TED2018
Lucy Marcil: Why doctors are offering free tax prep in their waiting rooms
露西 · 玛西亚: 为什么医生在候诊室提供免费报税服务
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超过90%的美国儿童每年至少看一次医生，这意味着病人需要在候诊室等待几个小时。如果用这些时间来做点有产出的事情——比如省钱，会如何？通过她建立的组织StreetCred，TED成员露西 · 玛西亚为候诊室的病人提供免费报税服务。重新想象一下能够帮助家庭摆脱贫困的就诊体验会是什么样。观看这个演讲，来进一步了解免费报税服务和指导如何帮助减轻美国的贫困现状。
Lucy Marcil - Pediatrician, social entrepreneur
Lucy Marcil is providing fiscal services to low-income families in the doctor’s waiting room. Full bio
Lucy Marcil is providing fiscal services to low-income families in the doctor’s waiting room. Full bio
Double-click the English transcript below to play the video.
你们当中多少人被医生问过性生活问题？
00:12
How many of you have had
your doctor ask you about sex?
your doctor ask you about sex?
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00:16
Your mental health?
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心理健康问题？
00:18
Alcohol use?
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饮酒问题？
00:19
These questions are almost universal.
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这些问题大都很常见。
00:22
But how many of you have had
your doctor ask you about money?
your doctor ask you about money?
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但有多少人被医生问过关于金钱的问题？
00:27
Most of us haven't.
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大多数人是没有的。
00:29
But that is strange, because
compared to most high-income countries,
compared to most high-income countries,
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这挺奇怪的，因为和
大多数高收入国家比起来，
大多数高收入国家比起来，
00:33
child poverty is an epidemic
in the United States.
in the United States.
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美国儿童贫困现象却很常见。
00:38
It creates conditions that may elevate
stress hormone levels
stress hormone levels
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这导致儿童应激激素水平升高，
00:42
and impair brain development.
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从而阻碍大脑发育。
00:44
Poor children in the US are one and a half
times more likely to die
times more likely to die
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和美国中等收入家庭的孩子比起来，
美国贫困儿童死亡的
美国贫困儿童死亡的
00:50
and twice as likely to be hospitalized
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可能性要高出1.5倍，
生病住院的可能性也高出两倍。
00:53
as their middle-class counterparts.
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00:55
So my colleague Dr. Michael Hole
and I started asking moms about money.
and I started asking moms about money.
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因此，我和我的同事麦克霍尔医生
开始询问起母亲们的经济状况。
开始询问起母亲们的经济状况。
01:03
We knew we needed to reimagine
what a doctor's visit looks like,
what a doctor's visit looks like,
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我们知道，我们需要重塑就医体验，
01:07
to get kids out of poverty
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帮助儿童摆脱贫困，
01:08
and to give them a fair shot
at a healthy life.
at a healthy life.
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给他们一个平等的机会，过上健康的生活。
01:13
Our questions led
to a surprising solution:
to a surprising solution:
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我们的询问最终得出了一个
令人吃惊的解决方案：
令人吃惊的解决方案：
01:16
tax credits.
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税收抵免。
01:17
It turns out, the earned income
tax credit, or EITC,
tax credit, or EITC,
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结果发现，所得税抵免，即EITC，
01:22
is the best poverty prescription
we have in the US.
we have in the US.
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是美国当下最好的缓解贫困的药方。
01:26
The average mom gets two to three
thousand dollars a year from it.
thousand dollars a year from it.
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每年每位母亲可从中获得两到三千美元。
01:31
When families get it,
moms and babies are healthier:
moms and babies are healthier:
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有了这笔钱后，母亲和她们的
孩子就会变得更健康：
孩子就会变得更健康：
01:34
fewer depressed moms,
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更少的母亲会患上抑郁症，
01:36
babies weighing more at birth.
