Benefits

By Paul Ford

Some thoughts on health insurance.

For years, I worked for myself, and when I was doing well I could afford health insurance, but the last few years I couldn't. And this made the world a threatening place, because I could be cast into a lifetime of debt by a single hospital bill. Every time I crossed the street I thought about what would happen to me if I was hit by a car, and I was nervous riding my bicycle, even wearing my helmet, because if I fell and broke an arm, I'd have to think of money first and pain second. So I stopped riding my bike.

Some people would pull back a little bit when they learned I wasn't covered. Because people without insurance are the living embodiment of risk, of the potential that life has to go wrong. I talked about this with my other uninsured friends, and they all agreed that they sometimes felt like social outcasts, like there was something wrong with us. We were not complete.

But now, suddenly, I find myself covered. I started a new job and received a blue insurance card in the mail. I sat for a long while on the edge of my bed, looking at that card, feeling its sharp edges in my hand. It was just a few square inches of plastic but it made me feel like a whole person to have it in my grasp.

What insurance promises is continuity in the face of fate. If you're uninsured and you get hit by a car, you are basically screwed. While you heal up you'll have a hard time making a living, and once you're healed you'll have an itemized hospital bill as long as a novel to pay down for the next several years. But if you're covered, you'll spend some time being tended by doctors and nurses, then you'll return to the life you had before you were hurt, and things will be roughly as they were, and you can forget that anything bad ever happened. That's the promise. Now that I have benefits I can plan my life knowing that if tragedy strikes, in the form of a hurtling bus, or a bullet, or some disease, I won't be left to fend for myself.

Having insurance also changes the way I see my body. When I was uninsured my body belonged only to me. When I was sick, I waited out the sore throat and fever in bed. But my body with benefits is partially the responsibility of others. I have a new doctor, a nice woman in Brooklyn. She tells me that I weigh too much, that I must take better care of myself, smoke fewer cigars and eat less salty food. I need to get on a plan, she says. And once I get on that plan, I think, I can get married, and my wife can share in my insurance, and we can have children and know that they will be protected by the full benefits of science and progress. Health care gives me a future. I talked about this with my mother, who has only a bare minimum of coverage and worries constantly about her health. She said, “Paul, what can you do? I'm one of the poor people in America now. At least I'm not alone.” And she's happy for me that I have entered the insured class and can enjoy the blessings of my benefits.

It was no fun, in those uninsured days, to feel that my life wasn't worth enough to save. Somehow having a job, working for other people—it makes me more of a full human being, and worth a doctor's time. So I keep my little blue card in my wallet at all times, and when I cross the street I think to myself, if I get hit by a car, it will be okay. I know that doesn't seem fair, and I don't like the equation that it represents, but that's the deal, and it's the only deal out there right now.