This, from The New York Times:
So why didn’t I get physicals? Why didn’t I get P.S.A. tests? Why didn’t I get examined when I started having trouble urinating? Partly because of the traditional male delinquency about seeing doctors. I had no regular family doctor; typical bachelor guy behavior.
I had plenty of warning signs, and that’s why I feel like a damned fool. I would give anything to have gone to a doctor in, say, October 2011. It fills me with regret. Now I’m struggling with all my might to walk 30 feet down the hallway with the physical therapists holding on to me so I don’t fall. I’ve got all my chips bet on the hope that the radiation treatments that I’m getting daily are going to shrink the tumors that are pressing on my spinal cord so that someday soon I can be back out on the sidewalk enjoying a walk in my neighborhood. That would be the height of joy for me.
The writer of those words, Scott Androes, is now dead. He did not have health insurance so he did not see a doctor when he first noticed the signs of prostate cancer.
When Times’ columnist Nick Kristof yesterday wrote about his friend’s death, he got replies like this one:
“I take care of myself and mine, and I am not responsible for anyone else.”
Here’s some of Kristof’s column:
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.
Readers’ Comments
Readers shared their thoughts on this article.
“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.
The United States, whose own Declaration of Independence vows “life, liberty and the pursuit of happiness”, has become a shockingly divided place, where far too many of those who have inherited, cheated, conned, off-shored — or yes, fairly earned — their good fortune — are now hammering the oars of their lifeboats against the desperate, clutching, frozen hands of those now dying and drowning in the icy waters of an ongoing recession.
Too many of of those now driving gleaming new luxury vehicles see people like Androes, if they acknowledge them at all, as mere bugs on the windshield, something small and annoying to be ignored or dismissed.
Androes screwed up. He, God forbid, decided to step off the hamster wheel for a while and take life a little easier, something many of us long to do at mid-life. With no wife or kids to support, he was able to do that. But he was not able to afford health insurance, which is sold here like any other consumer product — and which can be brutally expensive. When I was able to get onto my husband’s health plan at work, even unmarried, in 2003, I was then, as a single, healthy woman in my 40s, paying $700 a month.
That meant an overhead, every year, of $8,400 just to avoid medical bankruptcy. Given that my mother has survived five kinds of cancer, I went without many other amusing choices (new clothes, travel, eating out) for years just to be sure I could, and did, get annual mammograms and Pap smears and all the preventive medicine possible to stay healthy.
Many people in the United States now earn $7 to 12/hour, since the two largest sources of new jobs in this country are foodservice and retail, which pay badly, offer only part-time work and no benefits (i.e. employer-subsidized health insurance). They might as well make out their will now. Because they can’t afford regular medical checkups, nor medication nor ongoing counseling to manage their diabetes or heart disease, even if it’s been diagnosed.
A young friend — sober — fell on a slippery sidewalk, on a steep hill in the rain, and severely damaged one of his knees. He needs surgery that will cost $22,000. His employer, a Christian-based organization, the YMCA, refuses to help.
Yet another writer to Kristof said that people who are destitute medically have all created their own hells, and that’s where they belong:
“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.”
I am ashamed to live in a country where selfishness is considered normal behavior.
I am appalled by such vicious callousness.
I am sickened by a growing lack of compassion from those who have never known, and utterly dismiss in others, the sting, shame, fear and misery of poverty and desperation.
And you?
How does this make you feel?
Broadside 
I read the NYT too. This is a terrible tragedy. Actions do have consequences, including horrible ones. I know so many people who would not go to the doctor unless someone dragged them, and put up with their complaining misery. And then they wouldn’t comply with medical advice. And we have free healthcare!
Good point. But not seeing a dr out of fear (of a shitty diagnosis or nasty treatment) is still different from knowing you cannot afford whatever treatment or surgery you might need.
I’m not qualified – I’m not an American … not even a tax-paying alien. That last comment is so savage it’s taken my breath away. Have people’s attitudes hardened since the GEC. Has economic uncertainty turned people into primitives?