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更多的婴儿在出生时体重更高。
01:38
But one out of five families
who could get it doesn't,
who could get it doesn't,
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但有1/5本可以得到这笔钱的
家庭却并没有得到，
家庭却并没有得到，
01:43
and most who do
lose of hundreds of dollars
lose of hundreds of dollars
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还有大多数家庭会多花费几百美元
01:46
to the for-profit
tax-preparation industry.
tax-preparation industry.
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给那些收费的报税公司。
01:51
One day, a mom asked us
why we couldn't do her taxes
why we couldn't do her taxes
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有一天，一位母亲问我们为什么不能
01:55
while she waited for the doctor.
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在她候诊时帮她报税。
01:56
(Laughter)
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（笑声）
我们都知道那段时间很难熬，
那么为什么不利用一下那段时间呢？
那么为什么不利用一下那段时间呢？
01:57
We all know that purgatory.
Why not make good use of that time?
Why not make good use of that time?
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02:02
So we started StreetCred,
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于是我们成立了StreetCred，
02:04
an organization prescribing
tax preparation in clinics serving kids.
tax preparation in clinics serving kids.
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一个在儿童诊所提供报税服务的组织。
02:09
This is a brand-new approach
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这是一种全新的方式，
02:11
and one that left some
questioning our sanity.
questioning our sanity.
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有很多人怀疑我们是不是疯了。
02:15
After all, we're doctors, not accountants.
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毕竟，我们是医生，不是会计。
02:17
But we have something accountants don't:
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但是我们有会计没有的东西：
02:21
access to families.
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与家庭的沟通。
02:24
Over 90 percent of kids in the US
see a doctor at least once a year.
see a doctor at least once a year.
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在美国，有超过90%的
儿童每年至少看一次医生。
儿童每年至少看一次医生。
02:29
Their parents trust us
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他们的父母相信我们，
02:31
and will do anything
to give them a better life.
to give them a better life.
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为了获得更好的生活，
他们愿意付出所有。
他们愿意付出所有。
02:36
Doctors in every clinic around the country
could be doing this work, too --
could be doing this work, too --
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全国各地诊所的医生们也可以这样做，
这真的很简单。
02:40
it's simple, really.
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02:42
The hospital registers
as a tax-preparation site,
as a tax-preparation site,
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医院先注册成为提供税务服务的地点，
02:44
and everyone, from medical
students to retirees,
students to retirees,
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并且每个人，不管是
医学专业的学生，还是已经退休的人，
医学专业的学生，还是已经退休的人，
02:48
can volunteer as a tax preparer
after passing an IRS exam.
after passing an IRS exam.
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都可以在通过国税局考试后，
作为志愿者从事报税活动。
作为志愿者从事报税活动。
02:53
It's not as hard as it sounds, I promise.
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实际上没有听起来那么难，我保证。
02:56
I certainly never thought
I would be doing other people's taxes,
I would be doing other people's taxes,
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我之前从来没想过我会帮别人报税，
但我现在在做了。
02:59
but here I am.
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03:01
We're nearing the end of our third year.
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我们做这件事马上就满三年了。
03:05
In the first two, we returned
1.6 million dollars
1.6 million dollars
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在前两年里，我们光在波士顿
03:09
to 750 families in Boston alone.
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就帮助750个家庭获得了160万美元退税。
03:12
This year --
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今年——
03:14
(Applause)
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（掌声）
03:19
This year, we've expanded
to nine sites in four states.
to nine sites in four states.
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今年，我们的服务
将扩展至4个州的9个网点。
将扩展至4个州的9个网点。
03:23
Sixty-three percent of our families
have never heard of the EITC.
have never heard of the EITC.
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我们接触的家庭中有63%
都没有听说过所得税抵免。
都没有听说过所得税抵免。
03:28
How can you claim something
you haven't heard of?
you haven't heard of?
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如果听都没听过，
你怎么可能去行使权利呢？
你怎么可能去行使权利呢？
03:32
And half have never used
free tax preparation.
free tax preparation.
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一半的家庭从没享受过免费报税服务。
03:35
That two to three thousand dollars a year
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每年2,000到3,000美元的数目
03:38
goes a long way.
