I am in the hospital in Antonio, Texas, and I am pleading to make my children enough to leave the hospital today in front of the preschooler who will beg for me, politely and to call me. “We will do everything Dani needs,” she says.
“Of course” I say.
“But can it be today?” She asks.
Her child has a serious infection and is not ready to go home. In fact, DANI may need surgery. My mother wants to leave because DANI doesn’t have insurance. Every night, hospitalization means thousands of dollars for extra costs.
DANI was guaranteed by the children’s health insurance program chipPrograms similar to Medicaid are provided to patients who cannot afford health insurance. But there is a risk of rolling or losing the coverage every year. During the epidemic period, the federal government had to automatically roll people in the state. chip And Medicaid. But the requirements ended in 2023. After that, Texas predicted that the poor children would dismantle the poor children from the benefits with the cold vitality that threatened the Ministry of Health and Welfare to take action. According to Joint investigation propublica and Texas TribuneMore than 2 million Texas, most children and most children are Medicaid or chipI lost insurance benefits. Some have been separated by incorrectly entering the form or turning late.
The social worker of my hospital is helping this family but not hopeful. The application for review and processing is 3-6 months. There is not much money as a doctor. When I came to me, I cried and stuck to my mother. I lean back at the sink to wash my hands and listen to my mother’s worries. Eventually, you fall asleep. The family stays overnight and the child is in the operating room.
What is happening to the Texas people will happen to millions of people in different states. Last week, President Trump’s big budget bills voted to cut the Republican Party. $ 930 billion According to the parliamentary budget office, health care expenses. Medicaid and chip As with the application range of Affordable Care Act, face a large cut. Even Medicare, which provides health care for the elderly, is affected. The bill is set to achieve most of these costs. Documents and procedural barriers applied area; Medicaid recipients are expected to attend school, volunteer or school unless they have pregnancy, parenting or disability. (Texas has shown how “effective” bureaucrats can be, and about half of children without insurance are eligible to be guaranteed.) Experts can predict that it can lead to 55 million new preventive deaths between 1.1 million and 1.7 million Americans. The supporters of the bill said the cuts will focus on federal funds for children, pregnant women, people with disabilities, low -income families and the elderly. This is similar to that you cut the umbrella with kitchen scissors and claim that the cut will help to focus on the mission that the umbrella blocks the rain.
One of my first patients was an epilepsy child. When the mother’s mother went to the pharmacy, she found a progress in Medicaid Insurance and was asked to pay thousands of dollars to pay the anti -seizure. She could not pay the cost and the patient ended in the emergency room without medicine. My colleagues stopped the seizures, but our care was efficient. I couldn’t be discharged safely without proper medicine, and it would take a few months again. The charity program agreed to cover the medicine, but it took a few days to fill the prescription. As a result, preventive seizures have led to hospitalization for several days that are expensive and can be avoided.
When I was a medical student in Galverston, almost a quarter of Texas did not have insurance in 22 generations. The medical school I attended, like many fellow institutions, has a free student operation clinic that provides such patients with services. Some people drove to arrive for hours, and others simply walked on the street. When they arrived, they showed how poverty devastated human forms and poverty. I saw workers with broken limbs broken in the emergency room, and I saw that the approach to expensive orthopedics and surgery was rejected. Others received emergency stents and blood dilutions after the heart attack, but they continued their lives because they had no ability to follow the heart specialist. The clinic saw people with treatable cancer. Our students learned how to die because they could not pay for the treatment.
I am currently working as a pediatrician in San Antonio. Although it is one of the poorest metropolitan areas in the United States, it is a big city that strongly supports medical services in local home families in the poor. Practice of pediatrics often seemed to be out of the economic cruelty of American medicine. County Health Care Program is a sliding scale system supported by property tax. Most of my patients are in Medicaid chip; Some are personally insured. Even if we treat patients completely punched, we can generally find some kind of financial support because the region, state and federal programs seem unified with the promise of caring for children. For the poorest children, the hospital often eats bills.
It was a profound slogan that Galveston patients suffered and died of treatable diseases and could simply provide this standard treatment to Texas children regardless of their family income. When infants using Spanish in the southern Spanish can cause a pediatric orthopedic surgeon when they cause infection in the leg bones. When a new mother struck it on metadon throughout the pregnancy with opioid dependence treatment, I can teach newborn treatment through the withdrawal of opioid. I can order all the labs to find the cause of a young girl causing pain in the joints.
