Environmental Cancer — Who Should Foot the Bill?

Have you ever seen a cancer patient’s finances?

For those fortunate enough to survive cancer, fighting the disease is just the first war. Each treatment is a battle, each day a struggle. But as soon as you win the war against cancer, the second war begins. The war against the medical bills. Each month is a struggle, each payment a battle.

It is a cruel reality that people have to fight cancer physically and financially — putting a price tag on survival. There is no reason that any person should have to balance the cost of a treatment against the value of their life. Nor is there any reasonable excuse for extorting huge medical bills from families grieving over the loss of a loved one.

What makes this so difficult to accept, though, is that most cancer patients probably shouldn’t be paying for their treatment at all.

Most cancers are linked to environmental hazards and pollutants. Some cancers, like skin and lung cancer, have undeniable environmental causes. A couple of years ago in China, where air pollution is notoriously toxic, a girl became the youngest person to be diagnosed with lung cancer — at just eight years old. For decades, environmental scientists have been issuing warnings about climate change, dangerous pollutants and improper disposal activities.

Environmental management, though, has remained fairly static in the United States. There have been very few new laws or policies that actually address these environmental hazards. Gridlock in the federal government has stalled progress across many sectors, but climate change and emissions and pollution reduction have been particularly hindered by partisan politics.

It is the responsibility of federal, state and local governments to protect the individual rights of citizens, and to provide a safe and functional community for them to live and work in. There are many different opinions on what constitutes safe and functional — and even what individual rights are. Laws change, culture evolves. So where exactly does protecting citizens from pollution and hazards fall in the scope of government responsibility? This obligation exists — it must, because protecting the rights of citizens includes protecting them from threats like murder, assault, theft.

Traffic, criminal and civil law all exist in a functional society. Public health and the environment also fall into the scope of law. Somewhere in there, citizens are to be protected from pollutants, environmental hazards and unsafe industrial practices. When the government fails in this charge, though — what are the repercussions? A noncompliant factory gets fined, or shut down. A negligent executive could be fired or arrested.

But what is the government’s role when harm comes to a community? When a government has lax standards, it usually earns some of the blame when accidents or disasters occur as a result of the lack of proper standards. In the fight between Chevron and Ecuador, for example, Ecuador’s environmental regulations were more lenient than those in the United States. This created an incentive for drilling operations in the country to be carried out with less stringent safety standards. There is a heated debate about how much responsibility falls on Chevron, and how much falls on the government of Ecuador.

The scope of a government’s responsibilities includes a large grey area — this area encompasses matters like ignorance versus malicious intent. Or how much can ignorance alleviate a government’s liability?

This is a very tricky question. Lead, arsenic, asbestos and chlorofluorocarbons are just a few examples of highly hazardous substances that used to be prevalent throughout society. As time passed, science caught up with us and we became aware of the dangerous risks that these substances presented. Should a government be on the hook to pay retribution for all harm that comes to society as a result of a failure to protect citizens?

This is a slippery slope, indeed. Determining the amount of harm caused is just the first challenge. Then it would be more difficult to decide whether the government should be liable for the shortcomings of scientific understanding. This would put any government in a vulnerable position, which would ultimately lead to restrictions on scientific progress.

But what if a government does know about the hazards? Isn’t it an easy argument that an authority that is knowingly negligent should be held responsible for the consequences of their inaction? This is a fairly typical argument in negligence cases, but the defendants in most of these cases are companies or executives. What happens when the government should be in the hot seat?

In the United States, medical bills are complicated — insurance pays for some treatment, no treatment or all treatment, depending on the insurance policy and the illness or injury. Many cancer treatments are not fully covered under insurance, which leaves patients and their families left to foot the bill. And it’s often a very large bill.

The U.S. government is aware of the hazards and public health risks caused by environmental factors like air and water pollution, depletion of the ozone layer, oil spills or increased spread of disease brought on by climate change, deforestation and poor land management practices. It should therefore be a straightforward case that the government is liable for damages to its citizens. So why, then, are our family members and friends suffering in silence with medical bills, when it shouldn’t even be their burden to bear?