Tuesday, April 27, 2010

Band-Aid: Does health care reform change anything for musicians?

This past weekend, YOU SAY PARTY! WE SAY DIE! drummer Devon Clifford died after sustaining a brain hemorrhage during a show in Vancouver, Canada. It's heartbreaking, but one positive aspect of this devastating story is that Clifford--who lived in the Vancouver suburb of Abbottsford--was rushed to a local hospital by paramedics and quickly underwent emergency neurosurgery. Although Clifford lost his battle after a day on full life support, he was given all the care possible. Would he have received the same treatment had the incident occurred in the U.S.?

The truth of the matter is that U.S. health care policies differ greatly from many other countries and plenty of American musicians (and non-musicians) are forced to live without proper health care coverage. Change, however, is coming. A recently passed health care reform bill promises to expand coverage to 32 million Americans who are currently uninsured, making it so that anyone can stay on their parents' plan until they're 26. The bill also states that starting in 2014, insurance companies can't deny coverage to anyone with preexisting conditions.


So how will this affect musicians? After all, the road is hard. Just ask Brian Dales, 20, of Arizona's
THE SUMMER SET. The singer broke his ankle leaping off the stage at the San Diego stop of the AP Tour last month. "After the last song, I always jump down off the stage onto the ground then get on the barricade," he says. "This stage was a little too high, though, and I landed funny and my ankle just snapped. It's really easy to get injured out there on the road--really, really easy. Thank God I have health insurance, because if I broke my ankle and didn't, this would be a complete nightmare. "


Brian Dales (center) of the Summer Set

Considering many musicians' relationship with health insurance, or rather, the lack thereof, that's an understatement. For a lot of band members who get hurt or ill on the road, that nightmare is all too real. "We know plenty of bands that don't have any sort of health insurance coverage," Dales says. "They're always worried about getting sick or injured on the road."

For example, take Skyler Nielsen, 27, of Los Angeles rockers
OH NO NOT STEREO. "I'm a pretty good spokesman for this because I have a long history of getting injured," he says. "I lead a very adventurous lifestyle, so I hurt myself a lot. I've been in a few life-threatening accidents. I was dehydrated in Arizona and had to go to hospital for heat exhaustion. I had an allergic reaction on tour once where my head swelled up to three times its size."

Throughout all of that, Nielsen--who doesn't have health insurance--says he's accumulated hundreds of thousands of dollars in debt for medical bills. "My credit is so bad, I'm gonna have to buy everything [with] cash for the rest of my life. It's no one's fault but my own. This isn't a pity party, but I cannot ever buy anything on credit because of my choice to turn my back on my hospital bills." Ready for some irony? "The best part is even though my dad is a physician in Utah, I still don't have health insurance," he says. "Everyone who knows me thinks I have insurance because of that. But when I hurt myself or choke on something and have to go to the hospital, I just can't pay my bills."


The frequency with which Nielsen has required medical treatment might seem extreme, but his story is a common one. For bands and people who work in the music industry--many of whom don't have regular, steady incomes--health care is simply too cost prohibitive. For them, it's a choice between abandoning their music careers and simply hoping for the best. It brings to mind the joke about a Republican's health care plan: Don't get sick.


"None of us in the band currently have health insurance," says Timmy Brown of California punks
DOSE OF ADOLESCENCE. "It's just not very feasible for us right now. It's a hustle every day for us to get by. I know that for myself and other friends of ours, going to the doctor isn't very high on our [list of] priorities, let alone the fact that we really can't afford it, either." A year ago, Brown's brother and bandmate Jimmy broke both of his arms. "We're still trying to pay the bills," says Timmy Brown. "We weren't denied [coverage], but we definitely can't afford the hospital bills."

According to a recent survey by the
FUTURE OF MUSIC COALITION--a national non-profit advocacy group for musicians and music fans--33 percent of musicians do not have health insurance. A 2002 survey had that number at 44 percent. "We still found that musicians are uninsured at twice the national average," says AFMC project coordinator Alex Maiolo, himself an insurance agent in North Carolina as well as a musician. Part of the reason for the difference between now and 2002, he speculates, is because of how much easier it is to become a "musician" in the digital age. "We're seeing a lot of the same trends, but people who want to take their career a little further are hindered by the decision: 'If I quit my job at Whole Foods or Starbucks or whatever, I'm without health insurance.' It's a very adult choice people have to make at a very young age."

