“So what brings you in to the clinic tonight?” I ask, beginning a conversation with a middle-aged woman in typical fashion.
“I need some help with my medication,” she tells me, digging into her purse for the packaging from her last filled prescription.
“It’s for high blood pressure, but… I can’t afford it anymore.”
I take a look at her chart.
“Oh!” I say, pleased with my growing ability to recognize medications without aid from a reference text. “I think that’s on the Wal-Mart list. We should be able to give you a prescription for the generic which will be just four dollars per month at Wal-Mart.”
“I know,” she says. “That’s what I was prescribed. I can’t afford it.”
I don’t talk much about the Affordable Care Act in day-to-day conversation, even with the Supreme Court’s decision last week to uphold its constitutionality. In fact, I try to avoid it. It’s just not a conversation I’m poised to treat as small talk, simply because it’s a conversation that goes way deeper than I think most people realize.