In a recent guest opinion essay published in the New York Times, Dr. Lindsay Ryan, University of California, argues that end-stage poverty is killing Americans.
Dr. Ryan is an associate physician at the University of California, San Francisco, Department of Medicine. It is a safety-net hospital, which Dr. Ryan describes as “institutions that disproportionately serve patients on Medicaid or without insurance. You could describe the safety net in another way, too, as a place that holds up a mirror to our nation.”
Since 1992, the 340B Drug Pricing Program has enabled safety-net hospitals like the University of California to care for patients left behind by the health care system, including Americans experiencing end-stage poverty. 340B savings allow these safety-net hospitals and clinics to provide services like transportation, medication assistance, and primary and preventative care for free or significantly reduced cost.
Dr. Ryan routinely serves economically vulnerable patients experiencing life-threatening health problems due to social inequities based on race, class, primary language, and other categories.
Dr. Ryan shared several poignant patient stories highlighting the need for a strong public health infrastructure. They include a homeless man who would rather die than have his arm amputated unless he can find a permanent, affordable apartment, a 90-year-old man with dementia who mistakenly abandoned his rent-controlled apartment and is now living in a shelter bed, a Filipino immigrant learning to navigate the health insurance system to get treatment for acute hepatitis C, and a patient in her 20s who can’t afford rent after losing her job because of repeated hospitalizations for pancreatitis.
All of these life-threatening health problems can be prevented. Dr. Ryan says, “If healthcare is interpreted in the truest sense of caring for people’s health, it must be a practice that extends well beyond the boundaries of hospitals and clinics.” This includes massive investment in housing, addiction treatment, free and low-barrier health care, and social services to meet vulnerable populations’ basic needs.
