The debate over how to reduce the number of people without health insurance occasionally raises the fact that some people are uninsured by choice. But choice can be difficult to define. As part of our Profiles in Health Care series, New Hampshire Public Radio’s Jon Greenberg visited a carpenter who has chosen to be self-employed even if that forces him to make a difficult choice about health care.
Following the profile, Diane Rowland, Executive Director of the Kaiser Family Foundation, talks with NHPR Morning Edition host Lisa Peakes about the impact the uninsured have on the rest of the healthcare system.
There’s a group of new houses that has gone up on the edge of Gunstock Mountain in Gilford. By size alone, these homes were built to impress. Some are unfinished. In one, the garage has become a temporary wood work shop.
SFX
A man with short cropped hair and a small silver ring in one ear bends over a belt sander, fine tuning the fit of a small piece of molding. The piece will decorate a banister column in the main staircase inside.
CUT I’m Kevin Page. .. the more I have to deal with it.
Kevin’s back is no small issue. The reason he specializes in fine detail work is because he’ not up to more demanding work with heavy lumber. Even now, his back can keep him out of work for days at a time and he rarely is able to put in a full 8 hour day. It has cut into his earnings and left him with $2,000 in medical bills.
His financial predicament makes the question of insurance more a matter of affordability than preference..
CUT It’s my own choice because I choose not to spend the money on it. It’s just too much money though. I feel it’s too much money to spend at this point.
Kevin barely covers his living expenses each month. If he worked more, he might be able to pay for insurance to treat his back. But with his back as it is, he can’t earn the extra money.
But as bad as his back may be, it’s important to note that Kevin is making decisions about things that are more important to him than his health care. His top priority is how he makes a living.
CUT I enjoy what I do for work and I’m not going to work for someone else just buecasue they offer insurance. This is what I like to do. As far as the insurance, I’ve gonna have to deal with it.
For Kevin, being without insurance is the norm. He has almost never had insurance in his adult life. The construction industry has one of the highest rates of uninsurance of any line of work. Today, affordability might keep him out of the insurance market, but when he was young, left to his own devices, Kevin chose to go without health coverage.
CUT I was in good health. I felt good. I didn’t feel as if I was in need of it. And when I was younger, I certainly didn’t want to spend the money on it. Especially feeling like I could work all day and play all night. But that’s changing.
The value of choice is still very important to Kevin and any proposal that people like him might need to buy insurance in order to be in business meets quick resistance.
CUT I feel that my choice is my choice. It’s how this country was set up. For the freedom to choose to buy something or not. I would be very upset if someone told me I had to buy something in order to make a living. I probably wouldn’t conform to it.
Kevin says he doesn’t put the question of insurance in his mind because he doesn’t put the thought of getting hurt or being laid up in his mind. He says he tries to be positive. And ultimately, it does come down to his choice. He isn’t pleased with his situation but he’d rather work for himself than change.
For NHPR News, I’m Jon Greenberg.
