the poor stay poor – smoking in singapore

Mr L is a new case that presents to the surgical clinic. He has been referred for a right elbow superficial lump that warrants excision.

Straight off the bat, he says (in Hokkien), “Doctor, how much does it cost to remove this lump? Can I use Medisave? I can’t afford to pay, you know, this clinic visit, can I use Medisave?”

“Chill out, Mr L,” says the youthful, brash hip-hop-wannabe junior doctor (now called young-punk-doctor (in equivalent Hokkien), “let me take a proper history and do a proper physical examination just like how I’ve been taught to do in medical school, yo. Peace.”

55 year-old Chinese male, no past medical history of note. Smokes two packs of cigarettes a day for the past 40 years. Drinks two bottles of beer one time a week.

Singapore has bloody expensive cigarettes and alcohol. A pack of Malboro’s/Dunhill costs about S$11 (US$7.70/RM27) (guess-timated price). With cheaper alternatives, he’s spending a bit less than 20 dollars a day excluding food/drink/transport! Young-punk-doctor doesn’t spend 20 dollars a day! He doesn’t go drinking once a week (he doesn’t have time to)!

And here Mr L is, trying to figure out how to pay for a comparably cheap minor day surgery without even contemplating cutting down on a major cause of (a) his lack of cash (b) his future medical expenditure.



2 responses to this post.

  1. If it were that easy for them to quit – and if they had wanted to – they would have done it a long time ago, medical problems notwithstanding.

    Smoking is, in the first place, not a rational action, so why would you expect Mr L to behave rationally with regards to raising money for his surgery?

    Besides, cost of surgery aside, if he were concerned enough to want to remove the lump (which more probably than not is just a benign cyst given its location – assumption), you would think he would be concerned enough to quit smoking, given the various risks the latter poses on his health.

    Smokers are never rational, remember that. Never. They don’t operate in a logical, reasonable manner.


  2. Posted by CS on October 5, 2011 at 5:08 pm

    Contrary to what Am says I don’t believe it’s fair to say smokers are never rational. They simply value health and cigarettes/ beer differently from the rest of us. If they value cigarettes and beer over their health, then the logical thing to do is to pay for it instead of saving for medical fees.

    And what one *ought* to value is not something that can be answered with logic.


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