The rotten US health care system

Just last month I went for a routine physical examination followed up by routine blood tests and a bone density scan. According to my health insurance plan, all these were supposed to be fully covered. Of course, being a veteran of the bureaucratic health care system in the US, I know that nothing is ‘routine’ here and so before I did any of these things I had to spend some time making sure that I was going to a doctor covered by my insurance plan and that the blood-testing laboratory and the bone-density measuring facility were also covered procedures done by approved facilities.

After everything was over, I received bills charging me the full amount for both the blood tests and the bone density scans. This meant that I had to call the insurance company to find out what had gone wrong. After fighting my way through the thicket of the voice mail jungle to get a real live person, they said that one of the bills was due to an error by their processing office and the other was due to a wrong process code entered by the laboratory. (It fascinates me that these errors always seem to favor the insurance companies, never the patient.) So then I had to call the laboratory and tell them to re-submit the bill using the correct code.

Of course, I was not surprised this happened because I have had enough experience with the absurdly bureaucratic US system to know that this kind of hassle that patients go through is the norm. In fact, I fully expect that there will be more glitches and more bills requiring more phone calls from me. All this for relatively trivial and ‘routine’ processes. For other people, things are a lot worse. The wife of a friend of mine died after a long illness. In addition to dealing with his grief, he now has to deal with the enormously complicated details of who should be paying for what aspects of her care. Dealing with all the paperwork and bureaucracy is practically a full-time job.

Let’s not mince words. The US has one of the lousiest health care systems in the developed world. (For my previous posts on this topic see here.) This is not just my opinion. It is supported by numerous studies, the latest of which finds that the US ranks at or near the bottom on most measures when compared to six other countries (Australia, Canada, Germany, the Netherlands, New Zealand and the United Kingdom) in the quality of the health care its people receive. This will, of course, come as no surprise to those people who have paid close attention to this question and seen through the propaganda of the lucrative health industry and their bogus arguments about hip replacements and wait times and the like. (The organization Physicians for A National Health Program gives a lot of great information.)

A Business Week news report on the new study says:

Despite having the costliest health care system in the world, the United States is last or next-to-last in quality, efficiency, access to care, equity and the ability of its citizens to lead long, healthy, productive lives, according to a new report from the Commonwealth Fund, a Washington, D.C.-based private foundation focused on improving health care.

According to 2007 data included in the report, the U.S. spends the most on health care, at $7,290 per capita per year. That’s almost twice the amount spent in Canada and nearly three times the rate of New Zealand, which spends the least.

The Netherlands, which has the highest-ranked health care system on the Commonwealth Fund list, spends only $3,837 per capita.

The report also debunks the most common sound-bite made by supporters of the US system, that supporters of single-payer don’t really know how awful other systems are. The converse is true. People who have experienced health care in any of those other countries (like I have) are the ones who are amazed at how awful the US system is, because only they realize how much better it can be, and is elsewhere.

Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine, commented that “as a physician and public health practitioner, I have routinely spoken out in favor of health care reform in the U.S. The responses evoked have not always been kind. Prominent among the counterarguments has been: ‘You should see what health care is like in other countries.'”

“This report utterly belies the notion that the former status quo for health care delivery in the U.S. was as good as it gets. Others have been doing better and we can, and should, too,” he said.

In fact, the UK with its (gasp!) ‘socialized medicine’ turns out to be at or near the top.

U.S. patients with chronic conditions were the most likely to say they got the wrong drug or had to wait to learn of abnormal test results.

Overall Britain, whose nationalized healthcare system was widely derided by opponents of U.S. healthcare reform, ranks first, the Commonwealth team found.

An American physician now working in Canada gave the commencement address to newly minted doctors at the University of California at Irvine and he made some interesting comparisons with his experience working in the US.