Yes. I think there is a sort of fuck-you brutality that is really turning people very ugly…the rich don’t give a shit about the poor because the poor remain an abstraction, nothing that will shoot them or attack their kids or ever enter their field of vision. Unlike many other equally divided nations.
But how long will that remain the case? What will happen if the Republican candidate wins the election, and the ultra-conservative cliques become more mainstream? How long before prospectlessness turns apathy into anger?
I have lived in the States since 1988. I have never seen it this ugly or mean or uncaring…but Americans seem to have no capacity for organized, collective rage. Unions are hopelessly weak, everyone thinks that hard work will get them ahead and I cannot picture any sort of serious, real, sustained protest. I wish it would happen but Americans are terrified of being “in trouble” with the law or not ever getting another job…Job applicants are now often subjected to checks of their (!) credit history…simply because employers hold the upper hand. So if you’re broke because you can’t find work and have a ton of debt, they won’t hire you.
Ugly does not begin to cover it.
Oh dear … hearing this is all very distressing 😦
I have a dear friend sitting in the hospital right now whose colon cancer is so advanced and he is so fragile, that it can’t be treated. His time here is measured in weeks–all because he didn’t have health insurance. Yeah, he didn’t go in when he first had symptoms but is that any reason to wish him il. And yes, I, too, am utterly dismayed by the brutality and utter lack of compassion of so many of what I call “drawbridge Americans”–I got mine and tough on you. Not the country I grew up in and not the country I love. Makes me ashamed.
I am so sorry to hear this.
It shocks me in ways I can barely express that this happens in a nation that yammers on about being the Best In The World. Sorry, not in this respect.
Speaking of free healthcare, it’s a blessing, no question. There are so many sides to this debate. I believe that the patient in the story said he could afford to buy private health insurance and he didn’t do it. And he delayed going to the doctor to check out his symptoms because of tight deadlines at work…like my friend who died prematurely of breast cancer because she took way too long to check out a lump that she knew was there.
He was making $13,000 a year that year. I know of almost no health insurance plan anywhere that would have been affordable on so low an income. My self-employed friends tell me that $1,000/month is normal for a family, now…
I find it hard to believe that something that should be taken for granted–our health–can cost so much. I mean, the amount you paid in a year for health insurance is more than I have in savings! I don’t know how people do it.
I paid because I had to…I live in daily fear of finding a breast lump (my mother had a mastectomy) or worse (she has also had other kinds of cancer) so I could not tolerate the stress of discovering I might be seriously ill but not afford the care/treatment/medication I might need. It meant, like many others paying these obscene rates, I worked my ass off and enjoyed very, very few things in life beyond the very basics I could afford on a freelancer’s income — rent/food/gas/car insurance/phone. Health insurance was never, ever something I considered optional and I hustled really hard to be able to pay for it. I do not get sentimental and weepy about living in this country. I have seen, and lived, how insanely tough it is unless you are steadily employed, rich or have a family to turn to for help.
still, you’re to be admired for your hard work. as a college student who works part-time, i can only hope that by the time i’m off my parents’ insurance, i’ll be able to pay my own without any problems.
Thanks. You do what you have to.
With all due respect, I’d urge you to focus some energy on changing this system, not having to stay locked within it. Even letters to the editor — or your own blog. Add your voice!
yes ma’am!
I get so angry (and gobsmacked and baffled and confused) when I hear people talking about other people’s genuine tragedies as if they can always be prevented – don’t even get me started on the victim blaming I hear dealing with those kind of people across the counter in law enforcement! I’ve lived in poor places, the worst was a Pacific island where a good portion of my acquaintance lived in huts they built themselves in the jungle that had to be remade with every typhoon. Poverty is real and its crippling. Desperation is alive and well, even in seemingly put together people. Tragedy is a fact of life, not an avoidable nuisance experienced only by idiots and degenerates. Bad things happen to good people – all of the time. The wise and prepare as best they can, but that won’t stop it from sweeping all before it, and trying to allocate blame instead of working for a solution angers me.
