This little blurb by a doctor is making the rounds on Facebook:

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.

Respectfully,
STARNER JONES, MD

My first reaction to this thing was HOAX, but Snopes says it’s not a hoax. In fact, it was a letter published in a newspaper.

And there was even a follow-up letter by the same doctor:

I continue to receive numerous phone calls, letters, emails and face-to-face comments about my letter (“Why Pay For the Care of the Careless”) which appeared in your newspaper a few months ago.

Most people express highest approval for the opinion set forth. Indeed, the truth has an illuminating quality all its own.

However, a few have disagreed and all of them falsely assume that a person who holds the views which I espouse must have been raised in a privileged home. Nothing could be further from the truth.

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.

The fact of the matter is that it is often people who have come out of poverty themselves who most disagree with those who want to keep people in poverty by subsidizing their poor decision making. I come from a background where my parents were immigrants and my father worked 3 jobs and my mother worked one. We saw people around us who were poor like us, making these irresponsible spending decisions and they were encouraged to persist in it by welfare programs like Medicaid. They were getting tens of thousands of dollars in benefits, and they would lose those benefits if they worked their way out of poverty.

The fact of the matter is that we are doing the able-bodied non-working poor no favors by allowing them to persist in the worldview of poverty, which is encourages dependence, recklessness, consumption and waste. Eventually, the state runs out of other people’s money to subsidize the able-bodied non-working poor in their perpetual childhood, and then where will they be? We are already $16.5 trillion in debt, and this level of welfare spending is not sustainable. Eventually, they will have to fend for themselves. We will be leaving them uneducated, with no resume, and a host of addictions ranging from the lottery and cigarettes up to drugs and alcohol.

Instead of fretting over feelings, and worrying about being judgmental, we should be fretting about enacting policies that promote marriage, school choice, entrepreneurship, work and so on. Strengthening the family and rewarding hard work. If the concern is that health care costs too much, there are ways to lower the cost of health care with market-oriented reforms. We should be studying the economics of health care and promoting consumer choice, ownership and competition among health care providers. Government is not the answer.

I really recommend that everyone read a book by British doctor Theodore Dalrymple, who gives a close-up view of what government programs actually do to the people we would all like to help. I have linked to all the chapters here, so there is no excuse not to read it and get informed. Then we can read other books on consumer-driven health care in order to learn about how to reduce the cost of health care without growing government.