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能提供很大的帮助。
03:40
Take hunger.
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拿饥饿举个例子。
03:41
An adequately nutritious, low-cost diet
for a mom and two young kids
for a mom and two young kids
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一份够一位母亲，两个孩子吃的，
营养丰富价格便宜的饭菜，
营养丰富价格便宜的饭菜，
03:46
costs 477 dollars a month.
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一个月要花费477美元。
03:50
With EITC money, that family
can eat for five to six months.
can eat for five to six months.
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而通过所得税抵免获得的钱，
能支撑每个家庭5到6个月的食品开销。
能支撑每个家庭5到6个月的食品开销。
03:54
Or think about medical care.
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再拿医疗服务举个例子。
03:56
Twenty million children in the US
lack access to care
lack access to care
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美国有2,000万儿童没有接受过
04:00
meeting modern pediatric standards.
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现代儿科标准医疗服务。
04:04
And yet, the average cost of that care
is only 400 dollars per kid per year.
is only 400 dollars per kid per year.
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然而，这样的服务每年每个孩子
平均只要花费400美元。
平均只要花费400美元。
04:11
EITC money can help fix
this access problem.
this access problem.
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所得税抵免能帮助解决这些问题。
04:15
Perhaps most powerfully of all,
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可能最重要的是，
04:17
this money gives moms hope.
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这笔钱能给母亲们带来希望。
04:20
One mom used her refund
for her son to study abroad in Spain.
for her son to study abroad in Spain.
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一位母亲用这笔钱来
让她的儿子去西班牙留学。
让她的儿子去西班牙留学。
04:25
She was struggling to pay her rent,
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她付房租都有困难，
04:27
but she saw EITC money
as his shot at a better future.
as his shot at a better future.
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但她将所得税抵免看作是能
给儿子带来光明未来的机会。
给儿子带来光明未来的机会。
04:32
We have an opportunity,
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作为医生，作为公民，
04:33
as doctors and as citizens,
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我们有机会
04:36
to get to the root of this problem.
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去找到问题的根源。
04:38
We can reimagine health care
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我们可以将医疗服务
04:40
as a place addressing
the causes of poor health,
the causes of poor health,
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重塑为一个根治健康问题的地方，
04:44
be it infections
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不管其背后的原因是感染，
04:45
or finances.
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还是经济问题。
04:47
Thank you.
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谢谢。
04:48
(Applause)
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（掌声）
Translated by jacks peng
ABOUT THE SPEAKER
Lucy Marcil - Pediatrician, social entrepreneurLucy Marcil is providing fiscal services to low-income families in the doctor’s waiting room.
Why you should listen
Lucy Marcil, MD MPH, creates innovative solutions buffering kids from the adversity they face growing up with economic stress and poverty. As a pediatrician, she cares for children at Boston Medical Center. She co-founded StreetCred, a nonprofit addressing the health impact of financial stress by providing fiscal services to low-income families in the the doctor’s waiting room. StreetCred increases access to critical anti-poverty tax credits such as the Earned Income Tax Credit by integrating tax preparation services into pediatric clinics; it has returned over $3.2 million to 1700 clients at 9 sites in 4 states since its inception in 2016. StreetCred is now bundling tax services with enrollment in other economic mobility services to create greater financial stability.
Internationally, Dr. Marcil has undertaken pediatric health-systems strengthening. As a HIV/AIDS & Community Health Peace Corps volunteer in Namibia, she leveraged public-private partnerships to create a comprehensive orphan care program and girls’ leadership camps. In Bangladesh, she identified community engagement methods to build maternal-child healthcare systems in urban slums. In Kenya, she consulted for Jacaranda Health to transform newborn care systems.
For her work, Dr. Marcil has been recognized with the American Academy of Pediatrics Anne E. Dyson Child Advocacy Award and the Jack Kent Cooke Foundation Quinn Prize, and has been named a Café 100, Davidson College Game Changer and 2018 TED Fellow.
Lucy Marcil | Speaker | TED.com