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People without health insurance are described by health economists as "free riders". Isn't that term telling? I mean with the average cost of a family's health insurance at $12,106 per year, if you don't go along with the Great American Slavery of paying whatever last dollar you have left after paying for your prescription medications and doctor bills for your health insurance then you are somehow not playing the game according to the rules. Well there is something seriously wrong with this picture. One out of seven Americans are uninsured, our country spends twice as much on health care as other countries where everyone is insured, and yet our health care outcomes (how long you live, how likely your kids are to get to their first birthday) are second to last amongst industrialized countries.

For people without insurance, getting sick can be a disaster. In fact, half of all bankruptcies in America are caused by someone in the family getting sick. That means your house will be foreclosed upon, your children's education will be threatened, your marriage may be ruined by the financial stress, and you will have to work for the rest of your life because you will never be able to get ahead. What is worse, many Americans are dying because they avoid going to the doctor when they do get sick, thinking that they can't afford it. Does it have to be this way? I say not. I say that you can take control of your life by planning for your health care needs, changing your life, and educating yourself to become a smart health care consumer. And you can do it, even if you can't afford insurance. How do you do that?

The first step is by educating yourself. Expensive colonoscopies ($2000+) have not been proven to be more effective at successfully reducing death from colon cancer than a $2 test (guaiac) you can buy at the drug store. Taking your kid to the doctor in the US will likely lead to an antibiotic prescription (not to mention an expensive doctor and pharmacy bill)-that won't help her significantly and will increase the risk of future infections. The American Medical Association says you should not get a yearly checkup with a doctor if you are not sick. If they say that, why should you pay for it?

And what if you do get sick? If you get cancer or need heart surgery, you can go to a country like Thailand and get state of the art care in modern hospitals with doctors that were trained in America or an equivalent medical education system... for 1/10th what you would pay in the US. Ditto goes for nursing home care. Many Americans are waking up to the fact that they pay 1/10th as much when they go south of the border-and they prefer the climate.

OK, what if I get in a car accident, they won't be able to send me to Thailand, right? What many people don't realize is that they can get better trauma care at large urban hospitals, like Grady Hospital in my home city of Atlanta, that use a sliding scale form of payment, than they would get at most private hospitals. But you can't wait until you have a disaster to make those plans. You have to do your homework and plan ahead.

You can start a medical savings plan that will provide a cushion. Even putting a small amount into the plan every month will help ensure your financial future.

We all know that proper diet and exercise are important. But what most people don't realize is how much money they can save by taking the right steps. The vast majority of costly health care is for chronic diseases like diabetes and heart diseases that can be prevented by diet and exercise-over 90% of the time! That's pretty good odds.

So start doing the math and seeing what is right for you. Maybe you can live without insurance.

J. Douglas Bremner, MD, is a researcher and physician and author of 'Before You Take That Pill: Why the Drug Industry May be Bad for Your Health: Risks and Side Effects You Won't Find on the Label of Commonly Prescribed Drugs, Vitamins and Supplements.'
http://www.beforeyoutakethatpill.com