It is amazing the role health insurance plays in an individual’s life. I was oblivious, before beginning my service term, just how important that insurance card can be and how much power it holds. Even for a relatively healthy individual, who needs minimal health care services, not having insurance can be a huge barrier to gaining access to care. Many primary care offices do not accept people who don’t have insurance. Fortunately for our patients at Abbottsford Falls Family Practice, we are a federally qualified health center and see all patients regardless of their insurance status. This may be a great temporary solution for a healthy individual, but as soon as things with that patient get more complicated, such as the patient needs medication, a referral, or lab work, not having insurance makes things expensive and difficult.
This becomes abundantly clear when we see patients with chronic illnesses and worsening health symptoms. For these patients there are multiple aspects of their care that require that almighty insurance card to keep their health under control. There is even a group of patients who, given the barrier that the lack of health insurance creates, aren’t even able to find a diagnosis for their ailments. In these situations, the knowledge of your own body and its condition becomes a privilege, which only some can access. For example, we could have a patient walk into our health center complaining of a variety of symptoms that cannot be explained by a blood test or a provider exam. This patient will most likely be given medication or a list of referrals to be seen by a specialist. If this patient doesn’t have insurance, they may be able to get their medications at a discounted pharmacy, but seeing a specialist and getting most procedures is completely off the table. Therefore, whatever that patient is struggling with under the skin can never surface. This unexplainable and untreated pain and discomfort, could cause patients even more mental and physical pain for the rest of their lives.
Another example of patients that I see quite often is the uninsured pregnant population. As an AmeriCorps member, I have the opportunity to work specifically with the prenatal patients at my host site. These patients have taught me so much with their strength and resilience and we try our best to provide them with quality, compassionate prenatal care. However, this cannot always be possible. There is a subset of prenatal patients that come to our health center that do not have insurance and are uninsurable, meaning they will not qualify for insurance. Those that are uninsurable are most likely immigrants without documentation or individuals whose household makes too much to qualify for medical assistance. There is an increase in the limit to qualify for insurance through the state if you are pregnant, but it is sometimes not enough. And this fact has large repercussions. For example, if you are an immigrant without documentation, you are unable to have access to ultrasounds, your clinic will pay out of pocket for lab work (but will most likely only order the bare minimal blood tests), and you are unable to see a specialist OB/GYN if you are experiencing a more complicated pregnancy. In my opinion, this divide in how we treat the insured versus the uninsured is unacceptable. Knowledge in medicine is power, and without insurance you have a decreased and minimal access to gaining that knowledge through providers, test, and experiences. This knowledge will give you the ability to care for your life, and the life of your unborn child to the best of your ability.
At my host site, I advocate for my patients throughout the application process for insurance and find creative ways to help them fight their own barriers to care, because everyone is deserving of the knowledge and medical care to be healthy individuals.