Having a mind that makes unusual connections is not always a good thing but sometimes it can lead to striking insights. As might be expected for someone who works in the health care field and who is prone to occasional conversations  about this rather controversial subject (especially in light of the shambolic roll-out of the Affordable Care Act, whether one looks at the micro level of individual suffering or the macro levels of state and federal failures, at times my mind seeks to find novel ways of understanding health care reforms as well as their limitations and difficulties. It is my hope to show at least one of the major elements of failure that are shown in the health care reforms and how it relates to an issue of some importance and delicacy in my own life, and that is of the difficulties of dating and romance.
In at least some ways, dating young ladies and getting individual health insurance share some important parallels. Both of them involve calculations of risk and threat, as young women (and their parents) are full of calculations about these subjects, and insurance companies hire people who specialize in actuarial matters to manage these risks via the power of mathematics (specifically its aspects of probability and statistics). Both of them, ultimately, derive a great deal of safety in numbers, and these connections demonstrate how health care reform generally fails to address the most central lack of trust and increased risk that makes health care expensive and not always available for those who most need it, and that can also present some major difficulties with regards to the individual dating market. I hope you will all humor me while I draw some of these parallels and discuss their implications.
It is far easier to get health care if one goes as a group than if one goes as an individual. Not coincidentally, and for identical reasons, it is easier for a fellow like myself to spend time with people in groups than to talk to or go out with people on an individual level. Those who would not know or trust me well enough to spend time with me alone or with their daughters are much more comfortable if there is a large enough group to provide safety in numbers. Why is this so? A large part of it involves risk and how that risk is reduced. It takes a great deal of trust to be alone with someone, or to trust one’s precious daughter with a guy, and it takes much less trust to feel safe or to feel that one’s daughter is safe if there is a group of witnesses to make sure that nothing gets out of hand. A similar process is at work when it comes to health care, as it is far more risky for a health insurance company to insure ten people with diabetes or heart trouble as individuals than it is for them to insure them as a group, especially if those ten people with diabetes are part of a larger group of, say, fifty people, most of whom are healthy. The reason for this also involves safety–insurance companies exist to make money, and they only do that when they charge more for premiums than they pay out in benefits. Those who are certain to use those benefits consistently and expensively are not going to make money for an insurance company, but if those people are part of a larger and safer group, then they offer less risk and danger of loss.
What does this have to do with health reform? More than might be suspected. Health Care reform was conceived in order to deal with people who do not have insurance (like myself) as well as those whose health conditions forced them into expensive high risk pools, and the fact that a large number of people  are rejected for the health plans that they seek because of often minor conditions. Dating presents many analogous cases to this. The solution was to eliminate the questions that could be asked of people looking for health insurance, so that people only have to answer questions about their age, tobacco use, income, and number of people in the household (especially children) being insured.
It is not difficult to see, by looking at the analogous situation with dating, that this is a very flawed solution. For example, it is not uncommon for a single man of a certain age to face major difficulties largely on account of that age alone, apart from other factors. It is only through increased knowledge, and a good bit of time for people to do “underwriting” of the risks of being with or having their children with me that it is possible for any sort of personal conversation and flirtation. Being judged on one’s age alone is not always a good thing, not least for someone like myself. Reducing what information can be gathered about people can actually harm them when the information that is known is adverse, to put it mildly.
In light of these concerns, what is to be done? Safety sometimes requires large enough numbers that risks are spread through enough people to reduce that risk and make it possible for people to be accepted as part of a group that would not be accepted alone. This is true whether one is a somewhat amorous sort of person seeking affectionate and friendly company or whether one is a person seeking health insurance with a few blemishes. How do we aggregate people in such a way that all of them benefit rather than trying to make all of them come alone in search of their heart’s desires, or have the young subsidize the old or the healthy subsidize the sick or men subsidize women’s care? Right now the options pit some people against others, with winners and losers, and without addressing the structural issues of individuals versus groups, as well as the concern of prevention as an essential element of reducing difficulties in health as well as one’s dating life. Until we deal with those concerns, we will continue to struggle and muddle along as we have, or find ourselves in reform efforts that can even make matters worse rather than make them better.
 See, for example: