This post was written by Sarah McAfee, a former member of our team.
When my son was born in 2016, there were some complications. The kind of complications where—if the doctor’s suspicions are right, and mom has a rare platelet type—baby number one usually survives, but baby number two and beyond don’t. I was sitting at my desk at work when my doctor called to give me the test results, which confirmed his suspicions; I covered the mouthpiece with my hand so he wouldn’t hear me crying as my dreams of another child slipped away. However, just before they vanished completely, he told me about a cutting edge medical procedure that might be able to help. It would be highly-invasive and the odds of a healthy baby were slim, but with my excellent health insurance, at least I wouldn’t have to foot the bill for the million-plus dollars of care it would require. If it’s what I wanted, the health care system was ready to go to work for me.
I did want another baby, but not badly enough to risk my health and compromise my values.
I believe our health care system should be this eager to work for all Coloradans—not just white, straight, upper middle class, able-bodied, abundantly privileged families like my own—and it’s not. In fact, Center for Health Progress met a Latina last year who lost her twins after going into premature labor at five months. Insured by Medicaid, she couldn’t even access the necessary tests to find out what went wrong and whether or not it would happen with future pregnancies, let alone get access to the kind of advanced medical procedures that were offered to me.
This isn’t even a health equity issue—it’s a more basic health care equality issue. Health care equality is making sure there are no preventable differences in inputs, which in this case would mean she and I both have access to the same tests and medical procedures. Health equity is making sure there are no preventable differences in outcomes, which in this case would mean my child and her children all survive and grow up healthy and strong. Holding ourselves to the higher standard of health equity requires concentrating resources where the need is greatest. Not only should she be able to get the tests and medical care she needs to have a healthy pregnancy, but the health care system should be investing in ending the social and institutional inequities—such as racism and classism—that put those health care services out of reach in the first place.
Parts of Colorado’s health care system are beginning to invest more robustly in health care services for those who have historically lacked access. Denver Health has established its LGBT Center of Excellence, which is an open and affirming source of health care for LGBTQ Coloradans. The Center for African American Health has partnered with health systems to provide culturally-appropriate disease prevention and disease management programs. UnitedHealthcare is investing in affordable housing and other social determinants of health. However, there is much more that must be done within the health care system and within our society to achieve health equity.
That’s why I come to work every day. For too long, health care and good health have been a privilege, available to the select few. Health care systems cannot change this by themselves, but they hold an enormous amount of power to determine where and how we concentrate our resources. I want them to make smart, equitable decisions. And they can start with that million-plus dollars they’re saving on me.