Insure This

There is something to be said for not having a conventional job. I get to make my own hours. I don’t really have a boss. Sometimes I can work from home in my sweatpants. 

But there is a dark side to freelancing, and at its core is the health insurance debate. For those of us who freelance, or work an hourly job, or fall into the gray income gap between Medicare and health insurance, our health and physical well-being are a daily balancing act. 

Freelancers, especially, face a difficult choice when needing medical attention, because for us there’s no such thing as workman’s compensation. Part of being a 1099 employee is absolving your contract holder of any responsibility, should you injure yourself while on the job. For a model, that’s pretty daunting. On any particular day I face model stands with broken wheel locks, ancient space heaters, and uneven standing surfaces – and that’s not even counting the normal risk of bodily injury due to constant stillness and/or contortion.

For those of you who still think I am a financial drain on society for my desire to have affordable health care, here are a few things you might not know about individuals who are uninsured:

All medical visits are out-of-pocket expenses. That’s right, someone with little or no income can walk into a city clinic and not pay a dime for the visit, because it’s subsidized by taxpayer money. Someone with health insurance has those visits covered by their premium. Someone making between $15k and $30k a year is paying between $35 and $100 a visit to the same clinic (and, I might add, their only affordable option). 

And while some cities have great referral programs in place (NYC has some of the best), even certain visits to a specialist are not covered. I remember the year my PAP smear came back abnormal. I was sent to St. Roosevelt for a colposcopy to biopsy the cells on my cervix and hopefully rule out cancer. You can imagine my surprise when I received a bill for $635 -- a bill the hospital ate, because in my early twenties I didn't have the money to pay it.

We work when we’re sick. In fact, we work all the time. There is never a time of day when we are not answering an email or returning a phone call. If a lucrative offer comes up, whether it’s midnight on a weeknight or noon on a Saturday, we’re working, and that includes when we’re sick or injured. There are hundreds of us trudging into work every day when it would be better for all parties if we stayed home to get well. But without sick days to secure our jobs, or insurance to cover that visit to the doctor, working while sick is a necessary evil. 

Right now I’m working with an injury. Two weeks ago I slipped on the ice in front of my steps and torqued my back out of place. In all reality I probably re-injured a back sprain from fourteen years ago, but because I don’t have health insurance I’m treating myself with Epsom salts and copious amounts of Advil, while trying to take it easy on the box so I don’t do permanent damage (you know, since using my body is how I make a living). If it is what I think it is, medical treatment will require seeing a chiropractor three times a week for the next few months. I have neither the time nor the money.

We take other people’s prescriptions. When I and my girlfriends were all still living in NYC, one friend qualified for Medicare only because she had a life-threatening condition. The year her tiny Christmas bonus disqualified her, she went so far as to take leftover meds from people with insurance who could simply refill their prescription. Another of my girlfriends did the same thing to get regular access to her asthma inhaler. When my (nonlife-threatening) tera versicolor got out of hand last year, the least expensive generic medication was still nearly $200 for a two-week supply. And so I “borrowed” from an insured friend.

We work the system. When the poverty line is around $12,000 in every state, most of us making even as little as twice that don’t qualify for things like Medicare. That puts us in the awkward position of needing things like PAP smears and flu shots, without having the money to pay for them. So what do we do? We lie. I even know a doctor low-balling her patients’ income to have them qualify for free IUD birth control straight from the manufacturer, no taxpayer religious debate required.

The new healthcare system is not perfect by a mile, but it does go a long way to closing a big gap in coverage. It’s pretty easy to say from the right that it’s every man for himself, or from the left that we all need to take care of each other. It’s probably somewhere in the middle, like most of us who want some sort of comprehensive reform so we can continue to bust our butts for the freedom to work all the time, doing the things we love.