The Results of Catering to "Need" as Altruism Requires
Though not universal, the types of observations this physician makes are a real indictment of our whole altruistic system. I'm guessing all of us can think of way too many personal examples which make these observations credible.
(As a philosophical aside, one of the main goals of egalitarianism is to ensure that those furnishing other's needs can't and don't judge them. Were emergency rooms left to private charity, you can bet that the type of scum described in the doctor's observations would receive no, or very limited, voluntary help.)