TED第三天

Lucy MarcilatTED2018

Why doctors are offering free tax prep in their waiting rooms

00:00

How many of you have had your doctor ask you about sex? Your mental health? Alcohol use? These questions are almost universal. But how many of you have had your doctor ask you about money? Most of us haven't. But that is strange, because compared to most high-income countries, child poverty is an epidemic in the United States. It creates conditions that may elevate stress hormone levels and impair brain development. Poor children in the US are one and a half times more likely to die and twice as likely to be hospitalized as their middle-class counterparts.

00:43

So my colleague Dr. Michael Hole and I started asking moms about money. We knew we needed to reimagine what a doctor's visit looks like, to get kids out of poverty and to give them a fair shot at a healthy life.

01:01

Our questions led to a surprising solution: tax credits. It turns out, the earned income tax credit, or EITC, is the best poverty prescription we have in the US. The average mom gets two to three thousand dollars a year from it. When families get it, moms and babies are healthier: fewer depressed moms, babies weighing more at birth. But one out of five families who could get it doesn't, and most who do lose of hundreds of dollars to the for-profit tax-preparation industry.

01:39

One day, a mom asked us why we couldn't do her taxes while she waited for the doctor.

01:44

(Laughter)

01:45

We all know that purgatory. Why not make good use of that time?

01:50

So we started StreetCred, an organization prescribing tax preparation in clinics serving kids. This is a brand-new approach and one that left some questioning our sanity. After all, we're doctors, not accountants. But we have something accountants don't: access to families. Over 90 percent of kids in the US see a doctor at least once a year. Their parents trust us and will do anything to give them a better life.

02:24

Doctors in every clinic around the country could be doing this work, too -- it's simple, really. The hospital registers as a tax-preparation site, and everyone, from medical students to retirees, can volunteer as a tax preparer after passing an IRS exam. It's not as hard as it sounds, I promise. I certainly never thought I would be doing other people's taxes, but here I am.

02:49

We're nearing the end of our third year. In the first two, we returned 1.6 million dollars to 750 families in Boston alone. This year --

03:02

(Applause)

03:07

This year, we've expanded to nine sites in four states. Sixty-three percent of our families have never heard of the EITC. How can you claim something you haven't heard of? And half have never used free tax preparation.

03:23

That two to three thousand dollars a year goes a long way. Take hunger. An adequately nutritious, low-cost diet for a mom and two young kids costs 477 dollars a month. With EITC money, that family can eat for five to six months. Or think about medical care. Twenty million children in the US lack access to care meeting modern pediatric standards. And yet, the average cost of that care is only 400 dollars per kid per year. EITC money can help fix this access problem. Perhaps most powerfully of all, this money gives moms hope. One mom used her refund for her son to study abroad in Spain. She was struggling to pay her rent, but she saw EITC money as his shot at a better future.

04:20

We have an opportunity, as doctors and as citizens, to get to the root of this problem. We can reimagine health care as a place addressing the causes of poor health, be it infections or finances.

04:35

Thank you.

04:36

(Applause)