Let’s say it’s April 16th and you hate taxes, because
98% 12% of it goes to social safety net programs, better known as welfare. As everyone knows, most people on welfare don’t even need it. They just don’t want to work, and they probably make more money from lapping at the government teat than you do at your horrible job. The welfare queen has a storied history in American political discourse. We all know she’s out there, and most of us have a pretty good idea what she looks like. The problem is that the poor have so much power in America that specific welfare queens are carefully hidden. An actual person who picks up his food stamps in a limousine is almost impossible to find. So what do you do? Do you wait for the government to create a welfare queen for you? Of course not—you’re a hard-working American, so you make one up yourself.
Consider this exemplar of the form, from 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 “Medic…aid”! 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
First of all, if you need to communicate with the President, just go ahead and write on your Facebook wall. The FBI computers will see the character string “Dear Mr. President” and forward your message to the right person. Second, my indignation train was derailed by the discovery that this thing was based on an actual letter to the editor of a Mississippi newspaper by an actual Dr. Starner Jones, a name I thought was surely made up. The Facebook version has been improved, however, in subtle ways that preserve the mean-spirited pride of the original.
The capitalization is much more exciting, for one thing. Our patient also gets pretzels in addition to beer, has an “expensive Shiny gold tooth” instead of a shiny new gold tooth, and “chatters” on her telephone instead of just having it. Wisely, the editor has preserved the “R&B ringtone” which, along with the gold tooth, assures us that we are not accidentally calling a white person lazy.
Can you believe that woman can find 99 cents to spend on a ringtone, but not $250 a month to spend on health insurance like the rest of us? The implicit claim is that Patient X wastes her money on sounds and gold dental crowns instead of racially neutral porcelain ones, because the government gives her free health care. That causes a crisis of culture. If we stopped giving people free health care, the culture crisis we have mistakenly called a health care crisis would disappear. Irresponsible people would stop relying on government handouts and merely sicken and die.
Fixing the crisis of culture would be much easier than the Affordable Care Act, too. Instead of going through the complex and politically difficult process of changing the US health care system, all the President would have to do is remake American culture. That’s an unfair characterization of the Facebook version of Dr. Starner Jones’s argument, though. It doesn’t make a policy claim; it makes an ethical claim and presents it as an argument about what government should do.
The fundamental contention of this letter is that it’s okay not to help sick and/or poor people. That’s a tough sell, so the author wisely implies that they’re not really poor. People on Medicaid could totally afford to buy private health insurance, but they spend all their money on tattoos and tennis shoes because they’re irresponsible. Ergo, we should deny them emergency medical care. It’s okay to do that, because it’s their own fault they didn’t buy insurance. It’s the same reason ER doctors won’t treat you until you can prove that your injuries were not caused by your own mistakes. If you’re having trouble picturing yourself watching another person die because she has managed her money poorly, try imagining that she is black.
The argument in Dr. Jones’s letter us that we are not ethically obliged to give people medical treatment unless they pay us for it. It’s a position that contravenes two millennia of ethical thinking, but it appeals to elements of human nature much older than that. They’re the ones that thousands of years of civilization have tried to correct. I would say that idea—that we shouldn’t help poor people because it’s their fault—constitutes a real cultural shift in America. I suppose that whether it’s a crisis depends on how much money you make.