There are so many good opinions here but here's another way of looking at it. In old job (helping people think about career options) I've seen lots of people who are unable to work at all due to pain associated with back or shoulder problems who have been on the public hospital waiting list for 4-6 years for surgery. They have to take strong pain medication which upsets their stomach and mood. They end up on the disability pension. If they had PHI, they could have had the surgery and return to enjoying their life and returned to work. So think about the "cost" of 4-6 years of unneccesary pain and 4-6 years of unwanted unemployment. I know it's a small chance that this will happen to you, but is it a chance you are willing to risk?