Category Archives: In the News

The Community Mandate

Really, I don’t understand how the professional commentariat does it; how do you express your opinions on an issue over and over again? Once it’s said, it’s said, isn’t it? (Maybe that’s why they  always seem to be writing and saying things that are more and more silly.)

Anyway, I’ve been reading about this week’s arguments before the Supreme Court about the Affordable Care Act, and I just keep getting more and more frustrated at how much of the country just keeps missing the central issue about healthcare policy. I would like to explain this in the simplest possible terms, but I already did, back in January, 2008, long before Barack Obama was even nominated to run for president. This op-ed column was originally published in The Record, a prominent New Jersey regional newspaper, under the title, “The Moral Price of Cancer”. I never liked or wanted that title, and I hereby republish it on Something Entirely Different as “The Community Mandate”:


When I found out that I had esophageal cancer last July, many worries came to me. Will I die? Am I going to be very sick?  Am I going to be disabled? How will I tell my children? My mother? The one thing I didn’t have to worry about was how I would pay for my treatments. As a retired civil servant, I have excellent health insurance.

Esophageal cancer is a very aggressive, very dangerous cancer; surviving it requires very aggressive, very expensive treatments. Since beginning my treatments on August 1, I have had twenty-five radiation treatments, six chemotherapy infusions, and two major surgeries involving more than three weeks in the hospital and six days in critical care units. I have also undergone two CT scans, two PET scans, four endoscopy procedures, and four weeks of IV nutrition with visiting nurses. Next week, I begin another four months of chemotherapy. If I am very lucky, that, plus five years of frequent CT and PET scans, will conclude my treatments and my insurer’s expenses. If I am a little less lucky, there will be more treatments and surgeries over the years to cope with metastases.

Since being told I have cancer, I have spent more money at Starbucks than I have spent on health care, even with having been unable to drink coffee for two months of my treatments. (Now that it is a new year, I will have out-of pocket costs again, until I have laid out one thousand dollars during the year.)

Rick Grimes, who lives in a small town in Texas, found out he has esophageal cancer last September. He is forty-nine years old, with a two-year old child, and was disabled by an on-the-job back injury. He has no health insurance because insuring his small family would have cost almost as much as his wife earns at her part-time job. Yet, the Grimes family is too well-off to qualify for Medicaid.

Consequently, nearly four months after his diagnosis, and eight months after his alarming symptoms first appeared, Rick Grimes has not yet received any treatment for his cancer. (As of this writing, he does have an appointment to see an oncologist for charity care.) The tumor in his esophagus has now gotten large enough to seriously interfere with swallowing. Rick, who used to be muscular and active, now weighs 116 pounds, and has been to the emergency room for IV hydration.

If Rick Grimes dies, his death certificate should list his cause of death as “lack of health care.”

If I die, I don’t want to have to explain to St. Peter why I stood by quietly and let people like Rick Grimes suffer and die.

We don’t need our religious leaders or texts to tell us that the first imperative of a moral life is to take care of the poor and the sick. We know this, in our souls, our hearts, our bones, our guts, or wherever it is that we recognize incontrovertible truth. And our religious leaders and texts do all tell us this, very, very clearly. Isn’t it ironic that the United States, which in every measurable way is the most religious of the developed nations, is the only developed nation that does not guarantee everyone within its borders adequate health care?

Because we will be the last of the developed nations to provide universal health care, it shouldn’t be hard to get it right. All we have to do is look at what the other countries are doing, and see what works and what doesn’t. Most of Europe has efficient and effective health care; we can do it too.

There is no political or economic ideal that can compare in importance to the great moral imperative to care for the poor and the sick. We cannot excuse ourselves with appeals for limited government or economic self-determination; if we continue to fail in this most basic human responsibility, we fail as human beings.

Cancer still kills a lot of people, some cancers more than others. If I live and someone else dies, or I die and someone else lives…OK, that’s the way it is. But when people are dying because we failed in our duty to care, it shows the cancer we have allowed to grow in our hearts.


(Less than three months after this article was first published, Rick Grimes died of esophageal cancer with metastatic spread to his brain.)