A Health-Insurance Criminal Pleads His Case
Why I will ignore the mandate
Filed Under: Guest Column • Headline
If mandatory health insurance goes through, it will turn me into a criminal. I don’t have health insurance. I don’t want it. And I will refuse to buy it even though I can afford it. Before they lead me to the cells, perhaps the prisoner may be allowed to say a few words in his defense.
It’s understandable that politicians are eager to eliminate the medically uninsured. For years they’ve been told that we are the flies in the ointment of health care policy. It is said we are either a) wrecking the system by using services we don’t pay for, or b) we are deprived of needed medical care and therefore objects of pity and subsidy.
These points may apply to some uninsured but not to all. Some of us belong in what might be called the “successfully uninsured” category. We are not freeloaders. We believe we have an obligation to pay for the medical care we receive, and we always pay for it. I put no financial burden on doctors, hospitals, or taxpayers, and politicians are wrong to assume I am part of the country’s health care problem.
Politicians are also wrong to assume that I am an object of pity. Like many Americans, I have significant savings and can afford medical expenses out of pocket. (Census Bureau figures for 2000 show that over 18 million households had assets in excess of $250,000). Our savings make it possible for my wife and me to decline both private insurance and Medicare (we are 70). Those without savings are in a different situation: They probably need insurance, or a subsidy, or charitable help. My point is that if you can handle your own medical bills through savings and personal responsibility, this is a sound approach. Politicians should encourage this state of self-reliance, not make it a crime.
There are many advantages to being insurance-free. The first is flexibility. Several years ago, my wife had a serious bout with cancer. The successful treatment involved surgery and local radiation therapy. After much study she refused the more massive radiation treatment recommended by the doctor and pursued alternative therapies, including acupuncture, nutritional therapy, massage, and naturopathic medicine. Every decision was made in terms of what seemed best to treat this illness. We were not drawn into using inappropriate therapies because they were “free,” nor did we pass up desirable therapies because they were “not covered.”
The second advantage of being insurance-free is we avoid bureaucracy. We don’t fill out insurance forms; we don’t make phone calls trying to find out what’s covered; and we don’t play games (with the collusion of doctors) trying to get things we need paid for by someone else. If an aching back suggests the need for a different mattress, we go out and buy one and don’t waste time and money trying to prove to some clerk that it’s covered. When the government offered a new piñata of benefits in the form of prescription drug coverage, we entirely escaped the frustration of figuring out how to deal with its staggering confusion. While other seniors were closeted with lawyers and sons-in-law trying to decide what to sign up for, we went hiking.
How Much Health Care is Enough?
Refusing health insurance may have advantages, but what will happen if I face a medical problem that requires more than my savings? To understand my answer, consider a parallel question about some other commodity, say, housing. I announce that I believe in paying for housing from my own financial resources. Someone points out there might be a house I want that costs more than I can afford. That’s just too bad: I don’t get to buy it. I limit my housing consumption according to my resources.
I look at medical care the same way: If something costs too much, I do without. This position, so obvious and sensible in other areas, is considered untenable when it comes to medical care. In this realm the prevailing assumption is that everyone is entitled to all the health services he needs or wants.
It’s one thing to announce this entitlement as an ideal, but quite another to make it work. In the real world medical resources are limited, and therefore all approaches to healthcare funding employ rationing.
In tax-based systems administrators establish waiting lists so that some patients die before their opportunity for treatment comes up. They ban the use of expensive treatments and alternative therapies. And, without exactly saying so, they underfund medical facilities, so that patients wait in the halls of emergency wards, for example. In commercial insurance plans rationing is implemented by restricting coverage to specific procedures and specific doctors — and by setting upper limits to coverage.
Paying your own medical bills is simply another way of limiting consumption: If a treatment costs too much, you don’t buy it. The advantage of self-rationing is it is frank and open, and thus avoids the whining and blaming that characterize bureaucratic systems.
Paying your own medical bills also lets you see that there are more socially constructive ways to use funds than spending on health care. Suppose that to fix your limping gait requires complicated care costing hundreds of thousands of dollars. If others pay for this care, you might accept it. But suppose you are paying for it with your own savings. Now you might think twice about spending the money on yourself. You might know of a school for autistic children that could put the money to good use. Or you might have a grandchild who needs the money to start a business.
Such decisions are indeed difficult, but we need to face them if we are to make sensible choices about health care. Today we are not facing them. We are hiding behind the confusion of a tangled government/corporate system that pretends we can have all the medical care we want.
Spending my own money on health care helps me set a rational limit to medical spending, even on spending to preserve my life. Not buying health insurance and not allowing politicians to force others to fund my needs helps me keep my consumption of medical resources within fitting bounds.
This way of looking at health insurance may be old fashioned, but should it be a crime?
Comment by Joe on 16 November 2009:
Great article. I haven’t had so-called health insurance for most of my 64 years, and I am glad of it. I have learned to take care of my health without the help of our corrupted medical system. There is a doctor that I have seen recently to get his advise, but he doesn’t take insurance.