But the difficult lesson of early training never left me. I know that these resources can be exhausted. It can be removed by law and policy. If that happens, the cruel cycle is strengthened. Poverty makes people harmful to health. Meanwhile, medical costs often ruin their families financially. Children who have spent their first five years in poverty are difficult to learn, have a high possibility of asthma and obesity, are more likely to wear burns or gunshots, and are more likely to die from abuse. When they grow up, they usually be less likely to earn, they are likely to spend time in prison, and more diabetes and heart disease. In general, they will die at a younger age than those who grew up with more resources.
Poverty is common among American children. Children under 5 years of age are more likely to be poorer than other age groups. It can also be treated. In recent decades, the most effective sustainable policy to alleviate child poverty has been acquired income tax deductions, which provides taxes that receive taxes to their families with both parties and their children. Extended child tax deductions during the epidemic period reduce the record of children’s poverty. If you renew this credit in 2022, economic stability will be guaranteed for about 3 million children. The new budget legislation increases the current child tax deduction from $ 2,000 to $ 224 and creates a “Baby Bond” program to build savings for young people. I think this aspect of this bill is good news for the family. But I am worried that their beneficial effects will be dark due to health care costs.
Hospitalization is not only a poor family but also a poor family because of the bill. Parents can not pay for their family’s basic needs if they lose their jobs or miss a lot of changes while their children are undergoing odors in the hospital. One of those mothers apologized to me because I had to leave my daughter for the evening. She did not want to call the landlord or bring a legal advocacy team. She had a reason for her quietly wanting to leave.
“We will keep watching my daughter.” “We can do something that she needs because we leave the door open.” I was able to promise to protect the girl overnight. But I knew that I would release her in a harder and more dangerous life for US medical expenses.
The approach to medical services is often configured in terms of life saving at the moment. But a program like Medicaid is not just a hospital ticket. They are also part Among the most effective poverty eradication programs for children. Medicaid, like a social program that supports food, early education and access to houses, reduces costs and prevents debt. This last point is important. You can do medical expenses People are poverty. Even a family with personal insurance covers a financial risk when caring for children.
When important medical services are delayed because of the cost, children suffer. I witnessed the infection that was able to be treated early in the primary care clinic, and because of the lack of such a clinic. I took care of the newborn, who missed the fetal treatment of several weeks or months after the coverage was over. Ironically, the treatment of outpatient patients, which is cheaper than hospital treatment, is often the most difficult to get. Children who do not have insurance will be far from the clinic when they cannot pay in their pockets. One of the pediatric patients had to meet with ears, nose and throat experts. His tonsils were so big that they could not eat. The free clinic team sent him to ENT, but he retired due to lack of funds. He could not take out the tonsils until he was hospitalized at malnutrition.
As Trump’s cuts have been enacted for the next 10 years, I am afraid that Texas pediatricians are currently being experienced nationwide. Change will be cunning and bureaucracy can make it difficult for doctors to see. We cannot testify on behalf of children that we do not care because we do not appear in the clinic or have a lack of funds. I am afraid to see some of the machines of injustice for too long. Fills my children’s lunch boxes for the income of the system that fails the poor children.
Cut chip And Medicaid eventually affects the treatment of all children. Prior to this bill, many rural hospitals closed their pediatrics. Such troops often with Medicaid chip Pay less hospitals than other insurers for the same treatment. More than 300 US hospitals in rural areas can be closed as a result of Trump’s bills. Patients who can’t find a new insurance or can no longer find a place to live should see elsewhere. The goal is to provide care for all children in the community. I am worried that even mission -oriented health systems will eventually start turning punched children to tip and to prevent collapse.
I was once too forced to commit the drug for each human life. Now I know that in medicine, I know that the doctor’s ability to fulfill this dedication to living moral life depends on the treatment system that our society builds. I still want to use it. I was a working class from Texas and I want to take care of those children. But I don’t want to drive my family into poverty or change the future of the child into dust. For a doctor who cares for a poor family chip It threatens the ability to make the oldest promise in medicine. We will not harm. Every day, I meet my parents who are willing to sacrifice to save their children’s lives. They don’t have to do it. ♦
