Conservative Doc Doesn’t Want to Pay for Your Health Care

WMartin: Interesting post. Putting aside for a moment the notion that this letter reeks of the “welfare queen” argument of the Reagan era—I think the problem is one of pragmatism vs. ideology—to whit, that doctor is ALREADY paying for that women’s healthcare through taxes and inflated costs at the hospital.

It’s really a red herring to say that the new healthcare plan would be “paying for her healthcare,” when, in fact, there’s relatively little in healthcare reform that’s about extending a program like Medicaid.

The bill in the Senate, the way I understand it, is really “health insurance reform” reforming practices in the insurance industry regarding selective coverage, denials, etc.

The system is broken; that’s why people are trying to fix it. But one item that’s really not in the mix is the possibility that we would *stop* paying for critical care for anyone. If someone is somehow defrauding Medicaid, then that should be reported and prosecuted, no?

I think it’s really sad that a doctor would write that letter and send it out publicly.

God forbid Doctors have opinions, huh?

Putting aside for a moment the notion that this letter reeks of the “welfare queen” argument of the Reagan era

I was thinking the exact same thing myself when the “doctor” (assuming there is a chance that this doctor and the letter isn’t real) described the patient the way he or she did.

Dr. Jones is a real physician.  Works at UMMC.

God forbid Doctors have opinions, huh?

They can have all the opinions they want. It’s just disappointing that a doctor—with all the education and standing the term connotes—would deem this particularly opinion appropriate to share with the world.

It’s really a red herring to say that the new healthcare plan would be “paying for her healthcare,” when, in fact, there’s relatively little in healthcare reform that’s about extending a program like Medicaid.

Hmmm… The AP disagrees.

Senate Democratic leaders struggled Monday to get President Barack Obama’s health care overhaul on track for passage by Christmas, faced with moderates’ opposition to expanding Medicare and internal party disputes over abortion and importing cheaper prescription drugs.
http://news.yahoo.com/s/ap/20091214/ap_on_bi_ge/us_health_care_overhaul -I added the bold emphasis.

But, whatever the program is being called it will still amount to the government, i.e. you and me, subsidizing healthcare coverage for people who could not otherwise purchase it privately. If we are going to pay should we not be able to demand certain behaviors by recipients to keep themselves healthy as possible so as to be as little burden on the system as possible?

WMartin: You’re confusing Medicaid and Medicare. A buy-in for Medicare is hardly the same thing as expanding Medicaid. And Medicare Part D is a ridiculously convoluted cash sink saddled on us by the Bush Administration that certain needs some refinement. I know the spelling is similar but they’re different programs.

But, whatever the program is being called it will still amount to the government, i.e. you and me, subsidizing healthcare coverage for people who could not otherwise purchase it privately. If we are going to pay should we not be able to demand certain behaviors by recipients to keep themselves healthy as possible so as to be as little burden on the system as possible?

One—healthcare is already subsidized in our taxes and premiums; by formalizing the process and working to eliminate inefficiencies, we might actually bring those costs down.

But, two—yes, I do think we should be able to demand a lack of fraud in the system and crack down on it where it appears.

I don’t think we should regulate behavior in that sense, and I’m certainly not sure that the good doctor—in arguing from the painfully specific (and suspicious) to the general—has anywhere in his letter the rather reasonable suggestion that we might subsidize the healthcare of those who can’t afford it while holding them accountable in terms of not gaming the system.

They can have all the opinions they want. It’s just disappointing that a doctor—with all the education and standing the term connotes—would deem this particularly opinion appropriate to share with the world.

Sorry you had to face some else’s opinion.  We all have them, and not all of them agree with the JFP.

Dear Dr. Jones:
I wonder just how many sacrifices you made to earn your FREE money to attend medical school. I wonder if the young man’s gold tooth was put in by a Doctor (dentist) who charged medicaid for the filing and grinding of a good tooth.

I wonder if the tennis shoes were bought from a store like Belks that moved out of Jackson to get away from blacks like the person described in your letter and whose owners will be able to send their kids to Medical School with dollars earned from the poor as described by you in your letter.

