Health Care and Health Insurance

One of the main contributors to my nervousness and stress of graduating from school and trying to make it as a singer: Health care and health insurance.

Disclaimer: I’m not a health care or policies expert. I honestly don’t think I have the solution to any of the problems I might point out. This isn’t about politics. This is about me wondering how I’m going to survive in the real-world and some of the research I’ve done to educate and prepare myself.

As I’m learning, being a singer isn’t just about singing; it’s about finding a way to incorporate singing into a happy life. My parents have always said a big part of happiness is healthiness. And as my health insurance through school approaches its end date, the prospect of being without health insurance is scary.

About 60% of Americans receive coverage through an employer (employer-sponsored insurance or ESI), and that number has been falling since 2000¹. Of course I will be applying for jobs in NYC, and I hope I can get a job that includes health insurance as a benefit. However, most part-time jobs don’t offer health insurance and fewer employers are offering ESI these days. It would be great to have a full-time job with benefits, but there’s a good chance I’ll have to work several part-time jobs initially.

There are also individual health insurance policies I can look into (and I will). The downside of these policies is they are either expensive or provide shoddy coverage. The plan with the lowest monthly premium of $185 doesn’t cover office visits, prescriptions, or preventative care; only emergency room, surgery, and hospitalization are covered. It is an indemnity plan, and the people who use it are considered uninsured. Any conditions you have when switching from an indemnity plan to another kind of insurance plan can be considered pre-existing, which can impact your eligibility.

So yes, there are ways for those without coverage to get coverage, but what is the point if the coverage you get isn’t affordable and comprehensive? The indemnity plan I described above is not geared toward helping you be healthy and stay healthy — it is a safety net for when something goes terribly wrong (or if you have a baby … in which case the labor and delivery is covered but pre-natal care is not). So actually, it is an health insurance plan. It just isn’t a health care plan. I don’t think I properly appreciated the difference between those two terms until just now.

Health care in this country is expensive. A visit to the doctor’s office — just a visit, no procedures — can cost $150 out-of-pocket if you don’t have health insurance. If you do have health insurance, you’re usually responsible for just the co-pay for the visit, which in my experience has been from $10-30 (it could be more or less depending on the plan). So if you do have insurance and are paying $10 for each visit, that doesn’t mean the doctor’s office is only making $10; they are charging you $10 and the insurance company $140. Keep in mind that was just to see the doctor. That $150 did not include any extras. This is why affordable and comprehensive health insurance is a necessity — people can go bankrupt due to medical bills.

I have three degrees. I am smart. I’m a hard worker. I’m not the standard by which people should be deemed deserving of health insurance and health care; my point is that the uninsured are probably more like me and like you than some would expect. It doesn’t seem right, that in a  first-world society where over 91% of adults have cell phones², only 44% have health insurance³.

I have chronic allergies and use a daily intranasal spray to alleviate post-nasal drip and swollen nasal passages. Before a doctor diagnosed me and wrote me this prescription, I thought I was just always sick. I don’t like the idea of going back to daily sore throats and stuffy noses, so I’m hoping I’ll be able to continue filling this prescription. My current health insurance through school doesn’t include a prescription plan, just a prescription discount. I’m paying almost full-price for this nasal spray as it is, so it will be just a little more expensive once this discount is gone. But what am I going to do once my refills run out? There’s a chance the school doctor won’t approve additional refills without seeing me in person, which will be impossible once my coverage ends and I’ve moved to NYC.

A few years ago, I was laid off from my full-time health-insurance-included job. To maintain my coverage through COBRA, I was paying about $600/month. This continued even after I landed another full-time job and had to wait several months until I became eligible for my new employer’s ESI. In 2009, thanks to the American Recovery and Reinvestment Act (ARRA), my premium was reduced by about half. When I got that letter in the mail, I cried.

I am not completely familiar with the Obama Care Plan and other legislation passed regarding health care, but I am relieved that New York is one of the states implementing a Health Benefit Exchange. This Exchange helps individuals, families, and small businesses acquire coverage. They begin accepting applications this October, and coverage will begin in January of 2014. I am researching whether this is a good option for me.

Regardless of politics, I think health care should be seen as a right rather than a privilege. Healthiness and happiness go hand in hand, so let’s pursue both.

For musicians and artists looking for information about health insurance, Fractured Atlas is a good place to start. Here you can become familiar with terminology, get quotes, learn about health care reform, and find more resources. 

Footnotes:
1. http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2013/04/number-of-americans-obtaining-health-insurance-through-an-employ.html
2. http://www.pewresearch.org/fact-tank/2013/06/06/cell-phone-ownership-hits-91-of-adults/
3. http://www.pbs.org/newshour/rundown/2013/04/survey-finds-rate-for-young-adult-coverage-improves-while-others-decline.html
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