Healthcare for Some

“In my family, we know to not get sick.”

The college adviser’s words were met with silence. I glanced at the printed out version of the Common Application in my hands, unsure what made me more nervous — the many questions on the form, or my own ignorance on how to even begin answering them. I hadn’t realized that healthcare insurance was yet another aspect I needed to consider.

My worries seemed reflected by the rest of the students in the room. We were all a part of a college advising program, one specifically catered towards first-generation, low-income students who were unsure on how to navigate the road to higher education. Our advisor was a vibrant woman with enough energy to command the attention of a whole class of high-schoolers, an impressive feat in the mid-autumn season when the days were short and attentions were bound to wander. I particularly appreciated how she carried herself with bold fashion tastes and uncensored honesty — divulging her experiences growing up without stable medical coverage, not to scare us, but rather to make us aware of a lived reality for so many.

According to the United States census in 2018, 27.5 million Americans were reported to not have health insurance at any point during the year. At the start of my freshman year, I could be considered among these ranks when I did not purchase dental coverage in my student health insurance plan.

It was not a difficult decision to make.

When I was going through my package at the start of the term, I scanned through my benefits and noted the absence of dental coverage with mild confusion. It turned out that oral healthcare fell under the category of “optional” for Harvard students — but for those with backgrounds that couldn’t afford the separate pricing, it wasn’t so much an option as it was a decisive “no.”

Like most things in healthcare, dentistry comes attached with an intimidating price: According to one insurance company’s website, “a simple checkup costs only an average of about $85-$100 in the U.S., fillings run approximately $230-$300, and crowns go for $1,100 and up.” I can’t describe what it is like to sit with yourself, staring at a screen with numbers that sit heavy in the pit of your stomach.

In that moment, you make an intentional choice to risk a part of your well-being because you do not want to be a financial burden. You tell yourself that you’ll take such good care of your health that a medical authority won’t be necessary. And yet, the statistics are not in your favor. Studies have indicated that a lack of dental care can have huge health implications on the rest of your body. Not only are individuals missing preventative check-ins on gum disease by visiting the dentist less, “but people who do not have dental benefits are more likely to suffer from other, non-dental-related diseases” such as heart disease, osteoporosis, and diabetes.

Perhaps it was only the natural course for me to run into teeth troubles a few years down the line. Like all health issues, my first defense was to ignore it until it would go away, except the pain on the upper right side of my mouth persisted in this case. Enough that I finally caved and checked out the problem through Harvard University Health Services, earning quite an earful about my negligence from the dental assistants in the process. They suggested that I was too young to be so reckless with my teeth, and strapped to a dental chair with an X-ray to my right and microscope glaring down from the top, I felt so exposed, unable to tell them that I hadn’t been to a dentist in three years because I couldn’t afford it.

It is a rather unfair thing — how one part of your body can have such a profound impact on the rest of it. The connections of your bones and muscles and organs make it impossible to neglect one over the other, to choose to risk even one part of your body. And yet many of us still have to make these choices since our circumstances deal with a country without universal healthcare. Some of us know not to get sick because it is not possible to afford such a price for the bare minimum of our physical well-being.

I have been operating with this mantra for a few years now, just for a thing as simple as my oral health, and still it is not a lifestyle I would recommend. I am told to offer solutions in my columns, but even raising problems can be taboo — especially in a case like this when the fault is always misdirected back to the patient, shaming that one person for not being more vigilant with her body, instead of faulting the overarching institution of healthcare that simply does not support every person. But I will assert that Harvard could do better and start by adding dental coverage for all students in their health care package. Beyond the University though, that’s a decision we have yet to see play out — just be sure to stay healthy while you wait.

Tajrean Rahman ’20, is a History and Science concentrator in Currier House. Her column appears on alternate Fridays.