“The greatest wealth is health.” — Virgil

Health InsuranceI feel fortunate. I’ve never had to live without health insurance. Even during stints of self-employment, I carried an inexpensive policy that covered me for catastrophic events. I was in my twenties: healthy and lucky enough to stay out of harm’s way. There weren’t any tragedies but I don’t recall any regular doctor visits either.

However, I at least always had some form of coverage. This isn’t the situation for many Americans. A couple of weeks ago on NPR, Patricia Neighmond interviewed James Calhoun in a segment called Making Ends Meet Without Health Insurance. James is a web site developer who is still in his twenties.

She writes, “In recent years, Calhoun has worked for a number of small companies, none of which provided health benefits. Calhoun says that when the dot com bubble burst, there was a mass exodus of freelancers into the workforce.”

He calls these workers “perma-lancers” — “People who work as if they were full-time employees, but don’t have health insurance, don’t get paid vacation days, don’t get paid sick days, and if the advertising revenue falls off for a quarter, it’s no problem to stop an assignment.”

“They are expected to perform like full-time employees, but without the benefits. In other words, perma-lancers are easily laid off.” Neighmond continues on about his health care concerns, “Calhoun still loves what he does, but his enthusiasm is tainted by worries over whether he can maintain his career full-time and whether he can maintain his health.” He also tries to mitigate the risks that follow a typical 20-something and skips the snowboarding these days.

Calhoun is not alone. Millions of Americans live without the luxury of coverage and for many this is either a huge financial burden or a crap shoot trying to survive without basic and routine health care.

Liz Pulliam Weston wrote A Survival Guide for the Uninsured. She explains, “The more than 45 million Americans without coverage will get sick more, earn less and die earlier than those with insurance. Here is where to find help if you’re caught without it.”

eMaxHealth also lists some options for the self-employed and some apply to perma-lancers as well. Click on the link for the expanded explanation:

  • Consider COBRA coverage
  • Rely on someone else
  • Find a part-time job with benefits
  • Join an association
  • Find out if your state offers ‘Group of one’ plans
  • Shop carefully for an individual plan
  • Look into a Health Savings Account

The tip: Join an association is worth mentioning. They write, “Going it alone in your business doesn’t necessarily rule out taking advantage of group buying power. Group rates may be available through membership in an association. Check with your local Chamber of Commerce, trade and professional associations, and your alumni association if you’re a college graduate.”

I know two people that have done this. In the past, my partner, Jeanine accessed coverage through her law school alumni association. And a former colleague who is self-employed now gets coverage through his Chamber of Commerce where they offer its members a discounted group plan.

Now here’s an interesting fact about lesbians and health insurance. As a group, we’re more at risk for getting caught without coverage. A recent study shows Lesbians Face Significant Barriers to Health Care Access. Here’s an excerpt:

“Who benefits from the health care system in the United States? Studies have long pointed to disparities in access to care along racial and class lines. But, according to a new study by Columbia researchers, sexual orientation may play an equally critical role. The findings, published in the American Journal of Public Health, indicate that lesbians encounter more barriers to health care access than their heterosexual counterparts.”

“The authors used four criteria to determine health care access: whether a person had insurance coverage, had a regular source of care, had seen a provider in the last year, and had unmet medical needs because of cost issues. They found that women in single-sex relationships were at a significant disadvantage to women in heterosexual relationships in all four categories.”

“Women in same-sex relationships have lower rates of coverage than those in opposite-sex relationships. This may be at least partially attributed to the inability of same-sex couples to marry or form legal partnerships in most states. More than 40% of insured women in the U.S. are covered through another person. Women are also less likely to be employed in professions that provide an insurance package.”

There are ways to have coverage so don’t go without.