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US healthcare: how losing your job can kill you in the world’s richest country

BMJ 2015; 350 doi: (Published 20 March 2015) Cite this as: BMJ 2015;350:h1517
  1. Jennifer Corbelli, assistant professor of medicine, general internal medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
  1. corbellija{at}

Healthcare should be a right, not a privilege, says Jennifer Corbelli, telling the story of a US woman born with HIV who died an untimely death after she could no longer afford antiretroviral treatment

“It’ll be fair before you die.” Of the many lessons I’ve learned from my oldest mentor, this is one of my favorites. It has endless applications, whether you’re dealing with a 4 year old or a 40 year old. Your brother ate the last cookie? Fair before you die. You’re working two Christmases in a row? Fair before you die.

This little adage never lets me down when confronted with someone’s off-base self pity. Or when, not uncommonly, I need to give myself a reminder to quit whining. I wish I could say the same when confronted with the harsh realities that so many patients face; once I walk into a patient’s room, it lets me down all the time.

In Melody’s case, it wasn’t fair even before she was born. She and her twin sister were born with HIV. Her mom and dad had HIV. Her older brother had …

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