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I Moved Back to the US and Healthcare Sucks

Veena Vasista - Pyragraph
Deirdre Africa and I stiltwalking at a benefit event for Kelly McDowell, Wise Fool NM teacher and performer, in July 2014. The event was in part a fundraiser to help with Kelly’s expenses as a result of major illness. Courtesy of Veena Vasista.

I just returned to living in the USA, my home country, after 20 years of living in England. I moved from one of the most expensive cities (London) in the world to what is considered the sixth “poorest” state in the USA (New Mexico—this claim to fame is based on median household income; in so many other ways I think it is a very rich state!).

I insist on being a freelancer because I want flexibility to spend chunks of time away from my base. I want this freedom to work in different places. I want this freedom to to spend time with and support my elderly parents. I want this freedom to travel. A job where I’m an employee doesn’t afford that flexibility. Thing is, a job does—ideally—cover health insurance. In England, I had the National Health Service to look after me. (I did eventually acquire British citizenship, but the benefits of the National Health Service are not tied to citizenship.) When I embarked on being freelance in 2008, I didn’t have to think about access to healthcare as an issue tied to how much work I didn’t or didn’t have on the books.

Welcome back to the USA, Veena!

I’m determined to keep navigating through the ups and downs of the freelance life.

Yes, yes, I have acquired insurance through the Affordable Care Act. The legislation has made it affordable to me through tax credits. Still, the affordability of my plan ($0 deductible, $500 cap on out of pocket costs) is only because I earn so very little. My focus right now is an unfunded labor of love, writing a book about Wise Fool New Mexico and the Peñasco Theatre Collective. Just one solid contract for a few months could raise my monthly payment, the deductible and the out of pocket costs by a significant amount.

I would have to earn quite a bit to feel financially secure under these circumstances. Because I’ve seen how it works. I’ve seen a friend literally get hit by a truck and end up $7,000 in debt from medical expenses despite having a plan through the Affordable Care Act. I’m also watching her raise money to cover treatments not covered by her insurance.

Then of course, there’s complexity that is the insurance system. The system, as far as I can tell, is trying to fleece me however it can! But this isn’t unique to being freelance, so I’ll save that rant for elsewhere. What I am finding is that I sometimes feel some anxiety around this aspect of my life. It isn’t that I used to go to the doctor a lot in the UK, but when I did, I didn’t have to think about the costs.

Is it free healthcare? No, that’s a misnomer. UK residents pay through our taxes. I paid through taxes. How is it different? Well, let me put it this way. In 2003, I was in an accident and broke my back. I was airlifted to hospital. I was in hospital for 10 days and had spinal surgery. I had physiotherapy afterwards. Fourteen months later, I had another spinal surgery.

Throughout all this, I never saw a bill to do with my healthcare.

Compare this to a recent experience I just had with getting some blood tests done here—incredible. And perplexing. The paperwork from the insurance companies, from my healthcare provider, from the lab that did the blood tests has been very confusing. Just from two doctor’s visits and two sets of blood tests, I’ve already had to write letters of appeal to the insurance company and get a refund both from the lab and the health clinic.

The other day I started thinking I might set myself up as a freelancer who supports people to navigate their health insurance plan—keep up with the paperwork, write appeal letters, etc.

That is an advantage of being a freelancer, I guess. Well, one who also doesn’t have children or other dependents. I have the time and flexibility to spend hours on the phone sorting stuff like this out. I’m not trying to talk to my insurance provider’s customer service division while on a 10-minute coffee break during a work shift. (I honestly don’t know how people do it! Well, I do know—they don’t. Many don’t even try to make sense of their health insurance. Many just pay the bills they get sent—even if it means borrowing money or putting the payment on a high interest rate credit card.)

Over the years, while living in England, I used to hear about talk from people in the USA about staying in jobs or taking jobs when they really want to be self-employed. They do this, I was told, because of health insurance coverage. “Poor them,” I used to think.

Thing is, I’m determined to keep navigating through the ups and downs of the freelance life. If I can create a sustainable living from self-employment, I keep thinking, I can have such a rich life of being in service to my family, traveling, creating work that inspires me, and experimenting with giving life to love, beauty and play.

Ahh, yes, That’s right. That’s why I’m leading this rather unconventional life. Sometimes I forget—amidst challenges such as health insurance coverage. For me, this living a self-employed life is something I am choosing to do as part of my commitment to step more deeply into a life’s purpose of love, beauty and play.

Exhale. Sigh. Smile.

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