renaissance poisson

It's not just being unable to afford care, it's also foregoing or postponing certain care for fear of premium increases that would make all care unaffordable, or policy cancellations. It's taking into account with every ailment the possibility that one's insurance company will refuse to pay the bill after services have been rendered. It's wondering what excuse they're going to use to avoid payment this time, and hoping your doctor doesn't stop taking that particular company's insurance. In short, it's like those random-negative-reinforcement experiments that they showed were most effective at inducing learned helplessness in rats and dogs.

(And we have pretty good insurance, all things considered, but it's still like walking on eggshells.)