Our Health Care System Doesn’t Work for the People Who Need It Most

My life has been hard, but I’ve always worked even harder. I want to share a bit about where it’s gotten me — and what it might mean for you if you struggle like I have.

I grew up in a family without much money. When I dropped out of high school, my options were limited to minimum wage jobs.

That wasn’t enough to pay the bills to begin with, but things got worse when a dishonest employer shorted me on hours and wages. When I took $9 that was owed to me — just so I could eat — I ended up with a criminal record. That killed my dream of going to nursing school.

These things happen all the time when you’re poor. But growing up struggling can also instill a fighting spirit.

I became a home health aide, the closest thing to nursing I could get. I liked the work, but the wages were very low. I worked 60 hour weeks just to scrape by, which took a toll on my body.

Eventually, my mobility was compromised and I needed surgery that I couldn’t afford. As more health challenges piled on, I was forced to quit my health care job and try to get by on odd jobs.

Fortunately, in 2015, Pennsylvania finally expanded Medicaid under the Affordable Care Act. The promise of much-needed foot surgery was so close. But Pennsylvania’s complex, partially privatized system created more barriers. Complicating matters, I was married to an undocumented person, so I was scared to access services.

Eventually, I realized that the system wasn’t just failing me and my family — it was rigged against everyone like us: poor people working low-wage jobs, regardless of where we came from.

That’s when I got involved in Put People First PA, which organizes struggling people across the state. Through my work there, I got to be involved in health care again, this time as a community organizer and advocate.

Around the same time, I got involved with the Poor People’s Campaign, a national moral movement that links the issues I was living with to many others. I learned more about the disenfranchisement of poor people like me, of people of Mexican origin like my family members, of people in rural Pennsylvania, and beyond.

Getting involved with other people was so empowering. It also opened my eyes to all the ways our education, health, legal, and voting systems functioned to favor those with money and political clout — and leave the rest of us out.

For example, we had two hospitals serving us in our city, Lancaster. One of them, St. Joseph’s, closed, leaving residents reliant on the other hospital — which was badly overcapacity, especially during the pandemic. In St. Joseph’s place, developers want to build townhouses and boutiques.

County officials say we have to choose between health care and housing, but what kind of choice is that? My partner and I were among the many affected by the resulting lack of access to testing and COVID-19 care. We survived, but many others didn’t.

There are more than 800 hospitals that are set to close this year because they aren’t making enough money, even though the people in those communities need them. It’s not right. It’s not what this country is supposed to be.

Poor people work hard. We have ideas for quality health care, housing, and justice. But our voices are often silenced by the corporate interests that have undue influence over lawmakers.

If you’re as fed up as I was, you can join your state chapter of the Poor People’s Campaign. Get involved in fights over health care and voting rights. Show up at planning board meetings, city council meetings, and school boards. Be active with us.

Let’s raise our voices together and transform the systems that don’t serve us into those that will.


Tammy Rojas is a coordinator with Put People First! PA, a board member of the National Union of the Homeless, and a member of the Poor People’s Campaign.