Blog posts

Money Can be Exchanged for Goods and Services

By Dr. Nilesh Kalyanaraman

There’s a brilliant scene in The Simpsons that lodged itself in my head the first time I saw it almost twenty years ago. Homer is reaching under the couch for a fallen peanut and finds a twenty-dollar bill instead. This conversation with his brain ensues:


Homer: “Twenty dollars? I wanted a peanut!”

Brain: “Twenty dollars can buy many peanuts.”

Homer: “Explain how?”

Brain: “Money can be exchanged for goods and services.”

Homer: “Woohoo!”


Right now I’m in Baltimore, missing out on the DFA Patients Over Politics Tour that has made it to Charlotte, NC. Travelling from the Republican National Convention in Tampa to the Democratic National Convention, the DFA folks have made their message clear: focus on the people. In this high season of politics we are hearing a lot about the rising cost of medical care and how we can control cost. Politics and money matter not as abstractions but rather in how they affect people’s lives.


Last week I saw a man with a new diagnosis of asthma who was coming in to get an inhaler. We talked about his symptoms and how to control them but of greater concern to me was figuring out why a man in his mid 40’s had just developed asthma. Late onset asthma can be a sign of a serious underlying disease and so I ordered a number of tests to evaluate for life threatening conditions. His insurance only covered primary care services so I struggled to find a way to get him all the tests he needed. Eventually, I was able to get donated services from a local hospital and though his appointments are not for another month or two, he will get the tests.


Insurance that only covers primary care leaves its patients vulnerable to illnesses that require specialized testing and care. Such a plan gets created when the primary goal is to keep costs down rather than provide comprehensive health care. Seeing money as an object to be saved rather than as a tool to obtain needed services has led to thousands of people around the country every day facing life threatening conditions and dependent on the unpredictable good will of others.


This is no way to treat our neighbors, friends and loved ones. We have the money as a society to care for one another, to make sure that each of us can get the health care we need when we need it. In 2014 this man and millions like him will get Medicaid or private insurance on a health exchange because of the Affordable Care Act and that money will be well spent. Of course, we need to be wise with our money and minimize our cost to achieve our goals and this is exactly what the ACA attempts to do.


The ACA got the order right, it first asked the question, “How can we ensure that everyone has quality health care?” and only then did it attempt to answer the question of how we would pay for it. This is DFA’s message, that as we focus on politics, the debt, and soaring costs that we not forget what is most important to us, the health and well-being of our loved ones. Homer had it right, money is just a tool, it’s what you do with it that counts.

Share Your Comments


  1. Let us know what you think!

Your Comment


Join Doctors For America


or skip signup