Take a look at reality of health care reform

"A judgment is said to be true when it conforms to the external reality." - St. Thomas Aquinas

I loved the '90s supernatural drama "The X Files," with its ominous, blinking message - "The truth is out there." The "powers that be" seek to hide or distort the truth, that message whispered, but it won't stay cloaked forever.

The first round of Affordable Care Act (health reform) mandates, which took effect in September, reminded me of that message - that external realities exist, no matter how much wishful thinking or righteous indignation we throw at it.

Let's examine two sets of "external realities."

Consider first a young family without family health care coverage. According to the latest census findings, the majority of children live in households making $74,999 per year or less. Focus on the 0.7 percent who reside in households earning $35,000 to $49,999 and the 19.6 percent who live in households earning $50,000 to $74,999. These are typical middle-class households. Imagine for a moment that this family must either choose a sizable payroll deduction for family coverage or a premium for a "child-only" policy. There's the mortgage, taxes, utilities, car payments, car insurance, groceries, clothing, and a little recreation. Living paycheck to paycheck, would you choose to pay a premium for a healthy child who, at most, needs routine immunizations and the occasional office visit for colds? Or would you use that money for some other, seemingly more pressing, need? It is eminently understandable that such families would roll the dice and go without insurance. Before September, however, this was a risk with dire consequences should a child fall ill. Perhaps that risk served to pressure some families into taking the payroll deduction or buying a "child-only" policy.

Now imagine being an insurance company. By definition, insurance is an agreement that one party will assume a risk for a fee paid by the other. With life insurance, the buyer bets he will die, while the insurer, armed by the actuary, believes he will not. The few statistical aberrations are adequately paid for by the vast majority who make no claims. This majority forms a pool, which protects the solvency of the insurer and its continued ability to pay claims. With health insurance, the protective pool is formed by the healthy as a hedge against the claims of the sick. A pool composed entirely of the sick is called bankruptcy.

These two realities, of the family and of the insurer, crashed head on in September. As of Sept. 23, insurers are prohibited from denying coverage to children with pre-existing conditions. However, the mandate that everyone must purchase insurance doesn't kick in fully until 2016. If you are the young family, there is now absolutely no reason to worry about insurance. If your child stays healthy, as most children do, you can pocket the premium without guilt. Going without is no longer a gamble, because insurers have to cover your child if, God forbid, he or she should need an organ transplant or chemotherapy or some other treatment that costs in the hundreds of thousands of dollars.