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Jennifer Williamson is a twenty-something 
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Compared to other twenty-somethings I know, I’d say I’m pretty together.
I own my own business as a freelance writer. And business has been good. I pay my rent and bills, feed myself, pay off my credit card every month, and I’m slowly making a dent in my student loans. I even save for retirement. I’m a college-educated, productive member of society.
But I don’t have health insurance.
When I tell people this, the responses sometimes surprise me. For example, a friend of mine is an internist at a local hospital. We were talking about a mutual friend who recently hurt her foot and had to go to the emergency room. She didn’t have health insurance. I mentioned that I didn’t either. He looked at me as though I had told him I never finished high school. “Well, you just need to get it,” he said in a flat voice.
I suspect that among the haves, there’s an idea that the have-nots should—and can—just get insured. If they can’t, it’s their fault somehow. But it isn’t that simple. Here are some common misconceptions about the uninsured—and why they’re false.
People without insurance are just too lazy to earn enough.
I wouldn’t call myself lazy. I work harder now than I ever did in any of my previous jobs or in college. And someday I may make enough to afford to pay for individual health insurance.
But it takes time to build a business. There are millions of people all over the country who are self-employed, work very hard, and still can’t afford insurance. There are also plenty of hardworking people whose companies have unaffordable health care plans—or none at all.
The uninsured could get insurance if they took the initiative to change jobs.
Some of the insured would probably say that it’s our choice to work where we do—and that we could get insurance if we just switched jobs. But it’s more complicated than that.
Some people don’t have the education or qualifications to move to white-collar work that’s more likely to include health insurance. And that’s not necessarily their fault. There are plenty of no-fault reasons why some don’t go to college, including badly-timed pregnancies, sick or absent parents, and inability to pay.
Some fields just don’t pay well: nonprofits, for example. I worked in a nonprofit for two years, and we were lucky to have the meager coverage we got. But nonprofits do great work for society, and you wouldn’t want the people who do that work to quit en masse because they don’t have health insurance.
It’s also easier said than done to just “get a job” nowadays. For some people, it can take years—some start sole proprietorships just to make ends meet during long stretches between jobs.
People without insurance spend their money on other things.
Okay, I admit it: I don’t have health insurance because I fritter away my money on useless extravagances. A roof over my head, for example. Food—that’s something I’ve never been able to live without. Oh, and electricity, heat, that kind of thing. I know, I know. I really should cut back.
There seems to be a belief among the insured that if we just budget better, we uninsured could get our acts together and buy insurance. But that just isn’t true. I’m a very frugal person. I don’t buy designer clothes, I don’t have an expensive latte habit, and I live with three roommates. Believe me, I do everything I can to cut down.
But the least expensive individual plans I’ve found cost about as much as my rent. And that’s just not possible for me. It’s not a matter of better budgeting. It’s as financially out of reach for me as a house in the Hamptons. I won’t be able to afford it, no matter how I tweak my budget. And I know I’m not the only one.
People without insurance should just get married.
This one is more prevalent than you’d think. Remember my friend who hurt her foot? Her brother took her to the emergency room. When she told the doctor she didn’t have insurance, he looked at her brother, standing next to her, and asked if he had coverage. He said he did. The doctor said, “You two really should consider getting married.”
Of course, it was funny because he didn’t know the guy with her was her brother. But it also wasn’t funny at all, because he was partially serious. Is this what we’ve come to, in the most powerful nation in the world? In less enlightened times, women had to marry because they had no other way to support themselves. Is that the case for the uninsured now? Must we be forced into it because we can’t get covered any other way?
Of all the stereotypes and misconceptions about the uninsured, this one horrifies me the most. Marriage is something you should only do when it’s the right time in your life and you’ve met the right person. I’m not willing to compromise on marriage, of all things, just because I can’t get coverage.
You know the situation is bad when the uninsured are expected to make unreasonable compromises in terms of basic happiness to get insurance. In my case, I could get insured right now in one of two ways: by giving up my writing business, or by getting married. The second one is absolutely out of the question: I refuse to let lack of health insurance force me into a premature decision here, and I don’t think that’s unreasonable.
