Health insurance in America is a gamble

The terrifying prospect of losing your coverage—I can't wait till I'm old enough for Medicare.

Jul 03, 2024

Welcome to Everything is Liminal, a (mostly) free weekly publication. Paid subscriptions make writing possible and is the best way to support this newsletter. Thank you for being here. 🖤 Scroll down for links and art.

Last month, I was sent into a panic because we found ourselves suddenly faced with the prospect of losing our health insurance. Oh, there was a job loss involved in there too with this unexpected news of corporate restructuring, [UPDATE: crises averted for now, sorta] but it was the health insurance scare that sent me down a spiral.

If you had told me when I was younger that I’d one day be counting down the years until I qualified for Medicare, I would have laughed and dismissed it with a wave of my hand. But here we are in 2024 and I’m doing this very thing—counting down the years till I can sign up for Medicare.1

I literally cannot wait to get off the hamster wheel of this American health insurance system with its private insurance plans and finally reap the benefits from the government program I’ve been paying into with 30 years worth of taxes.

Granted, I still have a ways to go. I have a little over a decade till I hit 65,2 but despite the ever-looming threats of Republican cuts to social security and Medicare just when Gen X is getting ready to age into these government programs, I’m basically salivating for the day I’m old enough to qualify. Yes, please! Sign me up!

Which is saying a lot, considering I’m not exactly jumping for joy at the fact that I’m a mere stone’s throw away from becoming a senior citizen.

I know what you’re thinking. I can already hear the knowing chuckles from those of you who may already be on Medicare. Maybe the system isn’t a panacea of great, free healthcare like I’m willing it to be. At the risk of breaking my own clueless bubble, I only just learned that Medicare is, in fact, a very complicated, multi-faceted system of parts that requires a monthly premium for certain preventative services (hello, what?! There’s a “Part B” and you have to pay for it?). But look, it has to be better than this employer-sponsored system that we’re currently too entrenched in to ever hope for a reform in this country, right? Right??

You want me to pay how much for what?

We all know that healthcare in the U.S. is unaffordable for many, especially if you’re self-employed. It has long been an expensive albatross around my neck that have moved me to tears in resigned frustration more times than I can count, most recently last month. If only healthcare in America was worth the exorbitant prices we pay.

But it isn’t. In fact, it’s worse compared to other countries.

So what exactly are we paying for? Turns out, a lot of it is administrative fees!

In researching alternatives to an employee-sponsored plan, I looked up what it would cost on the healthcare marketplace—it had been awhile since I last checked.

Here’s what I found:

If you want truly top notch platinum healthcare for your family with zero deductibles and no coinsurance, it would cost you an average of $4,000–5,000 a month in New York. Whoa! 🤯
But even crappy health insurance on a bronze level family plan with a $4,600 per person deductible and endless copays is anywhere from $1,700–$3,000. That’s per month.

And good luck finding doctors and hospitals who will take it. This is what scares me the most about possibly having to buy coverage on the exchange. Fewer doctors and hospitals are accepting the networks in the city. For all of the positives that the Affordable Care Act has done for many Americans, it isn’t the most affordable or remotely the best solution for families like mine.

The dysfunction of American healthcare

For 30 years I have moved in and out of various models of employment with health insurance for my family as one of the main drivers of decisions. I’ve been cycling through a rotation of buying private insurance, leap-frogging with my spouse in getting insurance through jobs, getting a group rate through unions when that was an option (ironically the ACA killed that deal), and paying for years of COBRA in-between. I’m sure many of my fellow Americans can relate.

Despite all the acclaim and support for small businesses and entrepreneurship in this country, it’s neither easy nor affordable to navigate the complexities of figuring out your own healthcare, especially when we have a nonsense archaic system where healthcare is tied to our jobs. I’d wager it’s one of the biggest obstacles for people considering a leap into self-employment.

I was once interviewed and quoted in the Wall St. Journal many years ago when I was contacted by a journalist who read a blog post I wrote in 2011 comparing health insurance to gambling. This was during the years when we were running our bakery business and I was freelancing in order to minimize another equally exorbitant expense in this country—childcare.

I understand that the very nature of insurance is coverage just in case, but I realized, when faced with a huge hike in our monthly premiums one year, that I was essentially throwing money out the window by paying through the nose for insurance plans that we never even really used. We were fortunate to be healthy and rarely went to doctors other than annual visits at the time.

Still, making the decision to downgrade our plan to a high deductible one to save on monthly premiums felt like a gamble. After all, you never know when you’re going to need that coverage. A high deductible plan can work in your favor, until it doesn’t when someone gets really sick or injured.

An employer-sponsored system is stupid

Any time our yearly premium increases became unsustainable when we were funding our own insurance, I switched from freelancing to a full time job. The sweet relief of having an employee-sponsored, employee-subsidized health insurance was a worthy tradeoff to subway commute hassles, childcare conundrums, and the loss of flexibility.

But jobs don’t last forever, especially in this modern era of employment where things like a pandemic, AI, and profit-over-people can throw a labor market into one of the worst we’ve seen in years.

While our too-close-for-comfort health insurance crises has been averted for now (with a less than ideal trade-off 🫥), it reminded me of just how vulnerable we are when healthcare is tied to our employment. It leads to many of us staying in jobs that we’d rather leave just so that we can keep our insurance, and it also leads to stressful gaps in coverage when we do experience job loss.

Can you blame me for fantasizing about Medicare? (ok, break my bubble in the comments, go ahead).

Yours truly (and still insured for now),
Jenna

p.s. Feel free to leave a comment and vent away if you’d like to rant about health insurance woes. Consider this a safe-space where we can collectively bitch about our healthcare system.

This week’s art

I didn’t draw this week because life is a bit much right now. At this midpoint marker in the year, I still don’t know what I’m doing on the art side of things or why I’m doing it at all. Here’s some photos of art I saw instead.

Some (maybe most) art should be seen in person to fully appreciate the scale, the texture, and the craft. And pictured above, Delcy Morelos’ installation at Dia: Chelsea needs to be experienced to fully appreciate all the sensory effects. Working primarily in earth, mud, and geometric forms, it’s hard to describe the experience a viewer has when entering this space inhabited by this massive installation.

While closing soon on July 20, it’s been on view since October of 2023 and I was so curious to see how it’s held up nine months later. I was surprised and pleased to discover that the earthy smell of this structure was still present. I can’t describe how calming it is to sit on a bench in this room and take it all in. It has been my moment of zen.

I enjoy the energy of these paintings by Rita Ackerman, a Hungarian-born, NYC-based artist who unveiled a new body of work called “Splits” over at Hauser & Wirth. It really made me wish to paint on large-scale canvases one day. Interview with the artist here.