It was interesting for me, as an American physician practicing in Canada, to see the recent negative depictions of the Canadian system in TV ads and lay media, depictions that bore absolutely no resemblance to the actual environment in which I practice daily. My reality is very different. I can see any patient and any patient can see me – total freedom of practice. My patients’ parents have peace of mind regarding their children’s health. If they change jobs or lose their job altogether in a bad economy, their children will still get the same care and see the same physicians. Micromanagement of daily practice has become a thing of the past for me. There are no contracts, authorizations, denials, appeals, reviews, forms to complete, IPA’s, HMO’s, or PPO’s. Our Division’s billing overhead is 1 %. My relationship with the hospital administration is defined by professional, not financial, standards. I have no allegiance to any corporate or government entity, nor does one ever get in between me and the patient. This environment, which some denigrate as the ever so scary system of “socialized medicine” allows for more patient autonomy and choice than was available to most of my patients in California. (my emphasis)

That is not at all to say that I practice in a medical utopia. There is no perfect health care system. The Canadian system has its own set of difficulties, challenges, and shortcomings, and Canadians are also looking to significantly reform their system. But as physicians, we have to enter the debate and we have to enter it objectively, salvaging it from the bias, misrepresentation, and demagoguery that has characterized it. Health care should not be a liberal or conservative issue, for disease, disability, and death do not recognize political affiliations.

As a socially conservative Christian myself, my belief that health care is a fundamental human right, and my efforts on behalf of single payer universal health coverage stem from my faith, and not despite it. My faith calls for personal morality, but also for societal morality – how do we treat the sick amongst us, the weak amongst us, the least amongst us?

Some form of single payer health care system (whether socialized or not) is what the US needs. Now.

POST SCRIPT: This is the best the US can do?

It amazes me that the corrupt, wasteful, and greedy health insurance industry in the US is what some people want to preserve.

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  1. says


    Thanks as usual for an insightful post.

    Although some health insurance reform opponents will cede that wider coverage is a good thing, one of their oft-cited objections is that the new healthcare system will create a much more bureaucratic system with more red tape and obstacles.

    Can you demonstrate that this is not the case? Will bureaucracy be reduced by health insurance reform?

  2. says

    Actually, I fear that the critics may well be right. Although the reforms had some good points, such as extending coverage to more people and removing some of the restrictions, its big weakness is that it protected the interests of the parasitic health insurance industry, and they are the ones responsible for the red tape. This groups add no value to the system at all and simply makes money at the expense of sick people. But Obama and both parties are beholden to this industry.

  3. says


    Thanks for answering my question. As your writings on health insurance have all been clear-headed and straightforward, it is sobering to read your opinion on increasing red tape.

    So what we’ll have in America will not mirror Canada or any other country, but rather will be a new beast, uniquely American in its reams of paper-shuffling and bureaucracy. Maybe -- we will see.

  4. says

    The rising tide of wellness care stems from a number of factors that has an affect on us all. Very first, there’s an intensity of services within the U.S. wellness care system that has undergone a dramatic change when you consider that individuals are living longer coupled with greater chronic illnesses.

  5. peter lafond says

    i have a problem. Back in 1999 i was diagnosed with papillary thyroid cancer- a very treatable cancer. I am employed at the Mohegan Sun and have Anthem thru them- until 2008 this coverage was a benefit; now i pay 30 dollars per week for myself, daugher , and wife. Anyway i never had a problem: i had access to surgeons, endos, hospitals, residents, interns, nurses nuclear this that everything. It was dealt with swiftly and precisly. So what is Anthem doing? I am pro single payer, but i can understand some peoples’ concern- some are in my family and though they maybe loud mouthed, opiniated, and tea partiers they are americans too and have right too ( though they annnoy me to no end) and are not simply racists or whatever the current far left insult is so what to do?

  6. says


    First of all let me say how glad I am that you have insurance that has covered your treatment for a reasonably modest cost. And there are many like you who are similarly disposed to stick with what they know and are fearful of change. I can understand that and don’t disparage them.

    I am concerned at how fragile their care is. If people lose their job, they are done for. Many people with illnesses cannot change jobs. Although I have a job with insurance, there is a good chance that at some point one of my children or (looking further into the future) grandchildren and great-grandchildren will be out of work for a while. I like to have the confidence that they will not have to worry about health care.

    And then there is the paperwork, which really drives me up the wall. Even though you are satisfied with your care, don’t you have to deal with paperwork?

    And then there is the cost. The American system is so bloated and inefficient that the costs are simply unsustainable. This is where the next crisis is going to occur.

