My patients made me political.

Before I went to medical school, I had little interest in politics. It wasn’t that I didn’t care about my country; I spent seven years serving in the United States Navy and have always taken pride in being an American. I suppose the reason for my political apathy was because things had always gone pretty well for me.

I grew up in a conservative, upper-middle-class family with two working parents. I lived in a nice house, attended private school for several years, and went on vacations with my family. My parents worked hard (and still do) for what we had, and I’m confident that they made sacrifices I didn’t know about to provide that life for my brother and me. I never considered my family to be wealthy, but we were certainly comfortable. It’s fair to say that I faced relatively little adversity.

Throughout my childhood and into my young adult life, I was vaguely aware that there were people who struggled, but I rarely encountered them personally. Never once did I worry about where my next meal would come from, whether I would be able to stay warm at night, or if I would be physically, emotionally, or sexually abused by someone in my home. And at least to my knowledge, none of my friends worried about those things, either. My world, and for all I knew, the world, was pretty great.

It was my patients that changed my mind—patients that, due to a variety of societal problems, aren’t set up for a great future. Many children, through no fault of their own, are exposed to one or more “adverse childhood experiences”—a category that includes things like the loss of a parent, food insecurity, experiencing or witnessing abuse, or having a family member with substance abuse problems. Research has shown that these experiences have profound effects on a child’s ability to succeed in life.

Today, I woke up yet again in a country where our government has failed to prioritize the needs of our children. In their purported attempt to “reform” our tax code, the Senate has placed the interests of corporations and the wealthy above the needs of children who must strain their eyes to envision a promising future. And hidden within the 479-page Senate tax bill is a provision that eliminates the individual mandate for health insurance—a change the Congressional Business Office estimates will result in millions of Americans losing their health insurance.

Additionally, it has been over two months since Congress failed to reauthorize the Children’s Health Insurance Program (CHIP), which provides access to healthcare for nearly 9 million children who would otherwise fall through the cracks. The program, which has received broad bipartisan support since it was established in 1997, has apparently become too much of a financial burden. As Senator Orrin Hatch stated, “the reason CHIP’s having trouble is because we don’t have money anymore.”

To the politicians who voted for this tax bill or who do not grasp the urgency of reauthorizing CHIP, I extend an open invitation to spend some time in my pediatric office in rural South Carolina. If they did, they would watch me struggle to find help for a teen mom with severe depression. They would meet a mother and her child who now live with eight other people in a single-wide trailer because the house where they were staying burned down, and they have no money to rebuild or replace their belongings. They would spend time, as I do, with families whose biggest concerns are not whether to contribute to their child’s IRA or college savings plan, which private school to choose, or which SUV would be the most comfortable way to get them there.

Their concerns are far more basic: buying food and baby formula, paying for gas to get to the doctor, and hoping the power company doesn’t shut off their heat this winter. Many families are necessarily so concerned about providing for their children today that they have little time, energy, or money to devote to preparing for their future.

Because of my interactions with children and families who don’t have many of the advantages I did, I have become far more political and far less conservative. Without significant societal changes, millions of children will remain impoverished, imprisoned, abused, poorly educated, and poorly fed. Many of their lives will be derailed by substance abuse or unplanned pregnancies. And some of them will die, in one of the world’s most developed nations, from a lack of access to healthcare.

I respect that not everyone shares my political views, and there are plenty of reasonable conversations to be had about how to go about ensuring the best future for our nation and our children. But for anyone who doesn’t see a problem with our current situation, I’d encourage you to spend some time with the less fortunate. They have changed my perspective, and they may change yours as well.

As always, your comments are welcomed (even if you happen to disagree). I'll get back to you as soon as I can. Please try to keep it civil--I reserve the right to delete comments that are offensive or off-topic.

5 thoughts on “My patients made me political.

  1. The fact the individual mandate has been eliminated in the Senate bill was hardly hidden. That’s all the media has been talking about. Besides, the mandate represents a false choice. Either get insured or pay a fine. How does that help some poor person living in a rural or suburban area if they can’t afford either?

    • Removing the individual mandate hurts because insurance panels will be skewed towards sicker patients, and premium costs will go up to compensate, making it even less affordable.

      • What we’ve seen alot here in rural east Texas is the numbers are already skewed. In 2017 my family chose a faith based medical sharing program because our high deductible plan became unaffordable. We had a grandfathered plan that we lost in 2015 because we had a child. I would love to have that plan back.

  2. Chad, I am a former healthcare executive, now retired, and I volunteer in Pediatrics in an inner city “Safety Net” hospital. I work with kids primarily from lower socioeconomic sectors who also have multiple adverse childhood experiences, and the need for services of many kinds is profound. The loss of CHIP will burden them even further. I don’t care what their parents have or haven’t done, been or haven’t been or even where they are today. These are KIDS. Want to reduce crime in our communities? Treat KIDS with care, honor, and respect, regardless of their circumstance. I have personally seen how comprehensive care (medical, social, psychological) can transform a child’s life – forever. Please, please please let your elected representatives know defunding the CHIP program is investing in the future of our country. This sage advice is from the UNICEF website and describes well the benefit for ALL US citizens, and around the world: “Investing financial resources to help children survive and develop to their full potential is, first and foremost, a moral imperative. But investing in children is also important on practical grounds. It yields positive benefits to economies and societies. Since the foundation of an individual’s health and well-being is laid in early childhood, the most opportune time to break the cycle of poverty, or prevent it from the beginning, is during that time. Programmes that invest in early childhood development could generate considerable cost savings for government. Investments in children are increasingly seen as one of the best and most valuable long-term investments we can make.”

  3. I agree children are not prioritized in this country. 15 years of outreach storytime programs to preschools confirms it for me. I was fortunate to have the resources to keep my child home with me. We did only a morning program at 3 and 4. I was shellshocked the first months of my job at how we have young children spend their days. Crammed into small spaces, some of them there from dawn to dusk. It is not unusual to see signs reminding parents that there is a 10 hour per day limit…. that’s more hours than a fulltime job! I am not against preschools- I know that statistically some of those kids are a lot safer and get more attention and better food than they would at home…. but many of the teachers spend their own limited resources for preschool materials. 2 years ago I was again a bit shocked as a volunteer for our local Christmas Bureau when one of “my” preschool teachers came in to get toys and food for her own children. Many times the teachers work when they are sick themselves- they usually have no benefits. No work, no pay. And there is nothing like seeing the 1st thru 5th graders in the summer stuck in the preschools. We call it “afterschool” and “summer camp.” I will be very honest and say there are some places I would rather not use the facilities in…. I get to see some of my preschoolers at the soup kitchen when my church does it turn each month. There is NOTHING that makes children more or less deserving of educational opportunity and health care. I, like you, tire of the pretense that there is equal access. I look into the eyes of 500 preschoolers a month- they aren’t statistics. They are people!! Maybe if each politician were required to spend a week in my town’s preschools there would be a change of heart- I’m betting the money to fund childhood health programs might magically be found again. Thanks for the article.

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