The value of health | The current of UCSB
Teenagers, as a rule, do not know much about health insurance. But Laura Halcomb was way ahead of her peers.
“My parents were divorced and they both had insurance,” the doctor recalls. candidate in sociology at UC Santa Barbara. “I was switching from one plan to another depending on what I needed.
“My mom had an HMO, which was cheaper and easier to use, but offered less choice than my dad’s PPO. I remember I was on my mom’s HMO when, at 17, I needed to see a specialist, so I used my dad’s insurance. I remember my mom taking me to the specialist’s office and saying, “Wow, that’s really nice! » »
This visit not only exposed Halcomb to the disparities inherent in our health care system. It also foreshadowed his college career. A specialist in medical sociology, she is working in depth on her thesis, “Negotiating the Costs of Cancer Care”.
In it, she analyzes the complex and sometimes convoluted system of health care economics in the United States, including the often inscrutable methods by which prices are determined, and the ways in which doctors, hospitals, healthcare companies insurance and pharmaceutical companies jockey to make the system work for them.
“My experiences with the healthcare system definitely shaped my interest in the subject,” said Halcomb, whose research combines qualitative interviews with secondary data analysis.
His journey to complete this thesis became much smoother. She was awarded a Charlotte W. Newcombe Doctoral Thesis Fellowship, which is awarded for Ph.D. candidates who “address questions of ethical and religious values in an interesting, original or meaningful way”.
Verta Taylor, professor emeritus of sociology at UC Santa Barbara and chair of the department, congratulated Halcomb on receiving the prestigious fellowship, noting that it “will support his innovative research on the cultural, medical, and economic processes that influence the delivery of health care in the United States.
“His findings underscore the role charity plays in treating colorectal cancer patients, showing how charity care perpetuates inequity in access to treatment in America’s market-based healthcare system,” Taylor added. “We are very proud of our students’ research that addresses pressing social issues, such as equity in health care.
Born in Fullerton, California (a town in Orange County), Halcomb earned a bachelor’s degree in philosophy from Boston University, majoring in ethics. But even before graduating, she found her focus shifting from abstract constructs to practical concerns.
“I thought I was going to go to law school, but I took a sociology course the summer before my senior year,” she recalls. “I thought, ‘That’s really cool!’ I met a professor who advised me on an independent research project my senior year, about looking at single mothers by choice I enjoyed doing this research and my advisor suggested I apply to a school doctorate in sociology.
At the University of Houston, where she earned her master’s degree, “my original plan was to study birth control,” she said. “I was told about a project to make an affordable, long-acting, reversible contraceptive—a $45 IUD. People kept asking me about the price, which made me made me really curious why it was $45.IUDs are not particularly new technology.
“I realized the reason it was $45 was because someone decided it was going to be $45. I’m not sure an economist would agree with me, but at the end of the day, it was a decision about production and profit margins.
While delving deeper into medical device pricing, Halcomb came across the argument that nothing can be done about our seemingly arbitrary system, because any price restrictions would compromise quality. “Yet, anecdotally, I’ve heard complaints about the absurdity of this — stories like, ‘I got a bill and the hospital charged me $200 for an aspirin,'” he said. she declared.
Determined to find out more, “I started talking with people who regularly work with these complicated numbers and thought about why the prices are the way they are and what people think about it. ” His dissertation will examine this topic from a wide variety of perspectives.
Halcomb has been at UC Santa Barbara for seven years, working toward his Ph.D. This effort has been slowed by pandemic-related restrictions; for more than a year, she was unable to do the in-person interviews that are an essential component of her research.
But she will soon return to that work, speaking with cancer patients about how they managed the costs of their care. Before the pandemic, she spoke with a number of oncologists and found that “on the whole, they wouldn’t blame the pharmaceutical companies for the high price of cancer drugs. They were much more openly critical and hostile towards insurance companies.
Halcomb made good use of her time during the lockdown, poring over transcripts of congressional drug pricing hearings and analyzing approaches taken in Go Fund Me campaigns dedicated to paying for colorectal cancer treatment. Of more than 1,600 such efforts, she found that most involved a third party requesting funds for a friend or relative in need, “which lessens the stigma of patients in need of financial assistance.”
For Halcomb, the fact that people need to strategize about the most effective way to raise desperately needed funds suggests the precariousness of our healthcare payment system – and the need to study it further to find potential solutions. To this end, she is grateful to receive the Newcombe Fellowship from the Institute for Citizens & Scholars, which gives her $30,000 to complete her dissertation.
“It’s a really nice kind of camaraderie,” she said. “You have funding, so you can spend your time thinking, writing, and reading books in your senior year.”
Among the topics she spends time pondering: The fact that Americans hate the idea of the government rationing health care, even as many ration it to themselves by delaying doctor visits for fear of cost.
Needless to say, these delays can be dangerous and, ironically, make care more expensive, which ultimately increases inequities. This is both a practical and a moral question – an intersection which Halcomb finds particularly worthy of study.
“I find sociology to be an interesting way of thinking about good and bad,” she said.