance system in this country, I asked her why she should pay for her visit since Medicaid in the US would cover the visit for patients like her. She responded that everyone should pay for their medical visits because we can not value something unless we are willing to sacrifice something else in exchange.
Whoa. Lady, you just blew my mind.
How do we as individuals develop our sense of value? There are lots of things that play into our sense of value, but our families and our upbringing play a major role. It was your parents (or whomever raised you) who taught you how to shop for groceries, how to budget for the family and how to use credit. Our sense of value in monetary, time management and relational ways are the most commonly used one, but just how do we learn to place value on our health? Obviously this issue is more complicated than the value of $0.89/lb for red potatoes vs $0.92/lb on Russett potatoes. We can't just shop around in the sales rack of our health insurance. How can we put a budget on our health care expenses? The American health care system isn't designed that way, we cannot independently determine value, our insurance plan dictates how we value our health. A person with a comprehensive insurance plan and a low co-pay will have strinkingly different opinions on health value than a person without health insurance.
Our health system is commercialized and skewed to benefit the bottom line of insurance companies and not the individuals. It's an industry that permeates every aspect of our lives because without health, we have no quality of life and we are willing to pay what it takes to keep us going. Everbody gets sick, everybody get injured, everybody needs access to health care and insurance is how Americans get access.
For those who don't know, this is how insurance works: Everybody pays into a pool and in turn they get certain services. When an individual needs services, the insurance company takes money from the pool to cover the costs. In order for this to work, very few people should need to use services because the amount of money sitting in the pool must exceed the amount of money spent on services. That's why people with preexisting conditions can be denied from insurance: they will definitely need to use services and take money out of the pool and be a financial burden on the insurance companies. Many, but not all, private health insurance companies are for profit and will do what it takes to keep their money pool nice and big. So co-pays and premiums go up, eligible services get cut and the amount spent on services rendered gets topped off, after which you may be required to pay out-of-pocket. Yeah, they are the bad guys, but hey, that's capitalism in health care for ya.
While I strongly support a public option in health insurance, I don't think of private insurance as the devil: A healthy competitive economic environment renders high quality services at the best prices. While some employers provide options for health insurance plans to choose from, competition in the classic sense within the health care market does not exist: There is no transparency in prices for services, a concept we really would not accept in any other market. We pay a fixed price for services regardless of how much that service costs at that hospital or clinic. The medical facility bills the insurance company whatever their rate is for that service and as prices go up, premiums and co-pays go up for the individual because the insurance company doesn't want to eat those costs.
Imagine walking into a car dealership, buying a car and not knowing what it costs until you get your Visa bill. That's what the medical facilities do to insurance companies, who in turn charge us more. Costs for the same service varies from clinic to clinic, sometimes very drastically, but the consumer is unaware because we don't know what the prices are to compare in the first place. Using the car analogy, imagine the exact same car from two different dealers, one is $1000 more but you won't know that and therefore cannot get the better deal. What if our other perceptions of value were skewed like our health values are? Imagine having to pay an excessive amount for getting a haircut by a certain stylist at a certain salon if it's not within your PPO. Paying full price for Tropicana orange juice because only the store-brands are covered by your prescription plan. Only being allowed a 15-minute appointment to see your tax preparer. It sounds so ridiculous in other circumstances but somehow we accept these terms when it comes to healthcare.
Imagine walking into the front desk of a clinic. As you wait in line to check in, you look overhead above the counter and see a menu:
#1- 15 minute visit with MD- $20.
#2- 30 minute visit with MD- $35.
#3- Annual exam- $35, includes basic blood panel.
"Yeah, hi, let me get the #3, supersize it. Ooo, the colonoscopy is 2 for $20? I'll take one of those too."
Hey, you just never know.
