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merica needs a robust Medicaid program. I say that both as a physician who takes care of patients on Medicaid and as a man whose dream was made possible because of it.

My family’s story is the American story. My ancestors were from the state of Gujarat in India, and my parents were born and raised in East Africa before immigrating to the United States. My brilliant mother had only a seventh-grade education because my grandfather couldn’t afford to send her to school. My college-educated father worked his way up in the U.S. from busboy to waiter to taxi driver and eventually to mortgage underwriter. Though he always worked hard, he was often unemployed.

My older brother, Anmol, and I were born in the United States. Because of a congenital defect, my brother’s kidneys failed in infancy and he needed a kidney transplant before his first birthday. Complications from this illness caused a stroke on Christmas Eve before Anmol’s second birthday that left him blind, epileptic, and intellectually disabled.

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As I grew up, my family was on Medicaid and other public assistance like food stamps. Despite our financial struggles, we never had to worry about health care, especially for my brother. Medicaid and Medicare took care of him. His childhood transplant lasted 19 years before he had to go back on dialysis. About 10 years ago, Anmol received another kidney transplant. Thanks to many specialists over the years, and the grace of God, he has done well.

I graduated from a public high school, was fortunate enough to attend Georgetown University through need-based scholarships and grants, and was then accepted to the University of Maryland School of Medicine. I paid for medical school with federal student loans that I am now repaying through the Public Service Loan Forgiveness program (which President Trump plans to eliminate). After earning my medical degree, I was accepted into a dual-specialty residency in internal medicine and pediatrics at Penn State Hershey Medical Center in Hershey, Pa. Now, after finishing my residency, I am privileged to work at Massachusetts General Hospital in Boston, one of the world’s best hospitals, and to teach at Harvard Medical School.

My parents still live in the same house I grew up in. They depend on Social Security and financial support from me, since they could not build retirement savings of their own over the years. My brother lives with them and receives Supplemental Security Income. Medicare and Medicaid still cover their health. Although none of my brother’s chronic medical conditions can be cured, they are all well taken care of.

White House adviser Kellyanne Conway once said that those who lose Medicaid coverage should just find jobs, echoing the stereotype that Medicaid recipients are lazy, undeserving moochers that taxpayers shouldn’t have to support. In reality, 64.5 percent of children enrolled in Medicaid and the Children’s Health Insurance Program live in families with at least one full-time worker. Nationwide, 43 percent of Medicaid recipients are children, and 44 percent of children with special needs (like my brother) are covered by public insurance.

My story shows that providing for the good health of a family achieves positive outcomes for the long-term future. Because of the help my family had during my childhood, I was able to work my way up to the best job in the world, where I now help other families like mine.

A family like that came to my urgent care clinic a few months ago. My patient was a 15-month-old girl. She had been wheezing all day and had spiked a fever at day care. Her mom was working three jobs to support her family, and they were on Medicaid.

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My patient’s wheezing was likely an early sign of what will become asthma. Her mom had asthma, too; it ran in her family. Asthma is a completely controllable illness — if an individual with it has access to medication and frequent monitoring. In spite of how much my patient’s family is struggling financially, this child can grow up healthy because she has Medicaid. Without Medicaid, she would likely live in poor health from an eminently treatable condition.

Most people aren’t born wealthy. The American dream is the very idea that those willing to work for it can achieve success. By protecting their health, Medicaid is fundamental to helping the poor, the sick, and the unfortunate achieve that dream. Many in Congress and elsewhere have grown cynical and skeptical of Medicaid, believing that it is being abused and that it’s a general waste of resources. But they are mistaken.

Medicaid helped assure that I could live the American dream. I want the same for my patients. Indeed, we should all want the same for our fellow Americans.

Hemal N. Sampat, M.D., is an internist and pediatrician at Massachusetts General Hospital and instructor of medicine at Harvard Medical School. The views expressed here are his own and do not necessarily reflect those of his employers. Sen. Elizabeth Warren (D-Mass.) told his family’s story during a Senate floor speech on June 19, 2017.

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  • You said it yourself. “The American dream is the very idea that those willing to work for it can achieve success.” The problem is that too many Americans these days are not willing to work. They may not be the majority, but there are certainly enough of them that cutting them from the Medicaid and other forms of public assistance would leave more money for those truly in need like your brother. My able-bodied brother in law has never worked a full time job in his life, and has only just now (at age 37) gotten a legitimate job where he pays taxes and isn’t getting paid in cash under the table. For many years he has received food stamps and Medicaid, and has also received numerous Pell grants and subsidized student loans which will never be paid back. He was allowed to get these over and over again although he has never completed nor passed a single college class. I was there when he found out he was not eligible for more student loans or grants since he had never been an actual college student, and it wasn’t pretty. He prefers to work just enough to pay for his pot and alcohol. If those are covered, he knows he can get his food and health care for free, so he has no incentive to do anything else. If he had needed to work in order to put food on the table he wouldn’t be in this situation now. We now have multiple generations of people who have never had gainful employment, and that is a tragedy.

  • This is a great story to show that Medicare/Medicade is a program that helps many people. Most people need this because of their medical issues and not because they are lazy and are unwilling to work. Dr. Sampat gives a moving story and expresses the access to care should be afforded to all, no matter their financial situation. Great article. JC

  • Excellent article by Dr Sampat bringing the issue of the need for Medicaid to the forefront and why not to generalize everyone on Medicaid to be just taking advantage of the system. A careful need based Medicaid policy should be crafted which also cares for individuals that are incapable of expressing the need for such help.

  • While not an immigrant, I also spent my early years in poverty.
    My dear Father worked extremely hard to bring us out of it.
    As I grew up, working was a way of life.
    (Due to a very unpleasant divorce, I also spent many years without insurance. The cost of this was $100,000’s)
    I didn’t qualify for Medicaid.
    You are clearly a person of intelligence and drive.
    Unfortunately, you are exaggerating the part that Trump is playing in changing the Health Care system.
    The problems existed long before he took office.
    I suggest you reach out beyond your Harvard position and view the information from a different perspective.
    Sincerely,
    Cynthia Bush M.D.

  • Dr. Sampat, thank you for sharing your story to emphasize the importance of Medicaid/Medicare as foundational to the American dream. I view the often-quoted “pursuit of happiness” to be contingent on access to affordable healthcare. I am on Social Security Disability following a diagnosis of glioblastoma in June, 2016. Your story highlights the misguided notion that those of us benefitting from government “safety net” programs are merely lazy and jobless, pace the claims of certain government advisors. I’ll hold my comments at that, but thank you again for your article. Cheers, AH

    • Thank you Dr. Sampat, I am so moved by this story that it made me cry. I don’t know what we would do without Medicaid because my husband hasn’t stood up in 3 years due to a neuromuscular disease and my health insurance doesn’t cover what he needs.

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