Medicaid patients shall be checked for gold teeth at the revolving door

I saw this poorly punctuated bit of nonsense on Facebook the other day. Here's what this doctor supposedly had to say, although it is likely that this whole thing was fabricated to make a point.


Pictured is a young physician by the name of Dr. Roger Starner Jones. His short two-paragraph letter to the White House accurately puts the blame on a "Culture Crisis" instead of a "Health Care Crisis"..

It's worth a quick read:

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 pack of cigarettes every day, eats only at fast-food take-outs, 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 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.

Respectfully,
ROGER STARNER JONES, MD

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This kind of thing really irritates me for several reasons.

1) Medicaid is not automatically granted to all low-income people. There are eligibility requirements. In our state, at least, many Medicaid beneficiaries are families with young children. When I worked at the hospital, I met some of them. Sometimes the parents made me mad, like when I told them not to smoke in the house with the nebulizer machine and they looked at me like I was crazy and asked why. I didn't always agree with the choices they made for their children, but you know what? Denying people Medicaid coverage because they don't live up to your expectations leaves out the most important people: the children. What do you think would happen if we denied nebulizer machines or hospital stays to children who could barely breathe because their parents didn't do what we wanted? They could die. If the children were treated and the bills were sent to the parents who have no means to pay, the account would go to collections and the burden would fall on patients who are able to pay. They would just pay more for the services they need, because someone is going to pay to keep the hospital rolling and you can't squeeze water from a rock.

2) Why are poor people expected to be impervious to the pressure of our consumer culture? Tricky marketing works on everyone regardless of economic status. Dr. Jones is on his high horse about this woman's "costly tattoos, shiny gold tooth, expensive tennis shoes and new cellular telephone." I agree that most of these things are silly, but why do people only look down their noses at people who are on government assistance? This "culture crisis" involves all of us, whether we can afford luxuries or not. As I've said before, we vote with our money. If you want to sneer at people who buy things you think they can't afford, the least you can do is not be a person who promotes a wasteful lifestyle. I can make up an interesting little character, too. It's a woman with blonde highlights which are regularly maintained at the salon. She pays full retail for all her clothing at upscale department stores (a new wardrobe every season!), wears a large, sparkly diamond on her recently manicured finger and drives a shiny, gas-guzzling SUV. She enjoys monthly spa days with her friends and sometimes even gets botox and other treatments to enhance her appearance. She goes out to eat several times a week with friends or her husband--and not at fast food restaurants but at Olive Garden or a steakhouse. Why is it culturally okay for this woman to waste money while it is not okay for the woman on Medicaid? Because she "earned" it and "deserves" all these things? Maybe she earns a lot of money, but maybe she is putting it all on credit cards and is behind on her mortgage. For the purpose of this argument, it doesn't matter. She, too, is contributing to the crisis of people wanting too much. I don't see any problem with a few luxuries every once in a while. I've gotten my nails done, too. I like going out to eat as much as the next person--probably more--and I love to shop, albeit for different things than most mainstream people. But regardless of your financial situation, if you are going to spoil yourself, how do you expect to sit in judgment of others who naturally yearn for luxuries too, given that they are living in this same consumer culture which you have helped to build?

3) Why are people on Medicaid expected to take better care of themselves than everyone else? There are smokers and fast food addicts and non-exercisers and people who don't wash their hands after peeing on the same health insurance plan as my family. We strive to optimize our health and people who make the aforementioned bad choices cost us more money in the form of higher premiums. How would you like to have someone audit your lifestyle to be sure you're not costing me too much? Yeah, I didn't think you would. I wouldn't either. Annie explains this concept so well, and in greater detail, here.

4) Things like this doctor's letter perpetuate a stereotypical view of those who benefit from Medicaid. A few people may be like this, but most are not.

If a doctor truly wrote this, I am alarmed, as I wouldn't want to be treated medically by someone so simple-minded. Dr. Jones does not offer any solution. All he offers is finger-pointing. Our consumer culture and the notion that we deserve the world on a silver platter was created over generations and is not going to be fixed overnight. Perhaps the funniest part is how he does not recognize that his salary is, in part, paid by the same Medicaid program that takes care of these people he thinks do not deserve it. Many hospital employees would not even have jobs were it not for the Medicaid program.

I can agree with Dr. Jones that we have a culture crisis, but it's not something our president can fix, and it does not apply only to people on government assistance. To fix this crisis, we all need to reject the idea that we deserve to be spoiled. Rich, poor, or in between, we could all learn a little moderation. It matters not if you can "afford" luxuries. It's easy to get all puffed up about what we have earned and forget that all the things we have, including a well-paying job, are gifts from God. I don't think God intends for us to blow all our money on ourselves. No one is perfect--I covet and sometimes get things I don't need, too--but if we pay a little extra in taxes and it means a woman can take her child to the doctor without fear of a devastating hospital bill, I'm happy with that. And I don't care how many gold teeth she has or how many cigarettes she smokes.


(Also of interest is this post from Judgmental Hippy, which inspired me to go ahead and publish my post even though it wasn't full of sunshine and rainbows. Her post does have some four-letter words in it, just in case you wanted to know, but it offers great perspective on a similar issue.)