“Our country’s health care safety net is built on the principles of poverty medicine. The deeply entrenched American notion of charity care as the way to provide safety net services engenders stigma, shame, dependency, and resentment among recipients. People do not want to have to depend on handouts, on the kindness of strangers. Charity care further fragments an already-fragmented, disorganized health care system” (Ensign, 2016, p. 194-195).