Whatever your political views, 'Obamacare' can only be a good thing for musicians and engineers.
Back in 2004 I was diagnosed with renal-cell carcinoma. My left kidney looked like a dried-up raisin on the MRI scan. I wasn't thrilled with the first doctor my internist referred me to, but when you're staring a cancer diagnosis in the face you don't really know what to do next or who to trust. A good friend, Bil VornDick — a great engineer and producer whose production got Alison Krauss her first Grammy Award — made a phone call, and quickly I was connected to the Chief Medical Officer at Vanderbilt University, who happened to have been the drummer in VornDick's first band many eons ago.
After mentally reconciling the idea of a drummer and a surgeon inhabiting the same body, I was ushered a bit more quickly than usual through the bureaucratic maze of high-end medicine. I was lucky: my condition was caught in time, though I left hospital lighter by the 150g that the average kidney weighs. But I also left the premises a bit lighter in another way. Upon doing paperwork the day before my admission, I was reminded cheerfully by the administrator to bring a cheque for $5000 the next morning when I arrived for surgery. That amount would satisfy the remaining balance of my annual $9000 health insurance deductible, after various scans and consultations. I couldn't resist. I asked her what would happen if I didn't have $5000 handy. She said they wouldn't be able to treat me. And if I were to forego surgery? Would I die? She shrugged, as if to say, "Your call.”
I was lucky also that I not only had insurance but was able to afford it. Debbie Carroll, Executive Director of MusiCares, a charitable wing of the Recording Academy based in Nashville, estimates that as many as 80 percent of the 3500 people the organisation helps financially during the year (including many engineers and record producers) do not have any insurance. "I've seen a badly broken leg wipe out an individual financially,” she told me. "Even minor surgery can cost a huge amount of money, and then you lose even more by being away from work.”
At a moment that's been a long time coming, those who work in music production are on the cusp of a great opportunity: starting next year, they'll get to live without having to eat cat food. I'm not being hyperbolic. According to the American Journal of Medicine, 62 percent of all bankruptcies in 2007 in the US — just as the Great Recession was getting underway — were health related. Compare that to 2001, when health-related bankruptcies constituted 'only' 45 percent of the total. It doesn't take a university-financed study to determine that the self-employed are most at risk here, and those who labour in the trenches of music production are squarely in those ranks. Now, I have to ask you to set your personal political and social beliefs aside for a moment. What I'm going to talk about has been at the top of the news for the past year, but the focus today is solely on one thing: life and livelihoods. So take a deep breath, count to 10, and read on.
The Affordable Care Act, aka 'Obamacare', has the potential to change the way the self-employed get health insurance and care, for the better. Under the 'Obamacare' sobriquet, the law consistently draws negative reactions from the public, thanks in no small part to concerted and well-funded efforts to paint the law as economically unfeasible. Ironically, however, when you poll people about the individual aspects of the law, the reactions are quite the opposite. Who isn't in favour of benefits such as the fact that individuals cannot be turned down for insurance due to pre-existing conditions, and that there are also no longer any annual or lifetime caps on coverage? Additionally, 10 essential health benefits — including doctor visits, maternity care and hospital visits — are now required coverage. Young adults can now stay on their parents' plans until age 26 in most instances.
All of this is critically important for recording engineers, producers, mixers and anyone else who works for themselves. As a cohort, we're not the healthiest bunch — we spend too much time sitting in enclosed spaces, living off a diet cobbled from greasy-spoon menus from the studio lounge. Then there's the tour-bus existence, for those in live sound, where exercise is limited to humping amps and loudspeaker enclosures. And there's still a surprisingly high number of smokers among us, too. Some of that lifestyle individuals can change, some of it is simply part and parcel of being in this business. But at least now, with the ACA in place, whatever damage has been done can at least be addressed before it either kills you, bankrupts you, or both.
You get health insurance by going to online portals known as exchanges. These are essentially insurance marketplaces run at the state level. The exchanges offer four tiers of coverage: platinum, gold, silver and bronze. Bronze, at the lowest level, pays roughly 60 percent of medical costs; silver pays around 70 percent, gold is 80 percent and platinum covers 90 percent. The opening of the exchanges was bumpy, with technical glitches galore. That's to be expected, but they were glitchiest in the 36 states that opted out of running their own exchanges, leaving that chore to the federal government. Those states that embraced the new law, like California and New York — both states with a high percentage of self-employed people in the creative and technical arts — have experienced a smooth opening and have already seen insurance premiums drop for many enrollees. So unfortunately, where you live is going to determine how accessible insurance is going to be, at least in the beginning.
But it would be foolish to let either politics or the buggy portal start-up deter you from getting insurance. This new landscape doesn't discriminate between sick and healthy, young and old, like the old regime did. It's there, it's affordable, and it's more accessible than ever. Do it.