Follow-Up to A Christmas Day Health Care Suicide
Jan 10th, 2010 | 32 responses
In my December 27 post, I implicated our health care system in the Christmas day death by suicide of Athens, GA, folk singer and songwriter Vic Chesnutt. While I stand by that implication, Chesnutt’s friends are far more nuanced in their critique of the system.
In a Fresh Air interview aired earlier this week, Terry Gross spoke with Michael Stipe of R.E.M., who discovered Chesnutt and produced his first two albums; Guy Picciotto of Fugazi, who played on a couple of Chesnutt’s albums; and Jim Cohen, who worked with Chesnutt on many film and music projects. Chesnutt was in a coma before he died; the three of them were with him when he died.
From the transcript, here is the full exchange they had on the topic of the health care system:
Mr. COHEN: Vic was very open and honest about whatever state he was in. And so we knew that he was having some kind of a mental breakdown. There were, you know, bouts of terrible depression and insomnia and, you know, in between, him being his usual funny and smart Vic. But this was serious, and it was clear to people, and people scrambled to get help for him. And he was actually quite open to it. He was open to help.
And so I think, you know, for people to think that maybe he rejected that or that he just simply wanted to kill himself, I don’t think that’s right, personally.
He tried to get better, and the people around him tried to help him. You know, there was a local nonprofit health care center that tried, and a lot of steps were taken right away. But he was in a serious crisis, and when it came to dealing with a certain level of crisis, in my opinion, the system failed him. I mean, there were limits to what the emergency options were in his city, for one thing, like there used to be a psych ward at the hospital and there isn’t anymore. And then, you know, there were bureaucratic tie ups and things are always made harder for people in wheelchairs, and so on. And, you know, in the course of that struggle, Vic took an overdose of the prescription pills, the muscle relaxants that he had to take everyday, you know, that he’d taken for many, many years. You know, and that’s what happened.
GROSS: In the interview that he recorded for our show, he said he was worried about the possibility of loosing a kidney because he didn’t have adequate health care coverage, and he owed a lot of money to the hospital. He was afraid he was going to lose his house. He – because he had, you know, a preexisting condition, because, you know, he was paralyzed from the waist down, it was very hard for him to get health insurance. The health insurance he did have was very limited. It covered hospitalizations, or at least certain hospitalizations. He said it didn’t cover his medication. It didn’t covered doctors visits. So?
Mr. STIPE: My understanding of Vic’s insurance was that it only covered catastrophic conditions or emergency kind of situations, and Vic would wait and wait and wait and wait until he couldn’t take whatever compounded things were going on with his body. And then he would be taken to the emergency room, at which point his insurance would kick in and pay for part of the cost, but I think that these compounded other issues and other problems that he had and made it very difficult. And as Jem said, we have a system in this country that completely – absolutely and completely failed him as a person, and I think fails many people.
Mr. COHEN: You know, Terry, I think one of the things that we’ve all talked about is that we feel that to just say, okay, poor health care killed Vic Chesnutt – that no. I mean, that would be very reductive, and I don’t think that any of us would say that. But it – did it add to the weight that he carried? You know, did health care problems add a lot to his stress, to the load that was on his shoulders? To me, the answer is undoubtedly yes, you know.
Mr. STIPE: Absolutely.
In my earlier post I said:
Among the risk factors for suicide are physical illness and barriers to accessing mental health treatment. Among the protective factors is support from ongoing medical and mental health care relationships. Chesnutt had long-standing troubles with health insurance. Despite attempts to help.
In his November interview with Terry Gross, Chesnutt said this about his health insurance situation:
I can’t get – I’m uninsurable. The only reason I have any insurance now is because I was on Capitol Records for a while. And I had excellent health insurance there. And then when I got dropped from Capitol, I Cobra’d my insurance for as long as it was legally possible. And then -which was insanely expensive, to Cobra this very nice insurance. And then, when that ran out, the insurance company said they could offer me one last thing and that is hospitalization. It only covers hospital bills. That’s all it covers. And it’s still $500 a month. So, it doesn’t pay for my drugs, my doctors or anything like that. All it pays for is hospitalization. And yet, I still owe all this money on top of that.
I get that to blame Chesnutt’s death on our health care system would be wrong. But I can’t help believing that a better health care system might have saved him.
