Dance with coal until the music stops

Todd J. Broadman

The whole point is to die with dignity, with minimal pain, and on terms directed by the patient. At least that much I learned while on staff with Hospice. I’m grateful for having had the opportunity to sit with those contemplating a life lived, seeking closure, listening to their stories. Mostly just sitting with them.

Even noble organizations like Hospice have been ensnared in the mad economic web of the healthcare industry, forced to consolidate and trim levels of care so that their executives can grow their paychecks on limited Medicare billing.

There is a disquieting and uneasy relationship in this country between the economy of wage-earners and death. The disproportionate number of COVID-related deaths of the underclass is consistent with this tragic relationship, though the relatively short lives of the poor have an enduring history in this country. On the surface we see political fragmentation; the fault lines of life expectancy though, run deep beneath society’s shaky ground.

As writer Derek Thompson observes, “the price of inequality is paid in early death — for Americans of all races, ages, and income levels.” A resident’s zip code is now a reliable predictor of life expectancy.

Inequality and early death have tightened their grip on the white working class — particularly over the last two decades. Here we cannot point to systemic racism as the culprit. Here we find what Princeton economists Anne Case and Angus Deaton call “deaths of despair.” These are the nameless with one too many needle marks: over 160,000 of them dead to suicide and drug overdoses last year.

While Congress is parading a trillion-dollar infrastructure spending bill as manna from heaven or as President Biden prefers, “our moment to deal working people back into the economy,” both sides of the aisle have failed us all because they lack the courage and political will to admit that any long-term “jobs program” is a fantasy at this point in the game.

Sporadic confetti in the form of additional helicopter money from an already bankrupt Treasury does not address the psycho-social realities of hopelessness and misery on the ground. And there is good reason why the ruling political elites prefer to compartmentalize these “deaths of despair” as yet another drug epidemic.

The preferred narrative is that the soulless Chinese are lacing our perfectly good street heroin with toxic doses of fentanyl. Never mind that most of those visiting the coroner didn’t find life to be a festive garden party in the first place.

If life expectancy is a measure of development as most countries apply this metric, the U.S. has been degenerating since 2015. Each year since then life expectancy in the U.S. has gone down. In 2020, the fall in U.S. life-span was 8.5 times greater than the decrease in 16 peer countries. And while early deaths among poor, unskilled whites, make up a small percentage of this overall decline, their plight is a significant chapter in the story of a collapsing society driven by a mosh pit of greed.

In a white working underclass that is made to feel disempowered and expendable — feelings that have fear and anger as close cousins — we can see the echoes of what black communities have endured for most their history. As Anne Case sums it up: “if you treat people horribly enough for long enough, bad things happen.”

On the one hand, America’s early industry built a mythology around the stable and proud factory worker who could provide for the family, and then went about systematically dismantling the unions, off-shoring production, leaving unskilled low-pay work in its wake. Whole communities were made to feel obsolete. And unskilled work gets outsourced to firms that don’t provide health care coverage.

Package this inside the head of a 20-something who was weighing jelly beans at the mall before taking to the needle. He surfs the net and is a YouTube millionaire before his imagination shuts down altogether. Like the Hospice patient, he too wants to die — on his own terms and with minimal pain.

After years of globetrotting, Broadman finds himself writing from his perch on the Palouse and loving the view. His policy briefs can be found at US Renew News:

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