While I am currently a second year medical student, my story is one of a sister.
When I was six years old, my mother asked me a question that would forever change my childhood: “Honey, would you be alright with having a foster child join our family? It would mean a little boy coming to live with us for a while.”
My response did not take much thought; how could I refuse a new playmate? His name was John, and he was 4 years old to the day when he arrived at our home. Before I knew it, it was as if he had always been part of the family. Through many games of pretend African safari, a family vacation to Disney World, and endless days at school, he became my playmate, my friend, and, as far as I was concerned, my brother.
Without going into the details of his past, it is safe to say that John had dealt with far more emotional and physical trauma than any person, much less a child, should ever face. Like many children with a challenging background, John frequently found himself in trouble at school for lack of focus and rowdy behavior. After several parent-teacher conferences and conversations with the principle, the social worker and my parents agreed that John needed extra help. They decided to have him see a psychiatrist for counseling and treatment. The hope was that this physician could help John learn to deal with and accept his past as well as address some of the current issues he was facing in class.
The medical scenario we faced was not one of great logistical complexity. It required no x-rays, no CT scans, not even a minor surgery. Not a single biopsy or blood culture was needed. All we wanted was a doctor to work with John, address any psychological illnesses he may have been dealing with as a result of his past, and treat him to the best of his or her ability. Such a request would be simple and quite financially feasible to fill for a small child, would it not?
As many of John’s expenses were paid by the government to help cover the cost of his care, his health insurance was accordingly provided by Medicaid. Without this coverage, it would have been a considerable strain on my family to afford his costs in addition to my family’s medical costs, so my mother set to work to find a Medicaid-friendly physician. Running through a large yellow phonebook, my mom worked through physicians in the D.C area. Call after call, she was rejected. Time after time, she heard the same response: “sorry ma’am, but we do not accept Medicaid or new Medicaid patients”. When we finally found a doctor willing to see him, the “therapy” was short-lived. It turned out that this un-named doctor would see John for 5 minutes, increase his prescription for Ritalin he had started him on, and then move on to his other patients while charging Medicaid for an hour-long appointment.
Whether they had denied my brother or mistreated him, my then seven-year-old self hated those doctors, every single one of them. I did not know who they were or how talented they may or may not have been. I did not I understand the difficulty of their situation as physicians, facing their first years out of residency with over 100,000 dollars in debt, the complexity of the health care payment system, or the role of health insurance. I didn’t care about any of their reasons; I cared about John.
Regardless of political agenda or economic ideals, the goal of any health care provider, any sister, any person, is really quite simple: for their patients or loved ones be well. The cost for this medical care goes far beyond dollars and cents. Ultimately, it is the price one pays for access to care and thus for health, productivity, and years of life.
I am thankful to report that John’s story has a happy ending. He has continued on to beat the odds and is now attending college with a bright and full future ahead of him. However, his story is the exception. Every day I spend shadowing in clinic reveals the struggles so many families face in managing their medical payments. Whether it is taking half-doses of medications or avoiding appointments altogether because of the bills, the true cost of care for their lives becomes strikingly clear in their declining health.
Beth England is a medical student.
This post originally appeared on the Costs of Care Blog. Costs of Care is a 501c3 nonprofit that is transforming American healthcare delivery by empowering patients and their caregivers to deflate medical bills. Follow us on Twitter at @costsofcare.