My reasoning is a little different. I just don’t trust the system. I recently learned a new word, iatrogenic. I means caused by a physician’s treatment. About 225,000 people die per year due to iatrogenic causes. I recall back in the early 1970’s there was a nurses strike and the death rate dropped almost 20%.
No thanks. I’ll stick to the alternatives that the FDA and the AMA say don’t work. They have worked for me for many years.
Comment by Tiana on 16 November 2009:
Thank-you so much for this healthy dose of common sense!
We have insurance now, but didn’t for a long time. Because we use alternative therapies, don’t vaccinate, and have our babies at home with a midwife, most of our healthcare expenses aren’t covered by the typical insurance plan. That doesn’t bother us, though, because our health care costs are minimal.
I believe that we’d be better off as a country if people stopped assuming an insurance company (or the government) will pay for them to see a doctor for every little sniffle, and if we started looking at insurance as something to be used in case of an emergency–you break your arm, need an appendectomy, etc. Then, maybe we’d start taking better care of ourselves–eating right, exercising, and using homeopathic remedies and alternative therapies such as chiropractic care to prevent illness.
Brilliant Article!
Comment by D. Saul Weiner on 16 November 2009:
James,
I am very sympathetic to your position, though I would worry about not having insurance in case I got into a car wreck, or the like. I have little use for most of the expensive offerings of the MD / Big Pharma complex.
Wouldn’t it be nice, too, if we could buy an affordable policy from an insurer which supported natural treatments and which did not need to cover approaches which are outrageously expensive and dangerous?
Comment by Doc on 17 November 2009:
Bravo! Great article.
Comment by joni on 18 November 2009:
Thanks,
Great article. Well said. We haven’t had health insurance for about 7 years and like you, we have made the choice to take responsibliity for our health care and to pay for it when necessary.
Joni
Comment by Waldo Pepper on 28 November 2009:
So what happens when you brave individualists have a serious health problem? I know some of you have said that you have substantial assets, but unless you are very wealthy indeed, you can use up a substantial amount of money in a relatively short time. Are you counting your home among your assets? If so are you willing to sell it, or will you be another bankruptcy statistic.
Others have said they are young and healthy. Even the young and healthy have accidents. Who will pick up the costs if you were to have a head injury which will require intensive care for the rest of your life?
Yet another posted that prayer has kept them healthy. Will the church or maybe even the lord pick up the costs of a catastrophic health problem?
In all the above cases, if stricken by a serious health problem, it is very likely that you will soon outstrip your ability to pay the costs yourself. When that happens, those costs fall on the rest of society, weather through bankruptcy, or through using the medicaid program, or just reneging on the debt.
The United States is the only industrialized country on the earth that does not have universal health insurance, we spend twice as much per person for health care, while receiving care that is average at best.
So all you brave individualists, I hope you feel real good about your rugged individualism and I hope you never get sick enough to have to rely on my (and others) help to pay for your short sightedness.
Comment by Lilie on 1 December 2009:
I found out I had a very large tumor in my liver. I was being coerced into surgery by friends, family, and the doctors. Upon a second visit a year later, my doctor said this, “It could recede.” Once I heard that, I thanked the doctor and went on my way. Another thing, as soon as I went into the doctors office, a nurse took me into another room with the intention of taking my blood and checking my blood pressure, amongst other things. I was not sick, I was there to consult with the doctor who had knowledge of the tests that located this tumor. I declined. She was shocked that I did so. If you look hard enough, you will find something. Many people die with these things that never affect them, and die at a very late age. But these tests that look for things can then cause early deaths if treated. The doctor I saw was one of the best and performed more surgeries than most doctors. He was very wealthy indeed. But I also heard second hand that a nurse that worked for him said he performed many unneeded surgeries as well so I was skeptical. Plus, I was in my late 20’s and did not want a scar on my perfect six-pack, and the risk of opening up my vital organs to all possible infections, mistakes, etc. All in all, I have not had pain since and have started practicing a certain yoga that teaches how to heal yourself. It teaches you how to breath properly as to oxygenate your cells to rid illness and prevent any illness from ever occurring. It also helps balance your body, energy, and emotions so that you may live a more fulfilling life. It also incorporates goal achievement and fulfillment of any other wants and needs you may have. If you keep an open mind and do your research, there are many ways to find the proper treatment that is affordable and will save your life. Maybe what we need is a network of doctors that are there to fulfill their Hippocratic Oath instead of just trying to make a buck. That type of doctor will save your life and will be rewarded accordingly.
Pingback by Politickles » Blog Archive » We Don’t Need No Stinking Insurance on 13 January 2010:
[...] We Don’t Need No Stinking Insurance January 13, 2010, 6:40 pm If mandatory health insurance goes through, it will turn me into a criminal. I don’t have health insurance. I don’t want it. And I will refuse to buy it even though I can afford it. Before they lead me to the cells, perhaps the prisoner may be allowed to say a few words in his defense. – James Payne, The Freeman [...]