Dear Dr. Jones

This comment was written in response to a real doctor’s letter circulating on the Internet. It has appeared in various forms, but the gist of the letter has been verified by snopes.com. In the doctor’s words, “I contend that our nation's ‘health care crisis’ . . . 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 [and] 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.”

MY RESPONSE:

Dear Dr. Jones:

During the past thirty years, I have had the pleasure of becoming a grandfather a dozen times. Samantha was the eighth and was a delight from the moment she uttered her first cry at the indignity of being exposed to the assessing eyes of her mom and dad and the delivery room doctors and staff. As responsible parents, my son and his wife acquired healthcare coverage to offset the costs of any medical needs that might arise for them and their two children.

At age 6, Samantha developed a malignant brain tumor (anaplastic astrocytoma). Her parents were aware that not all of Samantha’s needs would be covered by their policy, but they were not prepared for the shock of receiving bills totaling about $240,000 in unreimbursed expenses, this despite her being a patient at St. Jude Children’s Hospital for eight weeks where virtually all her expenses were paid in full.

Thirteen months later, Samantha died. Over this period, my son’s family income was cut to less than half, a result of a tanking economy (he is a carpenter) and the fact that my son spent so much time in repeated visits to doctors and hospitals for treatment of seizures and all those other semi-emergencies that accompany a terminal illness like brain cancer.

In their case, there was no “crisis of culture” that rewarded irresponsibility and dependency. Few dollars were spent by my son and daughter-in-law on luxuries and vices (save an occasional jug of cheap wine) while refusing to take care of their family. However, a crisis of culture does exist when a society fails to provide a safety net for family members struck down by a medical disaster, which, I’m sure you’d agree, is a fair definition of an affliction like anaplastic astrocytoma.

Yes, there are people in America who could be called irresponsible in anyone’s eyes. However, there are many more like my son who make yeoman efforts to preserve and protect their families. These include the tens of millions in the lower economic brackets who must make the choice between bread on the table and top-drawer healthcare coverage. Unfortunately, it all comes down to assigning top priority to the most immediate need.

Your letter implies that “irresponsibility” is the rule for those without healthcare coverage. I suggest it is society that is irresponsible for not providing a way to at least subsidize basic preventive care and to provide a safety net for those who are victims of chance and circumstances not of their own making. And as middle and lower incomes continue to stagnate (while wealth becomes further concentrated at the top), the disparity between those who can and cannot afford basic coverage will only grow.

Sincerely,

Bill Britton