I see what you mean about Americans being selfish, but I personally think worse than being selfish is being self-centered. Selfish people look out for themselves, often at others expenses; self-centered people are often unaware that there ARE other people in the world who could be affected by their behavior. I think we live in an “I” society (as any number of Apple products can attest), and in spite of all the media and technology meant to connect us, are losing the ability to listen to, empathize, and work with others. We are learning to think, care, believe, help, and support only ourselves. Which is a far fall from John Donne’s, “Any death diminishes me because I am involved in mankind.”
It’s…overwhelming disheartening.
(On a personal note, the fear of lack of healthcare has kept me in my job when every cell has screamed at me to quit. I have a migraine behind my right eye building right now adding to the pleas, but stories such as those you’ve cited are why I couldn’t quit. The prospect is terrifying.)
Your email is so depressing — and thanks for sharing so much. It stuns me that a woman of your obvious intelligence and skill is stuck in a job you need to leave because you need health insurance. Slavery was outlawed in the 1860s…but it is alive and well in the US today in this respect. For a nation that vaunts itself as THE bastion of liberty, I find this hypocrisy appalling in the extreme.
The people who shrug and sneer at the poor have NO idea what it feels like to have no options. They have $$$ their families have $$$, they have yet to find a breast lump or suffer a persistent cough and know they cannot see a physician unless it’s in an ER. My 27 months in retail were the first time, and overdue, that I saw and lived — even part-time — how desperate one can feel when $11/hour is deemed a “high” wage and you cannot get a raise no matter how hard you work or how consistently and visibly you are productive. The system is deeply, badly broken for millions of Americans.
We live in an enormous machine. It moves smoothly, quickly, soundlessly for many — producing $$$$$$$$$, security, ego enhancement — and grinds others to a bloody pulp.
And one half could care less about the other. What they do not seem to grasp is that we are all connected. Until someone is clutching their ankle or shooting at their Range Rover, why would they?
Just imagine when Romney wins.
I suspect I am not the only person who is horrified by that prospect.
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I’m with you. I haven’t seen Kristof’s follow-up to his column about his friend, and I am shocked by your column. I can’t help despairing when confronted by so many people who don’t share the general ideals I thought were American, including helping out those in need.
Clearly, there are many, many Americans who simply don’t give a shit if others are suffering. It makes me physically ill to see this kind of behavior.
Frankly, I am not at all persuaded that Americans like to help others out. Through individual action, I guess that yes, they do. I do see it and have seen it. But through concerted, agreed-upon political public policy? No.
it seems that more and more issues that in the past were topics of discussion are now becoming much more hotly debated, to the point of causing a great verbal outlash as well as disturbing hatred between people and groups. i see two reasons: money and religion. insurance is about money. it’s about people who don’t want to give up a little of their money in order to pool it all together so we can all be taken care of. it’s about people who have a peter pan complex and believe they’ll never get sick- until it’s too late. then they’d give anything to have that choice back. the problem is money money money.
as for religion, i wonder why people are becoming so much more strongly divided. we are becoming closer to the militant muslims that we worry about. we are becoming more like the religion-based government that caused people to leave europe and head to america in the first place. i keep hearing about obama’s “war on religion.” but it seems the people saying that are too stupid to realize that it’s the opposite. it’s a war on protecting religious freedom. it’s a war to prevent us from becoming the united states of christianity. of course “war” is too strong a word,
as lincoln said, a house divided against itself cannot stand. we’re leaning pretty far over right now.
I’m saddened, horrified, and disgusted by the lack of compassion and the lack of understanding from so many. I honestly don’t get it. If it was only the wealthy protecting their interests, I wouldn’t like it, but I would understand. But it isn’t, so many fighting against their own interests….
The only answer I can come up with is that people are ignorant, and wilfully so. If you really want to understand the economic effects of your political choices, you have to pay attention — you have to read widely, often and deeply. You can’t just suck up Fox News and call it a day and think this is “reality.”
American seem to dislike complexity when it comes to such issues, no?
Yes, willfully ignorant sums it up. I would say it’s selfishness, but it extends too far beyond haves/have nots.
Bold words…and needed. You’re a wise one. Vote hard and vote well, America.
