Thursday, December 3, 2009

E-mail insidious in take on health care

Cary Clack
San Antonio Express-News

There's an e-mail chain letter making the rounds that, for some, is an indictment of health-care reform but that can also be read as an indictment of the American people. Unlike many chain letters clotting e-mail boxes, this one is correctly attributed.

Dear Sirs:

During my last night's shift in the ER, I had the pleasure of evaluating a patient with a shiny new gold tooth, multiple elaborate tattoos, a very expensive brand of tennis shoes and a new cellular telephone equipped with her favorite R&B tune for a ringtone. Glancing over the chart, one could not help noticing her payer status: Medicaid. She smokes more than one costly pack of cigarettes every day and, somehow, still has money to buy beer.

And our Congress expects me to pay for this woman's health care? Our nation's health-care crisis is not a shortage of quality hospitals, doctors or nurses. It is a crisis of culture — a culture in which it is perfectly acceptable to spend money on vices while refusing to take care of one's self or, heaven forbid, purchase health insurance. A culture that thinks, "I can do whatever I want to because someone else will always take care of me." Life is really not that hard. Most of us reap what we sow.

— STARNER JONES, M.D., Jackson, MS

Dr. Roger Starner Jones did indeed write this letter, which was published in August in Jackson's newspaper, The Clarion Ledger. Those forwarding it approvingly write that it should be published in every newspaper.

I received my copy from a semi-regular e-mailer who goes by the nameof "bobandlorene " and whose e-mails are usually apropos of nothing I've written.

For some reason, bobandlorene didn't send this to either of my colleagues, Scott Stroud or Jonathan Gurwitz, although both have written about health care more than I have. Just guessing, but I'm thinking the doctor's references to "shiny new gold tooth," "multiple elaborate tattoos" and "R&B tune" made bobandlorene think of little ol' me. I don't have a shiny gold tooth or a single tattoo but — busted — I do love R&B.

The good doctor is correct in suggesting that health problems would decline if we exercised more, ate better, and drank and smoked less. And it's his right to treat a patient and then criticize her in the local newspaper while conflating her with the nation's health problems.

But it's insidious to roil emotions by putting a particular face, one that's not sympathetic, to a catastrophic national problem. The faces of America's uninsured are as diverse as the faces of America itself.

I'm not foolish enough to pretend to have one-tenth of one-tenth of 1 percent of the good doctor's experience and expertise. But over the past three weeks, for a project I'm working on, I've been interviewing the uninsured. To a man and woman, they've worked hard all of their lives and, because of circumstances beyond their control — circumstances that have nothing to do with "culture" or choice — they
find themselves without health insurance. Their politics and ethnicities (and musical preferences) vary but none of them can believe they've reached this point in their lives.

Nor do "culture" and choice have anything to do with the illnesses, such as lupus and multiple sclerosis, that some of them have.

The health-reform debate is one of the most important yet contentious issues of our time. To make it more so by stereotyping the uninsured is as harmful and ridiculous as stereotyping recipients of food stamps or unemployment insurance.

The doctor was more right than he realizes when he writes that we reap what we sow. The costs are as much spiritual as they are financial, and that can be sung to the tune of R&B, country, rock or gospel.

Cary Clack's column appears on Sundays, Tuesdays and Thursdays. To leave a message, call 210-250-3486 or e-mail at cclack@express-news.net.