  7. Peter Lafond says


    thank you for your reply- actually i not so much afraid as appalled by liberal critics of the opposition to health care ( wheww!) I have many family members who are right wing and they have worked hard to get what they have. All they did was ask some simple questions ( as did I ) and instead of some reasoned response they got called ” racists” ” facists” Now the reaction to that was poor ( summer of 2009) but you can not jsut demand that people hand over their income ( i recognise the situaton with the military budet.) now i have a queston for you -- why are so many dark skinned people ( such as your self ) that have immigrated into this country are succesful? now that is a question we liberals need to address.

  8. says


    My response to your question would be that skin color has little to do with this issue but that a lot depends on the nature of immigrants in general and whether any specific subgroup forms part of a ‘voluntary’ minority or an ‘involuntary’ minority. I address this and the complex question of educational achievement at some length in an article that I published that you can read here.

  9. says

    I think the US health care system should learn a lot
    from many of the European models found in the most developed countries in the zone.

  10. says

    I am confused by the report: According to 2007 data included in the report, the U.S. spends the most on health care, at $7,290 per capita per year. That’s almost twice the amount spent in Canada and nearly three times the rate of New Zealand, which spends the least. Well The World Health Organization’s ranking
    of the world’s health systems shows the USA ranked at 37 worldwide, while NZ is at 41. Considering the difference in funding, something is wrong with the US system don’t you think?

  11. says

    There can be little doubt that the US health system is in need of serious reform but to literally turn in on its head and introduce ‘socialized’ health care would be a disaster. As someone who has spent most of his life under the UK National Health Care system I can attest to the fact that it is terrible and has only lasted this long because of those dedicated doctors and nurses who are prepared to ply their trade, despite the system they have to work in. For the past few years however I have enjoyed care under the wholly private (single payer) system in Thailand and I have to say that the standard of care I have received here is second to none.

    The US should not abandon its current system but should simply fix it.

  12. says

    Many people run into situations resulting in a loss of insurance or the cost is so high it’s unaffordable. One couple I know in their early 60’s, both could no longer work due to health issues and lost their insurance. They had to go without health insurance because of the $1,000 per month each they were quoted.

  13. says

    The NHS gets a lot of criticism in the UK but as a UK citizen I feel we should be a bit more grateful for it. The main problem it has, as with any government run program, is it is tied down by beauracracy. As has already been mentioned the doctors and nurses hold it together -- the problem is there is too much middle management, targetting etc. It means that the doctors and nurses often can’t be just left to get on with what they are good at.

  14. says

    I am sorry to hear about your experience with the doctor regarding your bone scan. Yes, something needs to be done in regards to our healthcare system. I’m just not sure we need the gov’t involved too much…this always posses a problem.

  15. says

    Now that the health reforms are in place, I am sure that the health care situation in the US will improve. The process may not be fast but we are on our way. Agreed that the critics of the Bill are right to a certain extent but that should not stop the Act from being implemented. If there are loopholes in the Act, then it should be rectified rather than completely doing away with the reforms itself.

  16. says

    I agree their is WAY to much middle management, therefore the physicians & nurses are left to deal with the mess, taking their focus off their main expertise of being a medical provider.


  17. says

    Interesting read definitely. I am surprised by the fact that insurance companies are so willing to take your money but not so interested to help you out when they are supposed to.

    I mean, how can they possibly justify billing the whole of the two procedures to the patient and say that it was a mistake of codes?

    Well said by the author that why didn’t this never happen in his favor and not in the companies favor.

  18. says

    Everything has gone crazy these days…Take for instance Senate bill S510 people do not realize that this will effect backyard gardens and roadside produce stands..Imagine not being able to share your crops with friends or the needy…
    health care and everything else has gone down the tubes and everybody still votes Republican or Democrat.

  19. says

    Sorry to hear about what you have had to go through…
    Now days it is all about the money and special interest groups.
    Things will never change unless we the people take back our voice..
    Voting Democrat or republican will not fix anything, we need to do something and fast.

  20. says

    Love this post!

    Hmmmm…I wonder who is behind all that bad publicity about *gasp* ‘socialized medicine’ (sarcasm).

    It has been so exaggerated to the point of lying about the “evils” of ‘socialized medicine.’ But you have to forgive the gullibility and stupidity that is sometimes the American public.

    Why universal healthcare is so demonized in America is beyond me, all we have to do is look at how much better it’s working in other countries and pretty much copy what is working better than our current healthcare system.

    The sad part is, Canada has pretty much worked out all the major kinks through years of trial-and-error, now all America has to do is copy them rather than trying to wing it and making a bunch of mistakes in the process lol.

