Occupy San Francisco: the teenager who was refused cancer treatment.
Occupy San Francisco protester Miran Istina stands outside the US Bank building on Market Street, San Francisco. Photograph: Martin Lacey
As Miran Istina puts it, she has been living on borrowed time since she was 14. Diagnosed with cancer, she was given just months to live after her health insurer refused to provide her with life-saving surgery.
Now 18, Istina, from the city of Sisters in Oregon, has spent the past three weeks living in a tent at the Occupy San Francisco protest and says she will stay there indefinitely, despite her illness.
She was inspired to take part in the protest by the refusal of her insurance company to pay for treatment for her chronic myelogenous leukaemia.
She said: “They denied me on the terms of a pre-existing condition. Seeing as I had only had that insurance for a few months, and I was in early stage two which meant I had to have had it for at least a year, they determined it was a pre-existing condition and denied me healthcare.”
Treatment would require a bone marrow transplant and extensive radiation therapy and chemotherapy, at a cost of several hundreds of thousands of dollars. Coming from an ordinary middle-class background, her family has no way of paying for the surgery that would save her life.
Following her insurer’s refusal, she spent three years travelling the US looking for a healthcare provider who would give her a chance at life.
Istina said: “I went all over the place, looking for someone to give a damn, really, someone to care enough to treat me. Because we were middle class, we couldn’t afford to treat my disease. We’d be in debt for the rest of our family life.”
After repeated refusals to offer her treatment, she said: “I decided I was going to spend the rest of my life doing whatever my heart wants.”
The Occupy movement attracted Istina as she ties the corporate influence on American politics to the decision that has sentenced her to death.
She said: “The corporate influence on politics influences just about anything that happens, seeing as politicians write the plans that healthcare has to follow. It directly links the fact that insurers only pick and choose those who are actually worth it [financially]. I just happen to not be one of the ones they wanted to be around much longer.
“The decision was absolutely influenced by some corporation or some bank saying, ‘we can’t afford her. She’s not worth our money.’ In end terms, corporate greed is going to cost me my life.
“I used to be really upset about it. I’m not as much any more. I’m angry, for sure, but I think me being here might help it never happen again. That’s why I’m here. It’s that there are other people this is going to happen to if this movement doesn’t succeed and that’s not healthy. I’m done being the victim. However long I have left is dedicated heart and soul to this movement, no matter what it takes.”
She has immersed herself in the movement, becoming the chief media relations officer for Occupy SF and organising fundraising events around the city. On Thursday afternoon she led a CNN television crew on a walk through the camp, to show how they were living, explain their motives and refute claims that the living conditions are unsanitary.
She said of her new life: “My heart is finally satisfied.”
The Occupy San Francisco movement has seen up to 300 protesters take over the Justin Herman Plaza, at the Embarcadero in the downtown district since October 5.
The occupiers are given food by local restaurants and have received donations from supporters to provide supplies.
Health professionals from the San Francisco General Hospital are providing round-the-clock care for Istina, who needs strong pain killers and constant monitoring of her condition. Earlier in the month she suffered a kidney malfunction which required urgent hospital treatment.
Throughout the afternoon four police officers kept a watchful eye over the groups of tents and makeshift shelters but the atmosphere was relaxed. When the officers staged a walk-through some of the occupiers shared jokes with them. One said: “Please leave the automatic weapons outside the camp. This is a peaceful protest.”
Another said: “We’re not doing any harm. We’re just a bunch of peace-loving hippies.”
But a raid on the camp is possible at any time. San Francisco mayor Ed Lee has repeatedly insisted that the camp is illegal and all tents should be removed but so far little has been done to enforce the law.
He has threatened a raid and on Wednesday night occupiers expected police to move in, sparking a larger than normal demonstration. Two candidates for the upcoming mayoral election joined with the protesters but despite the presence nearby of riot police, the raid did not go ahead.
- © 2011 Guardian News and Media Limited or its affiliated companies. All rights reserved.
This should be a crime.
I want to ask the Free-market healthcare advocates out there: what is your answer for this girl? What is she supposed to do? The Libertarian response to her situation seems to be that she should just do her best to seek the charity of others in an attempt to garner the money necessary for treatment. Yet she claims that she’s done that: she traveled across the entire country, for years, looking for an institution that would help pay for her illness. Not a single one would help her.
