Humiliation and Shame: Part of Being Insured in America

By Donna Smith –

Oh, the things we did not fix in the healthcare bill are shocking. Just as seniors falling into the Medicare drug benefit donut hole begin to get the $250 checks meant to calm their fears about our new healthcare legislation, the rest of us would do well to remember the abuses of the for-profit healthcare system that will continue and even accelerate in the coming years.

Health insurance is not health care. Health insurance is a financial product marketed and sold to protect health and wealth which may do neither thing very well. I view it as a defective product. Yet, very soon we will be buying more of it and helping more of our fellow Americans buy more of it with the subsidies that support the great health insurance bailout that is being called “patient protection.”

Yesterday, I went to the doctor for an appointment I waited weeks to secure. I am insured. I have what some would say is fairly good insurance from one of the for-profit insurance giants. I waited patiently in the waiting room, and then was escorted to the exam room. There was a flurry of activity around me. A thorough history was taken. X-rays were taken. The nurse said, “Oh, honey, are you in pain? Those X-rays show some pretty awful deformity.” I said I have been hurting for years but that I have waited until I could stand no more to seek treatment. Most of the time I take large amounts of OTC anti-inflammatory medication and muddle through. It’s the American way. It’s the insured American’s way. It’s the working, insured American’s way.

The doctor buzzed in rather quickly and began discussing a treatment plan with me. Some immediate care to relieve some of the pain, and some longer term non-invasive care to see if we could avoid surgery. I was hopeful and thrilled though a bit worried about how it would feel to get shots in the joints of my feet to help the heel spurs and the bone pain. I’ve had shots in my knees, and it isn’t fun.

Suddenly, as quickly as I had felt the anticipation of some relief, the flurry of activity ground to a halt. The doctor left the room. Another office person came in. She said, “I’m sorry Ms. Smith. Your insurance will not cover what the doctor wants to try.” Matter of fact. She’s said these words before – many times. I ask how much it would cost to pay for it myself. She answers. I cannot pay that much. The visit is ending. The hope is shriveling.

I could feel the muscles in my face tense as the humiliation spread through my body. This body, just moments ago worthy of plans to relieve pain and head for some better health, now was deemed unworthy of care. Shame. All that old shame I used to feel before our medical bankruptcy was rising in my gut. It hurt so badly. But I was determined not to show my anger or my sadness.

The doctor wandered by the room and saw me. He stepped in and gave me some soft inserts for my shoes. He said they won’t help much or for long, but that maybe it would be a little relief. He must have seen the look on my face and felt at least a little compassion. A little. I thanked him. But I could say little else, and I could not look him in the eye. I felt so ashamed, and I don’t even really understand why I’ve been so conditioned as a patient to feel it is my failure when these things happen.

On the way home, I alternated between sadness and anger. Clearly someone wasn’t being honest with me. Either the treatments this doctor was suggesting really aren’t a good idea (as the insurance company’s denial to pay would lead one to believe) and therefore are not approved for coverage or the insurance company just wants to push those costs onto patients who cannot usually afford them. Either way, I didn’t get the care I needed. Either way, I left hurting. Either way, I lose. The doctor made some money on the office visit and my co-pay at least. The insurance company avoided paying for anything beyond that.

My husband sat beside me in the car, sad and angry for me. As a person covered under one of our nation’s single-payer programs and a supplemental private policy, he has never heard the words I heard – he has never been denied care. He felt helpless for me. As I cried tears of rage, he sat silently.

And, so, how will any of this change under the new healthcare bill? It won’t. In fact, the pressure for insurance companies to deny more care will grow as they are compelled by law to take more people who have pre-existing conditions like having feet. Cherry picking the healthiest folks will require a bit more skillful contortions for the for-profit insurance companies, and doctors will leave more patients sitting on the edge of exam tables like naughty little children who do not deserve to be treated.

Healthcare is a basic human right in most of the rest of the modern world. Only in this nation do we believe that only the richest people deserve the best of care. It’s a wild twist on the old Bible lesson about it being tougher for a rich man to get to heaven than for a camel to get through the eye of a needle. We’ve made it harder for a working person or a poor person to get healthcare in America than for a rich man to get to heaven. We are a sick society indeed. No Golden Rule values herein.

Only when we finally decide that we believe in a compassionate and just healthcare system for all will we ever have the courage to change it. Right now we just don’t believe in that sort of system at all. As a patient, I am fodder. At least this morning I was able to turn my outrage back on the system that left me in that exam room alone and sucking back tears of anger. No one should go to a doctor to seek care and leave less well. That’s cruel and unusual.

I was raised to have more compassion than this for my fellow human beings, and I think most Americans were raised with similar values. How in the world did we get to a place where we participate in doing this to one another? Is this the system we want to leave to our children? Do you want to leave your child lacking care when he or she needs it? Your grandchild? Then, for heaven’s sake — for heaven’s sake — stand up and let’s get back to work to fix this mess. There is much to be done.


  1. Allen on June 29, 2010 at 12:55 pm

    I know the shame. I know in my mind that I have nothing to be ashamed of but saying that does little. I still feel the shame when I need medical treatment but am denied because I no longer am part of a single payer system.
    I know the opposite as well. In the past I’ve worked for various government agencies and had the best health coverage one can get in this country. I know how easy life can be when you know that whatever the sickness your covered. When I worked for the government, there was no shame attached to a doctor visit. It felt safe. There was no threat. There was nothing to fear. Whatever might be found, I had the coverage.
    It is so different now. In the last 4 years I’ve seen a doctor once. I dreaded the visit for three years. When it could be avoided no longer, I scheduled the appointment with dread, fear, and anxiety. The day of the visit I was numb and silent. I was too ashamed to speak up on my own behalf.
    America, the land of the corporateer.

  2. Miami Complaints on June 30, 2010 at 6:27 am

    We were headed down the wrong path because of the failed policies of the Republicans. Now the Republicans are still trying to push their failed polities on us and that is including trying to take away what little improvements were given in the Health Care Reform Bill.

    We are the only large country that does not have a single-payer because the insurance companies are making so much money that they can spend billions of dollars to influence politicans, I call bribe money. The people that buys insurance are the people that are really paying for these bribes by increased insurance payments. These types of payments to politicans should not be able to be used as write-off on taxes or should they be able to deduct the expenses from their business expenses.

    Just remember that each and every disaster, including the BP Oil Spill, that we have had over the past ten years or so have been the fault of the Republicans and the sooner we get them out of office the better for America and the American People.

  3. christopher olajide on September 21, 2010 at 12:57 pm

    pls i just want you to tell me 20 things that can not been insured by the insurance company. you know that thire some things that they can been insured by the insurance company like buliding. thanks you sir

  4. Neal Allen on December 29, 2011 at 8:21 am

    You should not feel ashamed, because your government has failed you.
    The politicians who take the bribes are the ones who should feel ashamed. The rednecks who back these politicians by voting Republican should feel ashamed, but they are too stupid. The hypocrites who make up the religious right and do the exact opposite of the compassion taught by Jesus should feel the shame, but they can do no wrong, because they are holier than you and me. I left America, because I despise its values. Shame on that country that allows its own citizens to feel this way.