the smedley log - suburban scrawl

Only one person without health coverage?

Having just received an email from my lone “no” vote (so far) in the “do you have health coverage” poll, I must admit a little disbelief myself. Surely, there must be someone else without the benefit of a health plan reading this blog. Whether or not that’s true (and whether or not I can stir such people to cast votes in the poll), the question will remain for at least a few more days.

Of course, if the question is no longer up, or if you’d like to ruminate further on the subject (with or without health coverage), feel free to leave a comment.

If it makes you feel better – I went without until I was 28 (well – not including some, nowhere near all, of my childhood).

I utterly fail to comprehend why living without “health coverage” is so… well… incomprehensible? I and my wife and first child lived without health coverage for most (4 out of 5) of my grad school years. And why not? We were healthy. We paid our bills and surely saved $thousands over what it would’ve cost to procure health insurance. People treat health insurance like it is oxygen and can’t understand how people can live with out it. How do insurance companies make money? They collect more in premiums than they pay out in benefits. Is this rocket science? It stands to reason, therefore, that the average person, of average health, will on average come out ahead by NOT having health insurance (assuming they aren’t complete idiots and spend the money they save from premuims on Slim Jims and licorice ropes). Obviously, however, one should prudently insulate oneself against bills that one cannot afford. This is why people should still have catastrophic health insurance… for the same reason they have homeowners insurance. So get the least amount of insurance as possible and pay yourself the rest. But we don’t need some nanny HMO (or nanny gov’t bureaucracy as the case may be) running around paying our normal, ordinary doctor’s and dentist’s bills for us, which are by-n-large far, far cheaper than premiums for “health coverage.”

Get a grip people!

Ellen – it’s just a curiosity, really. In real life, I know several people without health coverage, but I wonder if there might be more than just one online.

Steve – you have a point. Most of the people I know who live without health coverage are relatively healthy, but there are those whose routine healthcare would be comparable to paying for regular health coverage. But as someone pointed out via email earlier today, those people are probably much too busy taking care of other things to read this blog.

I hope you weren’t offended by that, Howard. They’d love it if they read it.

No offense taken (if I was offended by it, I probably wouldn’t have made mention of it). I actually appreciated the insight, as I wasn’t thinking of it myself at the time.

Another interesting note on this is the perception of what health coverage entails. Steve seems to have drawn a distinction between major medical coverage (catastrophic health insurance) and the lower levels of coverage offered by managed care options.

To be clear, when asking the question for the poll, I was thinking more of an all-or-nothing approach, to which someone with catastrophic coverage would have answered “yes,” as catastrophic insurance is still essentially health coverage. It also happens to be the kind of coverage that most lower income folks would come up drier on.

Steve’s response also underscores a distinction between “healthy” and unhealthy people. Make no mistake, if you have a chronic condition (or any number of risk factors, including the behavioral kind) catastropnic insurance coverage isn’t necessarily an affordable option. And if fewer “healthy” people buy into it, it becomes even less so – though I’m not sure I want to carry that argument to it’s final destination, at least at the moment.

Just a thought – I think a valid alternative question is how many people are paying for health insurance entirely on their own? I have a number of friends that don’t totally go without, they pay for it themselves.

As for Steve’s comment, it’s not unreasonable to feel as if you need to have health insurance. I’ve done without in my life – but with healthcare costs doing what they have, I would feel uncomfortable doing without it for any extended stretch.

Neither position is right – and I can see the benefits of going without. The big problem with doing without coverage is getting it when you really need and not being excluded because you have a pre-existing condition. Insurance companies often won’t cover pre-existing conditions (unless you get into a group plan) and they use this all the time to exclude people from being insured – and is a big reason why people feel the need to stay insured.

Excellent points Spencer. I’ve finally put up a new poll that kind of asks what you’re suggesting, I think.

It’s probably fair to note that Steve’s example was couched in terms of being healthy, which is a big difference maker in the equation – but the specter of unforeseen illness or injury would be a huge factor as well.