A loyal follower recently sent me this right-wing meme. (It’s actually been circulating via e-mail, and more recently Facebook, since at least 2009 – you can be the judge on whether or not its longevity is deserved): [Note: original punctuation left as is.]
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 costly pack of cigarettes every day 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 on 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.
STARNER JONES, MD
During my shift in the Emergency Room last night [last night’s shift in the ER], I had the pleasure of evaluating a patient whose smile revealed an expensive Shiny [with a shiny new gold tooth], whose body was adorned with a wide assortment of [multiple] 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 her favorite tune for a ringtone.
While [G]lancing over her Patient [the] chart, I happened to notice that [one could not help noticing] her payer status[:] was listed as “Medicaid“! During my examination of her, the patient informed me that [S]he smokes more than one costly pack of cigarettes every day and somehow still has money to buy pretzels and [purchase] beer.
And, you and our Congress [our President] expect[s] me to pay for this woman’s health care?
I contend that [O]ur nation’s “health care crisis“ is not the result of a shortage of quality hospitals, doctors or nurses. Rather, [I]t 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 on the irresponsible credo that [thinks] “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. [Life is really not that hard. Most of us reap what we sow.]
STARNER JONES, MD
Don’tcha’ just love how the creative-licensed version changed “favorite tune” to “popular R&B tune” – just in case there was any confusion about the patient’s skin color?
Still, despite the creative license that enhanced the racial undertones in Dr. Jones’s letter, the gist of it remains. Since Dr. Jones offers no solutions in his letter on fixing this ‘culture crisis,’ I’m not quite sure what his point was. Was it that this person, and others like her, should not receive care because of their lifestyle choices? Because as I understand it, and as former presidential candidate Mitt Romney so eloquently pointed out, people without health insurance can and do receive care at the emergency room, with or without Medicaid, and we end up paying for them anyway through higher medical expenses. (And obviously the only way to fix this would be to deny healthcare to people who can’t afford it – I may be a Republican, but I certainly don’t want to live in a country like that.)
Or was Dr. Jones’s point that people who could afford insurance should buy insurance? (Um, I think that’s addressed in the Affordable Care Act, aka Obamacare, so if this is the case, then Dr. Jones is preaching to the choir.)
Or is it that this one patient is representative of everyone receiving Medicaid? (Because I assure you, she’s not.) Or is it that this person had no business qualifying for Medicaid services because she obviously can afford it if she can afford “costly” cigarettes, beer, tattoos, cellular phone, and brand-name tennis shoes? That’s quite a leap in judgment, but since that’s been covered to death (just Google “Starner Jones” to read about it), let’s examine the other aspects.
A Republican who reads this meme probably jumps to: “See? That’s the problem with this country! That’s exactly why we must cut and/or end Medicaid!”
A Democrat who reads this meme probably jumps to: “Oh, great. Another isolated incident promoted to encourage the uninformed to think we should cut and/or end Medicaid.”
Let me tell you, as a Republican, there’s nothing that ticks me off more than thinking my hard-earned tax dollars are going to support those who are unworthy and undeserving of that support. BUT, as a human being capable of elevated thought, I also know that there will always be those who rob, cheat, steal, and take advantage of others (just look at Wall Street), but we cannot – CANNOT – allow that to be the reason to deprive those who are really in need (e.g. children, the elderly, and the disabled, who form the vast bulk of government aid recipients).
And here’s a little something that may actually shock my fellow Republicans. Democrats hate moochers, too. Whereas we Republicans are angry and indignant about those who steal our tax dollars, Democrats not only share that indignation, they take it a step further, denouncing said swindlers because they make it that much more difficult to help those who really need it.
See, this is one of the great divides between Democrats and Republicans in this country that really isn’t a divide at all. It’s the solution to the problem that divides us. Republicans tend to cry “Reject!” while Democrats lean more toward “Refine!”
Medicare/Medicaid fraud and abuse costs this country an estimated $60 billion each year. That’s right, $60 billion.
So how does one combat Medicaid/Medicare fraud and abuse?
As it turns out, that $60 billion in fraud comes primarily from healthcare providers in the form of billing for unnecessary or never-received equipment and/or services, artificially inflated prices, and kickbacks from suppliers when one patient’s Medicare or Medicaid card is used for a different patient.
Perhaps Dr. Jones should spend more time writing about the ethics in his own industry than a patient he once cared for.
There are tools in place to help prevent Medicaid/Medicare fraud and prosecute those who commit it, such as the Recovery Audit Contractor (RAC) program, and the bipartisan Improper Payments Elimination and Recovery Act, which was signed into law on July 22, 2010. But unfortunately, those tools are almost as costly as the actual amount of dollars recovered (and heaven forbid we put more regulation on the books). Still, there is progress (you can read an excellent accounting of that progress at the NPR Website, titled “Miami Serves As Model In Medicare Fraud Crackdown.”)
Personally, I’m more irked by the fact that my healthcare costs are driven so high in part because of the massive amounts of unnecessary ER visits and ambulance rides each year due to people not having insurance (ER visits are far more expensive than primary care physicians). I’m looking forward to Obamacare taking effect – it will go a long way toward reducing that (as it did in Massachusetts, where ER visits fell almost 4.5% from the time Romneycare went into effect in 2008 to 2010). That might not sound like much, but when you consider that the annual number of ER visits in the U.S. is approximately 140 million and rising, a 1% annual drop would equate to 1.4 million fewer ER visits each year.
Dr. Jones points to “a shortage of quality hospitals, doctors or nurses” as being the accused healthcare crisis. Funny, I always thought it was the 50-million-or-so fellow Americans who can’t afford health insurance, and the estimated 45,000 fellow Americans who die a preventable death each year due to lack of health coverage, as found by a recent study conducted by the Harvard Medical School. (Again, thanks to Obamacare for tackling this issue as well.)
And finally, for all those right-wingers who’ve spread this silly meme via e-mail, Facebook, or Twitter, and self-righteously thought, “Yeah, maybe I’ve made poor health decisions in my life, like smoking, drinking, participating in injury-risk-related activities, eating junk food, etc., but at least I’m paying for my own insurance,” I hope you’re keeping in mind that, while you may not be costing others their dollars in taxes, you certainly are costing others their dollars in higher insurance premiums.
Dr. Jones followed up his letter in the Clarion Ledger a few months later with one titled, “America Is Still the Land of Opportunity – For Everyone,” where he wrote:
I grew up in a lower middle class, single parent home in the rural hill country of Pontotoc, Mississippi. While attending public schools, I paid attention in class and did my homework. I ran with the right crowd and stayed out of trouble. My dedication in school resulted in a full-paid scholarship to the prestigious University of the South in Sewanee, TN. After college, I left to go to medical school with everything I owned in three bags. The rest is history.
Motivation, not entitlement, is the key to personal success and happiness in life.
One wonders what it was that so motivated the young pre-doctor Dr. Jones. Could it have been the simple fact that being poor sucks, no matter the safety nets in place?
It’s time to discuss real and rational solutions, and not let silly memes drive us to emotionally charged and misinformed conclusions.