I also wonder if this had been a white person with medicare and you discovered that there was a drinking problem, would you have made a referral to one of your colleages who practice addiction medicine in Madison? Or, would you have referred him/her to the smoking cessation clinic there at UMC? 

Did it ever occur to you, Dr. Jones, that the phone with the distinct ringtone was purchased because that person does not own a home or the credit to set up a land-line.

This is one of the most insulting and blatant acts of racism I have ever read.  My final question to you,Dr. Jones is: could it be that your patient, described with so many negatives, could not have had the same opportunities in life as you?

It seems that you were so occupied with what the person was wearing, ringing, smoking,and drinking that you failed to give us a medical assessment.  I hope he wasn’t having a heart-attact or a ruptured appendix.

Just asking.

I am not sure that the doctor giving a description of the patient is racist. He did not say what race they are in any way. Maybe, since justjess assumes that they are african-american the racism falls on your shoulders. Also, who says that this doctor got any FREE money for medical school? I know many people that take out hundreds of thousands of dollars in loans and work very hard through medical school. Maybe before you judge you should take a look in the mirror and take a deep look inside yourself.

Sorry you had to face some else’s opinion.  We all have them, and not all of them agree with the JFP.

Iron: Clearly. Hence my *disagreement* with the guy. Isn’t that allowed under your rubric? It’s called discussion. Try it.

hokie bird, my challenge to you is to just simply ask Dr. Jones about the patient he is describing. He will not back down from letting you know that he was referring to blacks that he sees in the ER at UMC and he hates the idea of the President asking for coverage for this stereotypical group. Black, gold teeth, expensive sneekers, cell phones, cigarettes, and booze.  This is the “Welfare Queen” argument made by so many.

Think about what you said.  “Some folks borrow hundreds of thousands of dollars in loans and work hard ....”  The population of poor smart black kids can not borrow from banks, “hundreds of thousands of dollars.” 

My neice is Chief of Staff at a Jackson facility. I know the cost of medical school and I can tell you this.  Everyone in her class who could have become MDs did not because of cost.

JJess- what exactly was racist in the doctor’s description? Are you implying that he made the description up to play to the racist crowd? Are you suggesting that there aren’t people that fit that description?

What is terrifying is that an emergency-room doctor judges the people who come through the door to this extent, and even publicly, whether based on race or not (and it sure sounds race-based, but I can’t know for sure). Doctors are supposed to serve the sick without judgement; doctors cannot know someone’s personal circumstance. It is scary to think what this kind of attitude can do to the profession. (Or maybe already has?)

I would think most doctors would be horrified by this e-mail, regardless of what they think of health-care reform. You become a doctor to help people regardless of circumstance, right? Please say yes.

There are also some biblical passages that might help give this doctor some peace.

Also, should Dr. Jones study emergency-room care at UMC if he doesn’t expect to deal with people he disapproves of from time to time?

I wonder why their class has so little diversity.

Very sad. I’ll say it again: It’s remarkable that he wrote this letter. I feel sorry for him.

Absolutely. He should have praised the patient for her pack-of-marlboros-and -12er a-day habits. Jeesh.

Absolutely. He should have praised the patient for her pack-of-marlboros-and -12er a-day habits. Jeesh.

And, presumably, the “R&B ringtone” should have some affect on healthcare premiums, right?

I agree with Jusjess’ letter to the doctor.  I agree with itodd that it really is disappointing to even know that this doctor is judging patients that he has vowed to care for in such a fashion.  I think hospital administrators should be alerted to the fact that this letter even exists.  Surely they are more interested in saving lives and assisting with their patients health, than this doctor seems to portray.  Certainly doesn’t make me feel good about getting the care I need when/if I go into an emergency room and I am NOT on Medicaid.

He even had the audacity to sign his name to the letter and that, my friends, is the ultimate slap in the face. 

I too share in these concerns about how the black community spends our money on unnecessary items; placing priority on things that redirect us from what is really important.  I’m just as concerned about whether this young lady has the money to feed her children, if she has them; if she’s on welfare.  But this is a systematic problem not a problem with one individual.

