Dear Dr. McIntyre (public questioning of medical decisions)

Dr. Mary McIntyre
Alabama Medicaid Agency
501 Dexter Avenue
P.O. Box 5624
Montgomery, AL 36103-5624
fax (334) 242-5097

November 12, 2004


Dear Dr. McIntyre

You have probably already received a large number of calls, faxes, and emails regarding the case of Lauren Rainey, which has been publicized on local news and the internet. I would like to add my voice to theirs. Revoking Medicaid coverage for a little girl who needs twenty-four hour nursing care is heartless and life-threatening. I can’t imagine how you can do this. Please rethink your decision.

You are probably asking, “what right do random people on the internet, whose only source of information is a sensationalist local news story, have to question my medical decisions.” As my grandfather would have said, this looks like “Monday morning quarterbacking.”

Actually, though, the public does have a right, indeed a duty, to question the decisions of public officials, even when we lack the relevant expertise. We have this duty in part because you are acting in our name. Mostly, though, we have this duty because we provide a different perspective, which can provide a check on the power of experts. Although you have more training than the public, you are also hampered by the biases that come from institutional cultures. The case of Lauren Rainey looks like such a situation. The distance between you and the case, created by institutional relationships, has blocked ordinary human sympathy. Hopefully the voices of the public will rekindle that emotion in you.


Sincerely,



Rob Loftis