This morning a friend called to say she had given up on her insurance company. She was down and out, and they kicked her in the gut.

How did it get this way? How has the state of health insurance gotten so out of hand? How many people have to go without care — care they badly need — before the system makes an about face? It’s so bad now that we think twice before we take care of ourselves. Why tell the doctor about that pain, when we know it’ll result in an extra $200 test? If we can go without that pill for one, two, three days in a week, that means a few extra days until we have to pay for the refill. “Screw the consequences, that’s money for gas or food or a movie” we tell ourselves. The thoughts form in our heads so quickly that the damage is done almost without fail.

Does anyone out there — who can make a difference — care?

We’ve gone out of business — out of the business of being healthy. And it makes me sad.

I don’t know what to even say.