Juliana, whose parents are immigrants from the Dominican Republic, was the first person in her family to go to college. Her parents, who recently retired after years of work as domestic servants, like to tell their friends that the family is wealthy now that their daughter has graduated from medical school. Why is their boast about their family wealth not quite accurate? They forget that most wealth is passed down through family generations and that having a high income is not the same thing as having wealth. They naively place their faith in a woman as a breadwinner. They ignore the power of government programs in helping families get out of poverty. They forget that doctors’ incomes will decline because of the Affordable Care Act.