No one relishes forking over a co-pay when visiting a doctor. Most of us realize it’s just the cost of doing business in a country where health care is, well, a business.

But if you’re poor or without a home, that co-pay is more than a nuisance. It can be a barrier, one of many that stand in the way of keeping your body — and the bodies of your loved ones — running smoothly.

“If you think your child might have an ear infection, you may have to choose: getting it checked out versus, ‘I don’t have that $20 co-pay so I’m just going to stay home,’ ” said physician Randi Abramson, chief medical officer at D.C. charity Bread for the City.

Said Abramson: “What happens is, if your top priority is having a place to sleep that feels safe and having food in your stomach — and making sure your family is safe — your health can become a much lower priority.”

Bread for the City removes that barrier. Its medical clinics — one in Northwest, one in Southeast — serve anyone, regardless of their ability to pay.

“If they come in here, they don’t have to worry about a bill or getting charged,” said Abramson. “If they need to come in for any reason, they know they can call or walk in.”

The clinics at Bread for the City serve all ages, from babies to the elderly. And they operate under what Abramson calls the medical home model. In addition to a primary care clinic, there are dental and vision clinics, as well as a behavioral health clinic.

The idea is to treat the entire person.

After all, said Abramson, we’re one package. When the disparate parts of that complex package are working together, the entire body experiences a beneficial ripple effect. (Good dental health leads to better cardiovascular health, for example.)

“When it’s not working, that has the opposite effect,” Abramson said.

Bread for the City’s clinics serve about 3,000 patients each year. On any given day, about 25 percent of patients do not have health insurance. They may qualify, Abramson said, but are trapped in a paperwork snafu, their coverage pending.

Illness does not wait for paperwork. Patients still need care. They still need medicine. They still need lab work.

Bread for the City maintains a fund just for such patients. “We are going to see you, even if you don’t have the funds,” Abramson said.

Abramson and her colleagues understand that many of their patients have precarious living situations, unforgiving work arrangements, punishing commutes, any of which can make getting to the doctor on time difficult.

“You had to take three buses to get here? I know what the buses are like right now,” she said. “I’m not going to turn you away because there’s a rule that after 15 minutes we’re going to cancel the appointment.”

The health clinic is just one part of Bread for the City, a partner in The Washington Post Helping Hand. The nonprofit provides groceries to families in need. It maintains a clothing room. It offers legal services. All of those things contribute to the overall health of its clients — and of the community.

“When we talk about health care, we’re being really broad,” said Abramson.

Health care includes making sure people are housed safely, that they have nutritious food, that they have the resources to resolve any conflicts that they may face.

“People who are low-income haven’t been given the power they need and the resources they need,” Abramson said. “We want to give people that power — and those tools and resources — so they feel healthy and have an improved quality of life.”

You can do your part by donating to Bread for the City through The Washington Post Helping Hand. Simply visit the website To donate a check by mail, send it to Bread for the City, Attn: Development, 1525 Seventh St. NW, Washington, DC 20001.

A generous gift

And I have some wonderful news: The Robert I. Schattner Foundation has pledged a $150,000 grant to our beneficiary charities, extending a challenge to Washington Post readers and other area organizations to match it — and beyond.

Who was Robert I. Schattner? Well, I think he was someone who might have enjoyed today’s health-care-related column. Schattner was a dentist who, early in his career, was eager to find a compound that would ease the pain after a tooth extraction. He invented something that did even more: Chloraseptic, the sore-throat medication.

He didn’t stop there. Schattner invented other chemical agents, including Sporicidin. He died in 2017 at 91. His foundation supports social service organizations such as our Helping Hand partners.

Thank you to the Robert I. Schattner Foundation. I hope its generous gift will inspire others to give to The Washington Post Helping Hand.

Twitter: @johnkelly

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