Las Vegas Sun

September 26, 2017

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Where I Stand:

The real effect of the election

Health care is an important issue this campaign season, and it goes beyond the rhetoric in the debate; it has real-life consequences. Unfortunately, the human cost is many times brushed aside, and people without insurance or in poor health too often have been vilified for their choices. Nicholas Kristof of The New York Times wrote a compelling column about what happened to a friend of his. The column took a full page in Tuesday’s Sun; if you haven’t read it, I would encourage you to do so. It’s a heartfelt story about how his friend made a few bad decisions and was without insurance when he was diagnosed with advanced prostate cancer. Here’s Kristof’s follow-up column, which is also a must-read. If nothing else comes out of this, we would all do well to reconsider the health care debate in light of the human cost many people pay. — Brian Greenspun

Nicholas Kristof

I wrote in my last column about my uninsured college roommate, Scott Androes, and his battle with Stage 4 prostate cancer — and a dysfunctional American health care system. I was taken aback by how many readers were savagely unsympathetic.

“Your friend made a foolish choice, and actions have consequences,” one reader said in a Twitter message.

As my column noted, Scott had a midlife crisis and left his job in the pension industry to read books and play poker, surviving on part-time work (last year, he earned $13,000). To save money, he skipped health insurance.

A year ago, he encountered difficulties urinating and didn’t see a doctor in part because of the cost. By the time the prostate cancer was detected, it had spread to his bones.

“I blew it,” Scott told me several times.

He repeatedly acknowledged that he should have bought insurance and should have seen a doctor as soon as his symptoms appeared.

Scott showed immense courage in telling his story. He worried that his legacy would be an unflattering article spotlighting his foolishness, yet he went ahead for two reasons. First, he said that readers might learn from his mistakes and call a doctor about that suspicious lump or mole. (If that’s you, do it now!) Second, he said he hoped that his story would help readers see the need for universal health care so that others wouldn’t suffer as he has.

That’s in part what this election is about. If President Barack Obama is re-elected, Obama-care will stay in place and health insurance will become close to universal in 2014. In contrast, Mitt Romney has promised if elected to work to repeal Obamacare — and any American who made a bad health care decision would continue to suffer.

To many of my readers, that’s fine.

“Not sure why I’m to feel guilty about your friend’s problem,” Terry from Oregon wrote on my blog. “I take care of myself and mine, and I am not responsible for anyone else.”

Bruce wrote that many people in hospitals are there because of their own poor choices: “Smoking, obesity, drugs, alcohol, noncompliance with medical advice. Extreme age and debility, patients so sick, old, demented, weak that if families had to pay one-tenth the cost of keeping the poor souls alive, they would instantly see that it was money wasted.”

That harsh view is gaining ground, particularly on the right. Pew Research Center polling has found that the proportion of Republicans who agree that “it is the responsibility of the government to take care of people who can’t take care of themselves” has slipped from 58 percent in 2007 to just 40 percent today.

Let me offer two counterarguments.

First, a civilized society compensates for the human propensity to screw up. That’s why we have single-payer firefighters and police officers. That’s why we require seat belts. When someone who has been speeding gets in a car accident, the 911 operator doesn’t sneer, “You were irresponsible, so figure out your own way to the hospital,” and hang up.

To err is human, but so is to forgive. Living in a community means being interconnected in myriad ways — including by empathy. To feel undiminished by the deaths of those around us isn’t heroic Ayn Rand individualism. It’s sociopathic. Compassion isn’t a sign of weakness but of civilization.

My second argument is that if you object to Obamacare because you don’t want to pay Scott’s medical bills, you’re a sucker. You’re already paying those bills. Because Scott wasn’t insured and didn’t get basic preventive care, he accumulated $550,000 in bills at Seattle’s Swedish Medical Center, which treated him as a charity case. We’re all paying for that.

Scott and I spoke Sunday morning about whether his story might move some critics of health care reform. He was weakening and mused that he probably didn’t have long. A few hours later, Scott slipped into a coma. He died Monday morning.

We can’t be certain that the cancer would have been found earlier, when it was more treatable, if Scott had been insured. But it’s a reasonable bet. Researchers have estimated that one American dies every 20 minutes for lack of health insurance.

In other countries, I’ve covered massacres, wars, famines and genocides, and they’re heart-rending because they’re so unnecessary and arbitrary. Those massacred in the Darfur genocide in Sudan might be alive if they had been born in Britain.

That’s how I feel about Scott. His death was also unnecessary and might not have occurred if he had lived in Britain or Canada or any other modern country where universal health care is standard and life expectancy is longer.

So Scott, old pal, rest in peace. Let’s pray that this presidential election will be a milestone in bringing to an end this squandering of American lives, including your own.

Nicholas Kristof writes for The New York Times.

Brian Greenspun is publisher and editor of the Las Vegas Sun.

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