If smoking is such a problem that it affects the entire nation all the way to paying for other people’s insurance; there is an easy remedy - and I’ve stated it before - make tobacco illegal.  Stop selling them for damn near less that what you pay for a gallon of gas.  Stop placing them on every street corner and then in between in poverty strickened neighborhoods.  I’ve heard all the arguments as to why this will never happen.  But it still makes no sense to me.  Everyone complains about smokers this and smokers that.  Well, hell, if they didn’t have the crap to smoke….they wouldn’t smoke, at least as much. 

This country isn’t trying to fix the problems that plaque us.  The country is simply set up to continue to keep poor people poor and rich people rich.  It all boils down to getting paid. 

This doctor has every right to have his opinion.  But I’m waiting to see a letter from him regarding the meth heads with no teeth who come into the ER.  Or the pill poppers who pass out and are rushed to the ER.  The fact that this letter doesn’t make any mention of these problems which are generally linked to caucasians, is the reason that some may consider that this doctor has a twinkle of racist blood lurking thru his body.

I pray he can save himself if he ever need emergency assistance.

Rex, you *have* to be smarter than that. Saying an emergency-room doctor shouldn’t publicly judge his patients is in no logical fashion equivalent to saying he should praise her or anyone else for bad habits. My doctor fusses at me all the time for working too much, eating food bad for my health, and so on. *That* is his job: to advise his patients without judgement and try to help me. Not to use me and my habits as an exhibit in a public judgement gallery. Not to mention making Mississippi look racist all over again by publishing it in the paper. Just Google it; glad all this great PR is coming out of our state.

(Come to think about it, my situation is a nice opposite to the one the good doctor described: My doctor is African American; I am the white bad girl abusing my health in this equation. And, no, he hasn’t written a letter to the editor about me to my knowledge.)

Yep, the R&B;ring tone takes the cake. Who is this guy? Jeesh.

Nice post, Queen. Right on.

Rex…if she’s listening to R&B;, she’s not smoking Malboros…..try newports/shorts.  If we gone do it, we do it all the way sweetie. LOL

The sad thing is that this is the kind of talk that defines how people think about our state. The rest of us—especially white people who don’t go with the program, so to speak—have to speak even louder to make sure the world knows our state has changed.

Speak!

You’re right Donna because coming from the black community we’re either simply complaining or we are pulling the “race card”.  Either way, we’re overlooked often times.

And Rex, no one is saying that he should have praised the young woman, but I don’t think he should have ran back to his office and created this letter and then send it out to the media either.  What he should have done is make sure this lady understands what she needs to do to live a more healthy lifestyle.  I mean is that not what doctors do?  I don’t even understand what side of your brain could have you defend this type of action.  Of course your response is to defend this doctor since it seems that race has entered the equation and you think everyone here is quick to pull the race card out.  But if you dare take a moment to think, just as a human being, what this letter is implicating, surely it wouldn’t be that strange to you to fathom that people of the same race and demographic as this young lady would find these words offensive, coming from one who is expected to offer her care.  This is his job.  He took an oath and I’m sure he applied to work in the ER where he will surely see mostly young African Americans coming thru there, just like this young lady.  He can’t have any negativity in his heart towards this young lady or anyone like her and continue to effectively do his job.  It’s impossible.  There is no way he can offer non-bias service to her or any other black woman or man with gold teeth and high priced tennis shoes. 

I am still trying to figure out how he knows a) that it was her cell phone; b)that the tennis shoes were high priced - maybe she got them from the dude that was just busted in memphis for selling counterfiet nikes….point being - he’s making judgements on this woman that a doctor should not make.  Simple.

No, Queen, you’re not playing the race card. The doctor played the race card in a letter to the editor about gold teeth and R&B;music. You and I and others are responding. There is a big difference. The apologists for this kind of garbage always try to blame those of us willing to call it out. But who cares what apologists for this kind of garbage thinks? They are this state’s past.

