Columns, Opinion

Highway to Health: U.S. healthcare system is sustaining the inequitable quality of care crisis

Last week, I stood outside an emergency room, hoping I took enough Benadryl quick enough to avoid a severe allergic reaction from the walnuts I unknowingly consumed in a sweet potato casserole half an hour earlier. I paced around outside, on hold with an East Coast-based health insurance agency, wondering if I was covered in a random Minnesota emergency room. 

Eventually, my symptoms gave way to the antihistamine and subsided — only after my insurance agency told me to cross my fingers and hope they covered my urgent health needs at this particular location. The entire time I asked myself, “Can I afford this out-of-pocket, and if not, is it worth it?”

Yvonne Tang / DFP Staff

Sadly, my story is all too similar to millions of others in medical crises. “Will my insurance cover my life-threatening emergency?” or “Can I afford this medical care without insurance and still pay for other basic needs?” are questions too many people in the U.S. have to ask themselves. 

In particular, undocumented immigrants and low-income residents are negatively impacted by the deductibles and tightly-wound U.S. healthcare system.

Undocumented immigrants rarely have access to health insurance, and if they do, the options are costly. Thus, many are forced to go to emergency rooms — and end up with thousands of dollars in medical bills — for conditions that may have been preventable if they had access to general care facilities. 

Undocumented immigrants are forced to suffer through diseases and disorders because of our country’s ineffient way of delivering affordable healthcare services. Community and free clinics are available to this population, but they rely on non-medical volunteers, donors and volunteers who are healthcare professionals to serve people who do not have access to healthcare.

A U.S. News article from 2016 covered the story of Morena, a Salvadoran trans woman who immigrated to the states in 2014. She was able to receive treatment for her HIV infection at a community health clinic in the District of Columbia. 

This was the only option she had after fleeing from gang violence in El Salvador. She was not able to afford the insanely high costs of a private or federally-funded hospital. They likely would not have treated her anyway, unless it was an emergency.

Now imagine the hundreds of thousands of people — whose stories are much like Morena’s — and the healthcare they need. Only a small portion of undocumented immigrants will have their healthcare needs met by community and free clinics. There are over 1,400 free healthcare clinics nationwide — and millions of undocumented immigrants.

The U.S. health and immigration policies give little agency to undocumented immigrants — restricting ease of access to health insurance and health resources, making it hard for immigrants to act independently — so immigrants have a much more difficult time finding healthcare support in the first place.

The cost of healthcare also significantly impacts low-income people. A recent NPR story profiled DeeAnn Dean, a woman who started a new business with her husband in rural Tennessee. 

In August 2021, a medical professional instructed Dean to go to the ER for her serious illness, but she was terrified of the price tag that would follow. Months prior, her husband was slapped with a medical bill that crippled their finances. Eventually, as her symptoms worsened, she had to seek emergency care and search all over for cheaper treatment before choosing an ER.

Her diagnosis? Rocky Mountain spotted fever. And she likely would have died in a few days if she had not received treatment. The result? A round of antibiotics and another hefty medical bill.

People with some form of health insurance, like Dean, still suffer from the anxiety that comes along with an unexpected ER visit. Dean had to extensively search for an affordable ER because of her rural location and her concerns about a potential bill..

Low-income individuals are much more likely to avoid emergency care and delay getting new prescription medications because it is much more challenging for them to address the high costs of healthcare. 

Some outrageous co-pays prevent people from seeking immediate ER care. In a 2017 NBC news story on insurance companies, one ER doctor interviewed stated one of her patients “missed an important window for treating her stroke” because the patient was worried about affording the ER copay.

While Medicaid has begun to address and continues to bring to light the issue of inequitable access to healthcare services, the United States has a long way to go in caring for its undocumented and low-income populations. 

According to the Centers for Disease Control and Prevention, health equity is established when every person can reach their full health potential and no population is disadvantaged. Focusing on health equity will bring higher quality care and more opportunities to sustain healthy lives for our undocumented immigrants, low-income communities and all others who are burdened by the costs of the U.S. healthcare system.





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