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in a piece titled Scott’s Story and the Election. He wrote this in part because of the response he got from readers after they read his first piece on Scott, about which I previously wrote in Nick Kristof offers a personal story of why we need Obamacare.

We saw the selfishness that has become too endemic, in part because of conservative rhetoric, in responses Kristof received.

For example:  

“Your friend made a foolish choice, and actions have consequences,” one reader said in a Twitter message.
  And also this:
“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.
  Those are mild compared to someone named Bruce who argued in part
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."
To his credit, Kristof takes a different viewpoint, which I explore below.

First, Kristof turns to the Pew Poll to show us how attitudes have changed, that among Republicans the percent who think government should function as the provider of last resort for those who cannot care for themselves has dropped from 58% 5 years ago to 40% today.

Kristof offers 2 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.
  He thinks those who argue from a Randian perspective are being sociopathic, and that
Compassion isn’t a sign of weakness, but of civilization.

And then

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.
 Here I might note that we do not necessarily ALWAYS pay for emergency room treatment - if you are treated in an emergency room to stabilize you but you do not have insurance you will still be billed.  Thus what is happenings to Scott is something different - treating him as a charity case, and for that the expenses incurred by the hospital are covered by spreading them incrementally across all paying patients, in a way not dissimilar from how being in large pool of insured spreads the costs/risks of expensive treatment across all members of the pool, even those who rarely need any kind of treatment.

Let me stop for a moment and point out the obvious - the larger the pool the less the additional costs imposed on individual members who do not use the services.  Logically and financially what would make sense is to put everyone into a single pool.  That is what Medicare does with our seniors, although there is nothing to stop them from obtaining additional insurance in private pools.

The costs that are experienced in Medicare are higher than they need to be had all who participate in the program had health insurance throughout their lives and thus been able to get preventative care or early treatment, many would need less treatment later in life, because they would have been healthier over the years.

Obamacare is a weak first step towards complete coverage.  It is weak, but it is still very important, in part because it provides for preventative screenings, including for seniors, because it provides an opportunity for young people to remain covered on parental plans until they are 26, because it addresses many issues of women's health.  We should remember it is a first step, and that we will still need more.

The coverage needs to include vision, mental, hearing and dental.  We need to stop cutting off much medical coverage at the neck.  Again, I remind people of Deomante Driver, the 12 year old from the school district in which I taught at the time who died from a toothache, an abscess.  His mother did not have enough access to dental care to treat both of her children.  The abscess spread to his brain.   Had he been able to get an $800 extraction he would have been a healthy young man.  Instead, he had multiple operations and the costs absorbed because he was a charity case exceed $250,000, yet he still died.

Kristof reminds us that an American dies every 20 minutes because of lack of insurance.

He reminds us that it is not like this in other civilized countries.

He compares the deaths he has seen in places of conflict like Darfur when they would not have died if born in Britain to how we have Americans dying because of lack of healthcare easily obtainable in other civilized nations.

His friend Scott has now died. Kristof views his death as unnecessary, and that life expectancies are greater in countries that have universal coverage.  He ends on a personal note:

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.
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Comment Preferences

  •  Tip Jar (14+ / 0-)

    "We didn't set out to save the world; we set out to wonder how other people are doing and to reflect on how our actions affect other people's hearts." - Pema Chodron

    by teacherken on Thu Oct 18, 2012 at 03:52:44 AM PDT

  •  The callousness of some of my fellow Americans (10+ / 0-)

    toward one another is unbelievable. Unless they are at a Mitt Romney level of wealth, there but for the grace of God go they. And that a 12 year old in this day and age can die because of a tooth abcess is shocking and totally unacceptable.

    My thoughts are with Scott and thanks to Nick Kristoff for writing such a moving and eloquent piece about his friend.

    Thanks to you, teacherken, for keeping us updated.

    "The arc of the moral universe is long, but it bends towards justice. We must put our hands on it and we must bend it in the direction of justice." MLK

    by mindara on Thu Oct 18, 2012 at 04:07:30 AM PDT

    •  "Compassion [is] a sign of civilization" (5+ / 0-)
      Recommended by:
      teacherken, gulfgal98, mindara, SaintC, BRog

      (as Kristof says).  It's a good remedy for that callousness.

      What I find strange is that those who oppose health insurance reform do so until a tragedy occurs and then suddenly they see the light. Compassion for others' pain comes through experiencing pain themselves.  

