Young and Uninsured: Not Much of a Choice

Originally published as part of Generation Invincible, Youth Radio's series exploring health care issues facing the under-thirty crowd.

By: Molly Adams

"So what do you do?" is a question people ask a lot when you're fresh out of college. I'm a freelancer, doing all kinds of broadcast production jobs. But that doesn't cover my rent. So I'm also a bartender.

None of these jobs come with health insurance.

I was lucky growing up. My parents were always steadily employed, sometimes by the government, so I always had health care. I remember trying to argue my mom out of a wisdom tooth extraction in high school. I said, "I bet it's really expensive! It can't be worth it."

"Honey. It's $70," she said back. "We have insurance."

A few weeks ago, before I was dropped from my parents' plan, I had an eye exam and a physical. It was like a last meal. I asked way more questions than I ever did before. I've started flossing my teeth every day, something I never did when I knew I could go to dentist if I had a problem.

My dad called me a couple of days before my final checkup. He asked what I was going to do. I told him Illinois provides free reproductive health care for women who make less than $1800 a month. But I didn't have any other ideas.

Then my mom picked up the line. She told me she studied some COBRA information and that I could get a plan for around three hundred dollars.

Here's the thing: $300 a month is pretty much everything I make that does not go into rent, my school loan payments, transportation, utilities, and food. It's the only extra money I have. If I pay for health care, I would literally have no other money. I couldn't save. I couldn't buy winter boots. I couldn't buy anything.

I have co-workers at the restaurant where I work who have never been able to put more than two thousand dollars into their checking accounts. And it's not just the artists. I know many people who are waiting tables or tending bar while they work two unpaid internships to earn a place in a company.

That's why a lot of us are just not that into health care. It doesn't make a lot of financial sense.

Read More About Health Care Issues Facing the Under-Thirty Set.

It's a priority for my parents because they need it: They're in their fifties. Colonoscopies, mammograms, all that gross stuff. I have other things to think about. Plus, dwelling on the fact I can't afford health care is stressful and we know stress leads to health problems so forget it.

For now, I'm lucky. I don't have chronic health issues. My safety net is having financially secure family members who could take care of me.

But I do worry about a Catastrophic Event. I ride my bike a lot in a city filled with bad drivers. I worry about getting into an accident. And when I think about not being covered, and maybe having to spend $20,000 on a broken leg, I admit I get bitter. Why is it that I'm working forty hours a week, contributing to society, and yet I still don't have health insurance? Aren't I earning it?

Maybe someday I will get hired full-time and score a benefits package in spite of the conditions that so many recent graduates are dealing with: a crappy job market and no health care. Until then, I have to decide between every extra purchase and health care. And right now, it really doesn't feel like a difficult decision.

Also From Youth Radio:

• Ten More Health Care Terms You Need to Know
• Rookie Docs Talk Health Reform
• Old vs. Young -- the Health Care Tug-Of-War

Youth Radio/Youth Media International (YMI) is youth-driven converged media production company that delivers the best youth news, culture and undiscovered talent to a cross section of audiences. To read more youth news from around the globe and explore high quality audio and video features, visit Youthradio.org

Comments

[Stegerfox]

Iam a nurse, and if you dont work in the hospital setting, there arent any healthcare options out there.
Small nursing homes and clinics say they offer small plans, but take a good 120 days to kick in, are very over-priced and under-covered. As an RN, Iam considered managment and am not offered the low-cost HMO that is available to our nursing assistant, maitenance and kitchen staff. They are fortnatley offered the better coverage through the SEIU union. And I, who spent many years in school and have given myself unselfishly to help countless others, cannot get decent coverage for myself or family. The last insurance I has a year and a half ago was $550.00 every two weeks. Not even my salary will cover that. And, like the article above, would not be able to afford food or clothes for my family if I did take it. For now, my son is on Illinois State Insurance (Allkids), and my husband and I are suffering silently letting our medical and denta health go ignored for fear of bankruptcy! Time for a change, most definitley!

