There’s a common belief that if everyone has health insurance, that we’ll all be better off.  It’s a kind of Utopian ideal, really.  With health insurance, people will make good decisions.  With health insurance, people will live longer and better.  With health insurance, no one will go without any care that they need.

Granted, I’ve met some people who don’t have insurance, but would really benefit from it.  I wish they had it.  I’ve met some people who have it and use it well.  I’ve met some who could have it, but don’t want to spend money on their health.  And this weekend, I met someone who has insurance, and made very bad decisions.

At an Aikido seminar I was attending, I met a very nice young graduate student who is an insulin dependent diabetic.  He wears a pump, but the pump became separated while working out, and all of his pump supplies were two hours away.

I offered to help.  ‘Can I call in some insulin and syringes for you to use?  The pharmacy is right down the road?’

‘No thanks, I’d have to pay for that out of pocket and then get reimbursed.’

‘What’s your glucose?’ I asked, wondering if he were high or low.

‘That’s the other thing, I’m out of strips and they’re expensive.  I can’t get any for three days, so I’m going by feel.  If I get them, I’ll have to pay and then get reimbursed.’

At this point, other students offered him money to help pay the cost.  No again.  In the end, because my child is diabetic, I went home and brought him some NovoLog insulin and syringes from our supplies.  I also insisted that he go to WalMart and get an inexpensive glucometer, which would come with several days worth of strips.  He did finally did that.

Now, I was glad to help.  But the problem I have is this.  This young man came with friends from two hours away.  He obviously ate food, and probably stayed in a hotel.  Furthermore, the seminar fee was $100.  He also pays fees to belong to an Aikido school.  (He never offered to reimburse me, either.  I didn’t want it, and don’t need it, but it would have been the courteous thing for a martial artist to do.)
See, despite being insured, he didn’t want to use any of his own money for something that could conceivably be life-saving!  Even though he’d get it back in the end!

In the days when glucometers were not readily available, one might go by feel, and by urine glucose and ketones.  Now, it’s simply ridiculous when the technology to check is so easily available.  Furthermore, not wanting to spend money for something as essential as insulin, when one has already spent money on a hobby, is beyond my comprehension.

This is what we face.  Insurance is no guarantee of good health, and certainly no guarantee of good health decisions.  Insured patients will still take ridiculous risks, smoke, drink, use drugs, ignore their prescriptions and doctor’s advice and all the rest.  But, if it is collectively paid for, it will all be done at the expense of everyone else.

And let’s be realistic, no one is going to cut off insurance from a federal benefit just because of bad decisions.  Witness the rush to defend the right to obesity!

Here’s the thing:  health just isn’t as important as entertainment or other things that cost money.  People with insurance have said to me, ‘I didn’t get that prescription, because I’d have to pay with my own money!’  As if I suggested that they sprout wings.  (Crazy talk, that!  Investing in your own health, when you could buy a new i-pod and download some music!)

I don’t blame my young friend, really.  He’s simply grown up in a system that says that your health is someone else’s responsibility.  Pity, that.  Because friends, it’s only going to get worse.

Edwin

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