What I’ve Experienced, and What I’ve Observed
I am an older millennial — on the very cusp. It’s a slipstream of about 10 years between 1975 to 1985 that those of us were born, old enough to remember rotary phones but digitally dexterous.
That age range is important for another reason — insurance coverage through a family plan ended for me at a much earlier age than most, not 26 years as it is today. When I was young, prescription commercials did not air on television, and obesity wasn’t tied to a BMI index. We were real casual about it and just lumped it all under the “fat” category. “Body shaming” wasn’t a term yet. Simpler times.
I turned 40 earlier this year — and I don’t have health insurance.
What I have to share should in no way be construed as medical advice. But in the meantime, if you’re still reading, here’s some things I’ve noticed.
People are reckless. Reckless on a scale that’s hard to convey. The reason is simple: When you can cheaply seek a doctor for your problem, you think nothing of climbing up on that rickety chair — the chair that is not a load bearing structure, by the way — to hang your self-portrait.
Millennials have been accused of thinking themselves as “invincible” due to their youth, but I have news: everyone I meet is as equally careless with their physical condition. I watch people handling sharp objects as though jabbing out their eyes is the side hustle that truly aligns with their passion. A man slipped and fell in a waterfall in Yosemite during the summer of 2019 because most people are unaware that a slippery scum coats the rocks. (He did not survive the fall.)
It is absolutely probable that tomorrow I might end up in a car accident. I may awaken with cancer. I may contract a vicious disease. When I explain I have no health insurance, I’m usually cursed as “being one of the problems of this country” because when I break my arm, I’ll be sucking up all of your tax dollars — specifically yours, according to the rumor, as in your wallet shall be physically opened and thine cash stripped from you to pay for me — and this will happen because I had the temerity to make a different choice.
Except, much of this is a relatively new attitude and mindset to how we regard life and death, and everything that happens in between.
I know this because my father was a doctor.
Ultimately, I took for granted those many years of listening to his phone calls to patients as a young child at his knee. It gave me a storehouse of basic medical knowledge that lurks in my subconscious, as unique to me as a fingerprint. When we took vacations, we stopped at the scene of accidents so he could administer emergency care. And during that whole time, he never asked for a cent, never cried off because he might be sued for malpractice. He exchanged his services for firewood and chicken eggs when people were too poor to pay him. Our house was littered with the trappings of the medical industry. My father taught me how to sew stitches. We had paper tape and gauze, hydrogen peroxide and rubbing alcohol littered here and there. These elements made the background of my childhood — the sight of mint green medical scrubs gives me a very different memory of all that I think of as “home.”
I took much of this medical knowledge for granted. As I got older, it became apparent to me that most people are unaware of how to treat themselves. Most people do not know the difference between a bacterial infection and a viral infection, and that one is unaffected by antibiotics and the other is not. People are unaware that most colds can’t be fixed by a magic pill, but only with your patience and care. Having pain does not entitle us to an anodyne — but we live in a world awash with pleasure. Is it any surprise that at the smallest hint of discomfort, we go running to the nearest authority to resolve it?
Having a father as a doctor also made it clear that our culture has a nearly cult-like reverence for the field. We treat doctors as high priests, when we should be as critical of them as any other field. They are being asked to care for your life — criticism is necessary and warranted. But patients allow themselves to be silenced and smothered by a medical culture that holds itself as the defining authority, and that it shall not be questioned. It does so by dismissing the patient before they even ask a question. By double booking. By inserting endless personnel between the patients and themselves. By rushing from appointment to appointment. By effectively cutting off a patient’s chance to speak and then declaring that they should have said something in the first place.
What I see is a world wracked with a very different disease — anxiety turned into a kind of neurosis, a fear of impending doom, convinced that any second we shall succumb to the hidden diseases, the cancers, the depressions, the immense terrors that lurk in our world and will find us, infect us, and kill us.
It’s a shame we’ve reached this kind of marketing-induced fear.
I’ve watched 20 year olds confess to me that they believe they have cancer. I’ve watched young women tell me imaginary symptoms they labor under, a laundry list that they take extreme pleasure out of creating, the conclusions they jump to as they self-diagnose online.
