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.