Earlier this month, Margaret Talbot published a story in The New Yorker about the heroin epidemic sweeping through large parts of white America. “The Addicts Next Door,” set in Berkeley County, West Virginia, an epicenter of the crisis, painstakingly describes the lives of numerous poor but also middle- and even upper-middle class whites coming undone by the influx of cheap heroin in the wake of escalating prescription opiate prices. “At this stage of the American opioid epidemic, many addicts are collapsing in public—in gas stations, in restaurant bathrooms, in the aisles of big-box stores,” she writes. There are many reasons for the uptick, but prime among them is “the despair of white people in struggling small towns,” towns that overwhelmingly voted for Donald Trump in last year’s presidential election.
I have to admit, I found it difficult to empathize with the people described in Talbot’s story—where’s the conversation about personal responsibility when you need it?—but I find my thoughts returning to them now as we wait on tenterhooks to find out whether the Republican-led Senate will make good on Trump’s promise to repeal the Affordable Care Act, arguably not only Barack Obama’s greatest achievement but also the very thing keeping many of these despairing voters alive. One of the great ironies of our era is that the care that so many Americans of all colors need—imperfect though it may be—is being rejected by a significant minority of whites who would rather destroy themselves than be helped by someone who is black.