The High Cost of Health for Freelancers

by Bob Poole on March 22, 2011

One of the drawbacks of being a free-lancer really hits home when you get sick with things like viruses, back pain, or the flu. You know – the kinds of things that keep people who work for a company home for a day or two while they recover. I was feeling pretty rocky yesterday and I even rescheduled an interview because of this bug. I’m also lucky because I do have health care insurance. But, I worry about my freelancing friends who just can’t take time off to be sick.

They have the normal costs of living to pay and many of them are already working hours that would make most people give it up and find a company to get a paycheck. But, they don’t do what they do for a paycheck. They do it because they love it and they wouldn’t want to do anything else. Even if it does mean working with the flu or pain.

Now here is where my worry part comes to play. I know that way too many of them don’t have any health insurance. And, not because they like to gamble with their health and financial future. They just can’t afford the premiums that insurance companies charge the self-employed. They also can’t afford to pay for many tests that they sometimes really, really need to have done. A good friend was told she needed an MRI last year. She was in serious pain and was unable to find relief through things she could afford to pay for like massage and acupuncture. When I heard how much she was going to have to pay for it I knew there was no way she could afford it. Shop around yourself. It was going to cost her thousands of dollars. She did without it. She tells me the pain gradually got much better. But, what if it hadn’t? What if it had been something significant?

Now Google the cost of an MRI paid for privately in any other developed nation. A $2500 spinal MRI in the US will cost you $500 in the UK. In fact, the costs are so much lower in other countries for medical procedures that there is an entire medical tourism industry.

We are facing a health care crises that is unimaginable. 17 Million people identify as self-employed, 15 Million are unemployed, and 12 Million have given up looking for work or are working part-time with no health care. The current number of total uninsured Americans stands at around 60 Million and many of them are self-employed working harder than anyone on Wall Street ever worked only to live knowing that one serious illness or accident could be devastating. How many of these people are our friends and colleagues?

If you’re self-employed, a freelancer, etc. how do you deal with your health care? What would happen if you needed expensive tests or procedures? What can we do about this?

{ 4 comments… read them below or add one }

Becky Blanton March 22, 2011 at 5:37 pm

Good post Bob. I worry about this too as I cannot afford premiums. Even if I could, there’s a year’s wait before I can actually use the health care. Then, I’m likely to be denied as a “pre-existing condition,” or some other trumped up excuse that the health care providers use so they don’t have to pay. They make it hard to collect hoping that 60% of people will give up and pay out of pocket – which they do. There are free clinics for the things like the flu, broken bones etc. My car insurance will cover me if I’m hurt in an accident. And there are the “doc in a box” clinics that charge from $50 to $100 per visit for other things. Many doctors are willing to negotiate fees way down – especially if you pay in cash! There are medical trials for many conditions – from hearts to hip replacements etc. It’s hit or miss, but there are options.

If you can provide proof of income many hospitals, particularly teaching hospitals, will provide you reduced care – kind of like insurance where you pay a $10, $12 or $20 co-pay and up. There’s Medicaid and Medicare – a long process to sign up and get your card and iffy now with Obamacare on the way.

The best alternatives are prevention. Eat healthy, exercise and take care of yourself. I’m putting the money for my health care into a $60 a month gym membership and healthy food. I relax, don’t stress, don’t drink, don’t smoke and am losing weight. 75% of the health problems most Americans have are related to stress and diet. The biggies – like cancer, stroke, and heart disease can be mitigated with a healthy lifestyle and a “catastrophic” insurance policy.

I turn to the internet and to friends in the nursing profession for help. There are also many, many, many labs that offer simple blood testing. You don’t have to go to a doctor and pay them $50 to order your blood work. You can go straight to the lab itself. Small town doctors charge less than hospital based doctors. Less overhead. Pay a doc-in-the-box or General Practitioner to interpret the results, or do that yourself online. If your numbers are in a danger zone then call in the experts.

Alternative practitioners, acupuncturists, naturopaths and herbalists or Nurse Practitioners (NP) all offer a variety of services for less than a physician. NP’s for instance can do pap smears and exams – everything but prescribe meds – and they are MUCH less expensive than doctors. They operate under a doctor’s supervision so you’re getting excellent care. They tend to spend more time with their patients and look for environmental and lifestyle factors more than doctors do too.

Look outside the box. There are many, many solutions. If you want traditional health care there are some freelance organizations that offer health insurance to freelancers at a group rate – making them more affordable. The trick is finding a good one!

Tom Bentley March 22, 2011 at 11:41 pm

Scary stuff Bob. Right now I don’t have insurance, because my Cobra expired. I had needed hip surgery right in time, though the insurance lapsed before the physical therapy was completed (which it is now). Of course, you can’t apply for new insurance while you’re getting physical therapy, because they consider you an unclear risk.

The surgery bills have been amazing: the best was the $28,920 for “supplies” (it said nothing else) which the insurance company paid $245 for. Then the surgery center wrote off $27,000 in that not-amusing game they play. But they’ve sent a cascade of bills, with seemingly overlapping and multiple, complicated charges. Who knows what I actually owe. Health care in this country—priceless (because you can never pay it off).

There’s a good discussion about health care on Peter Bowerman’s Well-Fed Writer blog, with 50 comments that are informative or hair-pulling:

http://www.wellfedwriter.com/blog/what’s-a-commercial-freelancer-to-do-about-health-insurance

Bob Poole March 24, 2011 at 12:20 pm

What a great list of resources and ideas, Becky! Thank you very much. I really like your nurse practitioner suggestion and, of course, preventative solutions.

Bob Poole March 24, 2011 at 12:26 pm

Hi Tom! Two friends of mine (both nurses) worked for insurance companies for the sole purpose to look for overcharges, mistakes, duplications, etc. like you are experiencing. They found found tons of errors. This at least is a case where the insurance company is helping the patient by helping themselves. Thank you for the link to Peter’s site.

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