My wife and I had a scare a couple of years ago. She hadn’t been feeling well – fatigue, mild fever – when she noticed one of the glands in her neck was extremely swollen. We agreed that she should see someone.
She was 24 years old at the time; she’d just started working at a state university where I was a student. Her job was not glamorous, but it afforded her something she’d only had sporadically since turning 22: health insurance. Over the next several weeks, as we bounced from specialist to specialist, holding our breath at each stop, we found out how valuable – and rare – insurance can be.
Young adults who are out of their parents’ charge and out of the reaches of public assistance (Medicaid does not cover childless adults) must obtain health insurance. Many are less than successful. The Employee Benefits Office estimates that in 2003, 27 percent of people aged 26-35 were without health insurance; 34 percent of adults aged 21-24 lacked coverage. Young people represent the fastest-growing group of uninsured Americans.
Most of my peers find insurance in one of three places: school, work or in the individual market. School’s a fine place, if you can get in (and stay in) and afford to live on a lean financial-aid budget. Premiums are taking a larger bite out of that pie, though. This year, I will pay about $2,000 for insurance – more than 12 percent of my living allowance for the year, most of it borrowed.
Employment remains the largest source of insurance: More than 85 percent of insured Americans get their coverage at work. Young people are no exception. However, the jobs they’re working (more blue-collar than white, more part-time than full) are the least likely to provide substantive benefits. In my wife’s case, her insurance was good, but expensive. The total monthly premium was around $400; her contribution was $100. It sounds fairly generous, but that was more than 10 percent of her take-home pay.
There’s also the individual market, which is attractive to many young workers – including self-employed entrepreneurs – because most of us are relatively healthy. What happens if we do get sick or injured, though? Individual insurance policies aren’t regulated like large group plans. They can deny coverage to whomever they choose and raise rates whenever they want. Most also have some form of restriction on pre-existing conditions – anything from six months to a year. If you can get insurance here, there’s no guarantee you can afford it or keep it if you get sick.
Of course, many choose to go without insurance. They might be lucky, or they might find a lump. Or break an ankle. A friend of mine fell down some stairs when he was 23 and without health insurance. He shattered his ankle, was in extreme pain, and was out of work for several months. With no savings and little family support, he was forced to declare bankruptcy. He was not alone; a recent Harvard study found that nearly half of all personal bankruptcy filings in the U.S. result from medical expenses.
Ultimately, my wife was fine, but there were some very tense moments. Had the diagnosis been a lymphoma, I don’t know what we would have done financially. Her employer’s contribution to her health plan was contingent upon her working three-quarters of the hours in a pay period. Once she used up her vacation and sick leave, we would have faced premiums of $400 with no income. Disability would have been an option after a period of time – but two-thirds of her salary would have barely covered health insurance and rent.
Medical disaster does not discriminate. It can happen to anyone, anytime. If I were to fall ill tomorrow – with cancer, or even depression – being a medical student would mean precious little. Years of hard work, perseverance, careful living – values we all venerate – would be worthless. It’s time that we recognize the heavy burden we place on the young (and the old) by not ensuring basic medical care or insurance for every American. We are all only one diagnosis, one accident away.
Anthony Foianini is a medical student at the University of Colorado Health Sciences Center.