I agree.  But what I’m saying is that if a black person tries to speak out on this issue (or any one similar), the reaction to our response would be that we are playing the race card or complaining.  We hear it all the time - you know- “black folks need to move on”, “they need to let it go”, “everything isn’t about race”, etc…

I know, Queen. Agreed. What white people get is similar: WE are just liberals playing the race card, or trying to be black, or dwelling on the past, etc. Some people will even act like we’re traitors to our own race. (Whatever.)I don’t pretend all that’s as bad as being on your end of it, but it is frustrating in its own right and, sadly, keeps some people from speaking up.

Of course, 40 years ago, either you or I could have been killed for calling out racism in public, so I guess there’s been some progress. Still a ways to go, though. Letters like this prove it.

This all reminds me of the other race controversy involving a UMC doctor after Katrina. I wrote about it here.

You’re confusing Medicaid and Medicare.

Yep, I am. You’re right. It’s pretty damn confusing.

I also think you have got another good point. We are all going to subsidize the health care for the uninsured unless we stop providing “critical care”, as you stated. And that is simply not going to happen. So, why not try to make it as efficient and inexpensive as possible? I can’t really think of a reason that doesn’t sound like the smartest thing to do.

Iron: Clearly. Hence my *disagreement* with the guy. Isn’t that allowed under your rubric? It’s called discussion. Try it.

Ooh, Snark.  Just what I expect.

Seriously, you have a point and I do too.  I happen to think his letter is past stupid.  He’s entitled to speak his mind and publish his stupidity, however.  You know the CL’s drools every time it gets a letter like that.

Iron, you’re acting like a goofy troll. Leave off the juvenile chiding and discuss the issue and the letter. That’s what others are doing.

No one said he isn’t “entitled” to speak his mind. The problem is whether a doctor *should* say such things. It’s a moral issue.

And, yes, I know the CL loves this kind of drivel. It brings out the racists who give them their page views. Beautiful.

Not a great long-time strategy for survival, though. It used to be when I was out and about, people would bring up the Ledger to talk about the bad reporting. Now, I hear several times a week at event how disgusting their Web comments are, and complaints about why they don’t moderate them better. One of their editors talk about it recently at a Jackson 2000 forum, and how bad they are, but apparently has no power to do anything about it. There’s corporate journalism for you.

Looking at the doctor’s letter, I don’t think it’s possible to state unequivocally whether the patient was black. What is clear is that she was probably not on a medical career track.

What stands out most for me, however, is the doctor’s mean spirit. Why did he go into medicine? Based on this letter, one could surmise it was to make a big pile of money, and he’s now angry to think someone who “refuses” to take care of herself might get a little bit of it. Surely, there’s nothing in the letter that would point to any selfless reasons for practicing medicine, is there?

How can he possibly know why the patient has tattoos, a gold tooth (I’d be interested to know how he knows it is “new”) or is addicted to tobacco? His assumption is that she’s a social parasite, “refusing” to take care of herself or buy health insurance.

Should we assume from his letter that if you can afford your vices without any public assistance that they’re OK?

“Life is really not that hard,” he says, spoken like a person who has never been broke, hungry or alone in his privileged life.

What an ignorant, self-important, selfish human being. It’s just sad, really, that someone who chose a career that is about taking care of people appears to have no compassion whatsoever. I hope I never end up his patient.

Agreed, Ronni. Doctors see patients all the time who refuse to take care of themselves. And it’s not just people such as he described who can’t afford today’s health care; working people are getting bilked left and right by the system. You go to the emergency for spraining your wrist, and you get bills from doctors you don’t remember seeing.

He’s extremely naive to think that this is about just helping that woman, whatever race she is.

Bottom line, though:  He wrote a letter that screamed race-baiting. An educated doctor should have known he was doing that, and that it wouldn’t add anything but ugliness to the debate.

And, yes, life really is that hard for many people. It is remarkable that he is at University of Mississippi Medical Center with that kind of attitude. I expect more public compassion out of them.

Ladd and Co.

Hint: Dr Jones states on the UMC Emergemcy Room webpage (thanks for the link ladd), that he is a seventh generation Mississippian.