32 Responses to “Follow-Up to A Christmas Day Health Care Suicide”
He was afraid he would lose his house? How can people be so overwhelmed by materialism to think that life is not worth living if you don't own a house?
A very sad case, but hardly one which should be used as a stage prop to argue for ObamaCare.
This example is not an indictment of our health care system. Nor would it have been “evidence” our food stamps are insufficient had he succumbed to something associated with starvation, for example, or killed himself after being a homeless-advocacy or -activist celebrity. Someone normal needs to be an example.
From the interview:
yes, that's what I was referring to
In my view, DaMav that statement is incredibly shallow and unimaginative. What does materialism have to do with it? You cannot conceive of anything else a house could mean to someone other than an investment or a possession?
Someone normal? What the hell does that mean? Is there any way that you guys can say something that does not confirm the heartless conservative stereotype?
The house was raised in the context of financial transactions in the OP. Nobody likes to lose assets, or lose money for that matter. But those who do so and become severely depressed because of the loss of material goods are materialist now, aren't they? Nothing shallow about being accurate.
Now as to imaginativeness, I'll try to use a metaphor next time. But the point I raised back on the 27th of December still stands. Trying to use this guy as a stage prop for ObamaCare is about as shallow as it gets, and way too imaginative to boot.
The house was raised in the context of financial transactions in the OP.
In the OP, there was one line about possibly losing his house to pay for a kidney operation. There was nothing about investments or assets or losing money. Chesnutt thought it was terrible that he might lose his house because he needed a kidney stone operation and didn't have health insurance to pay for it. Is that what you see as “materialist”?
But those who do so and become severely depressed because of the loss of material goods are materialist now, aren't they?
A, not necessarily, and B, nowhere in the OP does it say that Chesnutt became severely depressed because of the loss of material goods.
Nothing shallow about being accurate.
You're about as far from accuracy as I am from California. I believe it's 3,000 miles.
nowhere in the OP does it say that Chesnutt became severely depressed because of the loss of material goods.
So if this all has nothing to do with material well being or costs why is the evil health insurance system even being mentioned? Here we have an attempt to push the meme that this man killed himself because we have this health system that demands payment, and I observe that this implies materialism as a source of the problem and suddenly all the financial stuff doesn't make any difference any more.
OK, I'll buy that if you prefer. Then why does this show up twice in two weeks bemoaning health care costs when they are apparently (in your mind) irrelevant to the matter at hand? Maybe he just killed himself, costs had nothing to do with it, finances were unrelated.
I'm easy with that. He wasn't materialistic, costs were irrelevant, he just killed himself. A shame but nothing to do with the health care system. Just an attempt to play politics with a man's death.
So if this all has nothing to do with material well being or costs why is the evil health insurance system even being mentioned?
DaMav, do you know what the word “materialism” means? Because it doesn't sound from the above as though you do.
Here we have an attempt to push the meme that this man killed himself because we have this health system that demands payment, and I observe that this implies materialism as a source of the problem and suddenly all the financial stuff doesn't make any difference any more.
Actually, both Joe, in his original post, and the participants in the NPR interview, are crystal clear that Chesnutt's health insurance problems were not, in and of themselves, the reason why he killed himself. They were one possible factor among many others. And “materialism” is not in any way the source of the problem. Feeling stressed and anxious and fearful about money because you have serious medical problems and you lack the money to pay for medical care and you don't have any health insurance coverage does not indicate the presence of “materialism.” It's not “materialistic” to want to have the financial resources to see the doctor when you need to. It's not “materialistic” to find it very difficult to cope, emotionally, when you've been going through years of abject terror over not being able to meet the basic needs of living.
Vic was very open and honest about whatever state he was in.
He and anyone with his physical conditions could be on disability and Medicaid. The only problem is that it limits your income and assets. So the reason he didn't have this care is because he made to much to get it but not enough not to need it. I'm glad this country offers a safety net to those who can least afford it, but he wasn;t yet there. I don't see it as “Government Money”. When I think of it I think of it as money coming from people I see everyday. I don't see why Tom, Ellie, George, and John should pay for his medical bills so he can continue to live in a three bedroom house instead of the perfectly decent one bedroom apt. he would have on disability. I got pissed when I had to sell belongings to pay a debt and had some stress in my life until it was behind me, is that the fault of the debt or my coping methods? Blaming his death on the state of medical care in the US is like blaming life for not being fair.
