Telling stories

When freelancing can be hazardous to your health

Posted by southwrite on October 28, 2009

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Across America employees of major corporations are engaged in that annual ritual of open enrollment season. They get to choose from a “cafeteria plan” of different insurance, retirement packages, and — most important of all — health insurance coverage.

I’m one of the lucky freelancers for whom this process is more than just a memory or a potential article assignment. Since my partner is an employee of a Fortune 500 company with a generous benefits package I get health insurance too. For me a visit to the doctor is 20 bucks and I can get in to see just about any specialist for three tens. And, the package seems to cover just about everything that has come our way over the past couple of years.

I’m also a rare case in the freelance world. While some of the self employed have a spouse with company coverage, most don’t. Either they buy their own or just pay for medical care out of pocket when they need to or are able.

The plight of the uninsured (about 48 million or so) has been hashed out endlessly in the national press as healthcare reform legislation works its way through Congress. It seems likely that some kind of bill will pass and more of those millions will get coverage of some kind.

Not that many people will be happy with what emerges. Those who are comfortable and covered – like me – are likely to be concerned that reform means spreading the wealth around. Will insurance for my neighbor come at my expense – either in higher taxes or reduced coverage or even the dread R word — rationing? Few in my position see reform as benefiting them personally and that’s at the heart of much of the reluctance to embrace health care reform.

Those feelings even extend to many freelancers I know. Either they’re young and healthy or they’ve managed to cobble together some kind of coverage that takes care of the minor concerns that come their way – a bout of flu here or a sprained ankle there.

Plus, some of us are mucyh like teenage boys – we view themselves as being invulnerable to the accidents and bad luck that can ruin an otherwise secure life. The idea that “it won’t happen to me” is a nice fantasy because we are all either sick or going to be sick, says freelance writer Judith Levine.

“Our so-called health-care “system” promotes and exploits this peculiar American illusion: that the body is invulnerable and the spirit autonomous; that human need is a temporary aberration,” she wrote recently. And, she should know as she’s spent the last several months caring for a family member. Once vigorous and independent, her mother suffered a stroke that has  left her requiring full time care. Much of that work is done by Levine.

Being a largely full time caregiver has left her “walloped by human need, its depth and constancy.” It’s also a reminder for all of us how little stands between us and a similar situation.

Obviously, the ones who want healthcare reform are those who need it the most. They often have a pre-existing condition such as a chronic disease and in the private insurance market that’s the kiss of death. Private insurers want healthy customers who don’t file a lot of claims, not sick people who will be a continuing drain on their profits.  That helps explain why the Agency for Healthcare Research and Quality found that self-employed workers are twice as likely to be uninsured.

They’re usually the ones I find posting questions about how to find insurance on writers’ association forums. Groups such as the American Society of Journalist and Authors (ASJA) and the Freelancers Union offer access to insurance plans. Unfortunately, their options are usually the same private coverage offered in the open market – not a real group plan such as the one I have. Applicants still face underwriting – and high rates or rejection. These groups are too small to qualify for the big discounts that large corporations can negotiate.

Not having insurance when you’re sick can put you in a crazy and very deadly no man’s land. Studies find that lack of insurance leads to about 45,000 deaths a year. It’s not hard to figure out why. Without insurance many folks can’t afford the medication that can make a potentially deadly condition manageable. They put off going to the doctor when they’re sick and by the time they do a treatable illness has turned deadly.

I hope that the U.S. will move closer to the rest of industrialized world which has long offered universal health coverage to its citizens. Unfortunately, even if it passes,  it won’t take effect for several years after the president signs it into law. In the meantime, freelancers will continue to live with the knowledge that financial disaster is just one accident or diagnosis away.

The rest of us shouldn’t get too comfortable either. A spouse’s job loss or a divorce could spell the end of your coverage and then you’ll be on your own. An expensive illness can quickly bump up against lifetime maximum coverage and increasingly insurers are restricting coverage on new and costly drugs.

And maybe that’s a good reason why we should look at the problems of the uninsured as our own. Instead of viewing ourselves as solitary fortresses, maybe we should acknowledge that we’re all in this together.

5 Responses to “When freelancing can be hazardous to your health”

  1. Mickey Goodman said

    I’m one of the lucky freelancers with coverage too. On the other hand, my grown son, a Type I diabetic, has no insurance through his employer and can’t buy individual coverage at any price: that dreaded “pre-existing” condition. While I worry about my getting less coverage for more money under new mandates, I also feel strongly he should be able to buy affordable insurance. Therein lies my conundrum.

    • southwrite said

      The fact that so many people — like your son — can’t get insurance says a great deal about us as a nation. Are we a community that takes care of its own or do we just let the weak or the unlucky fall by the wayside?

      • Mickey said

        There are likely more people like my son who would be more than willing to buy insurance on their own — if a company would insure them at a reasonable rate. Is a “public option” the only option?

  2. That’s a nice little read Randy! You bring up some good points. As a young freelancer time tends to fly by being so busy. In the day to day life it easy to let health insurance slip under the immediate demands only to be concerned later down the road.

    • southwrite said

      Thanks. We’re all that way, I think. If its not our problem then its not a problem. And, its easy to start thinking our current favorable situation is both permanent and universal.

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