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I'm a self-employed professional in my 50s with a graduate degree. I earn a decent living as a contract employee but with no job security. I don't have health insurance because I can't afford it.

With 50+ years of health history behind me, inevitably there are doctors I can't remember, procedures that were inconclusive, or odd symptoms that went away.  But inadvertently leaving any of these off a health insurance application would allow health insurance companies to yank my coverage - a neat little trick called recission.  

In the past I have paid for health insurance and have been denied coverage.  I paid good money for junk.  I can't afford to throw away $800 a month for junk insurance any longer.

Follow me over the fold for my thoughts on why the only answer is single-payer health insurance.

Two years ago I fell down my stairs at home. I wound up in a crumpled heap in excruciating pain on my side and in both feet. I live alone and my neighbors didn't hear me calling for help. My side was killing me, especially when I inhaled. I suspected I had broken a rib. By sight it was obvious I had broken several toes.

This is what I was thinking: "I just got a job contract after being out of work for a month. I have $300 to last me to my next paycheck. I can't afford to call 911 (you have to pay the city yourself for the service if you don't have insurance). If I have a broken rib, all the doctors will do is bind it up and give me painkillers. The same thing for the toes."

So I taped my toes, hobbled to my car, and bought a back-support belt on the way to work. I worked for 3 days with only aspirin for the pain. The weekend came and, after being in bed for two days, on Sunday evening I realized I wouldn't be able to cope the next day if I didn't have better pain management, so I hobbled to the emergency room with my last $300.  

X-rays confirmed that I had a broken rib and three broken toes. The brisk nurse practicioner was suddenly more sympathetic to my whimpering, saying that she had seen doctors inject themselves right into the rib fracture with Lidocaine because broken ribs are so painful. I was given a real painkiller, and had my waist and toes taped.  

I also was told to stay home from work for one week, but unfortunately that was a luxury I couldn't afford. At least I had the painkiller and I didn't miss any work.  My rib and toes healed in about 6 weeks, so I got off easier than a lot of people like me who don't have health insurance.

Insurance is a simple concept:  if a specific activity or situation that a group of people have in common carries some risk, that group can choose to spread the risk among themselves to minimize individual financial disaster. Insurance is a collective choice which today thrives in different formats, including self-insurance.  What conservatives are trying to deny the American people is the opportunity to self-insure our health care by spreading the risk among all Americans through taxes.  Why is self-insurance ok for corporations but not for us?

It's obvious that the most efficent, most fair, and least expensive way to accomplish universal coverage is by having one group of insureds and spreading the risk among everyone in that group, rather than having innumerable private insurance companies fight each other for healthy members, and fight claims by the sick members they are stuck with. All that fighting takes money, you know?

Everyone has heard of supply and demand behavior - supply goes up, demand goes down, costs come down.  Demand goes up, supply goes down, costs go up.  Well, what happens when there is universal demand, like with health care insurance?

Friedman and Reagan were wrong in many ways, one of which is relevant here:  when the widget is a necessity, like electricity or roads or health care, free market competition alone will not reduce costs. Instead, the fact that there is universal demand (by definition with necessities) will cause costs to go up.  

Conservatives use the "socialism" label to describe any government service they don't like.  However, any necessity, by definition universal, will need some government action, because only the government has the legitimacy and resources to deal with problems that are universal in scope.  

Conservatives also tout a free market solution to everything, but you can't switch private insurance coverage freely.  Pre-existing health conditions, which alas are not subject to the free market, will always affect the decision to buy new health insurance or to switch providers, as well as the very availability of insurance itself.

Health insurance, like all necessities, is not something the free market was meant to handle nor is it competent to handle, as it has shown repeatedly over the last few decades. A recent egregious, but not unusual, example of insurance company bad behavior is a Scientific Americanarticle detailing health insurance companies investing in tobacco company stocks. As the article asks, "Is this who we want running our health care system?"

Originally posted to wiseacre on Thu Jun 18, 2009 at 12:59 PM PDT.

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