Thursday, September 15, 2011

Patients Can Make Their $10 Copays. They Just Don't Want To Pay You

The Census Bureau has made headlines the last couple of days when it released its latest statistics on being poor in the United States. According to their studies, there are over 46 million people who live beneath the poverty level in America, defined as a family of four who make less than $25,000 a year. While those numbers sound horrific, poverty is a relative issue.

Sure surviving on $25,000 a year for a family of four sounds pretty dreadful. But the poor in America certainly don't look like the poor you see in third world countries like Ethiopia or Somalia. The poor in America even compare favorably to those living in developing countries like China or Mexico where it is still common to see rural residents live on dirt floors without running water or electricity.

According to the Heritage Foundation, who dug a little deeper into the Census report, the poor in America are in fact relatively well off. Over 96% of poor parents say their children have never gone hungry in the previous 12 months. Eighty-two percent of the poor say they have never gone hungry in the previous year due to a lack of money to obtain food. Judging by the rate of obesity among the poor in the U.S. that statement is probably about right.

The poor in this country are also NOT living in squalor. Two-thirds of the poor have satellite or cable TV. More than 50% of poor families have video games like an Xbox or Playstation. One third have a flat panel TV and one fourth own a digital video recorder (DVR) like Tivo. Half the poor families own at least one computer. Nearly three quarters own an automobile while almost one third own at least two vehicles. The average poor person in America has more living space than a non poor family living in first world countries like Sweden, France, or the U.K. Anybody who has traveled to a foreign country or watched a TV show like House Hunters International can attest to the tiny and expensive spaces the citizens of other countries are crammed into on a daily basis with nary a single complaint.

Many doctors see this paradox first hand. Patients quibble about paying chump change for their office visit. Yet they are gabbing on their cell phones while their kids are playing games on their Nintendo Game Boys. The clothes on their backs are definitely not from the Salvation Army. They drive nicer cars than most medical students. They'd rather continue to subscribe to a broadband internet connection to stay up with their FaceBook friends than to pay you to maintain their health.

That is what's so frustrating about the poor in America. We want to help them escape poverty, but to many people, they are not helping themselves with smart savings and spending. Doctors sacrifice material wants for decades before finally having the funds to truly live a good life. Yet we are the people the government want to take money from because we are "the rich" by increasing our taxes and lowering our pay. In turn the government gives it to "the poor" who its own statistics show live rather well. So next time a patient tells you they can't make their copay, tell them you feel for them. In exchange may be you can make a barter by keeping their cell phone or gold bracelet. Why should doctors be the only ones who work for free?

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