Our Assumption

     I had recently counseled a young woman on why health insurance is essential to a healthy life, helping her apply for medical assistance from the government. But weeks later, I committed a flaw. I called her to break the news that she had failed to qualify for public health insurance. Despite her worsening hypertension, Medicaid coverage policies dictated that her income, as insubstantial and tight as her budget was, did not fall within the income brackets for insurance eligibility. Although a public health system should strive to engender good health in its constituents, by conveying the news, I made sure that a flawed policy’s denial of coverage reached its target.

 
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    These harsher moments always contrast with my joy when a client receives an approval for medical assistance or other benefits. As this reflection tempers my momentary glee, my gratitude for social services that do work for those in need ultimately deepens. This gratitude for a flawed system embodies the perspective National Health Corps (NHC) has begun to instill in me; whereby, our service and our discussions assume that gaps do, in fact, exist within the US public health landscape.
    For us in NHC, future advocates for wellbeing, this assumption is a powerful motivator. Since the flaws within policies often dictate our service, our acknowledgement of them drives us to re-imagine a healthcare system that can better address many patients’ inability to access proper healthcare. At my own site, Family Practice & Counseling Network’s Abbottsford Falls Clinic, recognizing our clinic’s flaws grounds our work in quality control. As we analyze our network’s data on adult immunization rates (Get your flu shots!), we make specific and measurable goals to continually improve our delivery of care.
    Instead of allowing us to hold complacent attitudes toward many clinics’ lack of resources and an opaque health insurance system, NHC creates a space for members to voice these experiences at our monthly discussions. At the most recent one, our program director, Sara Wein, prompted us with the question of “what would we wish to change at our host site?” I had noticed that while my site offered numerous prediabetic classes for adults, we failed to provide those same classes aimed at our adolescent patients. With the input of my fellow members, my thoughts consolidated to wonder out loud whether strengthening the city’s health education curriculum might solve this problem at its root. In the same way, my group members’ concerns for trauma-informed care or for future immigrants’ access to care reignited each of our individual and collective searches for potential solution.
    Over the course of two months, I’ve found solace in the fact that we have created a community that frames our understanding of public health in terms of not only our current misgivings on the healthcare system but also our future impact. 

This blog post was written by NHC Philadelphia member Vaibhav Penukonda.
Vaib serves as a Health & Benefits Advocate at Family Practice & Counseling Network Abbottsford Falls.