      What I find baffling, is how can people have so little imagination? Even if they've led charmed lives themselves, have they never read a book, or seen a movie, in which someone suffers? Do they have to feel it first-hand before they are capable of empathy?

      I suppose there are those who really are sociopaths who can't feel others' pain, no matter what.  But there seems to be a willful blindness in the official GOP position that is unfathomable to me.

      •  I totally agree...I cannot imagine ever being (3+ / 0-)
        Recommended by:
        BRog, political junquie, OldDragon

        of the mindset that "I've got mine, screw everybody else".

        "The arc of the moral universe is long, but it bends towards justice. We must put our hands on it and we must bend it in the direction of justice." MLK

        by mindara on Thu Oct 18, 2012 at 05:00:50 AM PDT

        [ Parent ]

      •  Republican Mantra (3+ / 0-)
        Recommended by:
        gffish, political junquie, OldDragon

        All research is bad or unnecessary research, unless it affects me.

        I always thought it curious that Republicans were against stem cell research, except for Nancy Reagan.  Or that Republicans were against gay marriage, except for Dick Cheney.

        I do not feel obligated to believe that the same God who has endowed us with sense, reason, and intellect has intended us to forgo their use -- Galileo Galilei

        by ccyd on Thu Oct 18, 2012 at 05:45:47 AM PDT

        [ Parent ]

  •  I broke forever with my closest friend... (9+ / 0-)

    about 20 years ago. He was my closest and best friend for decades. Dated my sister for a while. Drinking buddies back in the day, the guy I could call at 3 am for a ride home.

    But that all changed when his grandmother got sick at age 85, and spent weeks on a ventilator in the ICU. She was frail, demented, and obviously destined to pass away sooner rather than later. As a young family physician I felt obligated to gently mention to him that hyper-aggressive last-ditch care is often futile, cruel and wasteful when applied to frail elderly patients.

    His response simply stunned me. He said, "I don't fucking care. She's my blood. I want her kept alive if it takes the last dollar in America." So I had to know if he understood what he was saying; I asked him, "Do you feel the same way about other peoples' grandmothers? That we have an obligation to do everything possible for them too?" He said, "Of course not. They're not my blood. I don't want a fucking nickel of my money spent keeping other people alive. Let 'em die."

    It was a revelation. My friend was a sociopath. Smart guy, well educated, hilariously funny, fascinating to talk to. But a sociopath who could not see any moral or logical inconsistency in wanting to spend endless public resources keeping his elderly grandmother alive, and simultaneously wanting to prevent any resources going to preserve the lives of anyone else's grandmother.

    I haven't spoken with him since.

    •  Wow. Just ... wow. (1+ / 0-)
      Recommended by:

      Amazing that he would so openly express such a cruel & hypocritical view like that.

      Being the single intellectual in a village of 1,100 souls ain't much fun, especially when 1,099 of those don't think you're all that smart.--Lucy Marsden

      by Miniaussiefan on Thu Oct 18, 2012 at 05:02:38 AM PDT

      [ Parent ]

    •  That's horrible, but unfortunately all too common (2+ / 0-)
      Recommended by:
      Ralphdog, gffish

      an attitude these days. Not to mention that his total lack of concern over the quality of his grandmother's life not just the quantity.

      "The arc of the moral universe is long, but it bends towards justice. We must put our hands on it and we must bend it in the direction of justice." MLK

      by mindara on Thu Oct 18, 2012 at 05:03:58 AM PDT

      [ Parent ]

  •  Hard to understand (1+ / 0-)

    How the other side of the aisle can have not only different points of view but also different "facts" until you watch Fox news for a while.  It then becomes clear that a large part of our population is being programed to think in a Randian way about issues like healthcare.  I know I also have blind spots but hope they are more compassionate.  Great quote about compassion and civilization!

    •  This (1+ / 0-)
      Recommended by:

      Most of the blame for the sociopathy of wing-nut bubble denizens is due to it being reinforced daily by the likes of Limbaugh and FOX.

      Some of the blame does lie squarely at the feet of the FOXbots though. Being too lazy to think for yourself and have your opinions spoon-fed to you is weak and irresponsible.

      Perhaps one day the Fourth Estate will take their jobs seriously. Or not.

      by Anthony Page aka SecondComing on Thu Oct 18, 2012 at 09:19:00 AM PDT

      [ Parent ]

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