I'm with Kathy here–some of these comments are insensitive and selfish. The abject fear of a critically ill person facing high medical bills amid major disruptions in his life is not something to reduce to some moral or financial bottom line.
yeah, well its not something to use to sell a partisan political programme either now, is it?
I have a high deductable health insurance policy that is of no practical use in day to day health maintenance, but it's all I can afford. I keep it so that in the event of a healthcare catastrophe I don't lose my home of 22 years – a home I've worked for a love. If you don't understand the underlying dynamic in that, and the concept of a home representing much more than a material object, then you have a very, very superficial grasp of the larger problem.
Actually, Kathy, the real world question is how or why someone can see everything as “confirming” the “heartless conservative stereotype,” even if and when it routinely doesn't.
Discounting any haze over your definition of the word, “routinely”, I think Occam's razor appropriately addresses the question.
It helps if you look in the right place to find where the haze really is.
Nobody here is failing to understand the challenges facing so many of us with health care and its related financial concerns. (I've lived this in fact with a pre-existing condition, that has gotten worse, over more than thirty years.) The real issue (which may require mental assistance for some to grasp; it should not be a challenge normally) is that a good rather than poor example should be chosen to illustrate the plight that so many face, and that the universe of maladies should not be “blamed” on health care not being a complete entitlement currently. (It does harm rather than good to use a poor example to try to illustrate this or make improper inferences from such an example. [sigh])
DLS, your self-chosen status as arbiter of “normal” aside, I think we can agree there are countless examples that implicate our current healthcare system… even if this one isn't the perfect poster child.
DaMav. Your comments are not only insensitive, but totally ignorant.
Vic suffered from a terrible disease, that of Bipolar Disorder. When you suffer from such a horrible disease with debilitating bouts of depression, worrying about having somewhere to live and not becoming homeless is not materialism. Having a home is a basic need for survival, especially for a paraplegic person. The thought of losing your home would most certainly add stress, and this may have contributed to his condition.
When you are suffering a mental illness such as depression, materialism is the last thing you are concerned with. Just making it through the day is challenge enough.
Suffering from Bipolar Disorder myself, I can honestly say that the (expensive) healthcare I have had access to through my employer has saved my life. I do not want to imagine what could have happened had I not had access so such support.
I do not know you, but I hope you never have to suffer a mental illness without access to adequate health care. However, rest assured that if I did know you I would do everything in my power to help you, and would certainly not denigrate you in death should you fail to recover.
“When you suffer from such a horrible disease with debilitating bouts of depression, worrying about having somewhere to live and not becoming homeless is not materialism. Having a home is a basic need for survival, especially for a paraplegic person. To anyone, the thought of losing your home to pay medical bills would most certainly add a huge amount of stress to your life, and this may have contributed to his condition. “
Don't put me down with DLS but being worried or stressed over something is not the same as it causing your stress and/or concern. With his condition Vic could of lost everything and gotten medicaid and a small apartment without any trouble tru the various programs available. He never needed or was seriously at risk from being permanently homeless. You already said he was depressed isn't that the cause in itself rather than the issues used as a focus of the depression?
“DLS, surely health care should be easily available to the most vulnerable and needy in our society, or do you think these people should be ignored because of their “universe of maladies”? I think it is precisely for this reason, and because Vic was not a so called “normal person” (what constitutes a normal person, by the way, and why should it have any bearing at all on whether you get the care you need) his situation is an excellent example of the shortcomings in our current health care system.”
As I stated before I don't think there is a person here who would not want everyone to have quality health care. The real problem is how it's paid for. We do have a safety net and the reason Vic wasn't covered is because he made to much and had to much. Now maybe that's something to work on and as a conservative and capitalist the idea of making money is a good one. But Govt money is money that came from the people I see every day. And as I stated before I don't see why Vic should stop have others paying his bills while still living in a nice home. Sure I would prefer a house than the one bedroom he would need to move to, but why would I get to have people foot the bill, not for my treatment, but for my house? Hell he was a great musicians and I would have donated money to help him, but requiring people to keep him in his house?
