October 14, 2021 • Healthcare

The Gambler

Kenny Rogers
Don’t mind me. Just rolling the dice over here. (Kenny Rogers, The Gambler)

I’m still thinking about what it means to know your worth.

Earlier this summer I wrote about being grateful for a paycheck and rethinking that gratitude when a friend pointed out to me I was simply being paid what I was worth. She was right, of course. General gratitude in life, aka those gratitude journals we’re all supposed to be keeping, is very different from feeling like being paid what your services are worth is akin to winning the lottery.

But recently I’ve been considering the other side of this equation. So often women are told they must know their worth, as if simply knowing it is the solution as opposed to the first step down a long and uncertain path. Here’s what I mean, and you will likely not be surprised to hear it involves health insurance! This is America, after all.

A while back I switched health insurance. An exciting move since the one I was on had an $8000 deductible and $750 a month payments. The new one was only a $3000 deductible (“only”) and the monthly payments were less than half. Heaven. Or, like, heaven in America if you are a freelancer.

Not long after switching, I went for my yearly mammogram screening, and as is almost always the case, was told I needed to come back for a follow up because I have dense breasts and further imaging was necessary. (Side note: are there women who don’t have dense breasts? I’m always told this as if it makes me unusual, and yet, I’ve literally never met a woman who isn’t told her breasts are dense. Who are these breast unicorns?) 

Anyway! Back I went, thinking nothing of it because since I turned forty, this has been the usual routine. Upon checking in, however, I’m told that under my new insurance plan the follow up is going to cost me $550. I’ll spare you the long back and forth with the extremely kind receptionist, and the very American phone call that followed with the insurance company. The short version is: the flip side of my low deductible is that I have to pay out of pocket for most things until I hit it.

Again, let’s skip the conversation about why this might be beneficial if you are in a big accident, but less so when you are a freelancer on a tight budget, or that it probably evens out in the end, except payment plans exist for a reason and $550 is not walking around money (for me). It’s all terrible. I postponed the appointment till I could sort it out (i.e. 2022) and walked home performing math equations in my head. The conclusion I always come back to is, move to a country that has universal health care, and/or leave New York City, because this problem isn’t going away. I’m not leaving New York (on purpose, anyway). So, back to square one.

Not long after, as is sometimes the case, though you can never count on it, so it’s only a good story in hindsight, a potential project dropped in my lap. It involved the sort of money that could solve a lot of problems short term, including the great dense breast follow-up. I knew what I should be paid for it and what would make the project worthwhile, but the number that was initially on the table, while also of the problem-solving amount, was much lower.

And here’s where the know your worth bit starts to crumble. It’s one thing to “know your worth” in the abstract or when your bills are paid. It’s another entirely to know it in the face of very badly needing money and risking not getting any at all because you know you should be being paid more. The bill collectors know exactly how much you are worth to them, and they expect you to pay it, regardless of your own feelings on the matter.

What “know your worth” really means in so many situations, is knowing your risk. It’s asking yourself how much you are willing to gamble to make the money you think you should make.

America loves a gambling story. The ethos of this country is of the individual who risked it all and was rewarded beyond their wildest dreams. Fake it till you make it. The higher your tolerance for risk the more American you are. The truth is, in the end I was able to get what I wanted (no faking required). And it would have been very easy for me to turn this piece into an exciting tale of all that awaits when you know your worth and stick to it.

But the truth is, I was mostly just left feeling sad. And exhausted. And wishing that, over and over we were not asked to weigh our mental health against our physical health simply as a way of doing business. That life felt a bit less like I’d been perennially cast in The Gambler for reasons even I am not sure about (I’ve been on a Kenny Rogers kick this week).

In a dream world, I would much prefer to be sailing away (with Dolly in this case, I mean, the giggle, the SLIT in her dress…heaven). But like, I would settle for living in a country that did not have to be convinced quite so voraciously or regularly of my worth.