Thank you, Ganden Thurman

Not too long ago, I was read with interest this letter to the editor of the free daily amNew York:

U.S. deserves better health care
Our health care system and the health of the general population of our country are a disgrace--plain and simple. It's high time the government lived up to its constitutional duty to tend to "the welfare of the people" they are supposed to represent. Please grow up and tend to the issues at hand directly rather than blithering about such gross pseudo concepts such as globalization, privatization and capitalism. None of these abstractions has anything to do with our jobs, our country and its potential to become a more perfect union.

Ganden Thurman, Manhattan

Goodness, where to begin?

• I would argue that it is not axiomatic that the United States' health care system is a disgrace. By many measures we have a very effective and cutting edge medical system. (Anyone care to get an elective gallbladder done in Canada or Britain? That's right...you'll have to wait. A long time. That is, unless you have money to go the private route, I'd assume.) Yes, one might argue that the richest nation in the world should provide health insurance or coverage to every citizen. This is not, however, an inalienable right granted by our constitution, and I think its time we stop treating it as such. In other words, discussions about universal health coverage should begin, "Since we've progressed to where we are as a nation, let us consider as a society the advantages and disadvantages of providing universal health insurance to all citizens," not, "Our health care system is a disgrace."
• I might agree with you that the health of the general population is a disgrace. The difference, however, is to whom to assign blame. You clearly blame the government. I, from my humble 6 years in the field of medicine, blame the population. People who make bad choices and then expect the government to fix the problem are dead weight on society. If every American ate appropriately, exercised 30 minutes a day 4 to 5 days per week, stopped smoking, did not abuse drugs, drank alcohol in moderation, and followed his doctor's recommendations, I suspect that the Medicare coffers would burst at the seams. So perhaps that righteous indignation, sir, should be focused not on the government but on our societal sloth and excesses.
• "Welfare of the people." Constitutionally, this includes life, liberty, the pursuit of happiness, universal health insurance, cable television, and fewer dropped calls.
• "It's high time the government [took care of the people] they are supposed to represent." If you're going to write a letter to the editor, please proofread it, or at least ask a friend to edit it. A sixth grader should know that the proper pronoun for "government" is "it," not "they." (Sorry, I'm getting tacky here.)
• This is where it gets fun. The government is instructed to "grow up." Fair enough.
• "...[stop] blithering about such pseudo concepts such as globalization, privatization and capitalism. None of these abstractions has anything to do with our jobs, our country..." This makes me smile every time I read it. There's a story about an economist who visits China during Chairman Mao's regime. There he sees one hundred men digging a pit, while a backhoe sits unused. On asking why they don't simply use the backhoe to dig the pit much more quickly, the Chairman explains that then the men would be out of work. The economist replies, "Oh, well then if its work you're looking for, why not have the men dig with spoons?" The anecdote illustrates the difference between work and productivity, abstractions that have everything to do with our jobs and why our country is even at the place where we can talk about universal health insurance. People that don't grasp the difference between work and productivity, or between income and wealth, are the same people who think raising minimum wage helps poor people, that outsourcing hurts our economy, and that Wal-Mart has made people poorer, not wealthier. These are mindsets that, sadly, I cannot deconstruct in one post. But yes, Ganden Thurman, globalization and capitalism have everything to do with our jobs and our country.