Kristina Grossmann, founder of
ROCK FOR HEALTH, a group dedicated to educating and advocating for musicians on health care issues, presents a more drastic picture, estimating that 96 percent of musicians don't have health care. The reason for this number is that musicians, even those signed to record labels, are not considered actual employees of the business--they're considered temporary employees who do work for hire. "Anyone who works at a label is on contract and has health care," she explains. "The bands don't, and they have no other means of getting health care besides the American Federation Of Television And Radio Artists or the American Federation Of Musicians, which are two unions that are great, but it's still really expensive and you have to qualify for it."


Kristina Grossmann of Rock For Health

Grossmann founded Rock For Health in 2007 because as someone who has worked in the music industry, she found herself frustrated by the way people in that field are treated. "I have tattoos and piercings, so I've personally been denied proper care due to a doctor treating me like I didn't have health care just because I look like I don't have health care. I was working for Bayside on Warped Tour, and I got strep throat. [Doctors] didn't even test me for it. They said I was non-compliant which means, 'You can't pay for it.' My mother is a nurse, so I got her on the phone and she started yelling at the doctor saying they were denying me proper care, and that I did have health insurance. Once they found out I had insurance, they treated me completely different and started giving me proper care. That was the main instance that made me start Rock For Health. I know a ton of musicians who have been affected by not having health care, and it ends their career or they die. It's just terrible."

Nevertheless, many insurance companies essentially treat being in a band as a preexisting medical condition. That's partly because of the dangers associated with life on the road: constant travel, moving heavy equipment and working long hours. But there's also a morality component involved as well. "There's this whole misconception out there that being in a band is all about sex, drugs and rock 'n' roll," says Grossmann. "Any older person immediately associates going to a show with drugs and bad behavior when it's not the case. There are so many young bands that are straight edge and concerned about their health. So many people at other jobs do drugs and drink. Nobody equates being a waiter with being a drug addict. A lot of musicians want to get help and they just can't. It's so frustrating."


Gary Levitt, 29, of New York indie-pop outfit
SETTING SUN is one musician for whom health is a priority, but paying for health insurance is out of his reach. "It's just too costly," he says. "I'd rather take a chance, roll the dice and spend the money I'm saving on quality food and free time to exercise and be happy." Like every other musician who spoke to us for this story, he says most of his friends in bands don't have health insurance either.

Courtney Kaiser, 34, of Brooklyn indie-folk duo
KAISER CARTEL concurs. While lack of coverage in the event of a major injury or sickness is obviously a huge problem, she points out one of the more insidious ways this issue manifests itself: Uninsured musicians regularly neglect to have illnesses diagnosed ahead of time because of lack of insurance. "We had a good friend who is a drummer who wasn't regularly seeing a doctor because of the lack of health insurance," says Kaiser. "He had a heart attack and will have to pay a lot for his hospital bill. If he had insurance, he would've had regular check-ups and would have known that he was a candidate [for a heart attack]."

But it's not just lesser-known musicians who are unprotected: When
ALEX CHILTON of beloved power-pop pioneers Big Star died last month at the age of 59, it was partly because of his lack of insurance according to a recent story on Chilton from Nola.com:

"At least twice in the week before his fatal heart attack, Chilton experienced shortness of breath and chills while cutting grass. But he did not seek medical attention, his wife Laura [Kersting] said, in part because he had no health insurance."


For many younger people, not having health insurance probably seems like no big deal. People well into their 20s often forgo health insurance because they think don't need it. But for someone Chilton's age to avoid medical attention because he couldn't afford it, or simply didn't want to pay an outrageous fee to be treated, is simply tragic.


Lou Barlow, longtime
SEBADOH frontman and member of the recently reunited DINOSAUR JR., made it into his 40s without health insurance. "I never really had it because I couldn't afford it. It seemed ridiculous," he explains. "But it's a situation that almost had awful consequences for his family. "About five years ago, [my wife and I] had our first kid and my wife had complications," he says. "We couldn't pay for it. It was just really scary." Fortunately, a nurse helped Barlow find a program that would allow his family to apply for aid through the state. "We had to drain our bank account, cash out a 401(k) [retirement plan] and basically show that we had no money. It was pretty intense. I'm kind of lucky I live in L.A. [because] California has a lot of provisions for people who can't pay their medical bills. They don't tell people that these benefits are available, that if you make a certain amount of money you can go through certain channels and get the money to get help to pay for it."


Lou Barlow

Years ago, a friend of Barlow's almost didn't make it through while on tour. "He found out he had [been suffering from] diabetes for years. He was getting sicker and sicker and we were trying to get him to a hospital on a tour. He wouldn't go because he didn't have health insurance. I felt like I was watching him die, which I was. I finally got him to go to a hospital in New York City. He waited until the last minute to go to the hospital and found out he was close to a diabetic coma."