As for the first one, I probably could get insurance if I applied for jobs at advertising agencies and other offices. But running my own writing business has always been my dream, and I’ve never been satisfied working any other job. Not to sound overdramatic here, but the choice for me was between being happy with no coverage and being miserable and covered. And in America—a country with the right to pursue happiness written into the constitution—nobody should ever have to make such a choice.
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Leave your thoughts here. (20 responses)
- 1 Pingback on Sep 7th, 2007 at 9:23 am
- 2 Pingback on Sep 7th, 2007 at 12:32 pm
- 3 Pingback on Sep 24th, 2007 at 4:59 pm
New Grads should really look at programs like GradMed (6 month health insurance plans for the transition between college and a job).
Other people without it should do themselves a huge favor and get an HSA plan. An HSA is Health Savings Account for those of you who are interested. They’re really pretty cheap and protect against catastrophic charges from injuries. They’re a good option for people who otherwise don’t have many health expenses. They’re tax free i believe as well. The plans that run in conjunction with them are a great option. Please look into it.
For those putting savings into a retirement account but still without health insurance, what are you thinking? An injury without health insurance will wipe out that retirement account anyway. Get the health insurance and then worry about planning for the future; you’ll have the piece of mind that some freak accident isn’t going to ruin you.
This is really stupid. You save for retirement, but you don’t have enough to buy health insurance? Give me a break. You’re replacing a bunch of misconceptions with a bunch of excuses. Your friend is right. You should just get it. It’s easy to talk about not having health insurance until something goes wrong.
Do you feel lucky?
You forgot one.
Twenty-somethings aren’t convinced of their own mortality yet
I agree that there are many misconceptions about who does and doesn’t have health insurance, but like the others here, savings should generally come after you’re secured some form of insurance.
HSAs as mentioned are great to look into, and along the same lines try to look into something even if it’s just for emergencies/unforeseen events. After college and between jobs I was about to get pretty cheap high deductible coverage from Blue Cross. I wasn’t going to use this to go in for a checkup, a physical, or a cold, but I know that if I got into a car accident or something else completely out of the ordinary happened, I’d at least be able to cover the big bills.
Obviously no one ever plans for unfortunate things to happen, but I can tell you from experience after being in a car accident, going through surgery, therapy, the works, that without insurance my family would be in debt for decades. So at least try to look into some high deductible insurance or something along those lines…because even if you spend thousands on an accident or similar, it’s better than filing for bankruptcy.
I must say, I didn’t realize there was such a stigma attached to the “uninsured.” I had one month between jobs during which I had no insurance. It made me nervous, so I can’t imagine what it would be like without it for an extended period of time.
Most of the people you talked to were in the healthcare industry, so they’re going to be skewed that way since they see so many uninsured people. Whatever. If you don’t want insurance, that’s your choice. I wouldn’t let it bother me. If it bothers other people, that’s their problem. Unless, of course, they’re paying your medical bills…
Holly: I don’t think there’s much stigma associated with being uninsured for a little while between jobs. I didn’t really notice it until I’d been that way for about a year. You’re probably right that people in health care will have stronger opinions about it, because they deal with these issues every day. But you still get the condescention and assumptions from others; I’m not sure if Rebecca is in health care or not, but responses like that are pretty common.
Nathan and Rebecca: in theory, I agree. Health insurance should come before savings. But in practice, I save what I can afford–it’s not bucketloads. If I stopped saving for retirement, I still couldn’t buy health insurance with that money. So it’s not an either/or situation.
Thanks for the comments, everyone
Insurance is not for everyone. It is only (I repeat - ONLY) for people who can afford it. Jennifer (I assume she’s the poster) is absolutely doing the right thing for her. It sounds like she has weighed the options and decided that health insurance is not as important as other things, say being a self-employed writer. It is her money and she can spend it however she sees fit. That’s called freedom.
What would be incorrect is to force Jennifer to pay for something she doesn’t want. Could a huge accident wipe out her savings? Sure. But she’s accepting that risk. Life is not about avoiding risk at all costs. Life is about managing risks and rewards.
While I don’t agree with Jennifer’s conclusions (her lifestyle over health insurance), I can respect her decision as she’s exercising her freedom with her money and she isn’t infringing on other’s liberties in doing so. More people should wisely weigh the risks as she has done and make things happen. I hope it works out for the best.
Freedom of Choice is great and all but you have to draw the line at stupidity.
