When I was 14, I moved away from home for boarding school. By the time I came to Ann Arbor, managing my own time, living in dorms, eating at dining halls, and 90% of the changes that make the high school-to-college transition so hard for others weren’t new to me. I came in to college thinking it would be like high school, but with more people and a larger campus. For the most part, I was right. When I arrived at the University of Michigan, I knew what I expected, what my goals were, and how I was going to get there. One of the new things I experienced in college was UC 105/106. I went to a school of science and mathematics, and I had never taken a class at all similar to UC 105. Dr. Strecher’s talk about purpose started to seed doubt in my mind about my life goals. Over spring break, I went on a trip to Memphis and met incredible community leaders making a difference in Memphis neighborhoods. It also made the disparities we’d discussed in class much more real for me. Out of curiosity, I followed up my trip to Memphis with a couple visits to Detroit. All these things that I’d learned, seen, and experienced came together and stripped away my old “purpose.” For a couple days after, I was left kind of paralyzed by questions of what I was doing and what I wanted to do with my life.
I came to Ann Arbor with a unique advantage that made my transition to UM much easier. However, I think arriving in college so well-prepared may have closed my mind off to certain ideas and options. If I could go back to the beginning of freshman year, I would tell myself to be more open to exploring different options. Ironically, my first year of college has brought me less clarity on what exactly I want to do with my life. More importantly, my first year of college has taught me that that might not be a bad thing.
In Henry Wadsworth Longfellow’s novel Kavanagh, he writes, “we judge ourselves by what we feel capable of doing, while others judge us by what we have already done.” This could be interpreted as “every action has good intentions.” For example, I think that all of the Nazi scientists, whose experiments were abhorrent, had reasons that justified their actions. As bad as their actions were, the experiments did produce information with scientific value and real applications that could help people. They may have actually held the belief that they were doing a service for humanity. A less extreme example are the doctors that contributed to the opioid epidemic by overprescribing painkillers. I’m sure that most of the doctors felt that their prescription of painkillers was truly in their patients’ best interests. My point is not that all actions should go unpunished; it’s actually the opposite. I think as future health care professionals, we should always try to judge ourselves by our actions and the consequences of those actions, regardless of intention. The consequences of health care professionals only directly affect one person, the patient, and the health professionals’ intentions usually shouldn’t have bearing on how decisions are made. In other words, health care should be a service focused around the patient, and no one else.
It’s very important to learn about these things because, as Adam said in lecture, the past explains the future. It can teach us and help us understand how to fix things. With knowledge of Tuskegee, we can attribute part of racial health care disparities to African Americans’ perceptions of doctors and health care. This information gives us very valuable insight into places to start when trying to fix these types of problems.
My first semester of college has gone by extremely quickly, and I feel like I have grown a great deal professionally, but not as much personally. Having gone to a boarding school, I was already used to living in a dorm, being away from home, and having to manage my own time. By my senior year of high school, I feel like I had found a good balance in my life, and in my letter to myself I just wanted to be able to maintain that balance in my life. Going from high school to college did open up a lot more opportunities for me. While my high school did have many opportunities not available at a normal high school (e.g. research opportunities, higher level classes), the opportunities in college, especially a large one like UM, are almost overwhelming. I have learned to take advantage of these opportunities and create things for myself. While in high school, our teachers were required to spend time in the dorms to interact with students and my research position was set up through one of my high school’s programs. I did not have to work much to get opportunities. Here at Michigan, I have had to be more proactive in going to office hours to see teachers and I had to reach out myself to professors that I was interested in working for. I think UM is great because of its size, but it also requires me to be more active in making it the best possible experience for me. I want to continue to improve at playing a more active role in shaping my own life.
I think the biggest challenge that health care reformers have faced in the past has simply been the fact that a significant portion of the population does not understand the health care system. For better or worse, it seems that health related issues have usually been overlooked or brushed over by politicians and the American public in favor of other topics, such as war, politics, or the economy. I know for me personally, I have never really been concerned with health care issues and until recently really had no idea of how the health system worked. Aside from children who have parents who work in the health care system or have experienced being in the health care system a lot, most children never really get taught about the American health care system the same way they are taught about financial literacy or American civics. As a result, most people don’t really have any exposure to health care unless they get really sick. A study from the National Academy of Sciences found that half of Americans were not aware of the health care exchanges set up by the Affordable Care Act and that forty percent were unable to accurately explain what a “deductible” was. Perhaps unsurprisingly, those of lower income tended to have less understanding of the health care system than those of higher income, making it even more challenging for reformers. Without knowledge of how an existing system works, it is very difficult to reform that system.
My understanding of the history of American health care is limited since I am only 17, but I consider the Affordable Care Act to be the biggest failure in US health care reform. Contradictory to its name, the Affordable Care Act has actually caused the price of health insurance premiums to increase for most people. One year after its passage, costs of premiums increased 9% on average, and four years after its passage, costs had gone up 59% on individual plans. In addition, the ACA has been unable to convince many uninsured people to sign up for health care. A study in 2014 found that only a quarter of people who purchased an Obamacare plan were uninsured the year before. In addition, half of uninsured respondents said that affordability was their main reason for not purchasing insurance. Lastly, the Affordable Care Act has caused many health insurers to lose considerable amounts of money and withdraw from many states. As a result, people in Alabama, Alaska, Oklahoma, and other states will only have one option for health care next year.
Unlike the Affordable Care Act, I consider the State Children’s Health Insurance Program to be a success and a demonstration of the effectiveness of incremental change rather than massive overhaul. After ten years under SCHIP, the percentage of children uninsured fell greatly, even as the number of uninsured people grew. Perhaps rather than pushing for huge changes at once, health care reform could look for specific areas to target and improve on gradually.