By Larry Marsh, Kansas City Star Midwest Voices columnist

Not everyone without health insurance is poor. Some are young libertarians who, like a number of younger folks, think they're invincible (probably the same ones texting while driving).

Libertarians don't want government or other authoritarian entities controlling their lives. In a more general sense, a libertarian might define "government" as a collective entity that collects taxes (or insurance premiums) and set rules and regulations about what they can and cannot do. In this sense your health insurance card is like a government id card. It doesn't really matter to some libertarians whether the "government" is called Humana, Medicare or Blue Cross Blue Shield, it's just one more entity trying to control their lives.

To most people going without health insurance is a game of Russian roulette. To a young libertarian buying health insurance is like buying a lottery ticket. Statistically, buying a lottery ticket on average produces a negative return. No government or private entity would run a lottery if it didn't make money from the average player. The insurance industry operates the same way.

Let's do the math. If you were to survive 30 years without health insurance, what difference would it make? Let's say your health insurance premiums were a flat $500 a month for 30 years. Instead, if you were to save that and invest it compounded monthly at an annual interest rate of 3 percent, 5 percent or 8 percent, how much would you end up with? The answer is: $292,097, $417,863 or $750,148 respectively. (See formula below.)

Alternatively, you might get into a terrible car accident or inherit a debilitating disease, lose your job and your home and end up on the street.

My grandfather said "insure against those things that would dramatically upset your life, but not against things you could cover out of your bank account." I assumed this meant I should get health insurance with an appropriate deductible as well as anything that would otherwise require me to hire a gang of lawyers like liability insurance.

What should the average person do? A statistician has been defined as a person who can put their left hand in freezing water and their right hand in boiling water and say: "on average I feel just fine." If you can "feel just fine" under such circumstances then maybe you don't need health insurance, but for the rest of us health insurance is a necessary expense to avoid a potential disaster.

investment

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Also see:

We need to move beyond a one-size-fits-all health care system

Will public option life insurance doom us to a life of socialism?

The incentive structure of our health care system is all wrong

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