Who should save the sight of an uninsured South Carolina man who can’t afford eye surgery? That’s the question the Charlotte Observer asks in a story about a 49-year-old Republican who declined to sign up for Obamacare because he “prided himself on paying his own medical bills,” and is now upset that the Affordable Care Act won’t bail him out.

Luis Lang, a self-employed handyman from Fort Mill whose clients include the federal government, told the Observer he “knew the act required him to get coverage but he chose not to do so. But he thought help would be available in an emergency,” like the mini-strokes and deteriorating vision he suffered in February.

It’s not available though, because that’s not how insurance works. Insurance companies are profitable because they take your money before you incur major medical expenses, not because they save new customers’ eyes for free. It’s almost like the needs of the market aren’t aligned with the needs of actual human beings, as if the American healthcare system encourages people to gamble that they’ll stay healthy instead of getting insurance, and forces society to bear the costs when the house wins (which is always).

If only there were some way to make people get insurance, and maybe even help them pay for it to save all of us money in the long run.

Nahhh, that’s crazy.

Anyway, Lang is now stuck in a position where, suddenly having come around on this whole insurance thing with the impending loss of his eyesight, it’s too late for him to sign up under what his wife calls “The Not Fair Health Care Act.” Furthermore, his income has dropped now that he’s out of work, making him ineligible for a federal insurance subsidy. (What about Medicaid, you ask? Well, South Carolina was one of 17 states that opted out of the ACA’s Medicaid expansion.)

For now, Lang’s doctor, Malcolm Edwards, will keep treating him for free, but he doesn’t have the expertise to do the surgery Lang needs. And he can’t force his patient to take care of himself.

“There’s a lot of talk about personal responsibility in health care reform,” the Observer observes, “so it’s probably fair to note that Lang is a smoker who has, by his own account, been inconsistent in his efforts to control his diabetes.”

Cool.

Lang has set up a GoFundMe page, and people are donating—because even though it’s insane to blame Obamacare, the system really is fucked up—but they’re also chastising him for being “a poster child for what you claim to be against” and “voting against [your] own self-interest.”

[H/T Wonkette, Photo: GoFundMe]