Does that mean she now has a duty to die?
Meanwhile, if she had gotten cancer in France, she’d have been able to start treatment within days of her diagnosis, and paid nothing:
In France, the sicker you get, the less you pay. Chronic diseases, such as diabetes, and critical surgeries, such as a coronary bypass, are reimbursed at 100%. Cancer patients are treated free of charge. Patients suffering from colon cancer, for instance, can receive Genentech Inc.’s (DNA ) Avastin without charge. In the U.S., a patient may pay $48,000 a year.
But wait, you might say: France has (partially) socialized medicine, so obviously the downside must be that she’d have to wait YEARS to receive her care, right?
Wrong. France has very few waiting lists for serious illness, and its medical system out-performs America’s like a boss:
In a  World Health Organization health-care ranking, France came in first, while the U.S. scored 37th, slightly better than Cuba and one notch above Slovenia. France’s infant death rate is 3.9 per 1,000 live births, compared with 7 in the U.S., and average life expectancy is 79.4 years, two years more than in the U.S. The country has far more hospital beds and doctors per capita than America, and far lower rates of death from diabetes and heart disease. The difference in deaths from respiratory disease, an often preventable form of mortality, is particularly striking: 31.2 per 100,000 people in France, vs. 61.5 per 100,000 in the U.S.
Now I know America doesn’t literally have a free market in healthcare. But distinctions between corporatism and capitalism aren’t going to help someone who has cancer today. And I think most free market advocates would still argue that, within the American system as it stands now, she still has a duty to seek charity first rather than seek healthcare reforms that would lead to even more coercion (as I’m sure she is, given her seeming opposition to America’s for-profit system).
Now would her healthcare literally be “free” in France? Of course not. All french citizens are paying it forward through the tax system. But by doing so, they end up a) paying less per capita than we do now., and b) when you get sick and can’t afford payment, everybody else’s tax dollars pay for your treatment. This allows you to spend more time working and being productive rather, than say, wandering around the country for years begging other people and/or institutions to treat you so you can, you know, live.
Is this fair to the taxpayers of France? Free market advocates would argue no. In fact, they would argue this even if it was clear that socialized medicine, with all the coercion inherent to it, resulted in more people getting access to healthcare, increased life expectancy, and lowered per capita costs; because under Libertarian ideology, it is axiomatic that freedom always trumps physical utility. So even though a system based on coercion could at least conceivably increase human flourishing (and thus increase real freedom for a great many people by giving them to choice to receive care, which they are still free to deny in a socalized healthcare system), a lover of Liberty and Freedom must still reject it, because paying taxes is a form of tyranny worse than not being able to afford to pay for your cancer treatments, and certainly worse than the humiliation of being forced to beg for charity from other people.
This seems like a good time to quote Hayek, whom “true” lover’s of liberty have apparently disowned all together for his early-career apostasy:
[T]here is some reason to believe that with the increase in general wealth and of the density of population, the share of all needs that can be satisfied only by collective action will continue to grow…
Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance, where, in short, we deal with genuinely insurable risks, the case for the state helping to organise a comprehensive system of social insurance is very strong.
At the end of the day, this teenager’s situation boiled down to a matter of luck. If her parents had been lucky enough to have a job that included her on their health insurance, she wouldn’t be in this position. If she had been lucky enough to get cancer after her parent’s insurance kicked in, she wouldn’t be in this position. The insurance company would be paying for her treatment. Why should she be denied care simply because her parents couldn’t find a job with health insurance in time? Why should she be denied care because she can’t predict when she’s going to get stricken with cancer? Her situation is a function of temporal and biological fortune. I don’t think we should structure society in a way that penalizes her for that when it doesn’t have to be that way.
I guess at the end of the day, it really does boil down to a fundamental disagreement at the ethical level, as Kohenari pointed out to me recently I believe freedom is a means of achieving utility, not an end in itself. Libertarians, while generally believing that liberty inherently increases utility, nonetheless concede that in the hard/coneptual case where it doesn’t, they would still choose liberty over physical utility. I can’t do that. I think it is fundamental moral error to do so. I think it is fundamental moral error to tell this girl, or any similarly situated individual, to beg for charity or consign herself to death, while the girl who got diagnosed with cancer down the street gets treatment and lives, because dad was lucky enough not to get a pink slip in 2008.