It's Systems of Oppression, Racism, and Inequity People!

 

Allegations of Plagiarism Are Not New Weapons Used to Besmirch the Reputation of Black Leaders

I, like many of my friends and peers who are Black women with PhDs from traditional programs at predominantly white institutions (often referred to as PWIs), simply shook our heads in disgust and called or texted each other with comments like, “here we go again,” or “I am not surprised” when the “news” story broke about an anonymous person who instigated an investigation by a News & Observer reporter into Chapel Hill—Carrboro City Schools’ superintendent Dr. Nyah Hamlett’s dissertation. For many of us who matriculated through a traditional program at a PWI (not through an online university or program but who actually had to show up every day in the minority as "Black faces in white spaces") it conjured up feelings and experiences that many shared even though we may have gone through different programs at different schools. Experiences that include having your intellectual prowess always under microscopic scrutiny, never being given the benefit of the doubt when mistakes or errors are unintentionally made, finding mentally healthy ways to repel the routine microagressions, or having your writing ability criticized to humiliating degrees when your white peers are praised for their writing ability that would never stand up as superior to yours by peer reviewers or others outside of the program that you are enrolled.

 The reality is that if a sample of dissertations were pulled you would probably find some errors in citations or references that could be argued is an example of plagiarism in a large percentage of those sampled. However, in most of those cases, I would argue that it wasn’t willful intent but sloppiness or careless editing by not only the student but his or her advisor and dissertation committee members. Earning a PhD involves many more people other than the student. Therefore, calling into question the integrity of a dissertation also calls into question the integrity of the student, their committee, advisor, program, and school.

In addition to feeling the insult and hurt on a personal level that Dr. Hamlett no doubt felt, in preparation to speak at the recent Chapel Hill—Carrboro City Schools Board of Education meeting, which was three days after Martin Luther King, Jr.’s birthday holiday, I couldn’t help but to think about the controversy that surrounded a similar investigation into Dr. King’s dissertation. On October 11, 1991, the New York Times ran an AP article reporting the following: 

  “A committee of scholars appointed by Boston University concluded today that the Rev. Martin Luther King Jr. plagiarized passages in his dissertation for a doctoral degree at the university 36 years ago. ’There is no question,’ the committee said in a report to the university's provost, ‘but that Dr. King plagiarized in the dissertation by appropriating material from sources not explicitly credited in notes, or mistakenly credited, or credited generally and at some distance in the text from a close paraphrase or verbatim quotation.’ Despite its finding, the committee said that ‘no thought should be given to the revocation of Dr. King's doctoral degree,’ an action that the panel said would serve no purpose.” 

While I don’t endorse plagiarism and do believe that all scholars should demonstrate the highest of integrity especially those who are directly influencing or impacting the impressions of children, I also believe that what should be considered in these cases is the intention of the author combined with the degree to which suspicion of plagiarism is found not just in a couple of sentences but throughout the body of work by the author. People make mistakes, especially in haste or when fatigued by an arduous and grueling process, which I think many people with earned PhD’s would agree characterizes the process of matriculating through a PhD program especially by the time you make it to and through the dissertation process. There is nothing in Dr. Hamlett’s track record as an academician and administrator that suggests she is anything other than an intelligent, honest, and adept leader with integrity and an unwavering commitment to and compassion for all children. 

I am a native of Chapel Hill and went from elementary school, junior high and high school in the district on to graduate from undergrad at UNC Chapel Hill. It sickens me that in a school district like Chapel Hill—Carrboro, which has failed to deliver on its promise of ensuring a high quality education for all children and not just those from affluent backgrounds that this allegation of plagiarism is being used as a weapon to besmirch the reputation of and destroy faith a superintendent who by all measures has what it takes to help the district rise to higher ground. While the district is recognized as one of the top in the nation, behind that shining recognition is a dark reality. For decades it has failed to ensure that Black and in some cases Hispanic/Latino, refugee, and poor kids have the same educational outcomes as white and affluent kids in the district. Those students who are thriving in the district are those who have all the means to do so no matter what school district they are in. And, those students who have the most have parents who often fight the hardest and demand the loudest for more when the primary focus of the community at large should be on how the district can truly become a shining example for the nation by demonstrating its ability to produce children with little resources to excel academically and move from the bottom to the top.

