Why doctors are offering free tax prep in their waiting rooms | Lucy Marcil

50,806 views ・ 2018-08-20

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How many of you have had your doctor ask you about sex?
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Your mental health?
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Alcohol use?
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These questions are almost universal.
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But how many of you have had your doctor ask you about money?
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Most of us haven't.
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But that is strange, because compared to most high-income countries,
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child poverty is an epidemic in the United States.
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It creates conditions that may elevate stress hormone levels
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and impair brain development.
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Poor children in the US are one and a half times more likely to die
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and twice as likely to be hospitalized
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as their middle-class counterparts.
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So my colleague Dr. Michael Hole and I started asking moms about money.
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We knew we needed to reimagine what a doctor's visit looks like,
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to get kids out of poverty
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and to give them a fair shot at a healthy life.
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Our questions led to a surprising solution:
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tax credits.
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It turns out, the earned income tax credit, or EITC,
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is the best poverty prescription we have in the US.
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The average mom gets two to three thousand dollars a year from it.
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When families get it, moms and babies are healthier:
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fewer depressed moms,
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babies weighing more at birth.
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But one out of five families who could get it doesn't,
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and most who do lose of hundreds of dollars
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to the for-profit tax-preparation industry.
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One day, a mom asked us why we couldn't do her taxes
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while she waited for the doctor.
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(Laughter)
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We all know that purgatory. Why not make good use of that time?
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So we started StreetCred,
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an organization prescribing tax preparation in clinics serving kids.
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This is a brand-new approach
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and one that left some questioning our sanity.
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After all, we're doctors, not accountants.
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But we have something accountants don't:
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access to families.
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Over 90 percent of kids in the US see a doctor at least once a year.
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Their parents trust us
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and will do anything to give them a better life.
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Doctors in every clinic around the country could be doing this work, too --
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it's simple, really.
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The hospital registers as a tax-preparation site,
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and everyone, from medical students to retirees,
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can volunteer as a tax preparer after passing an IRS exam.
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It's not as hard as it sounds, I promise.
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I certainly never thought I would be doing other people's taxes,
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but here I am.
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We're nearing the end of our third year.
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In the first two, we returned 1.6 million dollars
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to 750 families in Boston alone.
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This year --
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(Applause)
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This year, we've expanded to nine sites in four states.
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Sixty-three percent of our families have never heard of the EITC.
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How can you claim something you haven't heard of?
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And half have never used free tax preparation.
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That two to three thousand dollars a year
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goes a long way.
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Take hunger.
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An adequately nutritious, low-cost diet for a mom and two young kids
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costs 477 dollars a month.
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With EITC money, that family can eat for five to six months.
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Or think about medical care.
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Twenty million children in the US lack access to care
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meeting modern pediatric standards.
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And yet, the average cost of that care is only 400 dollars per kid per year.
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EITC money can help fix this access problem.
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Perhaps most powerfully of all,
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this money gives moms hope.
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One mom used her refund for her son to study abroad in Spain.
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She was struggling to pay her rent,
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but she saw EITC money as his shot at a better future.
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We have an opportunity,
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as doctors and as citizens,
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to get to the root of this problem.
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We can reimagine health care
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as a place addressing the causes of poor health,
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be it infections
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or finances.
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Thank you.
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(Applause)
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