From a numbers standpoint not having insurance is not reasonable. One wrong move or freak accident could make it so she can never afford to live her beloved lifestyle ever again. Skip your morning starbucks (90+ dollars per month) and go out 1 or two less nights per month (20-60 dollars) and there you have the premium for some health insurance. We’re not saying get the comprehensive plan but at least mitigate the risk of catastrophe.
Jennifer, regarding “But the least expensive individual plans I’ve found cost about as much as my rent.”
Not sure what your rent is, but I pulled some quotes from reputable insurers at EHealthInsurance.com for around $100. The plans have high deductibles, but would be mightily helpful in the case of catastrophe. I like Brad’s suggestion about how easy it is to save $100.
As a twentysomething myself, I’m a big advocate of health insurance. Recently, one of my close athletic friends went through major health treatment. I would guess he racked up over $50,000 in medical costs.
So I will reiterate Rebbecca’s comment: do you feel lucky?
I didn’t have health insurance early in my freelance career. But after seeing what it provided me — when I took a job in TV — I did get on board. I think that health insurance in the early 20s is much easier to pass up than when you hit 40, or even 30. I never found HSAs to be something I could pursue. I just never had much discretionary income for that… Right now I do have a catastrophic plan… plus dental insurance that isn’t worth much… but it’s there. I do shudder at the thought of what toll a Real Accident or Real Illness would take on my life. The real issue as a freelancer, I think, is what you face when you’re in a situation where you can’t work. Loss if income seems way scarier than the need to pay for medical bills that haven’t materialized in my 41 years on this Earth.
I’ll go out on a limb here and be rude to make a point.
Single professionals without health insurance ARE lazy. They are too lazy to look for insurance. It’s there! Look at Presh. a couple of minutes on the web and he found some for $100. % minutes was all it took for me to find the same.
Hey, if you can’t afford $150 a month because you are poverty stricken, well that’s one thing. But if you just don’t want to afford it because it cuts into your spending money, that’s just stupid.
And no, I don’t respect your decision to live your life the way you want. Because when you default on your medical bills and go bankrupt, it affect MY medical bills. The hospital has to charge more to cover it’s losses from people like you.
Health insurance… get it!
Health insurance for healthy single young people isn’t all that expensive. I bought my own insurance a couple of years ago, when I was straight out of college and working for myself. It’s probably worth it to skimp a bit and have health insurance just in case.
I’m a European who lived in US for one year and it shocked me when I heard that a lot of the people that I lived with didn’t have health insurance.
I worked as an intern at a software company were a lot of people worked as contract workers (without health insurance). What a lot of people were striving for was to be full time and get insurance.
Now, being an entrepreneur in Prague, I’m glad that health care isn’t one thing I have to sacrifice in order to built my company.
Or maybe…the health care system just needs to be revamped.
here’s my idea if you are interested in getting insurance - student insurance. For the first year after I graduated from college I worked for a company that did not provide insurance so I signed up for 1 class as the local junior college. I went to the class learned some new things and paid much less for student insurance. It’s an idea, if you are interested. It worked for me because even though I had graduated I wasn’t ready to give up the learning. I did that for 2 semesters.
Hi Jennifer,
I’m still working full time and freelancing on the side, but every time I mention my goal of going full time freelance, my boyfriend (who’s a doctor and is a big advocate of universal healthcare) reminds of how expensive it will be to buy health insurance. He agrees that it’s a shame that lack of universal healthcare discourages entrepreneurship, but he doesn’t want to see me go into massive debt if I got sick. Hopefully with MA introducing the HealthConnector (for those who would be otherwise uninsured), it will be more affordable. Still, those who are self-employed and have existing medical conditions are really a rock in a hard place, because most companies won’t give them insurance or will charge them outrageous premiums. Watching “Sicko” made me realize how lucky I am to have coverage, even though I have to deal with office politics and a commute for me to get it.
Susan
Susan-
Watching “Sicko” should tell you that having health insurance means very little if you become an expensive case. I recall learning from Sicko that insurance executives that cut the “losses” are rewarded handsomely.
To those who have HMO health coverage, don’t become complacent just because you can visit a doctor. I had 3 linked health conditions that were never discovered by my doctors. There was no time to talk to me in those 15 minute appointments. I’ve researched all of these situations on my own and I’m feeling fine - but it was not my health insurance that got me here.