 I don’t know who the anonymous person was who instigated the investigation. I would recommend however that he or she use their influence and power to work with Dr. Hamlett, and the district’s school board and administration to help find solutions to more weightier matters like as Delores Bailey, Chapel Hill resident, former parent and Executive Director of Empowerment, Inc. pointed out in her remarks to the school board---homeless families with children in Chapel Hill and Carrboro who are sleeping in cars and yet getting up every morning and going to school, or, I add the children whose parents work multiple jobs and don’t have the time to invest like other parents into helping their children achieve academically but who are trusting that the resources are available in the schools they are attending, or the children who are trying to navigate through multiple adverse childhood experiences including parent drug use, violence, and trauma. That to me would be a far better investment of time and resources and would yield much greater, nobler, and lasting returns. It would also model the type of behavior that would inspire young people in the district to become upstanding, contributing, compassionate, and positive global world citizens, not bullies, meanspirited, and divisive scandalmongers.

  Click this link to review the Chapel Hill--Carrboro City Schools' Board of Education Meeting on January 19, 2022

The Middle Class and Poor Can't Catch a Break When It Comes to Paying for Health Care

The $18,000 Breast Biopsy: When Having Insurance Costs You a Bundle

Lauren Sausser August 23, 2022

When Dani Yuengling felt a lump in her right breast last summer, she tried to ignore it.

She was 35, the same age her mother had been when she received a breast cancer diagnosis in 1997. The disease eventually killed Yuengling’s mom in 2017.

“It was the hardest experience, seeing her suffer,” said Yuengling, who lives in Conway, South Carolina.

After a mammogram confirmed the lump needed further investigation, Yuengling scheduled a breast biopsy for Valentine’s Day this year at Grand Strand Medical Center in Myrtle Beach.

Among many concerns she had ahead of that appointment — the first being a potential cancer diagnosis — Yuengling needed to know how much the biopsy would cost. She has a $6,000 annual deductible — the amount her health plan requires she pay before its contribution kicks in — and she wasn’t close to hitting that. Whatever the procedure cost, Yuengling knew she’d be on the hook for most of it.

But the hospital wouldn’t give her a price. She was told her providers wouldn’t know what type of biopsy needle they needed until the procedure was underway and that would impact the price.

The hospital’s online “Patient Payment Estimator” showed Yuengling an uninsured patient would owe about $1,400 for the procedure.

“That’s fine. No big deal,” she thought to herself, confident it would be cheaper for her because she did have insurance. A Google search indicated it could be closer to $3,000, but Yuengling thought that price seemed reasonable, too. She wasn’t fretting too much about money as she underwent the procedure.

It soon brought the good news that she didn’t have cancer.

Then the bill came.

The Patient: Dani Yuengling, now 36, who is covered by Cigna through her employer, a human resources contractor for the Mayo Clinic.

Medical Service: An ultrasound-guided breast biopsy.

Service Provider: Grand Strand Medical Center, a 403-bed, for-profit hospital in Myrtle Beach, South Carolina. It is one of 182 hospitals owned by Nashville-based HCA Healthcare, which generated $58.7 billion in revenue last year.

Total Bill: $17,979 for the procedure, including lab work, pharmacy charges, and sterile supplies. Cigna’s in-network negotiated rate was $8,424.14, of which the insurance company paid the hospital $3,254.47. Yuengling was billed $5,169.67, the balance of her deductible.

What Gives: It’s not uncommon for uninsured patients — or any patient willing to pay a cash price — to be charged far less for a procedure than patients with health insurance. For the nearly 30% of American workers with high-deductible plans, like Yuengling, that means using insurance can lead to a far bigger expense than if they had been uninsured or just pulled out a credit card to pay in advance.

Ge Bai, an associate professor at Johns Hopkins Bloomberg School of Public Health, recently published research on this topic and said hospitals in the U.S. often set their cash prices lower than the prices they charge to treat commercially insured patients.

“We can very confidently say this is very common,” said Bai, who advised that all patients, regardless of their insurance status, inquire about the cash price before undergoing a procedure. “It should be a norm.”

