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Home » P.J. Parmar: Can We Redesign Healthcare to Profitably Serve the Poor? (Transcript)

P.J. Parmar: Can We Redesign Healthcare to Profitably Serve the Poor? (Transcript)

P.J. Parmar – TEDxMileHigh TRANSCRIPT

Colfax Avenue here in Denver, Colorado, was once called the longest, wickedest street in America. So there I was on Colfax Avenue, East Colfax at 2:00 a.m. with thirteen drunk teenage boys. I was scout master of an all refugee Boy Scout troop and had taken a few dozen boys camping. Most of them were asleep, but these thirteen had snuck beer into their tents and were drunk by midnight.

So we were taking them home one by one. As I walked the last boy to his apartment, I heard gunshots on the next block. As he turned on his kitchen light, I saw roaches scatter on the counter. And as his dad came out of the bedroom, I noticed four people were asleep on the living room floor. I showed dad a picture I had taken of the bottles we had found and gave him a look that loosely translated as, “I caught your son peeing on the campfire.” Dad had beer on his breath too.

I knew him because he was one of my patients. I knew the four on the floor because they were my patients. All of my scouts are my patients. That’s East Colfax, that’s where I’m a family doctor, and that night, I was practicing medicine. My office is there in the same place.

It’s a medical desert. There are government clinics and hospitals nearby, but they’re not enough to handle the poor who live in the area. By poor I mean those who are on Medicaid, free health insurance from the government. It’s not just for the homeless, 20% of this country is on Medicaid. If your neighbors have a family of four and make less than 33,000 a year, then they can get Medicaid, but they can’t find a doctor to see them.

A study by Merritt Hawkins found that only 20% of the family doctors in Denver take any Medicaid patients, and of those 20%, some have caps, like five Medicaid patients a month. Others make Medicaid patients wait months to be seen but will see you today if you have Blue Cross. This form of classist discrimination is legal and is not just a problem in Denver. Almost half the family doctors in the country refuse to see Medicaid patients.

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