Author: Richard Youngblood
I applaud last week’s article entitled, “Quality Healthcare Should Be a Right Not a Privilege.” Although I’m not an expert in the political-economy of healthcare, I do have some familiarity with the healthcare terrain. My Masters in Public Health degree (with emphasis in Health Services Management) in no means qualifies me as an expert on insurance issues. However, one of the takeaways from my degree was that I developed an appreciation for the enormity, complexity and challenging landscape that comprise the U.S. healthcare system.
Healthcare and health insurance is political and it needs to be recognized and accepted that we live and work in a political environment. Our “free”-market system dictates that these companies need to generate profits to return dividends to their shareholders.
What about Emmons? Is it fair to blame Emmons for the problems of the healthcare industry or to say that Emmons is no different than the corporate machine? I think not. I have found that it’s important to understand “why things are the way they are” before passing judgment. Things are more complicated than they appear. The complication lies in our work for improvement and systemic change.
If we can get beyond criticism we can put our energy into the difficult task of understanding the complexity of healthcare and work towards developing solutions. It takes courage, humility and discipline to reflect and take the time to talk to people, understand systems and develop solutions. This is at the heart of a good college education.
Let me offer some insight into the health insurance plan that Oxy offers. Documenting health insurance coverage is a requirement for all students. This is not Emmons’ decision, this is the College’s decision. Typically, student health insurance plans are not as comprehensive as you may have had growing up. Student plans are basic by design. The coverage is usually limited. Student health insurance is meant to be affordable.
The student health insurance that Oxy offers is for those who lack insurance coverage or who desire additional coverage on top of the coverage they already have (usually through their parent(s)). This is offered because it’s affordable and provides more than safety-net coverage.
To understand how Emmons does business is to understand how student health centers are structured and why. Many student health centers (unless at a larger (usually) public universities) are not designed to provide the full compliment of services that a medical group in the community can provide. Economics are at work, the services are limited. Most colleges aren’t in the business of providing healthcare. Healthcare services at colleges are typically secondary to the college’s core function: to educate its students. In a very real sense, it becomes incumbent on all people to understand the insurance industry. Most people don’t. Usually we pay attention to it when we are sick and when we want it to be there for us no matter what the cost. We expect it to work “right.” Moreover, we pay attention to it when we get sticker shock upon seeing the prices charged for healthcare services. Like it or not, we need some healthcare insurance to protect our finances. Unfortunately, costs incurred in emergency rooms and hospital-stays are very expensive and seldom are those visits are fully reimbursed. Until we have a reformed healthcare industry, I don’t foresee these costs going down any time soon.
Oxy and Emmons have worked hard to provide affordable healthcare insurance and services to students. Could the insurance coverage be better? Yes. Could Emmons provide more services? Yes. But there are cost considerations that would directly or indirectly affect all of us. Does Emmons make a profit? No. In fact, Emmons is subsidized by the College. The College believes in the health and well-being of all students and it is committed to doing so. The revenue gained from the services billed to you are returned to the College and in turn contribute towards sustaining our services.
I’m proud of the fact that what Emmons charges for healthcare services falls below what a student would pay if s/he went to a private doctor, yet we are still able to provide high quality care. As before, if a student felt that Emmons was too expensive, they can exercise their right to go elsewhere. For example, we make it known that Planned Parenthood Express is in Eagle Rock. We have had their information as well as other low-cost community healthcare providers listed on our website. In addition, we have provider lists hanging in a box at the Emmons’ front door and at the front desk.
A final point I want to make speaks to the lore that if you go to Emmons you will get a pregnancy test-even if you’re a guy. Oxy is like a small town. News spreads like wildfire and one or two instances of something going wrong, or being perceived as wrong, quickly becomes lore and then a myth. Sometimes myths are fun but I would offer that maybe there comes a time when we outgrow them because they aren’t entirely accurate, or they were based on half-truths. Or maybe never were true in the first place.
Since Emmons’ capacity to deal with pregnancy and STDs was brought up, I hope to dispel a myth. Most Oxy students’ age range from 18-22. Statistically, your age group is at high-risk for pregnancy and STDs. When a young woman comes in with a complaint of abdominal pain, cramping,or a missed period, although it may seem inappropriate for the medical provider to insist on a pregnancy test, it is the standard of care to rule out pregnancy in such cases. It is important for students to be informed and understand this. For a medical practitioner not to ask this line of questioning, in their efforts to be sensitive to the woman’s feelings of shame, embarrassment or fear associated with possibly being pregnant would be considered sub-standard care. The reality is, Emmons does not do much pregnancy testing since pregnancy tests are available over-the-counter at pharmacies.
I appreciate the scope of Ms. Pokrovskaya’s article. I’m pleased to know that there is an awareness of the challenges in the system. Now comes the hard part of being part of the solution.
Richard Youngblood, MPH is Director Student Health Services at Emmons Health Center. He can be reached at ryoungblood@oxy.edu
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