Thursday, September 16, 2010

"Health Care Crisis" vs. "Culture Crisis"

At least three seperate people on my Facebook feed have shared this link. I've copied the text below, followed by my response, because after seeing it so many times, I decided that my common practice of holding my tongue when I see something I disagree with on Facebook won't work this time around.

Dear Mr. President:
During my shift in the Emergency Room last night, I had the pleasure of evaluating a patient whose smile revealed an expensive shiny gold tooth, whose body was adorned with a wide assortment of elaborate and costly tattoos, who wore a very expensive brand of tennis shoes and who chatted on a new cellular telephone equipped with a popular R&B ringtone.


While glancing over her patient chart, I happened to notice that her payer status was listed as "Medicaid"! During my examination of her, the patient informed me that she smokes more than one pack of cigarettes every day, eats only at fast-food take-outs, and somehow still has money to buy pretzels and beer. And, you and our Congress expect me to pay for this woman's health care? I contend that our nation's "health care crisis" is not the result of a shortage of quality hospitals, doctors or nurses. Rather, it is the result of a "crisis of culture" a culture in which it is perfectly acceptable to spend money on luxuries and vices while refusing to take care of one's self or, heaven forbid, purchase health insurance. It is a culture based in the irresponsible credo that "I can do whatever I want to because someone else will always take care of me". Once you fix this "culture crisis" that rewards irresponsibility and dependency, you'll be amazed at how quickly our nation's health care difficulties will disappear.

Respectfully,
ROGER STARNER JONES, MD
If you agree...pass it on.




Why assume that the tattoos and gold tooth are recent acquisitions? Perhaps they were acquired during a period of employment, or at least better financial circumstances.

We don't know how the cell phone was acquired or paid for. Maybe it's prepaid, or paid for by a family member. And in this day and age, a cell phone is frequently considered one of life's necessities. Maybe the sneakers were a gift, or purchased on clearance.

Cigarette smoking is frequently an addiction. An expensive one, yes, but the tools to quit smoking aren't exactly cheap either. Not everyone can go cold-turkey without significant physical and emotional symptoms.

Fast food, while it might seem expensive to us, is frequently cheaper than purchasing healthy food to cook at home. This is one of the reasons that people in poverty are hardest hit by the obesity epidemic- fattening, unhealthy food is cheaper than fresh fruits and vegetables, if any fresh produce is to be found at the grocery stores in poorer neighborhoods at all.

I'm not saying that the woman in this story is a shining example of personal responsibility, but there are plenty of people (myself included) who have been productive members of society and still lacked health insurance. I'm generally considered intelligent and well-educated by most of the standards our culture uses, and I get confused when trying to understand insurance. It is easy to buy a six-pack of beer. Let us not forget that any number of private insurance companies will turn down a person for a pre-existing condition, of which this woman may have several.

Lastly, while I certainly advocate responsibility and taking austerity measures when necessary, why do so many letters like this assume that the poor don't deserve anything nice? Why do we expect people to know how to take financial responsibility when we live in a culture of conspicuous consumption and don't teach young people how to manage money?

Where's the letter of outrage about the man who makes $100,000/year, drinks to excess, smokes, and eats red meat, and who drives up insurance premiums for everyone when he needs quadruple bypass surgery? Do only the wealthy deserve health care? Are only the rich entitled to pleasure?

I believe that government exists to provide essential services to its citizens, and to provide a safety net. I am grateful these programs exist, so that if I ever need them, they'll be there. I don't mind seeing my tax dollars go to social programs. That's what they're for, and it saves me the trouble of having to write a seperate check to charity to cover these services.

There are many things wrong with our culture, yes. One is the failure of many people to take personal responsibility. But another is a pervasive "me first, screw the other guy" attitude. No man is an island, and a fall from grace might be just around the corner for any of us. Treating others with the compassion you would want if the situation were reversed is the first step in creating a better world.