Finding Health Care for the Working Poor

David Shipler, the author of The Working Poor: Invisible in America relates a story about how the Boston Medical Center uses lawyers to help poor people get better health care.

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Over the past few days, we've been hearing about poverty in America. In the weeks following Hurricane Katrina, the US saw vivid images of the poverty that exists alongside the country's affluence. Commentator David Shipler used to be a correspondent for The New York Times. He spent five years interviewing poor working families around the country. He found that poverty is not a one-dimensional problem, and for a family to escape poverty a number of major issues must be addressed. Shipler says there are creative ideas being used every day to fight poverty in the United States, and he describes one of them in our third commentary about poverty.


When I began my book on the working poor, I did not understand one very important characteristic of poverty. I finally got it when I heard a simple story about a sick little boy. He was taken to the famed Boston Medical Center where the best treatment came not from a doctor but a lawyer. He was eight years old. He could barely breathe. Attacks of asthma sent him again and again to the pediatrics department. He missed a lot of school. His mother missed work so often that she risked being fired.

Doctors gave the boy the usual inhalers and steroids, but then again and again sent him home to his slum apartment which they knew would make his asthma worse. There was a leaky pipe, which led to dampness and mold. There were dust mites embedded in the wall-to-wall carpet. Scientists have found that these conditions can trigger asthma, a disease that has risen among children living in the slums of America. The mother asked the landlord to fix the pipe and remove the carpet. He did nothing. A nurse visited the apartment and wrote the landlord a letter. No answer. So a lawyer in the pediatrics department made two phone calls to the landlord, and miraculously the pipe was repaired, the carpet was removed, the boy improved and the mother saved her job.

There are four full-time attorneys in the pediatrics department of the Boston Medical Center, paid with charitable donations. The department chairman, Dr. Barry Zuckerman, is a pediatrician, but he tells me that his lawyers are as important as his doctors.

The idea is catching on. The Kellogg Foundation has given $2 1/2 million for a center to help other clinics and hospitals enlist attorneys to attack the causes of some diseases. Blessed are the poor who have lawyers on their side.

So I learned that no single problem of a poor family is isolated from other problems. You can't solve poverty by solving only one problem. Even if the issues seem unrelated, like housing and health, they're linked in a kind of ecological system. They sustain and magnify one another.

Since 9/11, we've understood that to fight the war on terrorism we have to connect the dots. We also have to connect the dots to fight poverty.

NORRIS: David Shipler is the author of "The Working Poor: Invisible in America." He lives in Maryland.

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