Dear Cary,
I am 50 and have been unemployed for over a year. For the most part I have been holding my own financially through the help of unemployment insurance and what remained of my 401K. The problem is, I have come to the point where I just can't afford the cost of my healthcare. I am divorced and my kids have their own insurance.
Since I am only responsible for myself (or so I thought) I decided that I would cancel my health insurance.
I do not want to take another job just because I need health insurance. I realize that our country seems to be wedded to the idea that health insurance should be tied to where we work. For me, though, that just feels like another form of indentured servitude. I don't mind working hard, and in general I try to consume as little as I can (good for the environment and the soul). I am also more than willing to give up luxuries in exchange for the freedom to determine how to spend my days and my labor.
My question is, do I have a moral obligation to my family (possibly even society on a macro level) to buy health insurance? My mom has offered to pay for my insurance temporarily until I get a new job. According to her, however, that obligates me to take any job I can find that has health insurance. She "doesn't need to be supporting a 50-year-old son." I essentially told her that I appreciated her offer but I would have to decline. Well, now my family is furious with me. They say I am putting them all at risk by not getting insurance. They say that I could bankrupt the whole family if anything were to happen to me because they could all go broke paying for surgery or for all the exotic treatments I am going to need for all of the possible health problems they see in my future. I told them that I am currently healthy, and I that I am fine with whatever treatment I end up receiving should something happen. I assured them that I would take full responsibility for any future medical costs. I would not expect them to help pay for anything. Well, according to them, that is just being selfish and immature. They would still have to watch me suffer under what they are sure will be the substandard medical care that poor people get. What do I mean, I am not applying for any jobs related to the military industry? I must live in a dream world, etc., etc. If I were responsible I would take any job that offers healthcare.
Since insurance companies aren't exactly jumping at the chance to cover people over 50, my most likely hope for reasonably priced healthcare is through a future employer. There is certainly a chance that I will find a job I am morally comfortable with that has health insurance and all of this will become moot. In the meantime, I don't mind telling the insurance industry to kiss my ass. I would just rather not alienate my family in the process. It's like my obligation to support my kids has been replaced by an open-ended obligation to support the insurance company.
Sincerely,
The Health Care Rebel
Dear Health Care Rebel,
If your family members are concerned about your risk spreading to them, it's a legitimate worry. But maybe the cost of reducing that risk should be shared by all those who benefit from the risk's being reduced.
My suggestion would be to say to your family members that you acknowledge the fact that your lack of healthcare creates a risk for them, and that you are willing to share the cost of risk reduction with them.
Maybe you would share it just with your mother, or maybe others would contribute.
You certainly have the right to not purchase insurance for yourself, but it's an asymmetrical situation, because while your family members also have the right to turn their backs on you, they are unlikely to have the moral ability do so.
This is a model of our national situation, is it not? Though we as a society are theoretically capable of turning our backs on the sick and poor, and though in many ways we do allow the sick who are poor to die, doctors are like human family: They cannot really deny us care. We know this. And we can take advantage of this if we choose, by not buying health insurance. This is the argument for requiring people to buy health insurance.
What interests me a great deal, and what I have not heard talked about much, is the way that the government's failure to provide healthcare places power with business. Businesses are not democracies.
The good thing about governments giving health insurance is that it strengthens democracy. We can influence how health insurance is managed and conducted if we are able to vote on the people who run it.
We don't really trust democracy, do we? We don't really trust our fellow citizens. We would rather trust business owners. Why is that?
My passion is for democracy. Democracy is a really great idea.
For instance, the fact that the government actually protects an individual's right to go out on the street and speak his views is little short of amazing. Companies don't do that. What you give up when you work for a company is bigger than just your time. You give up a way of operating in the world.
I marvel at the fact that somehow we arrived at democracy. It is hard to see how we have arrived at such a happy and felicitous circumstance. I don't see how we could get there now, if we were to start anew. Imagine if we did not have 200 years of constitutional law to start with. Imagine if we did not have a settled body of law and understanding that grants us these remarkable freedoms. I do not see how in the current climate of idiocy, with the current leaders, we could come anywhere close to such a happy circumstance. I think we would be more likely to put people in prison for heresy.
So lucky we have been bequeathed certain laws. Even if we forget the ideas behind the laws, the laws themselves will persist for a while. Eventually, of course, as we forget the reasons we have the laws, as we become stupider and stupider, trending toward our eventual Idiocracy, the laws themselves will wither and die, and we will be back to debtors prisons, heads on stakes and religious inquisitions. Eventually, we will find our own ayatollah. Perhaps it would be Huckabee, that weakly affable deacon and buffoon.
As to the atmosphere in which such matters are currently being discussed: When one can publicly state obvious absurdities without being laughed off the public stage, isn't that a problem? Doesn't that say that anything is possible? Should we not fear the worst? If enough people believe crazy, dangerous things then crazy, dangerous policies can be passed, and we can begin our own descent into horror.
In fact, the formulations of Donald Rumsfeld are eerily useful. Our future is full of unknown unknowns.
Stranger things have happened. Greater civilizations have fallen.
So enjoy your freedom, my friend, and try to spread the risk.
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