Growing up, my family was destitute. If not for food stamps, we would have had little food — even so, there were times when our refrigerator was empty.

If not for Medicaid, we would not have had healthcare. We often lacked the money for basic necessities such as electricity and phone service. My family would have been homeless if not for the charity of my grandmother. Our vehicles were given to us by charity organizations.

I had one doll, not 30. Her name was Ashley and my mother made her by hand because we could not afford a Cabbage Patch Doll for Christmas.

I went to early college for free at the local community college in high school, a program partially paid for by grants from the U.S. Department of Education. I used Pell Grants to pay for my first two years of community college. I spent my last two years of undergraduate at North Carolina State University, working two jobs and racking up student debt, with interest subsidized by the U.S. Treasury.

From NCSU’s undergraduate program, I was accepted to three veterinary programs. I chose NCSU partially because it was half the cost of the other programs because I was a resident of that state. Still, I accumulated over $100,000 in student loans, though I was working three jobs.

I have put my education to excellent use to benefit the Southern Tier of New York. I opened a veterinary practice to provide care for pets in urgent need, who either don’t have or can’t access their family vets. For tens of thousands of people, I am often the only person available to help when their pets need it most. I have repaid every dollar of my student loans. I have paid far more in taxes than I received in subsidies.

I am the embodiment of the American Dream.

Our government is moving in the wrong direction. In U.S. Rep. Nick Langworthy and President Donald Trump’s America, the programs that enabled me to become the productive citizen that I am today would be obliterated. Medicaid — slashed. SNAP — slashed. Pell Grants — slashed. Department of Education — slashed. Without these programs I would probably be stuck in a cycle of poverty, still using the services that kept me alive as a child.

Among many other brutal cuts, Mr. Langworthy’s Medicaid plans would force constituents making as little as $1,305 a month to pay $35 per doctor visit. My own childhood showed me the cruel calculations these families must make — bounce a check or overdraw your account to take your child to the doctor or watch them suffer and hope they get over it. Do you put gas in your car or pay part of your electric bill or do you buy medicine?

Thirty-five dollars has a lot of uses when it’s all you have. Yet, somehow, it makes sense to Nick Langworthy to save money $35 at a time taken from the poorest of his constituents, in service of tax cuts to millionaires.

Every congressperson represents many more people who fall below the poverty line than billionaires. And yet, who are they fighting for? They spend their time allowing our president to receive billions in bribes while voting for budgets that take money from the desperately poor and give it to the filthy rich.

But every citizen in this country, poor or rich, gets exactly one vote. That is fair. The Republicans’ budget is not. They say “we have to make hard choices.” Apparently, the choice between justice for all or privilege for some is too hard for them.

That makes our choice at the ballot box a simple one.

(Dr. Katie Gies owns and operates Enchanted Mountains Urgent Veterinary Care on West State Street in Olean.)