{"id":1464,"date":"2008-09-18T13:31:20","date_gmt":"2008-09-18T18:31:20","guid":{"rendered":"http:\/\/blogs.terrorware.com\/geoff\/2008\/09\/18\/a-tail-of-different-healthcare-experiences\/"},"modified":"2008-09-18T13:31:20","modified_gmt":"2008-09-18T18:31:20","slug":"a-tail-of-different-healthcare-experiences","status":"publish","type":"post","link":"http:\/\/blogs.terrorware.com\/geoff\/2008\/09\/18\/a-tail-of-different-healthcare-experiences\/","title":{"rendered":"A tail of different healthcare experiences"},"content":{"rendered":"

I went to my first doctor’s appointment under the Healthy Indiana Plan yesterday, and went to the Volunteers in Medicine<\/a> (VIM) clinic to get my records from the checkup I had there a year ago.\u00c2\u00a0 I wanted to write about these experiences and it seemed convenient to frame it in the metaphors of ‘a tale of two cities’ or of ‘hell and purgatory’ (sadly, there’s no healthcare heaven to be found in either of these places).\u00c2\u00a0 I realized though, that this such framings don’t do justice to the many different experiences that people can have with healthcare, all of which need to be improved.\u00c2\u00a0 A race to the bottom or a game of “who’s got it worse” isn’t very productive.\u00c2\u00a0 Having no experience is a kind of healthcare hell.\u00c2\u00a0 So is working a job with inadequate wages to maintain health coverage.\u00c2\u00a0 So is having state subsidised healthcare for your kids, but no support for keeping you as a parent healthy.\u00c2\u00a0 So is having insurance, but it not covering important and neccessary procedures.\u00c2\u00a0 So is not being able to select health providers that respect your experience and values.\u00c2\u00a0 Sitting in the VIM clinic, I realize that even though I’m subject to many of the same shortcomings of a volunteer-run community clinic that everyone else in the waiting room is facing, the simple reality that my job doesn’t particulary care when I come into work that day makes my health care experience dramatically different than others.\u00c2\u00a0 It also reveals that giving people mobility with their health and care is inseperable from mobility with employment, childcare, and a bunch of other things.<\/p>\n

The VIM clinic is clean and pleasant, but a sense of stress permeates the reception and waiting area.\u00c2\u00a0 I think the VIM clinic is a necessary community resource and respect all the physicians and other volunteers who make the place go, but it is a band-aid and not a cure for the health care needs of Monroe county. \u00c2\u00a0 The times that I have been in there have always seemed hectic.\u00c2\u00a0 Patients become quickly frustrated when their records are lost, information about appointments was ambiguous, or expectations about timelines and procedures weren’t clearly communicated.\u00c2\u00a0 People working the counter try to respond politely and empathetically, but seem on the verge of cracking after being faced with the constant questions and demands that seem beyond the clinic’s available resources to coordinate all the records, appointments, and volunteer providers.\u00c2\u00a0 The woman in line in front of me is asking about what seems to be three different appointments.\u00c2\u00a0 She was supposed to get a call back about one last week, but never got the call.\u00c2\u00a0 She is told that a doctor can see her today, but that since she is a walk-in, she will have to wait.\u00c2\u00a0 The woman periodically returns to the counter asking if they can give her any idea of what time a doctor will be able to see her.\u00c2\u00a0 She is told she will just have to wait and she returns to the seats, looking nervously at her watch.<\/p>\n

I once heard a cocky critic of universal healthcare say that it was totally unreasonable for Americans to expect both the same quality of healthcare they had been receiving and that it be available to everyone.\u00c2\u00a0 He also said that the quality of healthcare in the U.S. is so much better than that in countries with nationalized healthcare.\u00c2\u00a0 What little I have seen of foreign nationalized healthcare systems seems similar, in some ways, to what I see at the VIM clinic.\u00c2\u00a0 Doctors have strange hours, and you might have to get bounced around a few times before finally getting to see the correct doctor.\u00c2\u00a0 It seems amazing sometims that such a system works.\u00c2\u00a0 And, despite high taxes (and attempts to evade them), and some inadequacies with the care, people do get healthcare, and it’s free.\u00c2\u00a0 I think the biggest difference with with more universal care, though, is that the experience is more universal.\u00c2\u00a0 When there are problems with the system, there is a collective knowledge about how to navigate around them.\u00c2\u00a0 It seems more likely, too, that problems are recognized as systemic and there is more posibility of a socio-political push to remedy them.\u00c2\u00a0 In the U.S., with the “beggars can’t be choosers” ideology that underlies so many of our systems, health care consumers are too often blamed for the quality of their healthcare.\u00c2\u00a0 We struggle to find a better health care situation for ourselves and our families, and in doing so, have little time or energy left to learn how to be health care advocates for ourselves and others, or to understand exactly why the system is so broken and what we need to push for to improve it.\u00c2\u00a0 The frustration experience of dealing with disorganization or waiting to see a doctors at free clinics or the total lack of accountability and run-around that one gets dealing with institutions like Indiana’s now-privatized Family and Social Service Administration is one more way that our culture punishes those whose lives do not match up with the equation of “hard work equals prosperity” that underlies our American mythology.\u00c2\u00a0 Sadly, more and more people in America are finding that they’re left out of this rosy picture.<\/p>\n

