Personal Responsibility: How Should It Play Into Who Gets Help Under Health Care Reform?

How should personal responsibility affect the availability and rights of an individual to assistance with health care coverage or payment?

The following was shared with me by a third party, who says it is the text of a two  paragraph letter of a young emergency room physician named Dr. Starner Jones.  I don’t know if this is a true letter or an urban legend letter.  However it’s perspective about health care reform as a “Culture Crisis” rather than a “Health Care Crisis” is thought provoking –  at least with regard to those Americans who claim they can’t pay for health insurance coverage or pay for the cost of health care for themselves or their families but can find money to pay for other “Necessities.”

The letter as shared reads as follows:

“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 ring tone. 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 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.



When deciding to tax or otherwise collect money from some Americans to pay for health care for other “needy” Americans, should some consideration be given to why the person asking for or being given the help “needs’ the help and why the person being asked or forced to help is able and expected to help.  

Some Americans who need more health care than they can afford to pay for are in a tough position despite their honest hardworking efforts.  Many of these individuals have worked hard, scrimped and saved, purchased health insurance, and done their part only to loose their job or be hit with an illness or injury requiring more care than their budget can handle. 

On the other hand, many people holding out their hand for health care assistance could have purchased health care coverage or better health care coverage but chose not to guard against a rainy day or don’t pay their health care coverage or medical expenses because they choose to buy other things that are more satisfying.  Many of these people making these choices also may make other unhealthy choices.

Should the help given depend on these choices?  How does personal responsibility weigh into the health care reform debate?  Share your point of view by joining the discussion at

For More Information

We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402,, Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters. 

Ms. Stamer has extensive experience in these health care reform, public policy and other health industry related representation.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here

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©2011 Cynthia Marcotte Stamer.  All rights reserved.

Author: Cynthia Marcotte Stamer

Management attorney and operations consultant Cynthia Marcotte Stamer uses a client objective oriented approach to help businesses, governments, associations and their leaders manage performance, operations and risks.

3 thoughts on “Personal Responsibility: How Should It Play Into Who Gets Help Under Health Care Reform?”

  1. “I don’t know if this is a true letter or an urban legend letter. ”

    You CAN know (there’s this thing called the internet…), and it is

    1. Thanks for your comment. I appreciate your input. What I am most interested in is your views on the concerns expressed in the letter rather than a discussion on whether the characterization of the letter as an actual letter is in fact true.
      The content shared expresses a perspective frequently expressed by physicians and others. For purposes of this discussion, the questions raised merit discussion regardless of whether it is in fact a letter that went to the White House or merely an opinion piece written to draw attention to the concerns it expresses My disclaimer merely alerts people that since the comment is relevant, I didn’t investigate to personally verify the accuracy of the report of the source of the opinion expressed. However, if I were to investigate it, I would not rely upon the internet. I would go to the alleged source as the unfiltered nature of the internet allows for the wide dissemination of materials that allow urban legends to spread like wildfire.

  2. As aptly written last year in an Indian edition of Reader’s Digest, morals and ethics are dipping and are going below the basic foundation……people just are not able to think about tomorrow and yes, the government should come down hard on such folks. In India, if a young begger who seems to be perfectly normal, physical and mentally, comes asking for alms, we encourage all to turn him / her away or ask them to do some task for which they can then be paid.

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