BRATTLEBORO — Let's pause a minute on this whole health insurance thing.
This is not a story about a website that doesn't work. Or even a government. It's about gambling.
Before I delve in, a few facts:
I'm 55, married, and have not had health insurance for the past 20 years.
Once, I was an actor with what any reasonable European socialist would call a good health plan. As I was transitioning out of that career and into another, a few years went by before I noticed I no longer had health insurance, and because I was not earning, I'd lost my eligibility.
I tried to swoop in and get a choice job that would restart my benefits. That bid failed.
Long ago, my wife and I referred to insurance as a scam - a massive gambling operation that is rigged so that most people have to lose in order for the house to stay open. And we didn't want to invest in an allopathic medical system that seemed broken. We decided that not buying health insurance was a risk we could tolerate.
Money that might've gone to insurance was set aside for acupuncture, Ayurveda, exercise, massage, meditation, yoga, and proper nutrition through local organic food. Groovy.
We maintained our dental health with biannual visits, and when my wife needed a crown for her molar, we skipped down to Mexico and got one - at 80-percent off the quoted price in the States. With the saved expense, we threw in a two-week vacation in Oaxaca.
Mental-health investments, when needed, went toward couple's therapy for a time and, recently, solo for me.
I'm told insurance companies have actuarial tables where they can accurately calculate the risk an average couple is worth in order to profit while insuring them.
We decided we were not average. Besides, why would we want to throw our lot in with someone who drank, smoked, or had questionable genetics behind them?
At the time, all of our parents were alive, and my wife's grandfather lived to be 96. We took nothing stronger than reasonable amounts of coffee, an occasional aspirin or glass of wine (for her), and regular helpings of arnica for bumps and bruises, with cold packs for swelling.
Our health seemed attainable and simple.
* * *
What is the line of risk below which this couple won't go? I know few people who would have managed the risks as we have.
Due to the change in health-care laws, I am being forced to reconsider because of a new factor in my own equation - namely, a $2,500 penalty for not buying health insurance. I'm still cognizant that a major injury or illness could undermine my whole financial life.
One reason why my risk tolerance might be higher than others' is that we didn't have kids, so we needn't worry about who will care for them if one of us is unable to earn.
Now that there is a law that will make me put even more than I've previously budgeted into the insurance pool, what will I have leftover for my own real health?
* * *
Before I stray too far afield, let's not forget the value of hope.
As in: Gee, I hope I don't get sick or injured.
Or God, as in: God, our health system is a shambles.
Emergency medical care seems like a great idea if I ever need it, but at $500 a stitch, I hope I never do.
Yes, there is much I can't control, especially when I drive 15,000 miles a year. But so far, the gods have shined on me, and the $50,000 that we have put toward real health is an investment that pays daily.
If we had paid for health insurance in that time, it would've have cost twice that and only made some corporation's bottom line a little more profitable.
* * *
The open secret, acknowledged by Democrat and Republican alike, is that the entire health care/medical system is broken. Many have ideas, but no one has the political capital or will to fix it. Even the most wide-eyed liberal will tell you that the Affordable Care Act - I insist on not calling it “Obamacare” - is, while historic, just the beginning.
The system is not radically broken enough to call for real change because it's still profitable. And as long as profitable companies wield political influence, the system will not change.
Insurance companies have seen the pot of gold at the end of the new law's rainbow after realizing that mandatory insurance would mean 40 million new customers. In order for it to be level for the entire population, healthy people have to invest in health insurance but must not draw out more than what they put in. Fear seems to be a marvelous motivator.
You don't have to have gone to Harvard Business School to see why insurance companies and parts of the medical industrial complex are motivated.
I get sick, and they profit.
I stay well, and they profit.
I risk getting sick, and they still profit.
How much do they need anyway?
If you could wave your magic wand and take away profit, you might be able to improve service.
* * *
I voted for Obama twice and think universal health insurance is a good idea (in theory), but now that it looks like I might have to pay into a system I have so little faith in, I am having pre-buyer's remorse.
When I had health insurance, I frequently thought, I'm not that sick but maybe the doctor (the guy with the answers to so many questions) will tell me something that I didn't know, or maybe I will learn something that'll make a difference.
And besides - I'm not even paying for it, my insurance is.
So wee-ha! Let it ride on black-42.
* * *
An interesting feeling would come over me on the rare occasions when I would be asked about my insurance status. At first, I felt a hint of shame as I admitted, “No, I don't have health insurance,” but eventually this same sentence became a proclamation to the entire dentist's office as a source of secret pride.
I noticed another phenomenon: There was a certain conspiracy in paying for services. When clerks or secretaries found out I didn't have insurance, they would reveal the lower option in a two-tier billing. Oh, you don't have insurance? Well, then, that is just $50 for today.
* * *
Back to risk management:
Do I pay the penalty for not getting insurance?
Should I claim that I'm a Christian Scientist and see if I can get a religious exemption?
Do I take an even-more-enormous risk and throw away the money I normally would be putting into my own health by doubling down on the insurance company's table and letting the roulette wheel of fate spin, knowing that the house always wins?
One of the big insurance companies has a tag line on all their ads: “Responsibility. What's your policy?”
Their policy is profit.
Mine is health.