I had heart surgery when I was 25.  

It cost me only $15 because I had great health insurance through the LA Times, and because California has strong health care regulations. The surgery cured me of a sports-induced arrhythmia that had haunted me since I was a boy.  It freed me of a tremendous physical and psychological burden.  It may have saved my life. 

A few months later, I left the LA Times and decided to let my health insurance lapse because I didn't want to make the COBRA payments.  In my early 30's, I was covered thanks to the Directors Guild, but I let my insurance lapse when I moved to Virginia and stopped making DGA films.  Again, I didn't want to pay for COBRA. 

When young healthy people do as I did -- stay out of the system unless and until we need it -- we drive up costs for everyone else. I paid $15 for heart surgery.  The rest of the tab was picked up by people who didn't have the option of gambling with their health, and were forced to pay rising premiums.  By spending most of the last 12 years uninsured, I have saved money, but it has cost me in other ways.  For instance, I fractured my wrist playing baseball and didn't see a doctor.  It never quite healed correctly.  I've also had to worry about the consequences for me and my family if I was in an accident, or if learned I had cancer but it was too late to treat it.

When I buy health insurance in 2010, I will be paying into a system that has already greatly improved my life.  If a few years pass before I need to go to the hospital again, my monthly payments will not have been wasted.  I will have had a sense of security knowing I don't actually have cancer, and I have coverage if I'm in an accident.  And, I will have paid my share toward the collective good, making health coverage more affordable for others. 

I hope the emerging paradigm shift in Washington will spread to all Americans, in particular to young people who think they don't need insurance, and may resent the choice between getting insurance and paying a fine.  To them I would say the gamble isn't worth it: buying into the new health insurance exchanges will be in the interest of your individual security, your family's security, and the nation's.