It’s been more than a week, and I think an update is due. Plus, I can give updates on my own status with my heart murmur, having seen the doctor this past Friday. The only thing that has kept me from updating until now is simply laziness (in other words, I was far too busy studying/eating/cleaning/sleeping to actually relax and write).
This past Friday I went to the Student Health Center to see my doctor about the previously mentioned murmur recently discovered. My doctor presumed it was most likely an innocent flow murmur, which occurs if a heart valve doesn’t close all the way or in time when the heart beats, allowing blood to flow back the opposite way, and the blood causes turbulence heard as noise. If you’ve ever heard turbulent water flowing over and through rocks and back upstream in eddies in a river, you should get the idea of what a murmur is. It was recommended that I have an echocardiography done, or an ultrasound picture of my heart. This would allow us to see exactly how the valves move as my heart beats and whether it is something requiring further work.
Now in the past, if a doctor ordered a test or procedure, I never thought twice about it. My parents flashed their insurance card, the receptionist punched a few keys and signed some papers, and I was on my way. I was approved, the doctors provided care, I went home happy. All those days are past now, however, and insurance must be discussed, especially since now, at age 23, I am cut loose from the family insurance and must provide my own means towards care. Recently, I made the change from my family’s insurance to a cheap health insurance plan where I pay less than $60 a month. It carries a $5000 deductible (in other words, until I accumulate over $5000 in medical bills, I am paying out of pocket), and the problem I ran into Friday was the fact that an echocardiogram costs $1500 optimistically. Realistically, it would be closer to or over $2000. To get around this, I am putting off getting the echo done until January, at which time I’ll be able to transfer over to a student health insurance plan offered by the university, which will fully cover the echo.
The Institute of Medicine of the National Academies currently estimates that approximately one in six Americans under 65 lack health insurance. This amounts to a little more than 15% of the current population, and with current trends, is expected to increase. The rise of small businesses, entrepreneurship, and decreased amounts of people working full time in large corporations that provide health coverage as a benefit are a few reasons to blame. Small businesses generally do not offer coverage even to full time employees, with the high cost of premiums for a small number of employees. In a larger corporation, this cost would be less per person, as it is spread out over a wider population of employees. Just to verify this fact, consider this; in 2003, a third of firms did not offer health coverage, and two-fifths of all employed persons worked for a small business firm of some kind.
Health insurance is essentially money in the pocket. Someone else’s money that is, and with that sort of mindset, it is easy to see why people who have the best insurance often receive as much medical service as they need or are recommended. But to someone in my current situation, medical care is not something you just run out and get easily. People lacking health coverage or having only marginal coverage tend to utilize less health services, wait longer before seeking medical care for illness, and have worse outcomes due to lack of care. Many times uninsured patients are hospitalized for what could have been a preventable or very uncostly condition, had medical care been received earlier.
Lack of insurance has repercussions beyond the clinic reception desk. Patients with excessive medical bills often end up being followed by collections agencies, and alter their standard of living considerably in order to pay off debt. The standing debt can impact a person or family’s ability to qualify for mortgage, be approved for home rental, or even result in eviction. Other debt can occur when a person turns to their credit card to pay bills, effectively exchanging one debt for another. Lack of coverage, leads to high medical bills due to lack of early treatment, which leads to debt, which leads to an impacted life.
How do we solve this complication of debt? Well, if I could answer that, then I probably wouldn’t be in medical school. Sorry this is abruptly ended, but I need to get what sleep is left tonight.