  21. says

    It absolutely infuriates me to hear your story. While I agree that our nations health care system is horrible and full red tape b.s. I still have problems accepting a socialized health care system, due to the fact that I am young and healthier than most. I do not feel like I should pay a large portion of my money to taxes to support those who do not take care of themselves, when I never really need to see a doctor.

  22. says

    I have experienced this myself a years ago. I tore my ACL and, although the extremely high medical costs were supposed to be covered by my health insurance, I got billed for the x-rays and ER visit anyway! I went back and forth between hospital and insurance company for years, finally my case was sent to a collection agency!
    I feel your pain, but now that I live in Poland, I chuckle when I see the word ‘bureaucratic’ used for anything in the U.S., as most of it is nothing compared to here in Eastern Europe, TRUST ME!

  23. says

    Hi Mano

    It is a shame that we pay all this money to be insured and then find that you really are not, or here are stipulations.

    Considering that we pay for our treatment, surely it should be miles better?

    Also with our research grants etc, we should have the best healthcare ever?

    Also it is true what you said, the payments always favour the insurance company and never the patient….there must be some law about that!?!

    Thanks for the voice

  24. says

    Someday the people will wake up and fight such crap…I just hope they don’t sleep to long..
    One way to fight this is to no longer vote Republican or Democrat, we must divide and conquer…

  25. says

    It scares me to see what is going on with Health Care reform. I feel that the system is going to get bogged down more so. As a Canadian living in a border city, I had comfort knowing that I could shoot across the border if I really need some kind of extended health care. Now, I am not so sure. The Canadian system is OK, but that is because we always had to option to travel to the USA if we needed. No what?

  26. says

    Maybe the people here in the United States would not need to sorry about their health care so much if they would not eat all this junk food that is so convenient for everyone and start eating healthy and working out.

  27. Peter says

    Dear Mano:
    I now recogmise i asked a very loaded question with repect to academic performance of minorities born here in the USA and those who are immigrants. I will be more careful.

    Thank you for the link to your article ( better late then never) i am reading and reflecting, but am already assimilating its conclusions and arguements into my thinking.
    Indeed it never occured to me that i was projecting white privalage ( which i learned about in the interim since 7/15/10) as in ” why,” are , ” they…” not ” performing,” to some standard. I am sorry to digress on this topic but i did not know where else to respond. Again thanks- i am learning a lot on this complicated topic.

  28. says

    Is the US trying to re-invent the health care wheel? Why on earth can’t they just replicate tested systems such as those in western Europe? It is true that not all systems are perfect, but some are better than others and therefore, the US should get one of these systems and then weed out the bad bits and will end up with near perfect systems. I hope it is not ego thing!!!

  29. says

    I have know about our health system for a few years now and it’s really a sad case. I myself is self employed and as such, I have no health insurance because with a large family, I can’t afford health insurance. It just behooves me to take care of myself and my children by prevention. I try to eat healthy- I try to eat raw foods as much as possible. Raw foods means raw vegetables and raw fruits. Its a difficult diet but I have been finding out that a strict diet made from raw foods would have wonderful healing effects on the body. You could find out for yourself by googling raw foods.

  30. says

    How unusual for all those “ex-Brits” to throw stones at the U.K health system. The NHS is undoubtedly overburdened by too much bureaucracy and too many layers of management, although if the new Government is to be believed, all of that will soon change.
    Having spent a couple of years in Spain it was very easy to see how many people returned to the U.k when they required emergency treatment or could no longer afford private health-care.
    There is much to be said about a system that takes care of every individual, whatever their levels of income/private health-care cover.

  31. says

    I is really frightening to think of where we are headed with health care. Unfortunately it is all about money and not a persons health now. Prayer is the only answer to the problems we face. Thanks for a great and informative post.

  32. says

    Mano, I can totally relate to what you experienced with U.S. Health care system. I have gone through the same thing and it really makes me angry and frustrated. I don’t see that we save that much from paying for health insurance. They manipulate meaning of any covered service into something bogus is how they changed in my case, therefore it’s not covered. Having to deal with these insurance company to uphold their responsibility is pure agony. I had to call many times and get transfer many times to speak to the upper supervisors etc. Then deal with letter writing for review dept. there is no end to the misery they put you through. Something must change, but I afraid the sham with these company’s
    are too deeply entrenched, I don’t think it will change at least not in my life time. Does anyone have the answer?

