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Every month More Voices invites readers to contribute short nonfiction prose pieces of 40 to 400 words on a healthcare theme.



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Health Insurance

The Financial Assessment


My Nicaraguan pediatrician friend astutely summarized her work: First you make the clinical assessment, then you make the financial assessment. In other words, a clinician may know the right treatment, but what good does that do the patient if the treatment is entirely out of reach financially?


In the clinic where I work, we don't take insurance. It's not a concierge practice but a church-based one, run on grants and hardscrabble for decades. For a provider, there's something freeing about not having to consider insurance. There's no frantic search through formularies, no restrictive list of specialists, none of the prior authorizations that suck up time and stamina--all things that have nothing to do with patient care but must happen in the insurance world. None of that.

Ben Franklin and Health Insurance

Everyone looks confused when I begin my class lecture on private health insurance by showing a picture of Ben Franklin on the hundred-dollar bill and dedicating the lecture to him. Students seeking nurse practitioner degrees and doctor of nursing practice degrees alike have no idea why one of our Founding Fathers deserves this honor.

Benefits and Burdens

When I retired from teaching in a suburban school district north of Detroit in June 2003, I left Michigan for my hometown of Pittsburgh with boxes of belongings, twenty-nine years of memories, and health insurance tied to my state pension. That insurance has served me well--except when it has not.