There is No Them

2013 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF COLUMBIA
Persons in family/household	Poverty guideline
For families/households with more than 8 persons, add $4,020 for each additional person.
1	$11,490
2	15,510
3	19,530
4	23,550
5	27,570
6	31,590
7	35,610
8	39,630

This week in the break room a few of the nurses were asking one another, "If you had the power and the resources to take on one cause, what would it be?"  I remembered reading the night before a mind boggling statistic about poverty in the United States:  more than 35 million Americans now live below the poverty line - which is saying quite a lot given than the poverty guideline for a four person household is a measly $23,550 per year. To put that in perspective, imagine a family of two parents and two children with the primary wage earner* making about $12.25 per hour over a 40 hour work week.  The current federal minimum wage is $7.25 per hour. Needless to say, the standards set by our government are ridiculously and embarrassingly low. 

And then there's the Affordable Care Act.  Apparently drafted in an effort to insure all, under the ACA, many of those working poor who make a wage above poverty line are not eligible for coverage.  Because the government made Medicaid optional, and 27 states opted out, those individuals and their families who make between the poverty line (but not below) and four times that amount are ineligible for both government subsidies under ACA for private insurance and Medicaid benefits.  Which states opted out?  Those with the highest number of families living just at the poverty line.   

As a nurse in a public hospital in a large urban setting, this really strikes a cord.  Every day we are the eyes and the ears of the war on the poor in this country, from the front lines.  But how many times are there grumblings from both nurses and doctors about patients who have not sought out preventative care, who's BMI is "too high", with uncontrolled, underlying conditions, who have had multiple pregnancies, abortions, losses, births, addictions. And how many times are these people blamed for their "lack of initiative" in caring for themselves.  Every day there is someone blaming a patient for poor health outcomes -- or for being overweight or impoverished or having multiple prior pregnancies or for being addicted -- and every day I wonder how these people can care for themselves when we can't - not even for 24 hours - suspend our judgement to simply care for them.  As we should without doubt and without question, as this is the root of our profession.

You aren't cared for because you care for yourself.  You're cared for because others care for you. 

*No the second parent doesn't work because they can't afford childcare.