Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Should doctors encourage their patients to get health insurance?

Mara Gordon
Policy
October 26, 2013
Share
Tweet
Share

She was a stressed-out mother of six, working a grueling job as a kitchen manager that required her to wake up at 4am every day. She came to her doctor for her headaches: searing, throbbing pain that made her vomit. She slept fewer than five hours a night. She had tried every over-the-counter pain medication I had heard of, and she had maxed out all of those doses. I met this woman during my family medicine clerkship, and like is the case for so many other patients with chronic pain, we didn’t have any great solutions for her.

Somebody down the line had tried prescribing her a drug for migraines, a drug she was taking more often than she probably should have, but that’s beside the point — she stopped taking it because suddenly it got too expensive. She had gone from paying about $4 a month to her drugstore charging her about $190.

It was hard to understand exactly why this happened, and the patient didn’t seem to know. Maybe she had lost her insurance, or maybe her insurance company no longer covered it. Whatever the reason, this price hike wasn’t something she could afford.

“It’s because of Obamacare,” her fiancé, whom she had brought along to the doctor’s visit, interjected. He crossed his arms and smirked.

“Well, actually,” and I bit my tongue. Actually, I wanted to say, the Affordable Care Act is probably the best thing that could possibly happen for your fiancee’s headaches. They were a working-class couple living in rural, central Pennsylvania. They were too rich for Medicaid, too poor to afford decent private insurance, and bouncing between part-time jobs gave them spotty coverage and a lot of anxiety. They are exactly the type of people for whom the health insurance exchanges were designed.

This suffering woman did not need to hear a medical student diatribe, so I refrained. But politics and patient care are inextricably linked, especially as of late. Does policy have no place in the exam room? Or just as I have an obligation to explain biomedical facts objectively and accurately, do I also have an obligation to the facts of American public health?

The facts of American public health, as any medical student learns in the classroom and sees firsthand in the hospital, are not encouraging. You’ve heard it before: we spend more money and yet are still sicker than all the world’s wealthy nations. And as a recent New York Times article lucidly explains, we also spend much more money on medications.

What role do those facts have in day-to-day interactions with my patients? Thus far in my training, I have often felt painfully underprepared when it comes to helping patients with healthcare-associated red tape. One might argue that information about emergency childcare centers for stressed teen moms or how to retroactively pay for your hospital stay when your Medicaid application is still being processed are beyond the scope of medical education; I can say that I have learned multitudes from our social work colleagues who help patients navigate scant social services.

But what about when patients are vocally opposed to health policy reforms that will probably make them healthier — healthier in an objective, quantifiable, pretty indisputable way? Take my patient with the headaches, for example. Access to reliable health insurance will help her get to the doctor regularly, help her pay for prescription medications she needs, help her access mental health services to get her stress under control. The Affordable Care Act will allow her to do that. Is it her doctor’s role to say something?

I’m not sure what I would do if I were her doctor, not just a student meeting her for the first time. I don’t think it’s appropriate for doctors to talk about their voting habits or to make patients feel bad for having different political views, but I do think doctors should, at the very least, encourage their patients to get health insurance. Lately that can feel like a partisan political act. Soon, I hope, it will feel as objective as measuring a blood pressure.

Mara Gordon is a medical student who blogs at Mara Gordon’s Blog.

Prev

A not-to-do list for those with chronic pain or illness

October 26, 2013 Kevin 6
…
Next

When do medical students lose their empathy?

October 26, 2013 Kevin 17
…

Tagged as: Medical school, Public Health & Policy

Post navigation

< Previous Post
A not-to-do list for those with chronic pain or illness
Next Post >
When do medical students lose their empathy?

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More in Policy

  • Why Medicaid cuts should alarm every doctor

    Ilan Shapiro, MD
  • Why physician voices matter in the fight against anti-LGBTQ+ laws

    BJ Ferguson
  • The silent toll of ICE raids on U.S. patient care

    Carlin Lockwood
  • What Adam Smith would say about America’s for-profit health care

    M. Bennet Broner, PhD
  • The lab behind the lens: Equity begins with diagnosis

    Michael Misialek, MD
  • Conflicts of interest are eroding trust in U.S. health agencies

    Martha Rosenberg
  • Most Popular

  • Past Week

    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
  • Recent Posts

    • The hidden incentives driving frivolous malpractice lawsuits

      Howard Smith, MD | Physician
    • Why what doctors say matters more than you think [PODCAST]

      The Podcast by KevinMD | Podcast
    • How Mark Twain would dismantle today’s flawed medical AI

      Neil Baum, MD and Mark Ibsen, MD | Tech
    • Mastering medical presentations: Elevating your impact

      Harvey Castro, MD, MBA | Physician
    • Marketing as a clinician isn’t about selling. It’s about trust.

      Kara Pepper, MD | Physician
    • Graduating from medical school without family: a story of strength and survival

      Anonymous | Education

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 17 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
  • Recent Posts

    • The hidden incentives driving frivolous malpractice lawsuits

      Howard Smith, MD | Physician
    • Why what doctors say matters more than you think [PODCAST]

      The Podcast by KevinMD | Podcast
    • How Mark Twain would dismantle today’s flawed medical AI

      Neil Baum, MD and Mark Ibsen, MD | Tech
    • Mastering medical presentations: Elevating your impact

      Harvey Castro, MD, MBA | Physician
    • Marketing as a clinician isn’t about selling. It’s about trust.

      Kara Pepper, MD | Physician
    • Graduating from medical school without family: a story of strength and survival

      Anonymous | Education

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Should doctors encourage their patients to get health insurance?
17 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...