Not This One, Not Alone, Not Without a Fight
What an insurance denial, a housing crisis, and a laughing baby reveal about the cruelty we have mistaken for normal.
A few weeks ago, I wrote about a health care system shaped by scarcity, distance, and denial, about what happens when care gives way to paperwork, when the road becomes part of the diagnosis, when insurance becomes less a promise than a maze, and when ordinary people are left standing at the counter, on the phone, or at the mailbox trying to prove they deserve help.
At the time, I was thinking about patients I had known through my years working in health care, especially in a federally qualified health center, where the failures of the system arrived as bills that should not have existed, as patients who thought they were covered until the claim came back wrong, and as families who had done everything they were supposed to do and still found themselves punished by rules they had never been taught.
I knew those stories were real, I had seen them and carried them. Then the denial letter came to my house; Oregon Health Plan denied the MRI my 8-month-old son’s doctor ordered for him. He has a vascular birthmark on his upper spine, between his shoulder blades. It has grown since we first noticed it. It used to be flat, and now it is raised and larger. He is a baby, so he can’t tell us if something feels strange beneath the skin, can’t say if there is pressure or pain, can’t explain whether something in his tiny body feels different than it did before. He can only laugh, reach, babble, press his warm little face into me, and trust that the adults around him will know when something needs to be checked.
His doctor said one of the things it could indicate is a tethered cord or another underlying spinal abnormality, and so the MRI was ordered not because I am anxious, not because we are inventing catastrophe, and not because anyone is trying to waste medical resources for fun, but because a clinician looked at a changing vascular mark on my baby’s spine and said, in effect, we need to see what is happening underneath.