I saw your blog and feel compelled to comment. Scott Androes was a personal friend of mine. I met him fifteen or twenty years ago and was privileged to have spent many hours playing poker with him, as well as talking about nearly anything you can imagine. He was a modest, quietly brilliant man, with a heart of gold. One thing that many people don’t realize is that Scott devoted much of his time and energy over they years to helping other people. When he lived in Portland, for example, he was on the board of REACH, an organization that helps low-income find safe, decent housing. That is far from a selfish attitude, by any rational measure.
I was stunned to hear of Scott’s death this week, but I was even more stunned at some of the reactions to the article in the Times. The callous indifference and cruelty of some of the comments is unfathomable. To frame this whole tragic situation as the result of some sort of moral failure on his part for not having insurance is incredibly harsh, perhaps even evil. I have to believe that if the people that made those comments became jobless and uninsured that the “moral” problems would be replaced by some other explanation that involved a failure of the system that has been put in place over the last few decades.
I will miss Scott’s intelligence and wit more than I can put into words. I know I am not alone, as I was present at his memorial service, which was a celebration of his life where everyone shared their memories of him. Although there was much grief there also much laughter as people revisited the experiences they’d shared with him though they years.
I hope that the telling of his story will open the eyes of some of the people that have been lead to view the lack of compassion in our society as some sort of virtue, so that they can see the human side of cases like this. If enough people can look past the dollars and see, instead, the suffering caused by the choices of our SOCIETY as a whole, maybe things will get better for everyone, even the people that don’t have money to support the insurance business.
Thank you for sharing more of his story.
I was horrified by his situation — and disgusted that anyyone anywhere could do anything but mourn his loss. I am sorry for yours.
I’m not surprised by the callous comments made by people. Appalled by them yes, but not surprised. Sadly they’re a reflection of this new world order that seems to thrive on selfish behavior and delight in the suffering of others. As nation we throw billions in aid to other countries but we can’t provide decent heath care to all Americans? All because of the misguided belief that the person created their the problem to begin with? True,sometimes people do cause their own problems does that mean when something catastrophic happens we turns our backs on them and say they brought it on themselves… Personally, I wasn’t raised that way,and I thank God everyday that I wasn’t.
I am really at a loss to even understand this sort of behavior. Every single one of us is likely to fall prey to some misfortune — even billionaires get incurable cancer, although they can afford useless treatment. I know some very wealthy people (some personally) whose spouses or kids have been suddenly killed or committed suicide or hit by a car. Shit happens.
Here is the bitterest irony of all, in my view….The United States is the most “churched” country and yammers on about religion and Christian behavior. There is nothing LESS Christ-like than ignoring or even disdaining the very real and pressing needs of the poor and sick. Such hypocrisy!!
I hear ya, their almost Calvinists in their views in so far as they conduct themselves as if their among the saved and those not exactly like them are the damned…
Indeed.
There are many sides to the healthcare debate; it is like a Venn diagram with overlapping components.
1) What part does the doctor or health care provider play in all this?
2) What role does the insurance company or lack of play? Yes, lack of a universal health insurance does affect care and peoples access to care.
3) What is the role of accountability for a person? Got ot any store and I wait in line to see people buy cartons of cigarettes, one while being on oxygen. One in three people are morbidly obese but that is not their fault. In the debate on health care, do not elminate the role of persnal accountability in this argumen. It is one aspect, but an important aspect.
4) I read your blog and I have bought your book. It is an excellent read. That being said, you are making a choice to freelance. I made a choice to be self-employed. I realize when I did this, obtaining health insurance on my own would be difficult. It is. I aloways have the option of going back to an employed model. You have decided to be a freelance writer. Stop complaining about your decision. If you don’t like it, do something else.
Lots of points here.
1) We, as users of the system and not MDs are not privy to the internal workings of it all…so I can’t answer this intelligently and neither can anyone without direct knowledge.
2) Insurance companies are only responsible to their shareholders so their only MO is maximum profit — which is most easily achieved by denying access to care and sticking users with the most costs possible. That is a moral wrong, in my view.