Grand Strand charged Yuengling’s insurance an extraordinarily high price for her procedure. By comparison, according to the federal government’s website, Medicare patients who need an ultrasound-guided biopsy similar to the one Yuengling received would pay only about $300 — their required 20% coinsurance for outpatient care. Medicare would pay the hospital the remainder of the bill, about $1,200. The hospital expected more than five times the Medicare price from Yuengling and her insurer.

Patients in Conway with private health insurance who are treated at other hospitals also typically are charged less than what Yuengling paid for the same procedure — on average about $3,500, according to Fair Health Consumer, an organization that analyzes health insurance claims.

And uninsured patients who pay cash prices and need an ultrasound-guided breast biopsy at the nearby Conway Medical Center are likely to owe even less — about $2,100, according to Allyson Floyd, a spokesperson for the hospital.

Meanwhile, Grand Strand Medical Center spokesperson Caroline Preusser blamed “a glitch” involving the hospital’s online calculator for the inaccurate information Yuengling received and said the correct estimate for the cash price for a breast biopsy at the hospital is between $8,000 and $11,500 “depending on the exact procedure and equipment used.”

The hospital removed certain procedures from the payment estimator until they can be corrected, Preusser wrote. She did not say how long that would take.

Resolution: Yuengling tried disputing the charges with the hospital. She called the billing department and was offered a 36% discount, lowering the amount she needed to pay to $3,306.29. Grand Strand Medical Center allows patients to set up payment plans, but Yuengling decided to charge the full amount to a credit card because she wanted the whole thing to go away.

“I could not sleep. It was driving me crazy. I was having migraines. I was sick to my stomach,” she said. “I hate having debt. I didn’t want to think about it. Obviously, that didn’t work because I’m still thinking about it.”

She said she requested on multiple occasions to speak to the hospital’s patient advocate and was eventually connected with an outside company, Parallon, which conducted an audit of her bill. She eventually received a letter dated May 26 from the hospital’s Revenue Integrity Department. It stated: “After a review of the charges in question and your medical record, the following was identified; The charges on your account were appropriate.”

“I don’t know why I actually expected a different outcome,” she said.

The hospital has requested that Yuengling return for a follow-up appointment related to the biopsy. She has refused.

Harlow Sumerford, a spokesperson for HCA Healthcare, told KHN in an email that the hospital system apologizes for any confusion caused by the payment estimator “and we are working to fix the issue.”

The Takeaway: With a family history of breast cancer, Yuengling was right to follow up with her doctor after feeling a lump. After failing to get a clear answer on her costs from Grand Strand Medical Center, she could have taken an additional step to explore what other hospitals in the area charge. Although her physician referred her to Grand Strand, she was not obligated to use that hospital. She could have saved a significant amount of money by opting to undergo the procedure elsewhere.

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Furthermore, patients like Yuengling who have a high-deductible insurance plan should consider paying cash prices for certain procedures and not involving their insurance company at all.

Jacqueline Fox, a health care attorney and a professor at the University of South Carolina School of Law, said she isn’t aware of any law that would prohibit a patient from doing that. After all, she pointed out, patients with health insurance pay cash prices for prescription medications all the time. It stands to reason they could do the same for medical procedures.

But some facilities make this difficult. Grand Strand Medical Center, for example, offers “self-pay” patients an “uninsured discount,” but that discount is limited to people who have “no third party payer source of payment or do not qualify for Medicaid, Charity or any other discount program the facility offers,” according to the hospital’s website. Only patients confirmed to have no health insurance are offered information about the discount.

In some cases, paying a cash price for a procedure might not make financial sense in the long run because none of it would be applied toward the deductible. Patients might save money on one procedure but end up paying their full deductible if unexpected medical expenses mount later during the calendar year.

Insured patients should reach out to their health plan for a good-faith estimate before a procedure. Under the No Surprises Act, health plans are supposed to give members an idea of their total out-of-pocket costs upon request. Ask for an “Advanced Explanation of Benefits,” said Sabrina Corlette, a research professor at the Georgetown University McCourt School of Public Policy, though she points out this part of the law isn’t being enforced yet.

The No Surprises Act also allows patients to file complaints with the federal government regarding their medical bills — whether or not they carry health insurance.

Yuengling filed her complaint in June.

Stephanie O’Neill contributed the audio portrait with this article.

Bill of the Month is a crowdsourced investigation by KHN and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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