It’s a SNAP to Care! by Pat Conrad MD

snap

“These and other resolutions students adopted will now move through the AAFP’s policymaking channels for review, referral and, when appropriate, further action by AAFP leaders and the AAFP Congress of Delegates.” Just as music is used in film to prepare the audience for terror or hilarity, so the preceding sentence promises ineffectual, expensive stupidity.

In this case, the National Congress of Student Members [of] the 2016 AAFP National Conference of Family Medicine Residents and Medical Students devoted themselves to patient welfare, taxpayer funded of course. The student members passed a resolution asking “the AAFP to advocate for maintaining current funding levels for the Supplemental Nutrition Assistance Program (SNAP) and encouraging increased funding for the program in the future.” In plain talk, the students don’t want any cuts to food stamps. On the one hand, I’m disgusted that these AAFP wannabes want this ridiculous organization to lobby for more federal welfare dollars. On the other, it’s funny seeing how unfamiliar these would-be FP’s are with the AAFP’s long and serious record of accomplishing absolutely nothing.

I know the students are young, and idealistic, and want so earnestly to matter. I also know that the SNAP program costs over $83 billion, and that the rolls have swelled to over 40 million recipients. More resources have not resulted in any long-term improvement to anything whatsoever. While the ranks of the food stampers have thinned slightly in the past two years, they have more than doubled this century.

Resolution co-author Paige Ely worked at a food bank, and said: ” In addition, between 2013 and 2014, the amount of funding cut in SNAP is equal to the amount all of the food banks in the United States need for three years of food,” she said. “SNAP provides much more food than food banks are able to on their own.” Sure, but what if money wasn’t taken out of local hands to recycle through the federal bureaucracy? Wouldn’t feeding people be better done at a local level? Alas, I wasn’t quick enough for Kandis Samuels-Leutzinger, a co-author of the original resolution. She thinks “funding SNAP through block grants is troubling because each state is able to allocate the lump sum amount received to different programs as they see fit.” Well we can’t have that, can we?

“SNAP is supposed to be used for food, and not all states specifically use it for food; it gets used for other things, which doesn’t necessarily help our patients and their nutritional needs, and this affects their health.” These advocates have no care as for who has to pay the bill, and herein lies the deadly problem.

Too many, far too many in medicine are insufferable do-gooders who have no hesitation in doing good with other peoples’ money, time, talents, resources, or hard work. If a med student thinks it is the proper business of medicine to lobby the federal government for welfare support, then he makes himself pliable for any further such suggestion. This isn’t a discussion about the role of government; this is a demonstration of how far medicine has fallen from any sort of principled or independent reasoning. Medicine now is not merely just another special interest, grubbing for tax dollars and leverage over competing industries. Groups like the AMA, AAFP, et al parrot the messages fed them by the central bureaucracy and a supportive media. Medical school faculties join them in selecting and encouraging students to mouth popularly acceptable positions and solutions with no thought to their larger social and economic effects. These students are already temperamentally conditioned to accept whatever new core measures/EHR/ICD-15/MACRA/SCHIP/meaningful use/MOC garbage is already being developed. Nothing pleases the industrial-compassion complex more than a willing tool with a medical degree.

“So to see this budget decreasing is alarming to me and many of our future patients,” Ely testified in a July 29 reference committee hearing. “Maintaining the funding is necessary and then, hopefully, being able to increase the funding will be enough to provide the nutrition that they need.” Sure Ms. Ely, I’m not against all semblance of public health or social responsibility, but where do you draw the line? DO you draw a line? What if their roof leaks, or their Internet goes out, or their car breaks down? Do you want to take your neighbor’s money to fix that too? Or what if they have morbid obesity and a jacked up HgBa1c, and you suffer financial penalties because you were deemed to give “poor quality” care, and then you don’t have the money to pay for the software update on your expensive, federally mandated EHR?