The complex that houses the offices of my primary medical provider that I chose (with a lot of effort<\/a>) seems more like a hospital.\u00c2\u00a0 It is a large and sprawling and awash with muted pastels, potted plants, and out-of-date sports magazines.\u00c2\u00a0 I get lost trying to find my backpack before I realize that the reception desk and waiting room where I’m looking is identical to the one just down the hall where I left my backpack.\u00c2\u00a0 It doesn’t feel particularly friendly, but it also seems like it just works in a way that the VIM clinic doesn’t.\u00c2\u00a0 At least, I don’t feel the same sense of stress here.\u00c2\u00a0 The woman that takes my information at the counter seems busy, but collected and she greets me pleasantly enough.\u00c2\u00a0 I’m at the right place, they’re expecting me, and despite the trouble I had getting assigned to this doctor, they take my insurance card without complaint.\u00c2\u00a0 This is a relief because, for the past two weeks I’ve been more and more worried about the cyst on the back of my neck that managed to double in size and become inexplicably tender at the end of August.\u00c2\u00a0 It surely must be infected and its time to have it removed.\u00c2\u00a0 I go to see the nurse and then the doctor and both seem competant enough but spend more time entering information into a database on their laptop than examining me.\u00c2\u00a0 The doctor takes a quick look at my neck and says that I’ll have to see a surgeon.\u00c2\u00a0 She warns that many providers in town don’t accept the Healthy Indiana Plan insurance, so finding one might be tricky.\u00c2\u00a0 With that, the exam is over.\u00c2\u00a0 It seemed prefunctory, but I can understand that in today’s healthcare system, the role of many doctors is just to redirect patients to other specialists.\u00c2\u00a0 An appointment is made with a surgeon and I’m happy that things are finally moving along. It’s nice to just not feel a sense of collective nervousness in this place.\u00c2\u00a0 However, when the person scheduling my appointment calls the surgeon, she finds that they don’t accept the HIP.\u00c2\u00a0 She says she’ll call the HIP and find out what to do an call back if the surgery needs to be rescheduled. I’m relieved that I don’t have to try to negotiate this myself, but I’m still nervous that she might not call back.\u00c2\u00a0 If I want one thing from the healthcare that I receive, I want to feel like others are looking out for my well-being and that I don’t always have to be suspicious or my own constant advocate.\u00c2\u00a0 I guess I’ll continue and wait and see if I’m any closer to that reality.<\/p>\n","protected":false},"excerpt":{"rendered":"

I went to my first doctor’s appointment under the Healthy Indiana Plan yesterday, and went to the Volunteers in Medicine (VIM) clinic to get my records from the checkup I had there a year ago.\u00c2\u00a0 I wanted to write about these experiences and it seemed convenient to frame it in the metaphors of ‘a tale… Continue reading A tail of different healthcare experiences<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[558],"tags":[560,171,407,186],"class_list":["post-1464","post","type-post","status-publish","format-standard","hentry","category-healthy-indiana-plan","tag-grep","tag-healthcare","tag-hip","tag-indiana","entry"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p4wnIz-nC","_links":{"self":[{"href":"http:\/\/blogs.terrorware.com\/geoff\/wp-json\/wp\/v2\/posts\/1464","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blogs.terrorware.com\/geoff\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blogs.terrorware.com\/geoff\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blogs.terrorware.com\/geoff\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"http:\/\/blogs.terrorware.com\/geoff\/wp-json\/wp\/v2\/comments?post=1464"}],"version-history":[{"count":0,"href":"http:\/\/blogs.terrorware.com\/geoff\/wp-json\/wp\/v2\/posts\/1464\/revisions"}],"wp:attachment":[{"href":"http:\/\/blogs.terrorware.com\/geoff\/wp-json\/wp\/v2\/media?parent=1464"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blogs.terrorware.com\/geoff\/wp-json\/wp\/v2\/categories?post=1464"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blogs.terrorware.com\/geoff\/wp-json\/wp\/v2\/tags?post=1464"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}