The exchanges created by the affordable care act are now online, and here is a web page with information about heathcare for the self-employed.
If you’re in post-production, a writer, or a filmmaker, there’s a very good chance you’re self-employed, and unless you’re a veteran or you’ve been elected to office sometime in your life, self-purchased health care is the only game in town (unless you’ve access to union health-care and you’ve managed to put in the hours to keep it going). If you’re just getting started, or if you’re currently in a slow period, paying those premiums probably seems like a low priority relative to rent, groceries, and gas.
My advice? When it comes to your long term well-being, buying health insurance is not optional.
Believe me, as a long-time freelancer I know that self-purchased health care is a pain in the neck. Up until now it’s been difficult to get, difficult to navigate the bureaucracy, it’s been expensive, and in my experience it’s difficult to use when something other then a routine doctor-visit is involved. And this is with private insurers. Maybe folks who are paying way more money for higher-end insurance policies then mine are having better experiences, but as as the beneficiary of a middling plan, I’m not persuaded that the service being offered by the private sector is any better then the government-run services I’ve been dealing with, including Medicare, for my elderly mother. Frankly, Medicare has been much easier to deal with then either our current or last private insurance providers.
Granted, I’m not necessarily thrilled with the way the Affordable Care Act has been conceived, as I don’t think that being compelled to purchase a service from a private corporation is the best precedent. However, it would appear that the Affordable Care Act was the only politically possible way to get rid of the absolute evils of (a) preexisting conditions denying people coverage for critical care, (b) the ability of private companies to simply rescind coverage for a variety of bureaucratic technicalities, (c) lifetime limits on provided care, (d) uselessly low annual limits on coverage. Paying for this by taking some baby steps towards creating a pool of more affordable insurance plans is, in my view, a reasonable tradeoff to get more folks insured, so I’ll take what I can get.
Yes, being required to pay for something sucks. But I’ll say it again, regardless of the law, no matter how healthy you think you are, health insurance is not optional. If you think it is, then you’re gambling with your life and your happiness.
I briefly went without coverage for a few years in my twenties. Just out of college in 1992, I was interning for free at a postproduction facility and also at a production company (unpaid) while working a seven day schedule doing two part-time jobs – watching an art gallery on weekends and working part-time retail in a computer store on weekdays. Neither of the paying jobs offered health care, and it was an easy thing to put off because I was broke, and I had the imagined invulnerability of youth (never mind that I was bicycle commuting in San Francisco at the time, which was an accident waiting to happen).
But I had a wake-up call when another twenty-something colleague of mine revealed that he had survived a rare bout of testicular cancer at a young age. It was perhaps the first time I realized that something medically catastrophic could potentially happen to someone like me, youth or no youth, and it made an impression. It took a while, getting to the point where I had climbed the career ladder a bit after freelancing as an editor and broadcast designer in San Francisco, but I finally started purchasing health care at the age of 26. I didn’t particularly enjoy sinking a lot of money every month into something I felt I never used, but I didn’t really want to flirt with the alternative.
In the years since, the only time I’ve had employer health care was when I was on staff at Apple for five years (their health care was fantastic and wide ranging). When I left Apple to go freelance again, my wife (a life-long freelancer) and I went back to purchasing it independently. Going forward many years, now that we’re in our forties, we both consider health coverage to be a vital monthly payment. We’ve seen too many friends and colleagues suffer too many illnesses that required financially ruinous medical intervention.
Here’s one last personal anecdote. Kaylynn recently had “elective” knee surgery. I certainly didn’t think it was optional, unless you consider limping painfully for the rest of your life and not being able to work in your 20-year-plus profession to be a valid option. Without insurance, that surgery would have been prohibitively expensive. But we have insurance, and so this relatively simple issue could be taken care of.
For all of these reasons, I’m glad for what little the federal government has done, and hope that this is the beginning of a more serious look at how health care delivery in the United States can be improved to be more universally accessible.