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Five years ago, as she watched her health care costs surge to stratospheric heights, Laura Moe opted for what seemed to her the only feasible solution to health care costs: stay healthy and wait for Medicare to kick in.

Laura, 61, a native San Franciscan, simply can't afford to buy health care. Not having it makes the self-insured small business owner nervous, but she feels there is no other out.

It wasn't always that way. When she was married, her husband's Kaiser coverage took care of both of them as well as their children. She wasn't all that enthused about Kaiser - the giant HMO made it difficult to get and hold on to a regular doctor. Nevertheless, "I was happy thinking that anything that came up would be covered. It was just sort of a net."

In the mid-1990s Laura and her husband divorced. She went on Cobra coverage for two years, but that ended and she sought health insurance for the self-employed. The least expensive option she could find would have cost her $320 a month. When she turns 65 that would climb to $727. She simply can't afford those kinds of numbers.

She had to ask herself if she was taking a dangerous gamble in dropping health insurance. Perhaps she was, she thought - her work, although she loves it, is stressful. Since 1984, Laura has owned a video production company in San Francisco, and shoots events - weddings, Bar Mitzvahs, other celebrations - from beginning to end, then edits what she has filmed. It is a job that takes time, energy and physical stamina, especially with the camera.

Nevertheless, Laura reasoned, "I'm a very healthy person. I'm holistic-oriented. I don't run to the doctor all the time." She decided to roll the dice and abandon health coverage. So far she has not faced a serious medical problem. She is hoping to get through to 65. "I'm just holding on for four more years, and then it's Medicare."

As medical advice, "drop your coverage and come back when you're 65" is even less reassuring than "take two aspirin and call me in the morning." For Laura it has created tremendous anxiety. "It's very scary."