Poor Brandy Coons.

In a front-page article by Kevin Sack in today’s New York Times Coons, a 23-year-old waitress in Atlanta, managed to get herself pinned up as the poster child for health-insurance free riding. Sack writes,

She may not fully appreciate it, but her decision to go without health insurance, like millions of similarly situated Americans, has become central to the pre-eminent policy dispute of the Democratic presidential campaign.

That policy dispute is over the question of a health-insurance mandate. Hillary Clinton believes one is necessary; Barack Obama thinks it isn’t. The candidates’ argument over the mandate is the real subject of Sack’s story, which does a good job of explaining the ins and outs of the two policies. Coons is merely there to give the piece a human face.

But there’s an interesting sidestory here that’s worth bringing out, since it too will have a part to play in either candidate’s health-care policies. The key lines in Sack’s story are these:

[Coons] could probably afford a high-deductible policy if she gave up her gym membership and spent less on her amateur photography. But she chooses instead to gamble against the odds of confronting a bankrupting catastrophe.

Those frightening words (”gamble” “bankrupting” “catastrophe”) in that last line make Coons sound like a typically unthinking young adult. As does this one: “Many free riders, including Ms. Coons in Atlanta, never consider that the care they receive in community clinics and emergency rooms is subsidized by taxpayers and private policyholders.”

But look again at the choice Coons has made. She decided that her gym membership was worth more to her than an insurance policy against “a bankrupting catastrophe.” What that means, of course, is that Coons is not averse to paying for her health care. But forced to choose, she’d rather spend her money on preventive care (exercise) than on an insurance policy to pay for reactive care.

A 1988 study by the city of San Jose suggests that’s not such an irresponsible choice. The study (here quoted from a National Park Service report) found that:

People who exercise regularly have 14 percent lower claims against their medical insurance, spend 30 percent fewer days in the hospital, and have 41 percent fewer claims greater than $5,000.

The last statistic is especially relevant. Sack chides Coons for not insuring herself against catastrophic injuries, exactly the kind that would result in claims greater than $5,000. But Coons’s decision to opt for a gym membership can and should be seen as a form of preemptive, preventive, proactive insurance. By keeping her gym membership, she’s reducing her risk of catastrophic illness and injury by nearly half.

To coin a phrase that fits the sloganeering mood of the primary season, Coons is choosing to spend her money ensuring her health rather than insuring against sickness. Of course one would hope for a plan that provided for preventive and reactive care—as the Obama and Clinton plans both do. But until the time that one of these plans becomes law, it’s worth thinking twice before calling people like Coons “free riders.” Given that preventive care has proved time and again to be cheaper than reactive care, hers can hardly be called an irresponsible choice.