Uninsured before The Affordable Care Act. She "waited out" her symptoms hoping they would pass.


(Interview 4/2009. Oil on canvas 40 ins. x 30 ins.)



Update 2021

This is another very early painting in Art As Social Inquiry's Healthcare in the US series. Before I started this project I was not aware that many people I knew faced health challenges alone.


By that I mean they did not understand the insurance/health system maze into which illness had pushed them. The blessing of a strong family/friends network did not matter unless those connections had the means and the savvy to maneuver our complex healthcare/health insurance system.


Even with expert or just competent advice, how much could a person help if an individual was uninsured? One could suggest using safety net providers or relying on the kindness of medical professionals for care at a reduced rate or for free -- not ideal solutions for a first-world country that spends about 18 % of it's GDP on healthcare. All that health spending amounts to $3.8 trillion. Why are some scrounging for care?


From a 2020 Kaiser Family Foundation brief. "Public hospitals, community clinics and health centers, and local providers that serve underserved communities provide a crucial health care safety net for uninsured people. However, safety net providers have limited resources and service capacity, and not all uninsured people have geographic access to a safety net provider. High uninsured rates also contribute to rural hospital closures, leaving individuals living in rural areas at an even greater disadvantage to accessing care."


I lost touch with this subject. I was unable to get permission to use her first name. I know she has married since I knew her. She gets health insurance as a dependent on her husband's insurance policy. He is the policyholder in a plan offered by his employer. But this was not always the case.


In 2009 this young woman had no health insurance, and she was sick.


Before the Affordable Care Act, the ill, uninsured person could ask to buy a single health insurance policy from an insurer. But the insurer could review the applicant's health history and decide not to sell a policy to a person who was sick. The Department of Health and Human Services estimated that over half of all Americans had condition that would make them uninsurable. The Affordable Care Act outlawed this practice of denying health insurance to a person with prexisting conditions.



In 2009 my business partner and I offered the subject a full time job. We knew we could promote her to full time and add her to our employer-sponsored group policy without her having to fill out a health history form. People applying to an insurer for an individual insurance policy faced a review of their medical history -- medical underwriting.


This subject would have health insurance and get her medical problems addressed. But we also knew we could be penalized by having to pay higher group rates for insurance. The insurance company could look at our claims history and decide we were not worth insuring if our employees had too many medical claims. They could drop us. We took the chance anyway. This was all before the Affordable Care changed the rules.


From Louise Norris at healthinsurance.org. "The ACA — otherwise known as Obamacare — changed all that. Small-group premiums can only vary based on age (with a maximum 3:1 ratio for older adults compared with younger adults), family size, geographical location, and tobacco use."



Artist Note (Aug. 2012)

This subject was one of my very first. I wanted to make the point that an uninsured person in dire need of healthcare will reach for whatever might provide relief – even a long distance phone call with a stranger. A doctor relative of mine tried to provide some general counsel over the phone.


In the end, this young woman knew she could not afford the tests her doctor would want. Her health history would warrant the doctor's need for tests. . She waited it out hoping the symptoms would pass. They did.


At the time I knew nothing about the healthcare world at large. I only knew that as a co-owner of a small business I had been reducing coverage for ourselves and our employees. We were choosing policies with higher deductibles and out-of-pocket costs. We were paying higher premiums for a lot less coverage year after year.


 

(from a 2009 interview)

Waiter, age 26, Uninsured

This subject was uninsured when she had a serious health scare. She relied on a phone conversation with her friend's sister (M.D.) who lived a thousand miles away. She had no in-person consultation. The subject was able to avert a health crisis. She embraced a more holistic approach to health with strong emphasis on nutrition.



I gave this friend portraits of her cats. I painted the two cats together

on two 24 ins. x 20 ins. canvases pushed together.