Insure this!

Why some twentysomethings won’t buy health insurance — even though it means they’ll be breaking the law
By MIKE MILIARD  |  October 31, 2007


Guinea pigs: The future of the nation’s health-care reform rests on the tattooed shoulders of Massachusetts’s young adults. By David S. Bernstein.
“Actually, y’know, no. I think . . . fuck ’em. I don’t care.”

Noel, a 38-year-old bicycle courier with gray eyes and a round, stubbled face, is sitting on a leaf-shaded bench in Post Office Square. And he’s just answered my question: do you plan to sign up for a health-insurance plan, now that anyone who isn’t covered as of December 31 will be penalized on their taxes?

I press. “Even though the Commonwealth is offering an array of subsidized plans for people whose income levels qualify?”

Noel laughs. And laughs. Hahahahahahaha. Aahhh-hahahahaha! “That’s funny, man! And how do you get these subsidized plans? You call one phone number, and then you’re redirected to another one, and another one?”

Well, to hear it told, that’s occasionally been the case. But it also seems fairly easy to navigate the Web site of the Commonwealth Health Insurance Connector (, an organization that was set up, in the wake of Massachusetts’s landmark mandatory-insurance law, to help people without coverage find a plan that fits them — and their income.

And this much is also true: being a bike messenger is an insanely dangerous job. According to a 2002 Harvard School of Public Health study titled “Occupational Injuries Among Boston Bicycle Messengers,” a sample of 113 couriers found that 70 percent had suffered at least one injury leading to lost work days, and 55 percent had accidents that landed them in a doctor’s office or hospital. Car doors swing open unexpectedly. Pedestrians stand stodgily on the sidewalk. Cars swerve around corners. Fractures, dislocations, and sprains! “Twenty-four percent of messengers reported wearing a helmet on a regular basis,” the study noted, “and 32 percent have health insurance.”

Noel does have a helmet. But he does not have insurance. This, despite the fact that he’s been injured on the job more than once. “Uh, I’ve been doored. Aaaaand I flipped over my bike on Beacon Hill and skidded across an intersection,” he says matter-of-factly. “One time I didn’t have to go to the hospital, I just toughed it out. And the other time . . . shit . . . I think I paid it myself.”

Although he confesses that “occasionally I think about it, and it kind of bothers me, yeah,” Noel has no plans to buy insurance anytime soon. He doesn’t like the government telling him what to do. If the financial penalties accrued get out of hand, he might be spurred to action, he says. But until then, he’s just going to sit tight.

Which is too bad. Because his participation is vital to the success of this groundbreaking program — one that has the potential to momentously influence the national insurance debate. In the meantime, Noel will go to work each day uninsured, hoping danger doesn’t loom just around the block.

The price you pay
“Individuals who cannot show proof of health-insurance coverage by Dec. 31, 2007, will lose their personal-income-tax exemption when filing their 2007 income taxes,” reads the stern-sounding diktat on Effectively, that’s a $219 fine.

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