  33. says

    Mano, I can totally relate to what happened to you cause I experienced the same. This is another example of big business holding all the cards. They call the shots and we the little guy end up hold the short end. They know even if we fight for our our coverage, most will give up because they make us go through their process of pure agony. Thing must change but how?

  34. says

    I fell so fortunate now to live in a country that has very little of the Health Care issues that the United States has. All though our health care system here in Australia has it’s bad points and flaws, the good aspects far out way the bad. I am very interested in this subject and I look forward to a positive out come for your country. I hope they get it right soon!

  35. says

    Well if Australia is looking to solve its health care flaws they should not look to Canada as a model. Canadians will tell everyone outside of Canada that the system works as wealthy Canadians cross the border to the US to see our doctors.

  36. says

    Health care should be considered a basic right of all citizens -- not just those who can afford it. The insurance companies have way too much power in deciding who receives financial assistance.

  37. says

    Guys…don’t get me started on the screwed up health care system we have here! I’m going to put it plainly…it is NOTHING more than a HUGE business scam. The problem is the ignorant people who fuel the healthcare industry are just sheep…being hearded algong blindly. take us folks (like Mano) who aren’t ignorant but actually at some point, legitimatly need healthcare and guess what happens! Voila…re-read his post if you want the answer.

    The US healthcare could be fixed so easily but the secret is our government doesn’t want it fixed because then their “secret society” would lose the billions they put into their pockets now…well, not only now but then and everyday!!!

    Thanks for letting me vent! 😉

  38. says

    You know rates would be affordable if doctors did not have to pay so much for their malpractice insurance. Some people see a procedure gone wrong as a payday. It drives up prices.

  39. says

    I think, You should try European health care model. We are satisfied with it, well except maybe dental services (they are still to expensive, queues are to long and service is not so good as expected). I hope You`ll find a way to solve this problem.
    Karolis from Europe

  40. says

    I think the issues may be economic. The prices are so high when they really don’t need to be. You may remember the $9000 screw.

  41. says

    one poster said’ “The US healthcare could be fixed so easily but the secret is our government doesn’t want it fixed because then their “secret society” would lose the billions they put into their pockets now…well, not only now but then and everyday!!” Is it a problem that should be left to government?

  42. says

    You are very helpful and patient with all of the comments, I appreciate that. What are your thoughts about using Medicare to pay for a National Health Care Program?

  43. says


    I have argued before that the most straightforward way to solve the health care problem is to extend Medicare to everyone. The structure is already in place and all it requires is expansion.

  44. says

    Well, I’m based in UK. Our health system runs under NHS(National Health Services) and it may not be the best in the world but thanks god we have a lot less problems as compared to US health system. If some body gets ill all of sudden the last thing he has to think is of money.

  45. says

    Hi Mano,

    I’m from Australia and whilst I have my fair share of complaints with government wastage, overwhelmingly I think we have a great system here. We have both private and public health insurance, and while public does lack some of the customer service orientation the private sector provides, the triage facilities at major public hospitals do function quite well to provide services to people in critical need.

    I made a trip to the US for the first time this year, and was shocked to see the level of advertising for prescription drugs! I realise the FTC or whoever the relevant governing body is has mandated some sort of disclaimer post each ad, and yet the amount of times I saw it repeated I think people will just get numb to hearing their anti depressants may cause suicidal thoughts…

    Certainly some room for improvement over there, though I fear this may be an issue that takes more than 2 terms of barack’s presidency to solve!

  46. says

    Fiona and Gavin,

    No country has a perfect system. There will always be a trade off between cost and service that will not please everybody.

    But the US system is the only one in the developed world where people are at the mercy of private profit-making insurance companies and can lose even basic coverage simply by losing their jobs or working for a company that does not provide insurance.

    This is crazy.

  47. says


    What might be crazier is the fact that if you lose your job/insurance and then you get a new job/insurance you are not often covered for for preexisting conditions. You have no idea how much money that costs people.

  48. says

    You do not need to look far. Cuba has free health care service. I think with the cost of America can provide free or cheap health insurance. In the UK, people are not happy because hospital car parks charges. America should re-evaluate where the tax money is spent.

