On April 30, I sat in Kalamazoo College’s Book Club coffee shop for about an hour, talking with Doug Stewart. Surrounding this interview, I attended two Healthy Michigan enrollment events, through which I participated in an application simulation, carried on casual conversations with enrollment counselors and navigators, and met Doug. Doug is the Director of Regional Outreach for Kalamazoo County as contracted through Summit Point – a “multi-scope, behavioral health, substance abuse agency” – and is the Lead Regional Certified Navigator for the Affordable Care Act, a Registered Nurse, and a certified case manager (Stewart, personal communication 4/30/14). His current contract positions him as “…the hub to help assist in coordinating, making sure that other agencies…were meeting with the Department of Health and Human Services and Michigan Consumers for Healthcare guidelines” (Stewart, personal communication 4/30/14). He told me humbly that his “background kind of fits kind of the scope of what they were looking for when the roll out of the Affordable Care Act was underway in looking at a point person who could help navigate, you know, consumers and provide resource information” (Stewart, personal communication 4/30/14). Doug quietly and passionately described to me the rewards he experiences from this “very gratifying experience” as he sees the effects on people receiving insurance and access to care, for some this being the first time in their lives.
A theme throughout has been story and impact (Stewart, personal communication 5/19/14). Doug told me the story, in great happiness and compassion, of a woman whom he helped enroll who was diabetic and had never had healthcare; unable to pay for her medications or receive continued and comprehensive symptom management for her chronic illness, the woman found herself in the emergency room almost every other week to receive care and manage her illness, all the while racking up massive medical bills and being unable to truly treat and manage her diabetes. He described how happy she was and how much it meant to him when she was approved for Medicaid, as it meant that not only would she be able to get coverage and care for the future, but that her medical costs from her many ER visits during January, February, and March would also be covered and she could, for once, go into the next month with significantly less debt (Stewart, personal communication 4/30/14). Doug described the impact he believes the Affordable Care Act will have, saying “having more individuals and families receiving healthcare coverage and/or expanded coverage through the implementation of the Healthcare.gov Marketplace and Healthy Michigan Plan programs will improve appropriate healthcare access, provide affordable quality health care for the residents of Kalamazoo County” (Stewart, personal communication 5/19/14). He also discusses how managed care and effective preventative care access will improve the quality of health for residents in the country, as well as lower healthcare costs.
In both my interview and field experiences, I have experienced such an air of deep commitment to and care about these efforts. Both Doug and the application counselor with whom I spoke went beyond what was expected or required of them to assist people in the fullest way possible. They described these efforts in such humble and ‘but-of-course’ ways that they gave the impression that neither questioned their belief in this work, its moral necessity, or the very human element of often-distant, impersonal statistics about health reform in the United States.