What most conversations about the self destructive foilbles of a certain minority of Black folks fail to include is that the systems, or lack of systems (such as quality education and economic opportunities), designed and propagated by the ruling class (white folks), creates and perpetuates the economic and spiritual poverty that the good doctor is so disgusted with.

The real kicker that is missing in the good doctors presentation and possibly his mis-education, is that Mississippi is the biggist “Welfare Queen” in the nation.  If it was not for the transfer payments MS receives from the Federal government the good doctor would probably not be a doctor.

If you want a good picture of MS without the Federal Welfare payments read “Good for What’s Buggin You” by J.C. Redd (founder of Redd Pest Control - bought out by Orkin in the 90’s)

http://www.angelfire.com/wi/Carver/norfield.html,
(this link is not directly on point, but it will give you a good starting point for your own researh into the life of the Redd family)
or listen to or read Jerry Clower’s comedy.

The good doctor is a 21st century overseer on the new MS plantation model.

Grow that poverty cotton, collect those Federal welfare poverty payments, give the poverty cotton slaves cut rate services (don’t vure em, just keep em alive, there’s gold in them thar diabetes, hypertension, kidney, etc diseases) at the plantation hospital store and keep the surplus to build my high doctor salary wealth.

Oh yes, and don’t forget to hate the source of your wealth.

This is a repugnant doctor for sure. The type usually can’t hold up to a light shinned on them either, as Justjess is suggesting. The doctor knows his constituents, though. Make a comment like this and Reagan, Bush 1, Bush 2 and the likes are awaken and ready to march.

I feel sorry for anyone in desperate enough need to have to seek his or her care. But of course he or she doesn’t care, otherwise he or she would have looked for and commented on medical symptoms rather than ones he or she considers cultural or stereotypical of certain kinds of people.

Unfortunately, even in paying situations, we black folks are too slow to discern or recognize that we’re supporting and enriching people who loathe, discount and despise us. We repeatedly make the type well off or rich as they intentionally and knowingly vote and create policies that harm us.

WMartin: Actually, after a little reading I just realized that I confused Medicare and Medicaid too…the House bill DOES significantly increase enrollment in Medicaid by increasing eligibility to certain folks who are at or below 150% of the poverty line. (I thought the “expansion discussion” was largely about Medicare for 55+, but looking back I realize I was wrong.) I apologize.

(BTW, it’s also not clear what expansion of Medicaid, if any, will make it in the Senate bill; current haggling is between 133% and 150%.)

In some ways, I think that’s disappointing, because Medicaid seems to vary widely in quality and enforcement from state-to-state, but I understand why they’re doing it, since Medicaid programs already exist in the states and I guess the CBO has scored that as less costly. Of course it also means more burden on states (eventually—it looks like the initial coverage has a high Federal match—90+% if I’m reading the bill right).

I also think you have got another good point. We are all going to subsidize the health care for the uninsured unless we stop providing “critical care”, as you stated. And that is simply not going to happen. So, why not try to make it as efficient and inexpensive as possible? I can’t really think of a reason that doesn’t sound like the smartest thing to do.

Well, that’s what the original HCR debate was supposed to be about. In my honest opinion I think the most efficient (and inexpensive) system would be single-payer for basic medical care, with a second tier for elective or “premium” care. But, since that approach is apparently considered the third-rail of American politics and completely unworkable, it looks like we’ll be getting a rather patchwork plan for the forseeable future.

It seems that part of the problem when it comes to *costs* is the “pay-per-service” approach instead of a “pay-for-results” approach, no doubt because the former is easier to quantify.

Of course, some of those cost cutting ideas are being addressed in the bill, and, the truth is, you’ve got to start somewhere.

I think one thing we’re losing with the likely demise of the public option is an opportunity to inject both efficiency and cost reduction into the system. I never thought the public option would be the *best* plan, but more like a mediocre insurance program for covering critical care and basic wellness (check-ups, etc.) along with, perhaps, other priorities that the public decides to fund like rehab programs, etc. Other plans would offer more complete coverage or better options and flexibility—and that’s why you’d buy up. It’d be competition.