  49. says

    You do not need to look far. Cuba has free health care service, said INSURANCE.I think the issue is not about providing insurance but moreover who can do it effectively. Also, at the end of it all is keeping inflated costs down. $5,000 for an MRI…really?

  50. says

    Very Insightful post!! You have experienced a really traumatic time regarding your bone scan.

    I Agree with you totally that our healthcare system need reforms.

  51. says

    Is the health care system in the US really that bad? I thought that with things like this, the U.S. is number one. Well, I’m thankful you have shared this. At least, what is real has been taken out from behind the mirage that some of us have seen through all the years. Thanks!

  52. says

    This story is an all too common one. It is unfortunate that more of the worlds resources are not devoted to keeping citizens healthy and alive. Fit and sharp-minded individuals can contribute huge amounts of discovery and invention to a world that needs their services desperately. Imagine a world where every person is healthy and able to synergize with his or her fellow man for the betterment of society. This world seems so far away.

  53. says

    It’s always surprised me how good New Zealand’s health system appears to be compared to other countries.

    “It fascinates me that these errors always seem to favor the insurance companies, never the patient.”

  54. says

    actually it is not problem of insurance company its fault of that billing person as he entered wrong number so all this things happened

  55. says

    Although many cases this is still a conjecture, the form of negligence, failure or accident the doctor’s office, but who become victims remains of the patient.

  56. says

    Although many cases this is still a conjecture, the form of negligence, failure or accident the doctor’s office, but who become victims remains of the patient.

  57. says

    I agree with subbarao we should not take it as expense, heath insurance is beneficial too. You have experienced a really traumatic time regarding your bone scan this is true. you can take it as one of your experience and try not to repeat this next time!!

  58. says

    I have had similar problems dealing with wrong codes for insurance, having to fight to get them right and so on. However the health care system in the U.S. is lets be honest, far from efficient. But so our our diet recommendations, and lack of focus on preventative medicine. Type 2 diabetes is taking the U.S. by storm and it is 100% preventable and curable. Yet the focus is on managing it primarily, not stopping it from starting nor making swift lifestyle changes to reverse it.

  59. says

    Health care is delivered by professionals in medicine, dentistry, nursing, pharmacy and allied health.

    The social and political issues surrounding access to health care in the US have led to vigorous public debate and the almost colloquial use of terms such as health care

  60. says

    Everyone has to understand that a great health care system comes at a huge price. It comes out of your pocket, by way of imposing huge taxes on your primary income. In Canada, the Health Care is free, but they take 1/3 off my salary to maintain this system. Plus, to get to see a specialist, it can take anywhere between 3 to 6 months, which is outrageous.

  61. says

    It really is a shame how the medical industry has become all about making a profit. As someone said above, medical professionals can no longer focus solely on a cure but now have to think about the finances in the industry…

  62. says

    Reading this article and all the comments gives me the feeling that most countries have some kind of issues with their health care systems. Guess that we can’t really rely on governments to take care of our health no matter which part of the world we are in.

  63. says

    I think the U.S. Health care system absolutely sucks. Actually I think the whole government system sucks. Mano, I used to work in a doctor’s office and I witnessed first hand how screwed up the billing department was. You made a good point too when you said it seemed like the mistake in the billing department was always in their favor. Where does it all end?

  64. says

    never view health insurance as an expence. sure it could cost money per month, but when you need it, health insurance can be one of the largest assets in your life.

  65. says

    I think a repeal of Obamacare is coming. Of course, that just puts us where we are and we still need change. Let’s take it slow this time and get it right.

  66. says

    I think it’s wrong to say the US Healthcare system is what is wrong, when it’s actually the health INSURANCE industry that has messed it up.

    Ban insurance and people could afford to pay once again for their medical procedures.

    As it is -- Obamacare just lines the pockets of the insurers.

  67. says

    The U.S. health care system is a complete joke. Once you have decided that you can put a price tag on someone’s health, you are in a lot of trouble.

    What’s next? Charging for premium prices for clean air? Maybe some water insurance to ensure you don’t get polluted water in your taps.

  68. says

    Many people run into situations resulting in a loss of insurance or the cost is so high it’s unaffordable. One couple I know in their early 60’s, both could no longer work due to health issues and lost their insurance. They had to go without health insurance because of the $1,000 per month each they were quoted.