Speaking to someone who has plenty, the speaker lays out what separates "you" from "we." You can pay for a hospital visit, make phone calls, throw out leftover food, and buy proper clothes. "We" can't, and the poem shows what that costs. Pain has no treatment, so the speaker describes slamming their heads against walls to cope with headaches. Winter nights mean a street fire instead of a warm sweater.
The repeated "you can afford" gives the poem a steady, accusing rhythm, like a list of grievances read aloud. The speaker doesn't shout, but the anger is clear. What stings most is the contrast: the wasted food and spare comforts on one side, the raw survival on the other. The mood is bitter and bleak, though also quietly dignified. The speaker isn't begging for pity. They are pointing out how ordinary things for one person are out of reach for another, and asking the listener to notice it.