This is a perfect example of how some people argue. Rather than defending an issue on the merits, they take a tragic figure, make him a “victim of the system”, and propose their solution.
Now if anyone challenges their rhetoric they can accuse that person of being insensitive and indifferent to suffering. It's a cheap shot pal. You're right about one thing, you don't know me at all.
Even the OP said he had “implicated the health system” in his death. But you now deny that it was a stage prop? And then you follow that up with your own argument for ObamaCare. Then follow with a little piece about how if I oppose it I must be “narrow minded” and “shortsighted” and advocate that we “keep health care as it it”. The only thing you didn't say specifically is “Oh DaMav you evil insensitive man, you must want nothing to change and people like Chestnutt to die”.
See, it was and is a political argument the whole time. The use of a tragic death to try and sell a political point of view. How “insensitive” of you.
Had Vic lived in a country as communist as the United Kingdom Of Great Britain, Canada, Germany or Spain he would have had a proper healthcare system backing him up. Not only it would have covered his medical expenses, it would also have helped with all the needed furbishing in the home of a person on a wheelchair.
He still might have ended his life, no doubt about that, but it would have been much less miserable.
What in any other civilized country is a basic and undeniable right for all its citizens is (still) a luxury in the US.
DaMav, you missed the point of what I was saying because you don't seem to want to enter a dialog with anyone that doesn't agree completely with your point of view.
1. I never said he was a victim of the system. However, it is a valid point to say that the system failed him. Was his death a direct result of the system? No, but I think it is safe to say it contributed to his condition.
2. He “implicated the health system”. Yes hid did. Did he advocate Obamacare? Did I advocate Obamacare? The answer is no. It seems as though you are paranoid about “Obamacare” (which nobody apart from you has even mentioned) while offering no solution yourself. Therefore, I believe it is a valid point to suggest you are being narrow minded and are advocating we keep health care as it currently is.
3. I'm not trying to use his death to sell my political point. Both Vic and the article's author used Vic's situation to try and highlight his point of view that the health care system as it stands is inadequate. I don't think I read anywhere (or indeed wrote myself) about advocating any political point of view, only the view that the health care system needs to change. In fact, the only person advocating a political point of seems to be you.
If you want to discuss any of the points I made in my posts I will be happy to do so. If you just want to argue against “Obamacare” and try and belittle people by accusing them of cheap shots because you can't think of anything else to back up your argument, then don't expect me to respond.
Finally, lets just be specific about this; I'm not calling you evil, I'm calling you ignorant.
Hi EEllis.
I think being worried or stressed is the same as causing it. It is self perpetuating, but that's just my point of view. You raise a good point and maybe right that he could have got a small one bedroom apartment, but I think there 2 things in this whole story. The first was his medical costs that could have resulted in him losing his home. The second was his mental disease, and I may be wrong, but I don't think this was the cause of his medical bills originally. The first problem undoubtedly had an impact on the second, but the second tragic event could easily have occurred without the first. It happens. Had Vic had access to adequate mental health care the outcome may have been different.
To clarify, in hindsight my argument is probably more about the access to mental health care, as this was the final thing that Vic needed. Even if he did lose his home and get an apartment, the end result may have been the same. Let's be honest here too, while Vic may have qualified (or may not, who knows) for medicaid and an apartment, that surely would not have been without any trouble, and there is something wrong with a system where you can fall through the cracks because you earn too much, but not enough at the same time. Specifically, I think the main problem was that he earned to much for medicaid while at the same time being denied adequate insurance because of pre-existing conditions.
Amyway, the point I was trying to emphasize is that losing your home, regardless of the cause or the outcome, is a highly stressful and horrible experience for anyone to go through, and having to go through this suffering a mental disease without access to health care support is unacceptable.
You are right, his depression is absolutely the cause, and that is absolutely why he needed help to treat it. One other thing to point out, even if he had got this care the outcome may well have been the same. I'm not blaming this entirely on the system. Let's be straight, Vic had a mental disease and it was this mental disease that ultimately claimed his life. However, with help, he would have had a much better chance of recovery.