It may not seem logical, but sometimes the choice between your health and going into massive debt is just too daunting for musicians to confront. For a lot musicians, even knowing where to
begin can be an issue. "People just assume that there's no help out there," says Barlow. "Whatever they whittled the new health care bill down to, at the very least maybe it will make it so people won't be afraid to ask, 'Is something out there for me?' You sort of assume that no one is going to take care of you and you're fucked if you've chosen this weird lifestyle as a musician. It's just a matter of asking about it and getting out and finding it, which is hard for a musician. In general we're not the most organized people."

One of the places musicians
can go to ask about health care is the nonprofit organization MUSICARES. "We're a safety net for the music industry," says executive director Debbie Carroll. "We offer emergency financial assistance to individuals in the music industry. When a music person is hit with some type of bump in the road, we can help them bridge that gap to get over that crisis at the moment. Whether it's medical expenses, dental needs, prescription costs... We also help with things like rent, utilities and substance abuse treatment." Over the past few years, the organization has worked with more than 1,400 music industry workers and dispensed more than $2 million per year in aid. That's because the relationship between the music industry and health care has been a long and tenuous one, she says. Like Grossmann, Carroll points to the work-for-hire status as being the crux of the issue. "[Musicians are] not the typical 9-to-5 individuals who are able to be covered under an employer's health care plan. And for many musicians, their income and revenue stream is such that it prohibits them from being able to afford health insurance. We've seen people who have, for example, fallen off a ladder and shattered their leg and been financially devastated. We've seen people who've avoided seeing a physician for many years for preventative care due to lack of ability to afford insurance to individuals who have been diagnosed with some catastrophic illness and are faced with hundreds of thousands of dollars of debt." Like Barlow, Carroll says that "music people in general are typically not detail-oriented. That's not their forte, they're creative. Even the process of applying for insurance can be difficult. That's not an excuse, but that does factor into the health insurance issue."

Another mitigating circumstance is that there's just not enough awareness about how insurance actually works. Even worse is that the horror stories that many musicians hear about being denied coverage for preexisting conditions actually turn out to be true. "We've heard from folks that it's too expensive, or that they have an illness that would exclude them from receiving health insurance," says Carroll. "For example: Hepatitis C. Unfortunately, a lot of music people are afflicted with that disease, and they've heard from others that they can't ever get health insurance so don't even bother. For some folks, that prevents them from going any further in even exploring it. We see people denied due to preexisting conditions such as diabetes, heart disease and cancer that has been in remission for several years. Also substance-abuse issues--if someone has been to treatment, even though they've been clean and sober for several years, insurance companies will look at that and it could be considered a preexisting condition that could exclude them from receiving coverage."


One of the aspects of this problem is that for American musicians, it's pretty clear that being a resident of another country might help. In 2006, Chris Shively, 27, a DJ from Chicago who performs as
CHRISSY MURDERBOT broke his arm very badly and required surgery.


Chrissy Murderbot

"They put a metal plate and eight screws in my wrist, a procedure for which I owe about $10 thousand that I still haven't paid. In any other developed country, this procedure would've been free, and it damn well ought to have been free in the richest country on earth." While Setting Sun haven't had anything as painful happen on the road, one of the band's members did see how health insurance works abroad when he lost prescription medication while on tour in Europe. "It's normally around $60 to fill, but while in Italy, the pharmacy gave him a new bottle for, like, three or five Euros with no prescription needed," says Levitt. "I've had friends get ill while on tour in Europe and they all said they were fixed up, treated well and not charged anything in the European hospitals."

Oh No Not Stereo have a guitar player who retains dual citizenship in the U.S. and Finland, and guess which country he turns to when he needs health care? "Any time he needs to go to hospital, he goes back to Finland," says Nielsen. "They have free health care. He had a bunch of cavities, so he went back to Finland. He scheduled an appointment that day, they gave him a bunch of medication before he got the cavities filled, gave him the free dental work, and he was back home the next week in L.A."


Depending which side of the political spectrum you fall, that's either the type of insidious, socialist plot President Obama is trying to force Americans into with the passage of the new health care bill, or the sort of medical system we should be pushing for ourselves here in the States. Rock For Health's Grossmann says that for musicians, there is a lot to be optimistic about in the new bill. "I'm really stoked about it because a lot of the results of the reform are what my organization were trying to push for musicians." Eliminating preexisting health conditions as a barrier to insurance, for example. "The reform doesn't allow insurance companies to do that anymore. Before, if a musician broke their arm on tour then tried to get health care, they wouldn't be able to get it. A broken arm is a preexisting condition."


