Health insurance, health insurance, health insur-blech.

Just thinking about the health insurance crisis in our country makes me want to throw up.  In case you need an urge to purge, here’s a quote from a NY Times editorial piece:

Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis.  And health care costs here have been rising significantly faster than the overall economy or personal incomes for more than 40 years, a trend that cannot continue forever.  It is the worst long-term fiscal crisis facing the nation . . .

Ok, so after I finished puking, I thought, “everyone says how expensive it is, but just how expensive is health insurance in this country?”

According to this 2008 report on employer health benefits by the Kaiser Foundation, also referenced by the National Coalition on Health Care, the average annual premium for single coverage in 2008 is $4,704.

$4,704 to cover one person per year.

Or, to break it down weekly, the average cost for an employer to provide health insurance to an employee is $90.47/week.

Yikes.

$4,704 per year.
$90.47 per week.

Steep, right?

You know what’s coming next, right?  Yep!  Let’s do what we do best and compare those figures to the costs on Broadway, shall we?

If you’re an employee working backstage on a Broadway show, then you’re part of a union (unless you’re an assistant company manager or a child wrangler or the Houdini Double in Ragtime).  If you’re in a union, you’re eligible for health insurance because your employer (The Producer) is paying a premium on your behalf.

So, how much is that Producer paying on a weekly basis for health insurance?  Here are some examples from four major unions:

Actors (AEA)$159/week or $8,268/year(76% above national average)

Company/House Managers
Press Agents (ATPAM)$175.83 or $9,143.16/year(94% above national average)

Musicians (Local 802)$218/week or $11,336/year(141% above national average)

Local Stagehands (Local 1)14.5% of gross earnings(115%/176% above national average)
$195/week or $10,140.40/year for Assts.
$250.07/week or $13,003.71/years for Heads
(Assumes NO work calls, OT, holidays, etc.)

These four unions alone charge an average of 106.5% ABOVE the national average for health insurance premiums, and that’s using the assistant rate for the stagehands, and not including any overtime, weekly maintenance, etc.  I recently asked a Company Manager of a long running musical what the average health insurance premium was for their local stagehands.  The answer?  $372/person!  (Oh, and don’t even get me started on paying a health insurance premium on a percentage and not on a flat fee.  Do you think the insurance company charges more for the policy just because the employee is working on a holiday and therefore gets paid more?  No.  And if health insurance is paid on a percentage, then when the plan gets a rate increase in a new contract year, and the wages also get increased, the plan gets a double-raise?  Color me confused).

So, if you’re like me, you’re saying, “What in the health is going on?”

Just wait.  There’s more.

If these unbelievably high premiums got all of our employees health insurance on the day they started work and they kept it for a considerable period of time, I might understand where the money was going.

But that’s not what happens.

If you’re an actor, you do not qualify for health insurance unless you work a minimum of 12 weeks in 6 months or 20 weeks in one year.

Yep, you could have worked for 11 weeks on a Broadway show, and your employer could have paid $1,749 into a health plan for you (almost 40% of the national average) and you can’t go to the doctor.

Oh, AND on top of the premiums the employee pays for you, you also have to pay $100 every quarter or an additional $400/year to keep your coverage.

So, if you’re keeping score, a Broadway actor working for one year has self and employer contributions 84% higher than the national average.

Read more about AEA’s plan here.

Musician?  They offer more immediate access to some sort of plan, but to get the best you have to work almost 20 weeks.

Read more about 802’s plan here.

And how about the richest plan out there . . . the stagehands, at a whopping 14.5% of gross wages earned. Surely they get killer coverage right?  You be the judge.

If you’re a Local 1 Stagehand, there are three tiers of heatlh insurance, and the quality of coverage depends on how much earn.  If you earn less than $35K (which is the equivalent of 26 weeks (!) at the lowest rate), you aren’t covered.  So, if you came up just short and made $34, you get nothing, despite the employer paying in $4,903.  And remember, the $35K threshold is for the lowest plan. To get the big boy plan, you have to earn $70k.

Read more about Local 1’s plan here.

Obviously this is a big problem on Broadway . . . and not specific to one union (although some are obviously more reasonable than others), so there have to be some serious underlying issues.

Some people will say, “But Ken, NY is an expensive place to get insured!  Of course it’s going to be more.”  Yes, it’s true.  NY is a more expensive place to be insured . . . but 176% more?  I don’t think so.  Take a look at this list of average health insurance premiums by state.  NY is not the most expensive and in ’07, the average premium in New York was $4,734/year.  Increasing that b
y a whopping 10% to account for inflation would put it at $5,207.40/year compared to our union figures above.  Still cheaper.

Another common argument is that because Broadway shows aren’t guaranteed lengths of employment, the unions need to charge for “portability,” or the ability of the employee to take the plan from job to job.  Ok, ok, I get it . . . but you know what?  If I were producing a big Broadway musical tomorrow, I would rather guarantee the cast and crew 6 months of health insurance or maybe even a year’s worth if I could do it on my own plan.  I bet I could save money AND give them all coverage starting almost immediately with no waiting period!

Employees win.  Employer wins.  Who loses?

Or what about this?  What about not paying for health insurance premiums at all (stay with me, now).

What about giving the employee CASH in lieu of the premium.

We could pay them a set figure – even 50% above the national average – and they could do with it as they please.  Producers would save money, they could get a plan of their choosing, and if they did it right, maybe even have a few bucks left over (I know they would if they were on my office plan, which costs me about $300 a MONTH for each of my employees, and we’re very happy with our coverage.)  I bet the Musicians would love this sort of arrangement, especially since during the last negotiation they had to give up a raise for two years of their new contract, in order to increase the premiums (yep, they gave up money to increase their premiums to 141% of the national average).

And if we paid out cash, we’d get to avoid all the red-tape and administration involved with these funds in the first place.

But maybe that’s where the problem is? Is there too much fat in these funds?  Does it cost too much to run them?  Or maybe the brokers are wise to how much money the funds have so they try and milk them?  Or more likely, is it because insuring one person is really paying for the medical issues of the others in the organization?

It’s obviously a very complicated issue, and this entry is without doubt a surface analysis, since I don’t pretend to know the internal workings of the health insurance industry.

But I do know this . . . what’s happening right now is not working for anyone.

The costs for the Employer are out of whack with what the rest of the WORLD is paying, never mind the country, and the Employees are not getting the coverage they deserve.

Maybe Obama’s health care reform will solve this issue, as I hoped for here.

But something has to be done because as that ipecac syrup of a NY Times article said, this is “a trend that cannot continue forever.”

And maybe the answer is not paying cash or having each show provide their own insurance, but the answer is certainly not building on top of the flimsy foundation of funds we have now.

We have to do what we do best.

We have to do something more . . . dramatic.

– – – – –