The government money/taxes argument could run and run and is bigger than this forum for sure! How we pay for it is a huge problem, and I'm not sure I have the answer. My point of view is that we, as the most advanced civilization on the planet, should take care of the most vulnerable in our society if they need it (NOT if they merely want it). Even though I am not, I'm sure I've just left myself open to be called a communist by some because of that point of view! Now, this doesn't mean keeping them in the lap of luxury, but some level of care is needed and this unfortunately costs money. I can't speculate on how nice Vic's house was, but I do agree with you that everybody would prefer a house and we shouldn't have to pay for more than is necessary just because of that.
“DLS, surely health care should be easily available to the most vulnerable and needy in our society, or do you think these people should be ignored because of their 'universe of maladies'?”
Actually, I believe health care should be easily available to everybody. You and other critics are being illogical (if not worse) if you infer that I do not believe so simply because I have made it clear I do not accept the generalization “indicting” [sic] our current system, i.e., blaming it for the death of someone whose suicide is largely and obviously independent of the nature of our system today.
“I think it is precisely for this reason, and because Vic was not a so called 'normal person' (what constitutes a normal person, by the way, and why should it have any bearing at all on whether you get the care you need) his situation is an excellent example of the shortcomings in our current health care system.”
“Normal” is obvious here; the man in question was troubled. It doesn't have a bearing at all on whether someone gets health care, but it immediately (to the honest and logical) shatters the argument associated with the individual's death, that it was “caused” [sic] by our current “evil” system (and by extension, that he had a “right” [sic] to any and all care he might possibly need or want).
Meanwhile, as I insist on being honest and logical — it's even worse news for advocates of health care entitlements, because there are many other, better, examples of “letdowns” or even “injustice” found in our system (deliberate misconduct by insurers, such as denial of care or payment of claims that isn't only heartless, but truly dishonest or illegal promptly come to mind), yet there cannot and never will be a magic complete provision of all health care, needed and even desired, to everyone all the time. We cannot afford that and never will.
“I think we can agree there are countless examples that implicate our current healthcare system”
I've never denied that, and in fact have recounted my numerous unpleasant experiences under our system. (Experiences in the new location where I am currently, on my current work assignment, have even led me to make ugly mutterings about our health care future — greatly “public,” institutionalized or bureaucratic, and facing chronic scarcity and an incessent effort to control costs, in part from rationing of various kinds with “attrition” as a characteristic of clinical patient experience.)
@ DaMav: Vic lived in a neighborhood surrounded by people who cared about him. His worry wasn't “materialist”—i.e. losing his house—in some aspects I imagine he feared losing his community. Plus, since I am assuming you are not disabled, you most likely do not understand all the modifications that have to be made for a house for a disabled person…ramps, lowered kitchen and bathroom counters, etc., modifications his house included. He (like most artists) needed a comfortable, inviting space to keep creating…something a crappy cinder block apartment would not provide.
He needed mental health care and desperately tried to obtain it during the final weeks of his life but was denied for a variety of reasons. Had he obtained it, he would most likely still be here, and his family, friends, and fans would not be mourning.
Quit attacking someone no longer around to defend himself. Says a lot about your character.
“Actually, I believe health care should be easily available to everybody. You and other critics are being illogical (if not worse) if you infer that I do not believe so simply because I have made it clear I do not accept the generalization “indicting” [sic] our current system, i.e., blaming it for the death of someone whose suicide is largely and obviously independent of the nature of our system today.”
I'm not blaming the death of someone on our current system. I am saying that it could have a been a contributing factor, it certainly did not help him when he needed it most. However, to say that his death is largely and obviously independent of the nature of our system today is just not true. It is largely and obviously related directly to the nature of our system today, because under that system he was unable to get the care he needed which may of saved his life.
“”Normal” is obvious here; the man in question was troubled. It doesn't have a bearing at all on whether someone gets health care, but it immediately (to the honest and logical) shatters the argument associated with the individual's death, that it was “caused” [sic] by our current “evil” system (and by extension, that he had a “right” [sic] to any and all care he might possibly need or want).”
Again, I'm not saying he died because of our health care system, and I certainly never said it was evil. I also never said he has a right to any and all care he might possibly need. However, people should have a right to adequate health care, which Vic did not. What I did say was Vic had a mental disease (he was not “troubled”. Depression is a mental health disease. Much like Cancer is a disease, so to imply that he was just “troubled” is not fair). It was this mental disease that ultimately claimed his life.
