It bothers me….

This past week I administered care to a middle-aged man who had recently relocated from Las Vegas with his wife with an all-too-familiar tale of a layoff and house in foreclosure. The new job required feats of physical labor beyond the limits of his overweight, deconditioned physiology, resulting in severe stress that produced symptoms that led to a workup he could barely afford. You see, his new health insurance wouldn’t take effect for another 2 months. I wondered whether he’d last in the job that long.

The next patient I saw didn’t have any insurance worries. He is an inmate at a state hospital for individuals that have been diagnosed with mental illness leading to criminal acts. While this man’s particular offense was unknown to me, a great many of the hospital’s denizens are violent sexual predators. Not only is this patient’s cost of care covered in full, he is chauffeured to every visit by two—count ‘em, two—guards. On more than one occasion I’ve had patients from this same hospital brought to our office only to decide after crossing the threshold that they’d changed their minds, and be ushered right back out the way they’d come. This particular fellow wasn’t of that ilk. In fact, the first words out of his mouth were a request for additional testing to screen for a noncardiac abnormality he’d read might be associated with his heart condition.

Now, I ask, is there really something wrong with allowing a person who harms society with unconscionable acts of depredation to die of natural causes? Is my heart hardened because I believe it immoral to ask society to pay for this felon not only in full, but over and above that required for any other citizen, with the intent to extend his life so we can pay even more to incarcerate him at the taxpayers’ expense to protect them from him? All while claiming we don’t have the resources to aid the working poor? Call me judgmental, but I find the brand of false compassion we cower behind extraordinarily hypocritical.

It bothers me.


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