I'm lucky to have a fair number of very brilliant young people who read this blog. They have high IQs, have already accomplished a lot, and are probably going to accomplish a lot more. Some of them are fantastically rich, some will be. Others are just well-off. And if experience is a guide, some of them will crash and burn. There are people of all kinds in my generation, and I expect it will be the same in the one that's coming up now.  

But one thing young people of all generations have in common is a very abstract and incorrect idea of what aging is about. Sorry. It's just plain true. I know from my own experience, having made some serious mistakes about health insurance in my 20s and 30s. And living to pay for those mistakes in my 40s and 50s. Fact is, you have to understand how insurance works, because decisions you make now will effect what kind of health insurance you get when you're older. And health insurance is central, for most people, to living. I was going to say "living well" but decided that wasn't what actually was going on. For many people, having good health insurance is that important.  

My story -- I needed heart surgery when I was 47. Partly it was due to lifestyle, and partly due to genes. No matter, I got the surgery, insurance paid for it, and I'm lucky -- I could have paid for it myself, but it would have hurt. The bill for my surgery and all other care was about $500K. The surgery made me healthy, relatively speaking.  

But if I hadn't had the surgery, I would have died in 2002. That's a fact. 

Most people could not have paid the money. I don't know what they would have done. Maybe they would have just died. Some of my young friends say they would accept that outcome, but I don't believe them. I am sure they wouldn't accept it if it was happening to them, or to someone they cared deeply about.  

Here's the thing -- it is going to happen to you. 

How do I know? Because that's what happens as we age. Health declines, and most of us need help to survive. You can't plan on not needing it. It doesn't work that way. 

I recently helped my father go through it. He had excellent insurance, in addition to Medicare. There was only one point in his ten-year decline when insurance started pushing us around. It didn't turn out to matter. But it was scary. He had been in the hospital too long, they wanted him to leave. Not sure if it was the best thing for him, but we put him in a different hospital, and negotiated with the insurance and hospital administrators. Believe me, this was the last thing we wanted to be doing at this point. You will feel the same way, if you have a heart, and if you love your parents. 

I don't know why young people can't extrapolate. They won't be young forever. Your parents won't either, nor your siblings. And god forbid your one of your children should get sick. That happens too, sad to say.  

Health is one of those things that no matter how much you prepare, you can never know what's going to happen. That's why you buy insurance.  

But here's the punchline. "The most important thing about the individual market -- more important than the high prices and the lousy policies -- is that no one has to sell you a health insurance policy. If you have the wrong medical profile, you could be simply uninsurable. That's how a free market works." That quote is from a Baseline Scenario report on why you must care about Medicare.  

That is so damned true. Tattoo it on your forehead so you can think about that every day as you're shaving or putting on your makeup. 

To me, I can't believe it's come to this in the US. We are dismantling our country before our eyes. If you think health care is a small thing, you don't know how life works. And you owe it to yourself and your family to find out.