"Neighbors Helping Neighbors"

The really obvious point is that while Tom Coburn may or may not help this woman and her husband (we'll see), he can't possibly help everyone in similar circumstances. Every Senator and Representative working full time on medical horror stories alone can't possibly help everyone in similar circumstances.

The other really obvious point is that "neighbors helping neighbors", however well-intentioned, are completely inadequate to the economic scale of even a single situation like this. We're talking hundreds of thousands of dollars here--more than you can raise with a bake sale or a car wash.

But it's actually much worse than that. People tend to live around people like themselves--that is, people in a similar income bracket. Tom Coburn is a doctor, and pretty well off (his net worth in 2007 was $1,358,097 to $4,250,000); odds are pretty good that his neighbors are comparably well off. Tom Coburn's neighbors probably could raise money for a medical emergency like this one. Tom Coburn's neighbors are also much more likely to have adequate insurance.

Conversely, people living in low-income neighborhoods are much more likely to be uninsured.

That's the really perverse thing about Coburn's "neighbors helping neighbors" comment: the greater the likelihood of needing help, the less available that help is, and the more your neighbors are able to help, the less likely it is you'll ever need it.