ABOUT THE SPEAKER
Lucy Marcil - Pediatrician, social entrepreneur
Lucy 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.

More profile about the speaker
Lucy Marcil | Speaker | TED.com
TED2018

Lucy Marcil: Why doctors are offering free tax prep in their waiting rooms

Filmed:
1,358,090 views

More than 90 percent of children in the US see a doctor at least once a year, which means countless hours spent in waiting rooms for parents. What if those hours could be used for something productive -- like saving money? Through her organization StreetCred, pediatrician and TED Fellow Lucy Marcil is offering free tax prep to parents right in the waiting room, reimagining what a doctor's visit can look like and helping to lift families out of poverty. Learn more about how free tax prep and guidance could be the best poverty prescription we have in the US.
- Pediatrician, social entrepreneur
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.

00:12
How many of you have had
your doctor ask you about sex?
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Your mental health?
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Alcohol use?
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These questions are almost universal.
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But how many of you have had
your doctor ask you about money?
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Most of us haven't.
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But that is strange, because
compared to most high-income countries,
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child poverty is an epidemic
in the United States.
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It creates conditions that may elevate
stress hormone levels
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and impair brain development.
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Poor children in the US are one and a half
times more likely to die
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and twice as likely to be hospitalized
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as their middle-class counterparts.
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So my colleague Dr. Michael Hole
and I started asking moms about money.
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We knew we needed to reimagine
what a doctor's visit looks like,
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to get kids out of poverty
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and to give them a fair shot
at a healthy life.
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Our questions led
to a surprising solution:
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tax credits.
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It turns out, the earned income
tax credit, or EITC,
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is the best poverty prescription
we have in the US.
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The average mom gets two to three
thousand dollars a year from it.
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When families get it,
moms and babies are healthier:
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fewer depressed moms,
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babies weighing more at birth.
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But one out of five families
who could get it doesn't,
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and most who do
lose of hundreds of dollars
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to the for-profit
tax-preparation industry.
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One day, a mom asked us
why we couldn't do her taxes
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while she waited for the doctor.
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(Laughter)
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We all know that purgatory.
Why not make good use of that time?
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So we started StreetCred,
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an organization prescribing
tax preparation in clinics serving kids.
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This is a brand-new approach
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and one that left some
questioning our sanity.
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After all, we're doctors, not accountants.
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But we have something accountants don't:
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access to families.
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Over 90 percent of kids in the US
see a doctor at least once a year.
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Their parents trust us
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and will do anything
to give them a better life.
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Doctors in every clinic around the country
could be doing this work, too --
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it's simple, really.
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The hospital registers
as a tax-preparation site,
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and everyone, from medical
students to retirees,
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can volunteer as a tax preparer
after passing an IRS exam.
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It's not as hard as it sounds, I promise.
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I certainly never thought
I would be doing other people's taxes,
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but here I am.
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We're nearing the end of our third year.
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In the first two, we returned
1.6 million dollars
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to 750 families in Boston alone.
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This year --
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(Applause)
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This year, we've expanded
to nine sites in four states.
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Sixty-three percent of our families
have never heard of the EITC.
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How can you claim something
you haven't heard of?
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And half have never used
free tax preparation.
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That two to three thousand dollars a year
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goes a long way.
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Take hunger.
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An adequately nutritious, low-cost diet
for a mom and two young kids
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costs 477 dollars a month.
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With EITC money, that family
can eat for five to six months.
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Or think about medical care.
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Twenty million children in the US
lack access to care
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meeting modern pediatric standards.
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And yet, the average cost of that care
is only 400 dollars per kid per year.
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EITC money can help fix
this access problem.
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Perhaps most powerfully of all,
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this money gives moms hope.
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One mom used her refund
for her son to study abroad in Spain.
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She was struggling to pay her rent,
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but she saw EITC money
as his shot at a better future.
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We have an opportunity,
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as doctors and as citizens,
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to get to the root of this problem.
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We can reimagine health care
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as a place addressing
the causes of poor health,
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be it infections
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or finances.
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Thank you.
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(Applause)
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ABOUT THE SPEAKER
Lucy Marcil - Pediatrician, social entrepreneur
Lucy 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.

More profile about the speaker
Lucy Marcil | Speaker | TED.com