[TexMark]

Of course it's all very complicated as an insurance company will not pay the $20,000 used in this example but likely more around $3,000 due to contractual agreements that they will provide the hospital with at least 100 broken legs a month or pay a penalty. The $17,000 difference is not a write-off as it is an agreed to cost.

Salaried employees get very upset when they have to work, especially when they know the time they could be standing around doing nothing has to be spent on treating people who cannot pay, so they become ever more disgruntled as they complain among themselves which lowers the quality of care so they demand more pay and still harbor great resentment for free loaders.

The problem with health care will never be solved until the ability to manage human expectations is understood by an educated and mature population. Either a broken leg costs everyone 8% of what they make, regardless of how much or how little, or health care needs to understand that time spend standing around doing nothing is better spent treating those in need.

Dream on!

[TexMark]

What's the difference in cost between a period of time when there are no patients and when one shows up and cannot pay?

Other than material, it is the loss of time associated with treating a patient who can pay. The more time a staff stands around doing nothing or treating those that cannot pay, the more expensive it becomes to treat those who can pay, but the difference between standing around doing nothing and actually treating someone who cannot pay is negligible.

The only real expense is the cost of the x-ray film and the cast. The rest is based on a profit motive and the inability to recover that $19,900 in additional fees. As a result, it is recorded as a loss. The time spent standing around doing nothing cannot be so easily recorded and is not a factor.

It's the same reason why planes fly half full instead of selling unsold seats for the cost of the extra gas -it ruins the profit incentive.

Luckily, this $19,900 does qualify as a tax write-off so, in a very over simplified example, the hospital gets 35% (corporate tax rate) from the government in tax savings to the extent that they can show a profit from those that can pay.

[TexMark]

Trust me, $138.50 isn't going to get you "Cadillac Coverage". Thus, while "Health Care Coverage will be provided for all", a family paying $554 a month will likely have a $10,000+ deductible they will have to pay before dime one is provided in coverage.

Doomed to failure is a polite statement.

It's simple math. The problem is, a broken leg really will likely cost $20,000 and the money has to come from somewhere. At $300 a month (to use the articles listed amount) , means that approximately 76 other people have to go health free for the month to cover it (+ 15% administrative cost by the insurance company) .

The deeper problem is that hospitals are "for profit". To fix a broken leg requires a doctor and attendant staff (who are all on salary), an x-ray (a paid for machine and an x-ray tech on salary), and some plaster.

[TexMark]

Dream on!

COBRA? I don't think so!

COBRA is a limited benefit extension designed to allow people time to locate another job, not to cover adult siblings who are not attending college (unless your parents are fired) . If you are in this situation, take some community college classes. Most insurance companies allow coverage up to age 24 for children of covered parents). No one says you have to pass or even attend the classes and the tuition is likely far less than any coverage -it's the books that are expensive! Besides, there are a lot of cool people there with social connections and progressive attitudes and it probably will not kill you to learn something even if you fail the class because you never bought a book.

Outside of an employer sponsored health care plan, $300 a month, even for a nonsmoking 20-something will likely come with a $2,000 deductible, a $5,000 out-of-pocket maximum and a whole host of other small print costs.

The current health care debate centers around providing health care for all starting in 2014. It is based on limiting the cost to 8% of the gross income of a household. The labor department states the average hourly wage is just above $18. If we use $20 for a couple who are both working and earning $20 an hour (or $83,200), with two children, this 8% threshold equates to about $554 a month or $138.50 for each family member.

[corwin]

No,It's not a difficult decision. I would agree with you, it makes little financial sense for you to purchase health insurance at several hundred dollars /month .Still, I see no other way for society to pay for health insurance for older Americans than to have mandated health insurance paid by young folks .It's somewhat like Soc Securty . You will have to pay initially for benefits later.