...

But having said all that, does the doctor’s “observations” in his letter regarding a Medicaid recipient actually speak to either efficiency or inexpensiveness? It seems to me that the only way that would be true is if the person in question is defrauding Medicaid, in which case the doctor should report her.

Otherwise, we’re back to the behavior question—how do you regulate that? You can charge two different insurance premiums for smokers and non-smokers, and perhaps test for other illicit substances. But beyond that, do you charge red-meat lovers more than folks who stick to lean fish? Or heavier people? Or fad diet fanatics? Or drinkers? Or people addicted to candy? Or people who drink too much diet soda? Or people who don’t eat vegetables?

Those are all things—as Donna points out—that your doctor should be telling you to do more of less of based on your health and circumstances. But I don’t see how (or where it’d be appropriate) to actually legislate that behavior beyond some basics.

I’m reading a book now called American Congo about the struggle of black folks for freedom in the Delta, Mississippi and Arkansas mostly, but also parts of Louisiana, Tennessee and Missouri. My feelings are so severely hurt at times as I read this book that I have to put the book down. Those plantation owners and their buddies, friends, comrades, descendants and so on are evil and devilish to the core.

We may not be able to “unequivocally” state this young lady was black - and I don’t believe anyone here tried to state that “unequivocally”, but I’d put my money on the fact that she was any day.

You guys didn’t post the response to that letter to the editor that was also listed on Snopes.  The response was written and printed in the CL the following week.  It was penned by a co-worker of mine who is now getting hate mail from all over the country!  Way to go Jennifer!  (I’ll have to show her this thread as well. She can’t believe this is getting as much response as it actually is!!)

http://www.snopes.com/politics/soapbox/starner.asp

The response is at the bottom.  I couldn’t get it to copy and paste.  Anyway, people are hopping mad at HER for her response.  She got hatemail from as far away as Washington State!

Here you go, Lori G.

“Health Care Reform Is Not ‘Us vs. Them’”:

Clinton

WMartin, I am amazed that you seem to take the side of this doctor. And I wish you would have posted the response in the first place if you had seen it.

Good for Ms. Sigrest.

Well, I didn’t really read the whole snopes page I was just looking for confirmation that it was real. After I saw the “correctly attributed” heading I tried accessing the clarion ledger archives. The search function there doesn’t find either of these letters, curiously enough. I got the letter, originally, in an email.

Actually, I did take the Doctor’s side as far as not wanting to pay for that woman’s health care. Frankly, I don’t want to pay for anyone’s health care whether they are black, white or whatever color or if they are healthy or make the worst choices possible in their own lives. But itodd made a great point I thought, that it doesn’t matter what we would rather do, we are going to do it anyway. I don’t want someone turned away to die because they don’t have resources to pay for their care. So, it may not be the best system to have some kind of government plan, but I think some sort of single payer plan will be the best possible system that doesn’t turn people away simply for monetary reasons.

I think it’s easy to be swayed by an argument to the unfairness of the system that asks everyone to pay into a plan that covers those that buy expensive sneakers and whatever else instead of buying insurance. But Ms. Sigrest’s and itodd’s points are well taken that once you really start to look at what is happening it only makes sense to replace the broken system with a better one. Is the currently proposed plan better? I am still reading it between doing everything else I have to do. So I don’t know yet, I guess we are going to find out.

Personally, I like Taiwan’s system.

Unfortunately in America, either you help others with their health care or they die….you choose.  It’s distressing that this, America that is suppose to be the land that beats all other, priding itself on equality and unification (supposedly) and people can send hate mail to an individual who doesn’t support the hatred this doctor exudes.  I have never heard so many people say “I ain’t paying for this”; “It’s not my responsibility”.  Well you’re right until this bug starts sneaking into your house or your mother’s house or your brothers house.  It’s so easy to say what you will and won’t do until it actually hits home.  God forbid someone in your family had to go on Medicare/Medicaid….ever.

