It's nearing lunchtime and the few people left on the hard chairs in the clinic waiting room are glancing at the television hanging high on the wall. In his examination room, Dr Jamal Gwathney has seen a two-month-old baby, a young woman with a heart pacemaker and chemical burns brought in after a fight with the police, and patients with asthma and diabetes.
But in clinics such as this, just across the Anacostia river from the great white dome of the Capitol, many of the ailments have an underlying cause: none of these people have access to adequate medical care.
"Their healthcare sometimes just takes a back seat to putting food on the table and a roof over their heads," says Dr Gwathney. "They don't come in until their health gets to a critical mass - until they have been having chest pain every day for two or three weeks, or until they start throwing up a little blood with that ulcer that they have and it gets them worried."
On the west side of the dome, in the K Street offices of the doctors profiled in local glossy magazines, medical practices are moving towards concierge-style care: for an annual fee topping $1,000 (£500), a trip to the doctor is akin to a visit to the spa, with appointments on demand, and even the most trivial ailments investigated by costly tests.
Between the two extremes is where America's healthcare system has unravelled. A patchwork of employer benefits and government assistance for the very poor and elderly has produced distinct differences. Those with very good jobs and generous benefits packages enjoy extensive, often almost wasteful, health cover. Meanwhile, tens of millions regularly put their health on hold because they cannot afford basic treatment, prescriptions, or even a visit to the doctor.
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