Ms. Ely, I’d rather you concentrate on your studies, pass your boards, mind your own damn business, and get back to me in about a decade.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “It’s a SNAP to Care! by Pat Conrad MD

  1. Sir Hakum of Hugo
    August 12, 2016 at 1:08 pm

    Most of my rural patients, if given the choice, would prefer to eat the lesser of two choices in regards to nutrition. You can offer them all the vegetables, fruits, lean proteins in the world. They tend to choose otherwise, hence our obesity epidemic.

    At what point does government money change that behavior? The answer is never ever. Unless you banned all shoddy foods, shot anyone found consuming them (or sent them to one of Doug’s BMI interment camps), and had all purveyors of underground bad food drawn and quartered, people will chose the crummy pleasure foods.

    My patients, bless them, make decisions. No, fellow readers, this is not a sloppy broad brushstroke. They have a better smartphone and great deal more cigarettes than I possess (I have zero of the latter).

    FLOTUS and her grand goodie-food plan for schools yields mountains of food waste and kids programmed by Big Food from birth to prefer Kit-Kats to carrots.

    More money thrown at the problem will never work. As above, compassion via other people’s money certain placates the soul of the many who dream, but it does not work.

    Pardon the rant. Just saw 8 diabetics in a row this morning.

  2. Rad2Dude
    August 10, 2016 at 9:05 am

    SNAP is a safety-net program that mostly goes to women and children. At a time when the gains of the last few years’ economic recovery have mostly gone to the rich, the increase in this program has helped to feed our patients left behind in that recovery. Plus, the dollars spent go directly back into the local economy, providing an essential stimulus for keeping small groceries in poor neighborhoods and avoiding food deserts within our cities. For some well-off doctors (and if you’re reading this, you’re probably far from needing SNAP assistance) to complain about a program that does help keep our patients fed comes across as uncaring and selfish. Want to fix the problems in the program? Great, let’s work on that. But ridiculing students for wanting to see their poor patients fed? You have better things to do, Doctor.

    • Pat
      August 10, 2016 at 5:55 pm

      Yes Rad, I have seen food stamp money going back into our local economy, often in the form of cigarettes, booze, street drugs, and more otherwise unfunded children.

      You think that I come off as uncaring and selfish? How easy it is to be caring and selfless…with someone else’s money. That has increasingly been the role of the doctor since 1965, and it stinks like the class warfare you apparently buy into. I’m immune to that, and the sort of ostentatious compassion that encourages students to become doctors who will swallow any idea, program, or attitude that the government feeds them. We should want physicians who worry less about appearances than about results.

  3. Steve O'
    August 9, 2016 at 8:47 am

    I am struck by the statement in the article that “Currently, SNAP provides $4.23 per person per day to feed people enrolled in the program. For many of the clients Ely saw, this represented the sole extent of their food budget. She pointed out that the current $4.23 isn’t enough to buy all the fruits and vegetables they need for recommended nutrients — and a number of states are expected to continue to reduce funding for the program in coming years.”
    I would give a failing grade to this proposal. The USDA, which probably has a better sense of what the food issues of the USA than even the AAFP, disagrees emphatically. (see http://www.ers.usda.gov/amber-waves/2015-september/following-dietary-guidance-need-not-cost-more%97but-many-americans-would-need-to-re-allocate-their-food-budgets.aspx)
    “The average American does a poor job of following Federal dietary guidance. Many Americans get too many calories from refined grains, solid fats, and added sugars, and do not eat enough fruits, vegetables, and whole grains….. Cost has been raised as a possible barrier to a healthy diet. However, both healthy and less-healthy diets are available at low and high cost, suggesting that cost is not the only, or even the most important, barrier.”
    If there is a genuine matter to study, it’s the elephant in the pantry – how does American food get more expensive without getting healthier? Why does the quality of diet NOT IMPROVE with dollars spent? How can a difference be made?
    This is certainly a more legitimate do-gooder project than mooching Government dollars. But universities live and die on mooching. Given that people with all manner of dollars to spend on food make equally lousy choices, then give them more money to spend on food.
    How do we get people to eat better quality food without nagging or compulsion? There’s a university-task-force level of idea. It doesn’t compel the sweet sweet grant money, though, in Nutrition 2.0

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