It’s been roughly 7 years since I’ve had health insurance. I started freelancing 8 years ago and it took a year before I decided to leave my job. What scared me the most about taking the leap was the lack of healthcare. I had a right to be worried. American healthcare is ridiculously expensive and can be unnecessarily convoluted. I’d already experienced financial setbacks because of medical bills in my 20s and learned to save for emergencies, but it’s never been enough. The difference between having healthcare and not is frustrating and financially devastating, as we see in bankruptcy cases across the country. If you’ve been fortunate enough to have good health insurance through your adult life, allow me to give you some examples of what happens when you don’t.
When I was 25 and an under-employed grad student in a new city, I had to have an emergency splenectomy, which included a week’s hospital stay with a short time in ICU. Several months later, complications landed me back in the hospital with another week until I could be released. The experiences left me with medical trauma and exorbitant bills. I applied for assistance but the process was intrusive and messy. It got to a point where I stopped opening my mail because I was overwhelmed by the memories and the idea of having to pay a high 5-digit bill on top of looming future school loan payments. It triggered a serious depression spiral that didn’t stop even after I found out my application for assistance had been approved and the medical debt cleared. These events made me vow that the next time I had health insurance, I would use it for every single twinge or cough I could.
That’s exactly what I did when I returned to full-time work after grad school. I took advantage of my insurance because I knew what it was like not to have it, which is part of why I kept giving my last full-time job chances to keep me onboard. It didn’t seem like my boss appreciated what I did and constantly expected more from me, while ignoring my desire to advance professionally. I knew I wanted to move to freelance but I was afraid of being without insurance again.
Not having guaranteed healthcare wasn’t so bad, until the day I bent over to shave my legs in the shower and my body reminded me I was never seeing 35 again. Standing upright was a fiery hell and I spent 2 days popping Tylenol and alternating cold and hot presses but my back was not getting better. I went to urgent care, where I received a vague diagnosis of a pulled muscle, a prescription for a muscle relaxant, and a bill of almost $200. The prescription was almost $50. It could’ve been much worse but when it might take another month or two to collect another $250, it can really set you back.
A recent long-term contracted gig provided health insurance, and I scrambled to make long overdue appointments and re-up prescriptions. The first time I picked up a monthly prescription with my new insurance, the price dropped from $50 to $5. I almost cried in that Walgreens. (If medicine can be as low as $5/month, just give it to us for that amount!)
One of the first appointments I made was with a gynecologist. I’ve been having increasing pelvic pain over the last few years, which I tried to get addressed at free clinics, but they often don’t have the equipment needed to assess such issues. Now with insurance, I went to a gynecologist who did an ultrasound but also referred me for an MRI. Even though the doctor said the MRI was necessary, I had to wait for the insurance company to agree.
Luckily, I received the authorization and went to get the MRI. My insurance paid a very small portion and I had to pay $1100 out of pocket, up front. No payment plans available. ELEVEN HUNDRED DOLLARS. When I handed my debit card to the admin nurse, she shook her head and said “these deductibles will kill you.” Perhaps, even literally because I honestly thought about not paying and continuing to suffer.
I decided to pay because of my own medical history and that of my family, which includes cancer. The only reason I could afford it is because I had money left over from the last payment of my publishing advance. It was money I’d hoped to use to stay ahead of bills. One of my utility companies keeps sending me exorbitant bills and when I call to argue, they tell me the meter is accurate, that people being at home more often in the last 18 months has caused everyone’s bill to skyrocket. So not only did I lose half my rent money on this MRI, I still have a $600 Con-Ed bill hanging over my head.
As of this writing, I don’t have the results of my scan yet, and I hope it will help explain whatever’s been going on in my body the last few years, but I can’t help feeling like I’m working to afford healthcare now. My emergency fund is now simply a healthcare fund.
My insurance will end soon and although COBRA is an option, I will not take it because my income varies so much, I can’t afford to take on another significant expense. The unexpected cost of that MRI, with insurance, has set me back and sent a wave of anxiety crashing over me that lasted almost a week. Money is one of my depression and anxiety triggers, and it’s so frustrating that trying to manage my physical health can lead to a mental health low.
I’ve been looking out for more work and making additional cuts to my budget because, if I get bad news from my doctor, I’ll need to be able to afford whatever is next. Now instead of saving money to go home for the holidays, I’m saving money to stay healthy. I was hopeful about the possibility of Medicare for All, but it doesn’t look like that will happen in my lifetime. I wonder how many others out there are wishing for healthcare relief that may never come.