Malkawi: The Human Side of Health Insurance

Imagine, for a moment, that you have two sick children at home, and you've just received a pre-authorization denial for an MRI scheduled for next week. Frantically, you call the insurance company, only to be met by an automated phone tree. All you want is to speak to a human being.

Most people never think about the human beings inside the insurance system until they are angry, scared, or desperate. I know because, for more than a decade, I was the voice on the other side of the phone.

I worked for a major health insurance company, beginning in customer service helping people understand their benefits. Later, I reviewed and processed claims before eventually becoming an underwriter for Medicare Supplement policies. It was a career I entered because I genuinely wanted to help people.

Heather Malkawi. (Photo credit: Texas Impact)

Working in the insurance industry taught me that my role mattered, no matter how much people yelled at me, because I was dealing with three of the most important parts of people's lives: their family, their finances, and their health.

Fear often came through the phone as anger. People were not simply calling about paperwork or policy numbers. They were calling because their child needed treatment, because they were terrified of medical bills, or because they felt trapped inside a system they did not understand.

Over time, I realized that many consumers do not distinguish between "the insurance company" and the people working inside it. Frontline employees often become the face of decisions they did not create, carrying the emotional weight of a system much larger than themselves.

One afternoon, I answered a call from a woman who was furious that she was contacting the insurance company for the fifth time regarding a procedure that had already been denied twice. Before I could finish my greeting, she shouted, "Why won't you people talk to each other? My doctor says they're waiting on you, and you say you're waiting on them!"

Once I understood the situation, I conference-called both the authorization department and the doctor's office to get everyone communicating directly. By the end of the day, the authorization was approved.

The company later recognized my commonsense intervention as a "Moment of Magic" after the customer wrote a letter of appreciation to company executives. But it was not magic. It was simply human behavior: listening, showing compassion, and taking the extra step.

Having worked in the trenches of the insurance industry during the rollout of the Affordable Care Act, I left the industry ten years later with far more empathy than I entered it with: compassion for people desperately trying to navigate healthcare, empathy for workers trying to help within systems they did not design, and a deeper understanding that behind every policy number, claim, and medical record is a human being trying to protect themselves and the people they love.

Most faith traditions recognize this truth. Compassion, mercy, and care for the vulnerable are central teachings across religions. In Christianity, Jesus' ministry repeatedly centers healing and restoration. In Judaism, visiting and comforting the sick (Bikkur Cholim) is considered a sacred responsibility. In Buddhism, compassion toward suffering is foundational. In Islam, caring for the sick and vulnerable is deeply connected to mercy and justice.

This week, Muslims around the world are celebrating Eid al-Adha, also known as the Festival of Sacrifice. The holiday coincides with the culmination of Hajj, when millions gather in Mecca for sacred rituals and prayer. Within Islam, health and life itself are understood as blessings from God, and care for others is viewed as a communal responsibility.

Across many faith traditions, healthcare is not seen solely as a financial or political issue. It is a moral one. At its core, healthcare is about human dignity, compassion, and our shared responsibility to care for one another with humanity and grace.

Editor's Note: The above guest column was penned by Heather Malkawi, a member of Texas Impact. The column appears in the Rio Grande Guardian with the permission of the author.

About Heather Malkawi

Heather joined Texas Impact in 2021, as a seminary intern, then served a year as the Unitarian Universalist Justice Fellow focusing on LGBTQIA2S+, Immigration, and Health & Human Service issues. She served as the liaison between Texas Impact and member organization Texas Unitarian Universalist Justice Ministry.

She brings over 20+ years in the non-profit social work and insurance industries. Now moving into the Public Policy Advocate role, she hopes to educate and encourage people of faith on the importance of telling their personal stories to create change here in Texas.

Heather is a graduate of Austin Presbyterian Theological Seminary (2024) with a Master of Divinity (MDiv), and her Bachelor of Arts in Sociology from the University of Michigan (2002). She received the Charles L. King Preaching Award & The Ethel W. Lance Human and Civil Rights Award. Heather is a candidate for fellowshipping with the Unitarian Universalist Association and a Live Oak Unitarian Universalist church member in Cedar Park, Texas.

Her current interests include interfaith understanding of religious trauma and its effects on individual spirituality, theatre, and large choral works of music. Heather was raised in Flint, Michigan. She has lived in Chicago and now Austin, Texas, with her two teenage boys.