This TED Talk features health care champion Mitchell Katz, recorded live at TEDMed 2018.

A few years ago, I was taking care of a woman who was a victim of violence. I wanted her to be seen in a clinic that specialized in trauma survivors.

I made the appointment myself

because being the director of the department,

I knew if I did it, she would get an appointment right away.

The clinic was about an hour and a half away from where she lived,

but she took down the address and agreed to go.

Unfortunately, she didn't make it to the clinic.

When I spoke to the psychiatrist, he explained to me that trauma survivors are often

resistant to dealing with the difficult issues that they face and often miss appointments.

For this reason, they don't generally allow the doctors to make appointments for the patients.

They had made a special exception for me.

When I spoke to my patient, she had a much simpler and less Freudian explanation of why she

didn't go to that appointment. Her ride didn't show. Now, some of you may be thinking, didn't she

have some other way of getting to that clinic appointment? Couldn't she have taken an Uber or called another friend?

If you're thinking that, it's probably because you have resources.

But she didn't have enough money for an Uber.

She didn't have another friend to call.

But she did have me, and I was able to get her another appointment,

which she kept without difficulty. She wasn't resistant, it's just her ride didn't show.

I wish I could say that this was an isolated incident, but I know from running the safety net systems in San Francisco,

Los Angeles, and now New York City, that health care is built on a middle-class model

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