Radicalization, Rage, & Healthcare

Oh look, it's me.

I have been going through cancer treatment off and on for almost 4 years now and in that time, we have witnessed significant changes in healthcare policy and cultural attitudes that have contributed to a growing sense of polarization in both society and within oneself. Because I am both a user of the healthcare system and work in healthcare, I have seen these changes not only radicalize whole populations but also produce feelings of rage - I have experienced these feelings often when dealing with the insurance company as well as just the intense rage that comes from not being in control. In case you've been having trouble keeping track of all the changes (legally and culturally) that have happened in the last 5 years, here is a brief timeline:

A Brief Timeline: Healthcare Changes (2019-2024)

2019:

• Legal: Introduction of state-level laws either expanding or restricting access to abortion, setting the stage for future federal challenges. In Texas, where I live, it has becoming increasingly and fundamentally unsafe to be a woman or pregnant person. This was the beginning of the end in my opinion.

• Cultural: Growing public discourse around mental health, fueled by celebrities and influencers openly sharing their struggles, leading to an uptick in mental health awareness campaigns. This is one of the few bright spots over the last few years and will become increasingly important as things become increasingly more chaotic.

2020:

• Legal: The onset of the COVID-19 pandemic led to sweeping emergency healthcare measures, including the CARES Act, telehealth expansions, and vaccine development funding. We should also include the temporary expansion of Medicare and Medicaid.

• Cultural: Polarization around public health mandates like mask-wearing and social distancing highlighted the politicization of health - which is still happening to this day. This shouldn't be a controversial issue: if you're sick or want to prevent being sick, mask up. The fact that so many people have an issue with this simple request to keep others in society safe/healthy, just blows my mind - perhaps because I cannot comprehend being that selfish.

2021:

• Legal: The Biden administration reinstated funding for family planning organizations and expanded healthcare subsidies through the American Rescue Plan. While I don't agree with everything the Biden administration did, what I can say is that the expansion of healthcare subsidies was perhaps the greatest thing that they could do for the American people.

• Cultural: The vaccine rollout intensified debates over personal freedom versus collective responsibility, with misinformation amplifying public distrust. It blows my mind that this was a controversial topic and people couldn't/wouldn't take the time to think about the needs of others & realize they were being mislead by some of the most ludicrous lies.

2022:

• Legal: The Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade, significantly impacting reproductive healthcare access nationwide. This absolutely pivotal decision, not only did it have the effect of making it increasingly unsafe to have a child (an already potentially dangerous proposition), it also took away any choice that women and pregnant people have over their own bodies.

• Cultural: This decision galvanized activism on both sides of the abortion debate, leading to protests, counter-protests, and widespread media coverage. There was - and still are - so much misinformation around the issue of choice & abortion. In my own opinion, the autonomy of one's body should be first and foremost - without that, anyone can take control of your life.

2023:

• Legal: Medicare introduced price negotiations for certain prescription drugs, addressing long-standing criticisms of drug pricing practices. I don't think that this is even close to enough, while it is a step in the right direction for sure. The ability to negotiate drug pricing should be extended to all drugs that are available in the market - it is unconscionable how much some of these drugs cost to the consumer.

• Cultural: Social media became a battleground for healthcare advocacy, with platforms hosting campaigns ranging from Medicare expansion to anti-vaccine rhetoric. I've taken to using the block and unfollow button very liberally. I've also been on the lookout for people in my life who knowingly spread misinformation and sadly, there were more than I thought there were.

2024:

• Legal: State legislatures proposed and passed divergent healthcare policies, particularly around transgender healthcare, highlighting the patchwork nature of U.S. healthcare governance. Just like with the abortion issue, for me, this goes back to bodily autonomy. Trans people deserve to feel at home in their body just like the rest of us. And as someone who has received gender affirming care (breast reconstruction after my double mastectomy), I believe that everyone should get that option as well.

• Cultural: Public trust in healthcare institutions reached new lows, according to surveys, as debates over access and equity continued to dominate discourse. It makes me incredibly sad to watch treasured institutions like the CDC or NIH lose their reputation, largely due to misinformation or people with agendas against the public good. While these organizations have made mistakes - especially with the management of information & making things easy to understand - I don't think that they deserve to be villainized in the way that they have been.

Personally, I think healthcare professionals deserve so much more respect than they are currently getting.s

I think about healthcare all the time; it's a huge part of my life. Not only do I work in the healthcare space at an insurance company (I do not agree with many of their policies and if I could change it, I would), I spend a pretty significant amount of time inside doctor offices. In my almost 4 years of treatment, I've have experienced so much rage and frustration - and I think many people with complex care conditions experience the same thing. A lot of the rage that I feel comes from the fact that this whole process is extremely complicated - often overly so. There are all these rules that come from dealing with insurance, prior authorizations, and generally having to justify your need for medical care.

As someone who works within the system, I KNOW it doesn't have to be this difficult. For example, every person with insurance is assigned a member number, this number does not change within the same insurance company regardless of if your work changes policies, you get assigned to another group, etc. Your insurance records follow you around like a bad tattoo, so you would think that things like your current treatment plan, medication authorizations, etc. would be easily renewed when the plan year turns over. You'd be wrong. Even though the insurance company has a library of records on you, they never seem to manage this process smoothly and effectively.

And yes, there are a lot of rules when it comes to insurance. But again, much of this is overly complicated, convoluted, and geared to advantage the insurance company so that they don't have to pay for people's care. The system is intentionally set up to advantage the insurance company and their shareholders. It's an awful system in all honesty. When the CEO shooting happened, I honestly wasn't very shocked and was more surprised that something like this hadn't happened sooner. It is my firm belief that there is so much suffering perpetuated by health insurance companies and if more people realized it, it could potentially unite us across the voting public.

Anyway, all of this is to say that I have FEELINGS and THOUGHTS about the health system that we have set up here. I will say that because I think about the system a lot, I am working on ways to make the experience better for those of us who don't have a choice in whether we deal with the system or not. My life's goal is to make the experience of healthcare just a little bit better for the individual, especially those with chronic and/or complex conditions.

That's all for now,

OS