Read my Xoxo blog post (and other Oaxaca posts)
http://samantha-in-oaxaca.blogspot.com/2008/10/honeymoons-over-back-to-reality.html
It must have been a nurse who uttered those words that shook my soul to the core, because we all know doctors are too self-consumed to share such wisdom. We were checking a patient in when she asked the elderly patient to pay for her visit. Unfamiliar with the insurance system in this country, I asked her why she should pay for her visit since Medicaid in the US would cover the visit for patients like her. She responded that everyone should pay for their medical visits because we can not value something unless we are willing to sacrifice something else in exchange.
Whoa. Lady, you just blew my mind.
How do we as individuals develop our sense of value? There are lots of things that play into our sense of value, but our families and our upbringing play a major role. It was your parents (or whomever raised you) who taught you how to shop for groceries, how to budget for the family and how to use credit. Our sense of value in monetary, time management and relational ways are the most commonly used one, but just how do we learn to place value on our health? Obviously this issue is more complicated than the value of $0.89/lb for red potatoes vs $0.92/lb on Russett potatoes. We can't just shop around in the sales rack of our health insurance. How can we put a budget on our health care expenses? The American health care system isn't designed that way, we cannot independently determine value, our insurance plan dictates how we value our health. A person with a comprehensive insurance plan and a low co-pay will have strinkingly different opinions on health value than a person without health insurance.
Our health system is commercialized and skewed to benefit the bottom line of insurance companies and not the individuals. It's an industry that permeates every aspect of our lives because without health, we have no quality of life and we are willing to pay what it takes to keep us going. Everbody gets sick, everybody get injured, everybody needs access to health care and insurance is how Americans get access.
For those who don't know, this is how insurance works: Everybody pays into a pool and in turn they get certain services. When an individual needs services, the insurance company takes money from the pool to cover the costs. In order for this to work, very few people should need to use services because the amount of money sitting in the pool must exceed the amount of money spent on services. That's why people with preexisting conditions can be denied from insurance: they will definitely need to use services and take money out of the pool and be a financial burden on the insurance companies. Many, but not all, private health insurance companies are for profit and will do what it takes to keep their money pool nice and big. So co-pays and premiums go up, eligible services get cut and the amount spent on services rendered gets topped off, after which you may be required to pay out-of-pocket. Yeah, they are the bad guys, but hey, that's capitalism in health care for ya.
While I strongly support a public option in health insurance, I don't think of private insurance as the devil: A healthy competitive economic environment renders high quality services at the best prices. While some employers provide options for health insurance plans to choose from, competition in the classic sense within the health care market does not exist: There is no transparency in prices for services, a concept we really would not accept in any other market. We pay a fixed price for services regardless of how much that service costs at that hospital or clinic. The medical facility bills the insurance company whatever their rate is for that service and as prices go up, premiums and co-pays go up for the individual because the insurance company doesn't want to eat those costs.
Imagine walking into a car dealership, buying a car and not knowing what it costs until you get your Visa bill. That's what the medical facilities do to insurance companies, who in turn charge us more. Costs for the same service varies from clinic to clinic, sometimes very drastically, but the consumer is unaware because we don't know what the prices are to compare in the first place. Using the car analogy, imagine the exact same car from two different dealers, one is $1000 more but you won't know that and therefore cannot get the better deal. What if our other perceptions of value were skewed like our health values are? Imagine having to pay an excessive amount for getting a haircut by a certain stylist at a certain salon if it's not within your PPO. Paying full price for Tropicana orange juice because only the store-brands are covered by your prescription plan. Only being allowed a 15-minute appointment to see your tax preparer. It sounds so ridiculous in other circumstances but somehow we accept these terms when it comes to healthcare.
Imagine walking into the front desk of a clinic. As you wait in line to check in, you look overhead above the counter and see a menu:
#1- 15 minute visit with MD- $20.
#2- 30 minute visit with MD- $35.
#3- Annual exam- $35, includes basic blood panel.
"Yeah, hi, let me get the #3, supersize it. Ooo, the colonoscopy is 2 for $20? I'll take one of those too."
Hey, you just never know.
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