Singles and Health Insurance, Part I

Some 17% of the U.S. population wakes up every morning praying that today is not the day they get hit by a car or trip on the stairs or hear the doctor say "cancer." Because again today, they are uninsured, and a visit to the emergency room could bankrupt them.

Sixty percent of the uninsured are single. This probably surprises no one, but it should outrage everyone. Single adults in this country are the only minority who can still be discriminated against with the blessing of the law, and nowhere is this more obvious than in the private healthcare industry, in which singles subsidize the right of married employees to cover a spouse under their insurance plan.

When a married worker loses a job, chances are she can be covered under her husband's plan. If she can't, she has the cushion of her husband's income to fund COBRA until she can find another job. When a single worker loses a job and can't afford the aptly named COBRA, whose provisions are leaner and meaner than a viper, she has no recourse but to join the ranks of the uninsured.

That's if she had insurance to begin with. About three in five low-wage, hourly employees are single, and these low-income jobs are the least likely to offer health benefits.

But let's talk about a different single, who lucked out. He has a stable, salaried position that, up until a few years ago, provided full benefits. But in 2006, along with two-thirds of large corporations surveyed by Mercer Human Resource Consulting, his employer shifted part of the cost to him. Now the discrepancy between what he and his married coworker pay for insurance is visible in the big, boldfaced numbers on his paycheck.

According to a 2005 survey of 80,000 policies sold by eHealthInsurance, the national average on a monthly premium for an individual policy was $148, while the average for a family policy was $110 per member. That means our hypothetical corporate peon loses $456 annually to his smugly married coworker. If Single Schmo and Smug Married are chained to their desks for another 40 years, Single Schmo will shell out $18,240 more than Mr. Smug! In the meantime, Mr. & Mrs. Smug Married have two incomes to cover their substantially discounted premium, whereas Single Schmo has just one for his full-price coverage.

Let's not forget, either, that while a married employee is free to add a spouse and a whole gaggle of kids, singles are much more limited when handing out the healthcare goodies. Extending coverage to a parent, sibling, grown child, or other relative is simply out of the question. That's right. A single's blood relatives, his birth family, are deemed far less worthy to reap his benefits than an unrelated woman he's known perhaps a few years whose most durable tie to him is a piece of paper called a marriage certificate. And though some employers have seen the light and now cover unmarried domestic partners, that coverage is taxable. If the domestic partner were a legal spouse, he or she would be covered tax-free.

Then there's the double whammy of inadequate coverage, literally adding insult to injury when singles are already paying through the nose every month. Among the medical necessities that are often labelled unnecessary by the private healthcare sector are treatment of "preexisting conditions," dental work, vision care, mental health services, birth control, prescription medication, medical devices like pacemakers, wheelchairs, and prosthetic limbs, blood work, xrays and other scans, chemo and radiation, ambulances, emergency room visits, and that catchall category under which everything else falls, "preventative treatment." Little leaves a single as defeated as the realization that, after he's coughed up five or six thousand dollars a year for the last two decades, he's also going to have to cough up a lung before he gets coverage for a life-threatening disease.

For instance, last year I was evaluated for a genetic condition that would have required multiple risky, invasive surgeries had I tested positive. After testing negative on two out of three measures, I was advised to have one last exam to be sure, for which I was referred to a specialist in ophthalmology. However, when I called the ophthalmologist, I was informed that they wouldn't be able to conduct the test without also performing a standard intake exam. Unfortunately, a standard eye exam was not covered by my insurance policy because this was, you see, "preventative care." The out-of-pocket cost of this exam was about $300. I agonized over this for months until, one day, I found myself at the optometrist's to renew my contact lens prescription (also not covered, of course), and the sympathetic doctor agreed to perform the test at no extra charge. (It was negative.)

I don't know what I would have done if Lady Luck hadn't come to my rescue. I suppose I would eventually have forked over the cash--150% of my monthly premium--to ensure my peace of mind. But if that test had cost thousands instead of hundreds, or if I had been worse off financially, I might not have had that choice.

It's no wonder, then, that singles who can barely afford rent, transportation, and the pinstriped shirts on their backs are opting out of pricey premiums and applying that money to personal emergency funds instead. But unless you can hoard away a cool million or two, relying on personal savings is still a gamble.

So what's a single person to do? Anybody who claims there's an easy answer for this one would be lying, but if you're single and uninsured, Singletude can point you in the direction of some viable options. To find out more, check in again tomorrow!

Are you single and uninsured? If so, how did you lose your insurance? Do you agree that the current healthcare system discriminates against singles?



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