The Case for Compassion
Americans never fail to be swept by a collective moral imperative to help people when disaster strikes. There is some genuine compassion at the core of who we are as a nation. After a hurricane (or at least a hurricane on the mainland), our government mobilizes to make massive federal funds available to help remove people from danger and to rebuild their lives. On top of this, everyday Americans open their wallets and donate millions of dollars to help those in need.
But for some reason, we do not have the same moral imperative when it comes to a different kind disaster that strikes people every day. One that is no less deadly: illness. And without health insurance, a cancer diagnosis is a category 5 fuckstorm.
I’ll leave it to others to argue about how to pay for healthcare, as well as legitimate arguments about what we, as a country, might have to sacrifice for every man, woman and child to get the medical attention they require. But the point I won’t concede: human decency means that in the richest nation on earth, we do not allow people to die for lack of medical care.
And yet, we do.
I don’t want to hear “we don’t let people die on the streets, we have emergency rooms.” Until you can start getting chemotherapy in the emergency room, let’s lay this disingenuous argument to rest.
My dad is a super republican. He is one of the “35%.” He has always been conservative but I have always respected his pragmatic East Coast interpretation of republican dogma. (NY values!) He never spewed talking points. His arguments always were about the story underneath the things politicians said in public, and always far more sophisticated. So I didn’t agree, but I respected him. Unfortunately, much of that independent thinking is gone, now that FOX News has taken hold of him in his elderly years. As a younger man and father of three girls, he wouldn’t so easily have gotten past the pussy grabbing comment. And definitely not the toddler-esque geopolitical ignorance.
But you still won’t find a more honest republican than my dad, when it comes to healthcare. “The only way to bring medical costs down is to deny people access and to reduce usage of services,” he tells me. Having worked at a health insurance company his entire career, he understands better than most.
And there it is. The truth from an honest republican and an honest ex-health industry executive that I love with all my heart: you bring down costs for the people who have coverage by denying others, especially old or sick people who are expensive. They do raise costs for all of us. So you kick some of these Americans to the curb, oh say 30 million or so, and viola! Cheaper health insurance for you and me. The plan is as elegant in its simplicity as it is bestial in its brutality. My dad will say it, but, understandably, people hoping to get elected are rather loath to. They tend to say other things instead.
But once you get to this place of bare naked honesty, you can decide if, like my father, you can stomach sacrificing one group of people for another. Or, if you think, rather, that it is immoral to allow some people – young, old – yes, this includes innocent children – to be denied medical treatment when they are ill, and doom them to suffer. And then to perish.
There are legitimate philosophical arguments about how to approach the cost of healthcare – single payer, medicare buy in, health savings accounts, empowering consumers, blah, blah, blah. But there is only one argument that really matters: should people in the richest nation on earth guarantee access to medical treatment, even to poor and sick people?
The thing about those who say that, no, we do not owe anything to those unfortunate people, is that there tends to be a deep down bias guiding this belief.
Why do we owe anything to the people of Houston after a hurricane? Why is hurricane relief a right, not a privilege? Why did my dad deserve a 5 figure check from FEMA after Sandy?
There was a great article recently in New York Magazine that asked this question. Why do some Americans feel it is necessary to help people who have suffered a spectacularly cinematic disaster, but not those suffering the less telegenic catastrophe of, say, getting cancer.
Is it because those people in Houston look like you? Maybe you know someone living there? You can see their suffering and imagine how you would feel, if it were you? Congratulations. That’s empathy.
Where we get into trouble is that, it’s harder to empathize with someone you can’t relate to. If you’re not poor, poverty can be an abstraction. Same with the rural white poor in relation to the urban black poor. They are different from you. You are poor because the factory closed. They are poor because they are lazy and have no values.
This phenomenon takes many forms.
Our country weeps with Paris and London when there is a terrorist attack. We see ourselves in their devastating news photos. Their values are our values. But slaughter in Yemen? Who are those people? Their culture is backward, their religion is cruel to women, their government is an abomination. What do you think is going to happen when you can’t make a good country? Yemen is like the drunk driver wrapping himself around a telephone pole – no sorrow to waste on that guy, and his self-inflicted demise, right?
I am guilty of this thinking too! It makes the human suffering seem less relevant. The compassion doesn’t quite flow the way it does for cultures we can relate to. This is human nature, for better or worse. It is simply easier to empathize with people who are more like us, or that we know. Think of the many politicians who had extremely belligerent views toward homosexuality and gay marriage. Until their brother’s son came out.
If my husband and I both lost our jobs, lost our health insurance and had no access to a healthcare exchange, we would suffer. And this suffering would lead my dad to have some different ideas about how reducing access to medical care is a net positive for the greater good. I can guarantee it.
Even though our biases muddy things up, human suffering is human suffering. If we owe it to our citizens to protect them from a hurricane or a terrorist attack, why do we not also owe it to them to protect them from an attack on their health, which is just as existential a threat?
I love my dad. I love all my fellow Americans. I was heartened to see the groundswell of activism that drew people into their senators’ office hallways during the healthcare fights. Democratic politicians applauded the activists and there were lots of refrains of “you did this!” and congratulations all around about the power of the people.
But the truth is not as rosy. Even though people protested in all 50 states, and even though only 20% of Americans supported their bill, only two or three republican senators heeded the pleas for mercy. The vast majority were not moved by the activism. This alarms me. Republican healthcare legislation will come up again. Once more, Americans around the country will have to call their elected officials daily, beg, plead and share their most intimate personal health details to explain what is at stake.
John McCain is on the verge of extinction. What if he is not there next time to stand in between 30 million people and the doomed wasteland of the uninsured?
Though I have health insurance and my children are healthy, I worry away over the thought of this. It breaks my heart to think that so many people dangle over this man-made abyss, even in a country so rich. A country that has the capacity to show such compassion. When it chooses to.
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