A multiple choice quiz

A good friend—a college roommate with whom you've stayed close over the years—comes down with cancer. Because that friend is single and quit his job after a midlife crisis, he doesn't have health insurance, so he waits too long to seek treatment for his ambiguous early symptoms. By the time he finally seeks medical help, the cancer has metastasized into his bones and his diagnosis is terminal. He cannot afford the treatment required. You:

a) Express sympathy.
b) Express sympathy and offer to help with his medical bills.
c) Decide to pay all of his medical bills so he can have the best care possible during the final months of his life.

Most people, I imagine, could find a choice on this list that they are comfortable with, even if it is likely to be a). That's why I didn't include

d) Savagely tell him that he has brought his suffering on himself and mock him during his final days.

So when Nicholas Kristof of the New York Times wrote a column last week about his former roommate from Harvard, to whom the unspeakable events described above had actually happened, I figured he was making the strongest case possible for why we need nationalized health care, or at least a makeshift system like "Obamacare" that is designed to bring more people into the ranks of the insured.

That's why I was taken aback yesterday when Kristof published a followup column expressing shock at the number of readers who had been "savagely unsympathetic." It doesn't take much effort, after all, to say "your friend has my sympathy; sorry for your loss." (Kristof's friend did in fact die on Monday morning.) Instead, readers lambasted him for making a foolish decision—whether it was the one to quit his job or the one not to seek help earlier isn't clear. It appears that all Kristof's column accomplished was to fortify the battle lines between those who support the Affordable Care Act—which is what I will insist on calling it from this point on—and those who are desperate to repeal it.

I am writing this because I still want to believe that most of those people, if it were their friend whose life was at stake, would at least choose option a) above. Sympathy is famously inexpensive, but at least it is a human and moral response. Mockery of the dying is not. So when Kristof is deluged with messages from people who are "not sure why I'm to feel guilty about your friend's problem," I'm not sure what I'm supposed to think, but I do know what I feel. I feel something akin to the disgust at humanity found in the satire of Jonathan Swift.

To me and many others, the Affordable Care Act, for all its imperfections, is quite simply the best thing that has happened to this country since the Voting Rights Act of 1965. It is an expression of the very best in our nature: the mutual sympathy with our fellow beings that binds us together as a society. It shows we understand that when we extend a helping hand to others, we are sewing the fabric of civilization together, so that we know it will be there when we or someone we care about needs it. It shows we know perfectly well that we are not savages living in relentless competition with the clans of our neighbors, but an advanced society in which all are interconnected.

That's why this presidential election matters so much to me. If Romney and Ryan win, and if they succeed in repealing the Affordable Care Act, I will be forced to conclude that America's best days are over. I will be forced to conclude that I do in fact live in a country controlled by people for whom sympathy is not an option and shared responsibility is not a concept. I will be forced to conclude that the majority of my fellow citizens would choose "none of the above" as the best answer to the question that I posed at the beginning of this blog. As someone for whom not caring is simply not an option, and who understands grace as all-encompassing and all-forgiving, I will despair.