Life Without Health Insurance


A version of this story ran in the August 2012 issue.

Sean Fleming has been uninsured most of his adult life. He works about 30 hours a week at an Austin bakery, and picks up additional work at a coffee shop. The 41-year-old is among one in five—or about 6 million—Texans without health insurance.

“I do not get sick often, but when I do, I tough it out. That means I just deal with it until it goes away, and I try to miss as little work as possible. On rare occasions, I have had to go to a clinic and get some medication—antibiotics. I pay out of pocket. I tore the ACL ligament in my right knee when I was 25, and I have never had surgery to repair it. I missed a couple weeks of work until the swelling went down and I could get around, and then I went back to work. … The knee brace I bought cost me around $500, which I put on my credit card.

“We have a daughter who is 28 months old. We pay for her insurance. My wife is pregnant, and she is a self-employed massage therapist, so we are paying for this birth … We are using midwives and they are letting us pay the bill off monthly at no extra charge, which is nice. My biggest fear about living without insurance right now is that my wife is not covered. I am used to not being covered, but it really scares me to think that she is uninsured, especially if there are complications during the birth and we have to go to the hospital. That would financially ruin us.

“I have been following the health-care debate for some time, and I am a supporter of the president’s health-care reform law. I was surprised and gratified that the Supreme Court upheld the law. I would not say that I know all of the parameters of the law, but I have a basic understanding of the main points.

“In a modern society, I firmly believe that health care is a right, not a privilege. Any person that supports a system that can refuse health care to individuals based on prior sickness is morally bankrupt, in my opinion. People who are sick need health care the most, and they should not be denied it because of profit margins.

“I think expanding Medicaid is great. When you make minimum wage, or close to it, it is almost impossible to pay several hundred dollars a month on health insurance. Only people who have never had to live on minimum wage find that confusing.

“I think providing tax credits to small businesses that offer coverage is good, but only if the coverage that is offered is also good and affordable. [My employer] provides insurance, but even after their contribution I still cannot afford it. I think that it is awesome that [my employer] does this, and I am proud to work at a small, local business that cares enough to try and take care of its employees. But my share of the premium is still more than I can afford right now. I don’t blame [my employer] for this because the health-care system in this country is built on profit, not health.”