A Washington D.C., nonprofit directs musicians through the health-care system, note by note
Earlier this summer, the Burlington music community was rocked by news of life-threatening injuries to two of its favorite sons. In June, longtime Queen City stalwart Daryl Rabidoux  was critically injured in a car accident in his adopted hometown of Providence, Rhode Island. Barely a month later, Burlington bouncer Mikey Van Gulden  was struck by a taxicab while riding his bicycle home following a shift at Higher Ground.
After asking, “Oh, my God, is he OK?” most people’s follow-up question about both victims was, “Did he have insurance?” And as is the case with a majority of musicians and artists nationwide, the sad answer is “no.”
America’s health-care system is in critical condition. According to the 2000 U.S. Census, 39 million Americans — 14 percent of the population — were uninsured. In 2005, the National Coalition on Health Care  reported, that number jumped to 47 million (16 percent).
Who are these uninsured Americans? Conventional wisdom would suggest they’re the unemployed, right? The dregs of — or drains on — society. You know, like rock musicians.
Not true, says the NCHC, which reports that eight out of 10 uninsured Americans come from working families. Forty percent of the working uninsured are in households with an annual income of $50,000 or more.
The country’s least insured demographic is the 18-to-24-year-old set — 29.3 percent of them had no coverage in 2005. And guess which way that number is trending.
Many young Americans go without insurance because they are healthy and seemingly unlikely to get major illnesses. Still, the risks of not being insured can be significant. Just ask Van Gulden and Rabidoux.
But the true risk of going without insurance is subtler than headline-grabbing catastrophes might suggest, says Alex Maiolo, who created the Health Insurance Navigation Tool  (HINT) with partner Chris Stephenson under the aegis of Future of Music Coalition, a nonprofit advocacy group based in Washington, D.C. HINT is a free service that helps musicians sort through the miasma of head-spinning health-care jargon and find sensible insurance solutions.
Maiolo, 39, knows what he’s talking about. The Property and Casualties insurance agent by day is a member of Chapel Hill psych-pop outfit Violet Vector and the Lovely Lovelies  by night. He points out that the cost of America’s young uninsured manifests itself in dangerous ways. Rather than footing the bill for basic treatment such as physicals and preventative care, uninsured musicians —and young people in general — will often delay seeking medical attention until it is absolutely necessary, or an emergency. At that point care becomes much costlier and, in some cases, less effective. Lack of proper care early in life can also lead to the onset of preventable diseases later on, which further increases the burden on the system.
Future of Music Coalition  launched HINT after its 2001 online survey of more than 2700 musicians found them likely to be un- or underinsured. It’s important to note that the program does not sell health insurance, nor is it affiliated with companies that do. And Maiolo cautions that there are no magic tricks to make affordable coverage appear.
The options vary greatly depending on an individual’s work status, income and state of residence. For some, the solution may be as simple as increasing hours at their jobs to qualify for employer-provided insurance. Others may need to purchase a policy out of pocket — though several states, including Vermont (via its Catamount  plan), offer subsidies to defray some of the costs. Musicians who actually make a living performing can incorporate their band to take advantage of incentives reserved for the business sector.
Insurance systems and regulations differ by state. According to Maiolo, they generally fall into three categories.
In the first are states that allow insurance companies to do business as they see fit. In other words, insurers can refuse individuals coverage, or charge high-risk individuals more for their premiums.
The second category is more inclusive but penalizes those who “choose to be sick.” That is, those whose lifestyle choices — such as cigarette smoking — make them more likely to require major health-care services.
The last category is referred to as “community rating.” Rather than assessing risk on an individual basis, companies that offer insurance in “pure” community-rating states, such as Vermont, base their premiums on the risk factor of the population at large. In this case, all citizens are offered coverage at roughly the same rate.
This system works well for older people who are considered higher risk, as the costs of their coverage are offset by the relative good health of their younger neighbors. The latter group, however, pays comparatively higher premiums and typically uses the system less. Not an attractive deal.
Since its inception, HINT has helped hundreds of musicians sort out their health-care options. It also works with those who have coverage but can’t make heads or tails out of their insurance plans. Not all policies are created equal, and simply being insured doesn’t mean you’re covered for everything.
“I think we all agree that the current system is not a good system,” says Maiolo. “But it’s what we’ve got. And while we can talk about what might be a better way, in the interim the short-term solution is to demystify how it works.”
For more information on HINT, or to schedule an appointment, visit www.futureofmusic.org/hint .