Ignorance Isn't Always Bliss

The Fall semester at NYU is drawing to a close, so students are a-buzz with studying for finals and finalizing research papers. I attended my Healthcare Management class last night with anticipation because of the case studies we would be working on. We, the students, had our usual banter back and forth regarding health care issues and practioners deliverance of care. One question posed to us was which practitioner give better quality care - private or public? Before we were allowed to answer, our professor half-jokingly said to be careful what we said about public practice physicians! (She is an associate executive director at a public medical center in Manhattan.) No one spoke up so I did. I stated that I would go to a public practice physician anytime because they have seen almost everything and would know what treatment to give. Good answer, she said. The class continued on uneventful until the last 5 minutes. A fellow student, K., told a story of her experience with her new primary care physician's office. What a story it was.....

K. went to a clinic (affiliated with Columbia-Presbyterian Medical Center) located in Long Island City. When she arrived for her 3:30 p.m. appointment at 3:15, one other client was being served. She noticed that this client handed the clerk her "Benefit" insurance card (also known as Medicaid) and the clerk didn't even acknowledge her. No eye contact, no good afternoon - nothing. She just took the card, logged her in and gave back the card to the client. When K. handed her Oxford insurance card to the clerk, her whole demeanor changed. She had eye contact and addressed her by saying: "Good Afternoon, Ms. So-and-So". K. was appalled at the disparity in treatment by the clerk. When K. went to sit in the waiting area, there was screaming children with no kind of toys or activities supplied by the clinic to occupy their time, and a clerical worker was giving a survey to another client out in the open instead of being in a partitioned area. The final straw was that by 4:45, K. wasn't called to see her physician so she got up and left. While the class understood her frustration about the treatment of the clients at that clinic, one student took it to a level that was uncomprehensible. This student, C., stated that she works at Columbia-Presbyterian, and that her mother has a friend whose daughter is 18 and pregnant and on Medicaid. The mother was disturbed about the negative treatment that her daughter receives at Presbyterian and C. had the gall to say "Well, if your daughter can't afford to have a baby then she shouldn't be pregnant". This statement through the class in to a tizzy! A few people wouldn't even let her finish her statement because they were outraged that she, being a healthcare management student, would voice her negative opinion so openly. I was so heated that I couldn't say anything but fold my arms against my chest, lean back in my seat and say that I don't agree with your statement. The professor did nothing to calm the class down and just let us argue it out for a few moments before ending the class. How could this student be so ignorant to believe that a person that has private insurance is better than a person who receives Medicaid? Is this person so stupid not to realize that Medicaid/Medicare drives the healthcare system? That it covers her paycheck and without Presbyterian receving monies from Medicaid/Medicare she would be unemployed??? Does she realize that she could get hit by a car, lose her job, not be able to pay in to COBRA and Medicaid would be the one to pick her up and pay her medical bills??? This woman has no business being in the healthcare industry. The first thing that is taught to healthcare practitioners and support staff is 'first, do no harm'. That is exactly what C. is NOT doing. She could be doing irrevocable harm to a client pysche by treating him/her inferior. She doesn't know the circumstances of why a person would be on Medicaid or any other social services program. But that is neither here or there. All people need to be treated equal.

Once I got home, and spoke to a close friend about what transpired in class. I realized that this student is totally oblivious and desensitizied to the plight of Medicaid repicients. Then it dawned on me that why is she attending NYU? Presbyterian employees, their spouses and offspring are able to attend Columbia University for FREE. Who would choose NOT to go to an Ivy League school compared to a quasi-Ivy League schoool? It's a no-brainer! I then realized that she is, in essence, 'ghetto' and probably couldn't make it through the interview process while at NYU, their entrance in to the adult division is very lax. (Not that I'm saying that NYU is a quality school but for the adult division, the criteria isn't as rigorous as with the other schools within the university.) C. does not converse like a person registered at an institution of higher learning. She talks 'street' and it is obvious to the class (I thought I was the only one that noticed it). She just has issues and she needs to deal with them because with an attitude like that she will still be sitting at that reception desk, greeting clients, having a B.S. in Healthcare Management, and not moving up the corporate ladder.

Sometimes ignorance is bliss but not in this case. She has given me a renewed vigor to try to effect change in the healthcare industry. No person, regardless of their socio-economic, physical or mental status should be treated any different from someone who possesses private insurance. In a perfect world, that would happen but since we live in reality, the people that receive Medicaid need to be treated with dignity and respect. You never know, your circumstances may change and you could end up on Medicaid and be on the receving end of bad treatment.