But not anymore. "The preexisting condition clauses will allow many more individuals who are unable to obtain insurance to get access," says MusiCares' Carroll. Another clause of interest to musicians, particularly younger ones, is one that will allow people to stay on their parents' insurance plans until age 26. Previously, it would have stopped at age 19. "A lot of musicians start in their late teens and early 20s and are just trying to get going," Carroll says. "Allowing them to stay on their parents' plans will help considerably. A lot of new bands barely have money to cover their rent. This will get them coverage they need while allowing them to still pursue their music career." Both women agree that provisions making preventative care affordable will have a positive effect on the scene. "Preventative services will no longer require copayment or be counted against one's deductible," says Carroll. "That will allow more people to access those services and take care of themselves on the front end, which I think will benefit everyone in the long run."


Grossman says, "Preventative care is going to be free now. They can't charge you a co-pay for getting a flu shot or something like that because it's preventing an illness. Immunizations and vaccines, too. It makes perfect sense if you think about it. It costs a lot more money to go to the hospital with the flu than to get a flu shot. Stuff like that is huge for musicians. There are so many other different plans they can get now. It's so much more affordable. They went from having to pay, like, $400 per month to $500 per
year. I'm really excited about it." Many of the bands she works with have expressed excitement as well. "I help a lot of band [members] when they're around 20. I started working with the Cab when [some members were] 19. More often than not, musicians in their teens are more obsessed with their health than anyone else. Not performing a show means you don't have gas to get to the next venue. A lot of the younger musicians who have chosen not to go to college to pursue their career in a band, they were immediately taken off their parents' health insurance--if you went to college you could stay on your parents' insurance. [Now,] they're not going to be taken off just because they don't go to school."

Maiolo agrees that things are looking up. "These stipulations could benefit musicians who may have otherwise been prevented from vigorously pursuing their careers due to insurance restrictions." But, as he told us, "It's not like a thousand flowers have bloomed and until you're 26 years old you can do whatever the hell you want and have this utopian, young adult, post-collegiate existence. Somebody is going to be paying for it."


Nielsen says he's still paying. "I am one of the many, many people that are on the very bottom of this totem pole," he says. "It can only get better. I'm not expecting them to dismiss my hospital bills. All I expect from here on out is to be treated like a guy who has insurance from his work. It's just an equality thing. If you contribute to society, you're entitled to the same rights that the next-door neighbor is. We pay taxes just like everybody else."


Levitt of Setting Sun is cautiously optimistic as well. "I'm familiar with the bill that passed and it has great potential, but we're still at the mercy of the private insurance industry. The main looming question is affordability. Having 32 million more people as part of a pool to make the cost come down could work; we'll just have to wait and see."


Barlow actually can't believe the bill even passed. "I never thought it would," he says. "The majority of people seem to have that whole concept of, 'People should take care of themselves.' It destroys my spirit to hear that. I was, like, 'I can't even watch this go down.' I think it's naïve of people to think that everyone should just take care of themselves. People who run corporations are really good at making money and taking care of their own, but those people are not necessarily born with any empathy or understanding of other people. I think as a society, we should take care of the people who can't take care of themselves. That's just what I believe. A lot of people don't. They're like, 'Let the corporations take care of it.' Why the fuck would a corporation take care of people? That's not what they do."


While it seems like things may get better for uninsured musicians in the near future, there are still a lot of questions about the real impact health care reform will have. Maiolo wrote in a
pieceBillboard, "There's much to commend in the historic bill that President Barack Obama signed March 23. That doesn't mean it's perfect. It's not a single-payer system that would cover the medical expenses of every American. And there isn't a 'government option' that would provide security outside of the private-insurance nexus." He told us, "This is kind of a sweet hand out to the insurance industry. This entire thing, in my opinion, doesn't suck. That's the best thing I can say about it. I can't say we've had massive reform here. What's happened is a bunch of people said they are starving, and the solution is, 'Well, we should make them buy food.' Oh, really, thanks? This is so far from giving us universal health care in a way that I think would solve this problem. At the end of the day, we're taking the existing system, which has proven itself time and time again to not be the best way to administer health benefits to the populace, and we've decided we just need to patch it. If you have a horse with two broken legs and you need to ride across the country, sure you could put two splints on those legs and drug the horse and ride to California. But it would probably be better to just get a new horse. That's just the logical thing to do."

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