When There's No Insurance...

I know a married couple who are getting along without health insurance and say they prefer it that way. They don’t get sick often. When they need a doctor or medical treatment, they pay cash. They don’t carry any kind of insurance, except on their vehicles (being working musicians, they do spend a lot of time on the road.) These folks have made no secret of their views in recent months. They believe insurance is a dirty game, and choose not to play it.

I can respect that. My own feelings about the insurance industry aren’t exactly warm and fuzzy. If I had to sum it up, I’d sigh and say, “Can’t live with ’em; can’t live without ’em.”

But I know plenty of musicians, artists, and small-business owners who don’t have health insurance. In most cases, I don’t get the idea that they are happily paying cash for their medical expenses. They simply avoid going to doctors. They don’t get checkups. If they get sick, they try folk remedies or just wait for it to go away. And if, God forbid, they suffer a serious injury or an illness that can’t be cured with a few cups of herb tea, they go to the emergency room. Where they often get decent treatment. And then their friends get together and organize a benefit show or a silent auction to help them pay the bills.

In the past twenty years, I’ve attended more of these benefit events than I can count. I’ve served on organizing committees, donated items to auction, and been a performing act at one or two. Musicians in my community spend so much time playing benefit shows for free, I wonder how they make any money at all. But most are glad to do it, when asked. They know that, fate being what it is, it could be their own bills that need paying next time around.

I used to think of all this as an informal support network for people who were “outside” the health care system. But two years ago, as my spouse and I were discussing how much we could afford to donate to a friend who fell off a horse and broke herself in several places, it hit me that I’d been looking at it wrong.

It takes a great deal of time and energy to stage a successful benefit. With few exceptions, all that work is done by unpaid volunteers. And folks, this is PART of the system.

I’m lucky enough to have health insurance, but it doesn’t come cheap. My employer pays most of the premium. I kick in a share for my dependents. And over the years, in order to keep us insured, I’ve made some choices I wish I hadn’t had to make.

There are people who are much worse off than I am, and some of my tax dollars are used to provide health care for them.

And then our crazy, dysfunctional system counts on me and the rest of my crowd to dip into what time and money we have left, to take care of people who fall through the cracks: the hundreds of thousands of Americans who can’t afford health insurance (or can’t buy it at any price) but are too well off to qualify for public assistance.

Ah, well. For your friends, you do what you have to.

But wouldn’t it be better if all the people you care about could afford their own health care, and you could show your friendship by dropping off a casserole or offering to mow the yard while they’re laid up?