Health Class

There is a wealth of data that tells us that class is a huge determinant of your health. This information is critical for policy change. And as someone working in the fields of human rights and social justice, I fought hard to share this information with decision makers that could do something about the issue.

While committed to this work, it was in many ways theoretical. I was an employee of a well-funded nonprofit that believed in providing – and could afford to offer – excellent health care benefits. I had access to excellent health care and dental plans. My doctors and dentists were excellent. My copays were small. I could go to any hospital that I wanted to for care.

And then The Great Recession, which had seemed to spare my organization, hit us like a ton of bricks in 2011. I was laid-off. In fact, as a manager, I laid myself off to save more critical functions. I was able to remain on the organization’s health plan, but I now was responsible for the entire monthly fee. And it was expensive.

Eventually, I had to leave the plan. The costs were unsustainable with my reduced income. I went on Mass Health. And despite being appreciative that I had this option, I can tell you that there was a significant change in the type of health care to which I had access. I saw firsthand that class can determine whether you live or die.

Class Is More than Income

As I began this journey through the health care system, I realized just how lucky I am to have the type of education, assets and occupational background that became my battle suit throughout the process. Without these class background gifts (and they are gifts that I was given and did not earn without lots of help from others) I cannot imagine how someone with limited resources could make it through the gauntlet that is our health care system.

First, I tried to enroll in the system at least five times before I got someone on the telephone who could actually help me. And during even that final, successful try, I was on hold for 45 minutes. How many people at jobs paying low-income wages have the luxury of staying on hold for 45 minutes straight? Most have only a half-hour lunch or dinner break.

Getting Access Is Really a Pain

Once enrolled, I learned that two of my three health care providers would not accept the plan. The reimbursement process was cumbersome and paid less than they would accept. My dentist also dropped me for this reason. I cannot blame them; we all need to get paid!

I also found that I no longer had access to certain non-generic medications. I have a nerve pain condition that requires that I take the name brand version. Despite the fact that the generic does not work as well and I suffer from constant low-level pain with it, my repeated requests for reconsideration were denied.

Despite this, I realize that I was one of the lucky ones throughout this process. My class background taught me how to navigate this system. I had doctor friends that help me figure out who to call and what to say to get most of what I needed. My education and policy advocacy background helped me negotiate for my needs. And, honestly – and sadly – I saw that the way I dress, speak and present myself made a difference in the way health care providers treated me vs. others on public health assistance. Providers assumed correctly that this was a temporary situation for me and treated me with dignity. Not so for many of the folks waiting in the clinic with me.

I was lucky, but what about all of the other folks with limited means for whom access health care determines whether they live or die?