3) Yes, all true.
4) I disagree. Many people choose to work for themselves — not simply out of some wish to be a pioneer or work at home — but because they cannot find a FT job paying as much (or anything) in their field. Why should they, I or any of us be penalized by paying through-the-nose rates?
A wonderful post, Caitlin. Thank you for continuing to raise interest in issues of importance, including this very vital one during election season. Though it’s too easy for people to say, “It’s not my problem,” when it comes to the health and the uninsured, we are all connected. One way or another, the health of one person impacts the health of all of us. I love the quote by Jiddu Krishnamurti, “It is no measure of health to be well adjusted to a profoundly sick society.”
Thanks for making time to read it, and comment. We all pay for one another’s suffering, whether financially or politically or, yes, karmically.
Thank you for your article. I was not aware of that NY Times article. I am a Canadian who is recently unemployed and lost my extended health benefits from my job. Six weeks ago, I was running uphill and tripped on a crack in the sidewalk, flying into the pavement. I knew that it wasn’t the type of accident where I would pick myself up and continue running. I somehow managed to get on the bus to the hospital (I knew that ambulance rides are not necessarily covered) and got seen immediately at the Urgent Care department upon presenting my medical card. After x-rays, it was determined that I had dislocated my shoulder, broken my arm and shoulder and tore my rotator cuff tendons. Since then, I have been to my GP once, been to the hospital two more times and seen an orthopedic surgeon twice. I have had five sets of x-rays. If I had no coverage, I would not likely been able to afford all of this care. I might have been googling possible remedies instead. Now that I am on the way to recovery, I was informed that I would have to have physiotherapy sessions three times a week. At that point, I was terrified, because Canada’s healthcare system does not cover that. I imagined myself trying to wing it on my own all because I can’t afford it. For that moment, I thought that this must be what it’s like for under or uninsured Americans. Luckily, my Doctor categorized me as an outpatient of the hospital, so I would be covered under Canada’s healthcare. There are very few Canadians who would ever begrudge any fellow Canadian universal healthcare, it is ingrained in our character. Although I admit that our healthcare system is far from perfect, I could never imagine having a population that is so callous and uncompassionate (just from reading the comments to that NYT article). I fear for you Americans if the wrong party wins…
Thanks for such a long comment.
Sorry for your awful injuries! Rotator cuff is seriously painful stuff.
I’m also Canadian, living in the US since 1988, so am very aware of what Canada offers and how differently Canadians view the absolute necessity of making sure everyone has access to healthcare. It is one aspect of the American character that I will never, ever, ever understand.
Americans LOATHE government, so anything govt-run and single payer makes their eyes roll back in their heads with terror.
I can relate to the sadness and frustration that your article brought to our attention.
I recently lost a friend who was employed, but was in the probation period in which he had to wait 90 days before being insured. It was during the 90 days when he was diagnosed with small cell lung cancer. So he lost the battle, because it took almost 2 months before he got any services and the cancer grow into other organs by then.
Prior to that he was unemployed for over a year, so health insurance was out of the question to purchase. He had just finished changing careers when he started the new job and was happy to be working again. However, after the diagnosis he was let go. So for him he slipped into the abyss.
We have truly entered a new age when we have lost our compassion for others. And without remorse have created the “disposal people” by to just letting them die. Especially when they have been an upstanding citizen, paid their taxes and did an honest day’s work — the world is changed!
What an unspeakable story…although I am glad you shared it here.
First, I’m sorry for your loss. I can’t imagine watching someone die because the care they needed was out of their financial reach.
But, yes, if Romney wins and Obamacare is repealed, I have no doubt this sort of horror will continue and grow. Too many Americans have decided that others are disposable. Wait until it’s someone they care for…
That’s crazy. I’m wondering how anyone who isn’t considered wealthy can afford health insurance at all. It’s astronomical! Private health cover is fairly expensive here in Australia but US costs make it sound completely reasonable. Do you have a public health system at all?
Medicaid for the poor and Medicare for the old. That’s it. (Oh and the VA for veterans.)
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