Note: My dad is a radi­a­tion oncol­o­gist who came out of retire­ment to take a job at the Uni­ver­sity of Mis­sis­sippi Med­ical School in Jack­son. He recently sent this letter to the pres­i­dent and has agreed to let me post it here.

+++

Dear Pres­i­dent Obama,

I am a physi­cian who treats cancer patients at the Uni­ver­sity of Mis­sis­sippi Med­ical Center. I left pri­vate prac­tice after 30 years to do research and help the dis­ad­van­taged. In Mis­sis­sippi, I see the poor­est of the poor, and the sick­est of the sick. In my entire career prior to coming here, I have never seen as advanced cancer in so young a pop­u­la­tion as in the Mis­sis­sippi Delta black pop­u­la­tion. I was par­tic­u­larly struck by a case I saw today and want to share it with you as you look at health care reform for America.

A young (37 year old) black mother of 4 was diag­nosed as having cer­vi­cal cancer 7 months ago in her small Mis­sis­sippi Delta town. She was sent to a doctor and hos­pi­tal in a neigh­bor­ing town for a hys­terec­tomy, but was told she needed to be on Med­ic­aid or pro­duce $350 to have the treat­ment. Since she had no money, she returned home and was treated “symptomatically” until this last week­end when she became so sick, the local hos­pi­tal admit­ted her, found the cancer had spread and blocked her kidney. They bypassed the kidney block and sent her to the Uni­ver­sity in Jack­son for care. Her cancer is now so far advanced that she will undergo exten­sive radi­a­tion ther­apy and chemother­apy. She has only a min­i­mal chance to be cured at this advanced stage. We will house her and feed her through the treatment- but her young family will need to fend for them­selves while mom lit­er­ally fights for her life. This is a battle she may not win- but it is a battle that NEVER needed to be fought had she had the appro­pri­ate treat­ment 7 months ago. How do we as Amer­i­cans explain to this family that their mother’s life may have been cut short because she didn’t have Med­ic­aid or $350??

When did Amer­i­can Med­i­cine move from help­ing sick people to just making a profit? Why is the most pros­per­ous nation in the world ignor­ing the health care needs of its poor­est citizens?

As you dis­cuss reform of the broken mess we call Amer­i­can Med­i­cine, I con­sis­tently hear the terms “access” and “affordability” but rarely do I hear us dis­course about the qual­ity of care afforded to the poor. I respect that hos­pi­tals, physi­cians, and insur­ance com­pa­nies feel threat­ened by change- but a system based on profit (per­sonal or cor­po­rate) will never put the needs of the indi­gent patient first. If we are to truly reform Amer­i­can Health­care we must- as a society- pro­tect our most vul­ner­a­ble cit­i­zens. I believe that EVERY provider should be required to treat ANYONE who needs his ser­vices regard­less of that person’s abil­ity to pay. We require this of hos­pi­tal Emer­gency Departments- but only for “emergency care”.

As you work to expand cov­er­age it is imper­a­tive that such cov­er­age to the poor not just be a ges­ture. At one point in our careers we all started with high hopes and grand ideals. As we progress, much of this ide­al­ism has been lost to finances and bal­anced bud­gets. In this instance, I believe it is the respon­si­bil­ity of the gov­ern­ment to force Amer­i­can Health­care to live up to its lost ide­al­ism and do what is right and good for the most vul­ner­a­ble of our soci­ety. If you (as a hos­pi­tal or physi­cian) can help, I firmly believe the gov­ern­ment should require that as part of your priv­i­lege to par­tic­i­pate in our health­care system, you deliver care to all who are seri­ously ill. This may be a bitter pill for some providers to swal­low, but it is really the best med­i­cine for our ailing health­care system.

His­tory will not judge your admin­is­tra­tion by the per­cent­age of the pop­u­la­tion cov­ered by health­care, but will look to see if your new system improved infant mor­tal­ity, decreased obe­sity, decreased dia­betes and ulti­mately improved the life expectancy of all Amer­i­cans. Per­son­ally, I will judge your admin­is­tra­tion suc­cess­ful if I no longer see young black moth­ers from the Delta dying an unnec­es­sary death because they lacked $350.

Sin­cerely,

Dr. Michael Baird

Asso­ciate Pro­fes­sor of Radi­a­tion Oncol­ogy
Uni­ver­sity of Mis­sis­sippi School of Medicine