“Meanwhile, as I insist on being honest and logical — it's even worse news for advocates of health care entitlements, because there are many other, better, examples of “letdowns” or even “injustice” found in our system (deliberate misconduct by insurers, such as denial of care or payment of claims that isn't only heartless, but truly dishonest or illegal promptly come to mind)”
I agree completely. However, that is not the point in question here, the point in question is about having the access to adequate health care and the problems you mention are a very relevant yet different topic in the overall health care debate.
Yes, there is no magic wand, certainly, and we can never afford desired health care, but I think needed health care is something we can achieve. Maybe not immediately, maybe not in a few years, but I do believe it is a achievable.
Vic's scenario was definitely not common, but certainly not unique. I stand by my claim that it is an excellent example of the current problems because if it cannot help people in his situation, then the system is failing the people that need it most.
“It is largely and obviously related directly to the nature of our system today”
That it may have exacerbated the problems the man had, there is no question. Nor is it a question of being characteristic of “our system”; as I've written elsewhere, I've had thirty years' experience with a pre-existing condition. (I'm current switching locations once more, and once again being asked by the local insurer, doing the underwriting, for “more information” — it's a predictable, tiresome routine for me.) The point is that it was not “the” cause, or even necessarily the primary cause, or the “factor” that led to his decision to kill himself necessarily.
“people should have a right to adequate health care”
Actually, that's not true. There is no “should” here. It certainly is desireable, and I'd like to see better access and higher quality of care for everybody (I do not think only of myself and my own situation). It's my belief that government (including federal) involvement in health care is inevitable (be it the “public utility” model or the non-profit quasi-private model, or public-clinics-and-hospitals model), but to create a government entitlement to health care is a conscious decision to be made — it is not a human or inherent right.
“I think needed health care is something we can achieve”
Agreed. (even accounting for flexibility of the definition of “need”)
“the problems you mention are a very relevant but different topic”
“[Vic's] [I]t is an excellent example of the current problems”
I was illustrating other abuses or wrongs found in our system — and examples where “the system” could be more clearly blamed, unlike this case.
The main issue raised by the comments is that it was wrong to generalize from this example, and “blame” the “system” or “society” (“our health care system”) for the suicide; other, more important problems are associated with the suicide, and this was a poorer example to use for any kind of generalization.
Just to clarify again, neither the article or I am blaming his suicide on the system. What I am saying is it failed him when he needed it, and I think it is fair to say this failure may have been a contributing factor and as such can be implicated as A, not THE, cause. We will never know.
I agree that there are many other and more wide ranging arguments. I don't think that makes this a poor example, though. I'll stress again, that was not the topic of the article or the discussion (or at least what I though was the topic), that topic being, what level of care currently is available, and what level of care should be available. I think the example is good because it is specific to these points.
I'm sorry to labor the point, but in the health care debate generalizations are thrown around that are inaccurate and that's what I am trying to avoid. This example should not be generalized as an indictment of the system as a whole, you are correct, but I think you'll agree that it does highlight, in a very stark manner, a major problem we need to correct.
I don't believe my posts (although some other posts may) have generalized this into something bigger. I'm sorry if it has been construed that way because it was not my intention at all, and I've tried to be specific about this.
“people should have a right to adequate health care”
“Actually, that's not true. There is no “should” here.”
I feel differently, but you are perfectly entitled to your point of view.
Thanks for an interesting and thoughtful discussion on the matter. It's a refreshing change to some of the mudslinging and shouting that goes on. I wish you the best of luck with your location change and insurance coverage.
“This example is not and should not be generalized as an indictment of the system as a whole.”
I believe other, better examples can be found, although I don't believe there ever will be any “magic” example that constitutes a 100% generalizeable case. Plenty of people have no problems currently. (These people would not want to risk things being made worse for them in the name of “reform.” At a distance but also part of the news these past several months are those who have had problems and find them objectionable, but developed concerns nevertheless once “reform” began progressing, because they realized they also could have had their situation made worse.)
“It does, however, highlight one of the problems we need to correct.”
Without a doubt — inability to get “coverage” (actually, comprehensive, affordable health care).
“I wish you the best of luck with your location change and insurance issues.”
[cynical grin] It's already proving to be poor luck, again. Thanks, though.