Nate Chinen (NYT) brings some much-needed mainstream attention to the plights of Andrew D'Angelo and Dennis Irwin, both of whom are fighting virulent cancers, neither of whom has medical insurance. It's a good piece, but it raises some issues that could benefit from a wider view -- especially in an election year where both Democratic candidates are promising major health care reform. [John McCain, for his part, promises more of the same. As a US Senator, his health care coverage is just fine, so what's the problem?]
The article is pinned on the idea of community support -- when jazz musicians get sick, the jazz scene steps up with benefit shows and the like:
When the focus turns toward the health of jazz musicians, the discussion assumes a different, less abstract character: solicitous and supportive. Most people who play jazz for a living are accustomed to self-reliance. When that system fails, they lean on one another.
“Since I’ve been on the scene, there have been benefits for musicians that were in need, unfortunately, because so many of us are,” the guitarist John Scofield said in the rear stairwell of the Village Vanguard on Monday night. Along with the tenor saxophonist Joe Lovano and the Vanguard Jazz Orchestra, he was playing a benefit for the bassist Dennis Irwin, who has recently been struggling with a spinal tumor.
Benefit shows are great, of course, and I know both Andrew and Dennis have been floored by the tremendous outpouring of love and support in their time of need. [A reminder that the first benefit show for Andrew is tomorrow (Friday) night at the Union St. Tea Lounge -- I will be there, and I hope you will be too.] But let's get real -- treatment for brain tumors and spinal tumors is crushingly expensive. The costs run in the hundreds of thousands of dollars and could easily push past the half-million mark. The people showing up for the benefit shows at Small's and the Tea Lounge and kicking in whatever they can are primarily other jazz musicians. You know, the people who can't afford health insurance in the first place. This is not a viable solution.
We also see, lurking in the wings, the old right-wing trope that people who "choose" to live without health insurance are "irresponsible," and therefore if they are faced with crippling medical bills, they deserve what they get. Chinen acknowledges the sentiment and tries to defuse it:
It may seem negligent that so many jazz musicians lack basic health-care coverage, but monthly fees through an organization like the Freelancers Union easily run to several hundred dollars, and these days many gigs in New York literally involve a tip jar.
Jazz musicians living in New York -- even relatively well-known jazz musicians like Andrew D'Angelo and Dennis Irwin -- have trouble enough paying the damn rent every month. If you have a full-time day job and are lucky enough to get decent coverage through work, your employer shoulders much of the cost of health insurance -- but as a freelancing musician, it's all on you.
Chinen mentions the Freelancer's Union, which is an organization that sells health insurance to the self-employed -- but in order to even be eligible, you need to show them proof of either 20 paid hours each week over the previous eight weeks, or $10,000 worth of income over the past six months. If you're working mostly cash gigs, this documentation can be difficult or impossible to come by. Even if you are eligible to join, the least expensive plan with the highest deductible still costs $239.64 every month. And if you have a couple of lean months and can't afford the premium, you lose your coverage.
Still, Chris Speed blames himself:
“A lot of my friends, myself included, don’t have insurance, which seems really idiotic, especially now,” he said.
But this is absurd. Chris Speed doesn't have heath insurance because he can't afford to have health insurance. Not having a reliable extra $240 of disposable income kicking around every month is not a moral failing or a stupid mistake, it's simple a fact of life for the overwhelming majority of NYC jazz musicians.
What is idiotic is the American system of for-profit private health insurance, which costs far more and covers far fewer people than any other system in the developed world. It forces poor working musicians into an impossible situation, and then lays a guilt trip on us for "choosing" to be the victims of a broken and exploitative system. As jazz musicians in America, we gamble with our lives, placing a sucker's bet every month: health insurance or rent, health insurance or food, health insurance or buying an instrument, heath insurance or renting a rehearsal space, health insurance or making a record, health insurance or hiring a publicist to promote your record, health insurance or going on tour, etc. Not to mention that even those who do mange to obtain heath insurance often still end up bankrupted by medial bills. (And of course, then there's the Bankruptcy Bill.)
And then if the unthinkable happens -- if you are diagnosed with a brain tumor, or a spinal tumor -- the system says, "Too bad for you, but it's your fault for not having gotten a real job. If you cared about your health, you wouldn't have become a musician in the first place. But, hey, don't despair, I'm sure your fellow musicians can raise a few hundred bucks for you at benefit show. That'll really put a dent in those six-figure medical bills."
Ezra Klein, the blogosphere's best health care wonk, has a piece in the American Prospect: Why 2009 Is the Year for Universal Health Care. Let's fucking hope so.