Here are dispatches from what we like to think of as part of the civilized world. This story couldn’t have been written in any European country. Well, maybe Romania.

“For a lot of people, it’s a choice between being able to survive in New York and getting health insurance,” said Hogan Gorman, an actress who was hit by a car five years ago and chronicled her misadventures in “Hot Cripple,” a one-woman show that was a hit at last summer’s Fringe Festival. “There was no way that I could pay my rent, buy insurance and eat.”

Nicole Polec, a 28-year-old freelance photographer living in Williamsburg, Brooklyn, said she has attention deficit hyperactivity disorder and has a client who procures Ritalin on her behalf from a sympathetic doctor who has seen Ms. Polec’s diagnosis. Ms. Polec’s roommate, Fara D’Aguiar, 26, treated her last flu with castoff amoxicillin — “probably expired,” she said — given to her by a friend.

When Robert Voris last had health insurance, in 2007, he stockpiled insulin pumps, which are inserted under the skin to constantly monitor blood-sugar levels and administer the drug accordingly. He said the tubing for the pump costs $900 a month, so lately he has instead been injecting insulin with a syringe. But Mr. Voris, 27, a journalism student at the City University of New York who works at a restaurant in Park Slope, Brooklyn, is constantly worried about diabetes-induced seizures like the one that sent him to the hospital last summer. (Because it happened at work, his boss covered the ambulance and other bills.)