I think they love it. I think they enjoy it. We buy and sell trivial diseases that are not quite enough to outright kill us, but just enough problems that we can bemoan our ill fortune and flash our wounds like a new brand name pair of sneakers. We have commodified disease. They become our identities, our prized possessions.
Meanwhile, everyone I talk to is entirely unaware of the progress that has been made in recent years regarding treatment of the HIV virus. I still talk to people who think it’s still a death sentence. MS, I hear, is also gaining ground in terms of a potential cure. But no one in media or marketing is interested on reporting on cures.
As a child, my family lived in an exceptionally rural space. The predominant issue was not whether or not we had healthcare, but whether we had access to it. All the healthcare in the world is meaningless if you’re an hour away from the nearest medical doctor and you slice open a major artery.
We had to learn to care for ourselves, to trust our bodies, to sew our own stitches, and more than that — we didn’t spend a second thinking about what would happen if we stepped on a rusty nail, drowned in the river, or slipped on the rocks, or fell off the horse.
It never entered our heads, because it didn’t matter if we did get hurt — we had no options. So we lived. The way people had been living for millions of years, without insurance, without a safety net, without the thought that something could happen to us any second.
One of the greatest shames of Obama care is that they never reached the number of enrollment they wanted from the millennials. And yet, healthcare insurance seems to be the only business that believes it’s entitled to a guaranteed customer base — a perfectly healthy section of people who, in truth, don’t need insurance for unnecessary healthcare.
It’s the ugly truth: your body is a perfectly tuned machine. Hippocrates once said, “Patient, heal thyself.” And make no mistake, not everyone is born in good health. There are people born with diabetes, spina bifida, cerebral palsy, epilepsy. People born with rare disorders, cancers. These are the exceptions, not the rule. This article is not for those exceptions who need to be cared for — and just as my father cared for people in exchange for very little in return, there is no reason affordable healthcare can’t be delivered to them. Because when healthcare is cheap, insurance is unnecessary.
But for the vast majority? The best period of your health will be here, in your youth, before age-related factors begin to kick in.
Various circumstances served to yank insurance away from me for different reasons. Lately, the biggest argument against it hasn’t been unavailability, but affordability, and I know I’m far from the only one too poor to spend the money.
I sat down and did the calculation myself — compared the tax penalty against what I’d actually pay and understood that the only thing worse than getting sick with an illness that might be catastrophic to my health, is to face the economic catastrophe of poverty. And poverty will ensure my ill health.
When you’re poor, you can’t afford good nutrition. When you’re poor, you can’t access the help you need. When you’re poor, you end up in situations like overworking yourself. You soothe your anxiety with bad habits — smoking or eating that extra bag of chips you know you don’t need, or worse, you reach for something harder, like heroin.
And that’s the reality of life if you live in the poor section of town. You see the faces of your peers and ten years down the line, you can see the weight of the despair and the drugs and all it has taken. There is no cure in the world for the grinding hopelessness of a life like this. Some people are in poverty because ill-health was too expensive. But some people are unhealthy because poverty is the disease.
The best health decision I could make was not giving money to an insurance company.
Add to the reality that even when insured, people can’t cover their bills, the answer was even more obvious — what is the point of insurance if it doesn’t even serve the purpose to which it was created?
If I became sick, and insurance was not adequate enough to cover my expenses, that’s no longer a business contract — that’s a swindle.
For all those reasons, I decided against paying into it.
A small percentage of people like me have opted out. I don’t pretend to fully know their reasons. We just aren’t participating. There may come a time when it will work for me. But I’m not counting on it. Instead, I’m putting the money I save to work for me — and I’ve never been so healthy in my life. I am easily healthier than I was as an adolescent. And if I died tomorrow for lack of insurance, I would have no regrets, but go laughing into the infinite.
In some ways, it reveals a deeper tragedy in our modern existence. At the turn of the century, we were a world that had yet to develop plastics that would revolutionize medicine. Penicillin had yet to be discovered until 1928, and would extend our lives in ways we had not imagined possible in a world where bacteria alone was enough to snuff out our lives (and still does, on a lesser scale). Lack of anaesthesia meant people had to go through operations with their eyes open, their senses aware.
For all the medical knowledge we now have today, we have no cure for the suffering and discontent of an unfulfilled life. Insurance never has, and never will, cover that catastrophe. And that may yet be the greatest threat to our well being.