This is how I interpret the doctor’s points below:

- Individuals are responsible for their own actions (example: indulging in excessive drinking or smoking)

- It is unreasonable to expect others to be *required* to provide relief (or additional relief) for someone for their irresponsible actions or lifestyle (you engage in a certain activity or lifestyle then you are required to burden the consequences of your actions…not someone else)

Without reading anymore into this I would think that most people would agree with this basic premise, wouldn’t they? We apply this principle to everything else in our daily lives, don’t we?

- Individuals are responsible for their own actions (example: indulging in excessive drinking or smoking)

Yes, people are responsible for their own actions, although at times—particularly in cases of addictive substances like cigarettes and alcohol—a community effort to intervene on behalf of individuals is in the common interest.

Some people start drinking, smoking or doing drugs—or eating excessively or avoiding exercise—when they are young and less informed, and it can be in the public interest to help them overcome those addictions or health problems.

Historically (in this country) access to healthcare has been subsidized (at varying success rates) by the corporations that people work for. As those costs have increased and fewer corporations offer the sweeping benefits they once did, we’ve began to find ourselves faced with a crisis in the healthcare industry that invites reform.

(Having said all that, I think the real crime here—which the doctor points out—is the choice of musical ringtone. If you want a takeaway from his brilliant letter, THAT was a righteous statement clearly designed to further intelligent debate on the issue.)

- It is unreasonable to expect others to be *required* to provide relief (or additional relief) for someone for their irresponsible actions or lifestyle (you engage in a certain activity or lifestyle then you are required to burden the consequences of your actions…not someone else)

Within limits, yes. Those limits being the democratic process.

For instance, I believe it was *rank irresponsibility* for George Bush to take us into the Iraq War in the way that he did in 2003. So, within the limits of democracy, I could do things about it such as write about it in my newspaper, donate to or campaign for political rivals, etc.

What I wasn’t able to do is stop the Treasury from writing checks for that war.

As for healthcare, we seem to have a fundamental principle—which, to my thinking, is a civilized one—that we care for people who are sick, even if they can’t afford to pay for that care. If we want to amend that to “if they don’t smoke,” then we can, but it’ll take a consensus and democratic action, and then you may have to deal with the consequences of people lying in the street, suffering of their wounds or illnesses, or otherwise warehoused in jails or holding pens of some sort for the diseased and addicted.

So, given the current consensus, we care for folks, even if they eat too much or smoke or drink or do drugs. (In the latter case, we often also put people in prison, which is generally more expensive.)

The notion that we provide “additional relief” is not really the issue—I think the point here is that the system needs reform, and one element of that reform (since we’re not moving to a more logical single-payer system) is to come up with ways for everyone to have health insurance coverage of some sort. That way, we can better manage the costs—including the hidden costs of providing only critical care to a large proportion of our population.

Without reading anymore into this I would think that most people would agree with this basic premise, wouldn’t they? We apply this principle to everything else in our daily lives, don’t we?

In many cases we don’t.

Examples:

- The same logic argues *against* providing fire service to people who are irresponsible with their chimney or smoke in bed. But, we don’t do that—the fire department’s mission is to answer every call. Likewise, we send an ambulance or emergency vehicle to most 911 calls that warrant them without determining the caller’s ability to pay and regardless of the responsible behavior that is or is not being displayed at the time.

- The Metro has spent a great deal of time and treasure (with significantly more coming) looking into flood control in Jackson to help developers and individuals who built in the flood plain over the past 30 years, knowing full-well that their homes or businesses could flood.

- Nationally, one example might be the fact that this country spends a great deal of money in order to subsidize the price of gas and overall the cost of fossil fuels, including research & development, diplomacy, military action, transportation, leases and rights management and other efforts all designed to keep the price at the pump low while enabling some US-based multinational companies to enjoy some rather extraordinary profits.

My point is that we don’t really live in this perfectly libertarian system—we live as a society, governed democratically (for the most part) and we make decisions as such as to how we’re going to prioritize collective spending. One way to do that—as is being considered with varying levels of success by at least one political party in Congress—would be to reform the health care system in such as way that historically costly elements of it are better managed, while more people are given access to the system on a basis other than critical care.

