Musicians Face Medical Maze
ALHTEA LEGASPI: That's Scotland Yard Gospel Choir's bassist Mark Yoshizumi.
YOSHIZUMI: And I shattered both of my scapula, the wing bone, and broke some ribs and stuff - that was the worst of it.
LEGASPI: Last fall the band was heading on tour, but they didn't get far. In Indiana, their van's tire split open and they rolled numerous times.
YOSHIZUMI: I had three surgeries and you know I was probably in the hospital in critical care for a couple of weeks and then a couple more weeks in like recovery, and then spent a month in a rehabilitation hospital, ‘cause I had to learn how to use, you know I kinda lost communication with the lower half of my body for a while and I had to learn how to walk again.
LEGASPI: Singer-guitarist Elia Einhorn split his head opened, sustained nerve damage and cracked two vertebrae. Guitarist Mary Ralph broke her pelvis and multiple bones, including her collarbone, tailbone and one of her thoracic vertebrae. She also recently discovered she broke her foot in the accident. One of the only band members to not require major medical care was violinist Ethan Adelsman. That's a good thing, because the band's expected medical expenses could add up to more than one million dollars. Most of the band is insured and the majority of their costs are covered. Adelson is not. He's held freelance-type jobs since his 20s.
ADELSMAN: I'm 33 now, but you know, I haven't had – I've been working as a violin teacher and random odd jobs, and never had enough money to pay for insurance so I never got it.
LEGASPI: Many artists and musicians make up the more than 46 million people in the United States who aren't covered by insurance. In fact, the only reason his bandmates are insured is because of other jobs, like waiting tables. Elia Einhorn's insurance is provided through his job as a waiter. It's a co-op type situation, and though he's grateful for it, the rates are rising.
ELIA EINHORN: Now I'm paying $250 a month, you know and that's really tough for a working musician on tour. You're paying your rent, you're paying your, you know say, let's just say a Chicago rent, I don't know $500 to $600, and then you're paying somewhere between $200 and $400 in insurance. It becomes impossible to do anything in the arts. I mean that's why Britain has such a supported artistic system: they have health insurance for everybody.
LEGASPI: The changes to the American health care system are likely to affect people in the arts, much like the rest of the nation, according to health care expert David Dranove, He's Kellogg's Director of Health Enterprises Management program at Northwestern.
DAVID DRANOVE: So what the new law's going to do in 2013 is essentially require everybody to participate in the insurance market, so that insurers should have some confidence that when they sell to individuals they're gonna get the cross-section of the risk pool. It won't just be the less healthy individuals buying insurance because they're desperate for it, it will be the healthy individuals buying it because the law's requiring them to buy it. That strikes a lot of people as unfair because it's forcing people to buy health insurance whether they want it or not, but it strikes others as essential to making health insurance market work. This is the only way to make those with health problems able to get affordable health insurance.
LEGASPI: And Dranove says in the independent health insurance market, which many artists find themselves in, the healthy may find their rates rising with the new reform.
DRANOVE: What's going to happen now is because of the restrictions on charging high premiums for very unhealthy high-risk individuals, say somebody who's been diagnosed with diabetes, the insurance companies are gonna have to make up for their expenses by charging higher premiums for healthy individuals. I think the result is that the range of premiums that an insurance company is going to charge is gonna become much narrower. And that's good news for everybody who's got pre-existing conditions, and perhaps bad news for pp who are in good health. I think though that's probably the only way to try to keep the entire risk pool intact, without charging excessive premiums to pp who've already suffered serious health problems.
LEGASPI: To offset their healthcare costs, Scotland Yard has had benefit concerts. Their label also started a donation fund. Yoshizumi's independently purchased insurance restricts his rehabilitation expenses to $5000 in his lifetime. He wasn't expected to walk, and will be in physical and occupational therapy for a while.
YOSHIZUMI: It's kind of a nebulous future in terms of what my health expenses are going to be. I was really, really fortunate to have private insurance, I'm a freelancer. They covered a lot, like the surgeries and stuff like that. I think my family was freaking out b/c my family was getting bills. I had a helicopter for example that took me from the accident scene to the hospital and it was like 25 grand or something like that. And the insurances couldn't figure out who would pay it. So the bill came to my family and they didn't know what to do, they definitely couldn't pay it. And it was pretty scary and they were really worried if no insurance was going to pick it up, what was going to happen.
LEGASPI: Dranove says the independent market is a place many artists might find themselves in once the reform bill kicks in.
DRANOVE: A lot of pp have crunched the numbers, and believe that many employers will drop their health insurance, they'll pay a fine that the government is going to impose, but they'll still be better off, as a result their employees are going to have to fend for themselves on the federal health insurance exchange.
LEGASPI: But with more affordable health options, Dranove says more artists might be willing to make their art their livelihood.
DRANOVE: People have been reluctant to leave their jobs for fear of losing their health insurance. They've been reluctant to work for small companies because small companies often don't offer health insurance. There's been reluctance to be an entrepreneur, go out on your own, because of the difficulty of getting health insurance. All of these problems are going to be addressed to a pretty large extent by the health insurance reforms that are going to be fully in place in 2013. And that might be the biggest benefit of the Obama reforms, is making sure that decisions about where you work, the kind of job you do, and whether you want to go out on your own and stake your own turf as an entrepreneur will no longer be driven by your fear of losing health insurance.
LEGASPI: As for Scotland Yard Gospel Choir, having health insurance literally saved their lives. As Ralph says, it's worth the price to cover all.
MARY RALPH: I can't imagine going through this and fearing that like my debt was growing every, every, every day, and no one in America should go broke while they're fighting to survive. Like that's strong language, but that is the case, that is what we're talking about.
Scotland Yard Gospel Choir performing “Praying is a Heartache” from the release, And the Horse You Rode In On
Scotland Yard Gospel Choir performing “Tear Down the Opera House” from the release, And the Horse You Rode In On