The sentiment “if it ain’t broke, don’t fix it” has a strong foothold in the United States, as does the thought that it takes a whole lot to prove that something’s “broke.” Nonetheless, Americans are increasingly declaring that health insurance in this country is very badly broken. The reality, many say, is that insurance coverage often is nonexistent for preventive care, is slight for regular office visits, and peters out during catastrophic situations and hospitalizations. Additionally, because there is no organized health care system in the United States, there are always complicated questions about the specifics of insurance benefits.

Health Affairs recently published two personal essays on questions sparked by encounters with the health system and insurance restrictions. The essays are free access and appear in the Narrative Matters section of the journal. This ongoing section features the narrative, or personal story, side of the impact of health care policy.

Jay Himmelstein, a professor and a director of a health policy center at the University of Massachusetts Medical School, discovers the frustrations of insurance limitations first-hand when his graduate student niece, Emily, is diagnosed with an aggressive form of cancer. Worried about her health, her mounting treatment bills, and the limitations of her school insurance policy, Emily wonders whether declaring bankruptcy might be the only solution.

Health economist Phil Musgrove gets an up-close-and-personal view of American health care and its emphasis on insurance when he rushes a stranger to an emergency room and gets a “paper first, people second” reception.

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