Great response Itodd.

One thing I think is missing in the Drs’. letter is this notion that you touch on, the common good. Many times, average citizens don’t realize that one way democratic govt. protects their rights is by providing for the common good. This is against market principles and even against public sentiment(in many instances, check desegregation) and yet is so important to the overall cohesion of society.

To add to the great examples you cite, might I suggest public schools, public roads, and the many other services provided by the State to ensure social cohesion and collective functioning.

To think that democratic gov’t doesn’t already help those people in need, and many that aren’t in need, regardless of the percieved “worthiness” of that help on behalf of a few citizens is something lost in this health care debate. Just last night I heard a plethora of callers berate State Sen. George Flagg on the radio because he objected to drug testing medicaid recipients, like callers were arguing for. The alternatives to not helping people like this would not be in teh interest of the common good. and, though a private insurance company may drug test, the public medicade need not do this, because it is in the interest of the common good that addicted people get treatment (or else risk a rise in property crime, homelessness, and incarceration). Is this profitable (market-wise)? no. Is it even popular? Not in the least, but be thankful that the people are being helped.

When it’s all said and done, and believe you/me, this thread has drawn some very special attention, I wonder if Dr. Jones really understood the conditions given him under his swearing to uphold the committment spelled out in the Hippocratic Oath?

Just asking!

My question is, after the publication of this letter, why is this idiot doctor still on any hospital’s staff? There is no way his judgement can be trusted when dealing with patients who are not white. Makes you wonder what kind of medicine this guy is practicing.

Yeah, I kinda wondered about the Hippocratic Oath myself. And it’s remarkable that people defend this. He’s a *doctor*—in an emergency room. It’s not like he’s signed up to only do plastic surgery on the rich. It’s his responsibility to help people, not spread stereotypes about them for political purposes or because he doesn’t want “pay for (their) health care.”

The health-care system is so, so broken. If it wasn’t, perhaps it wouldn’t attract people who would say such a thing publicly about his patients.

I wonder if any HIPAA laws were broken by this doctor. Even though he didn’t mention the patient by name, the fact is that he described the patient and given that the letter was printed in August, it’s quite possible that the patient who was treated during that time read the letter and could’ve felt embarrassed.

I agree with golden eagle; I doubt any HIPAA laws were broken, but there is a doctor-patient confidentiality that is being breached here, if only as a matter of ethics.  He would not know so much about this woman if she had not trusted him with that information, and he abused her trust by ridiculing her in public.

Also, hearing “life is really not that hard” from a guy with a professional doctorate after his name…that’s really rich.

I don’t think his license needs to be suspended or anything like that, but he’s living proof that you can be smart enough to graduate from medical school and still be an idiot when it comes to public policy.

Can I just say as a medicaid recipient who has multiple children who use to work three low wage jobs and can’t work currently but would love to, and doesn’t drink, smoke, get high, or have tattoos, however I do have a nice cell phone free upgrade I might add, that I too am often frustrated by the behavior of others in my community but it doesn’t excuse this doctor’s behavior the bottom line is if you don’t want to pay for health care fine but to evoke the welfare queen image, which he did, is ridiculous to say some people deserve health care and some don’t is crazy but yet people wish to scream about death panels. He had no business even looking at her payment status truthfully it shouldn’t be known by the doctors in my opinion that’s exactly how people die, this is exactly why I don’t go to UMMC ER the last time I was there I was so disrespected and it was basically because I didn’t have insurance before the doctor even did the exam he said you know we usually only see people in the ER for things that will kill them in the next 24-48 hours I was in there for severe right side abdominal pain and then asked me if I had a preferred pain killer as if i was drug seeking later I heard him tell the nurses there was nothing wrong with me before he ran any tests and he used my name talk about HIPPA! @baquan your right we do need it for all those people because when I worked to much to get medicaid I had to drop a job why? because all my kids have asthma and two have autism and those are what pre existing conditions so even if I could afford my employers insurance it wouldn’t cover what i needed it to cover the most.

Well said, Tony. Thanks for taking us to a greater level of understanding.