Millions of Americans are stuck in what some economists call “job-lock” or the inability to leave employment because of the risk of losing health insurance. A 2001 paper from Princeton’s Center for Economic Policy Studies showed, for example, that self-employed people are 25% less likely to have health insurance than office workers.
Uncertainty surrounding the future of the Affordable Care Act (ACA), widely known as Obamacare, has left many people feeling too scared to risk leaving full-time employment to attempt something on their own. After several failed attempts to repeal the ACA, the current administration may, in its latest tax plan, get rid of the individual mandate that requires most Americans be insured.
The cost of job-lock may, however, be more damaging than keeping people glued to full-time work: America may be becoming a less creative place – and a less attractive place for creative people.
Future generations who will be raised to shun creative careers in favor of healthcare-providing employment
A high job-lock rate is repeatedly linked to fewer small businesses, despite the seemingly universal agreement that small business is the “backbone” of the American economy. And yet a 2009 study by the Center for Economic and Policy Research showed that the US has fewer manufacturing small businesses than almost any other country – and a self-employment rate of about 7%, compared with 13.8% in the UK and 26.4% in Italy.
But what about the people who don’t want office jobs at all? America is full of creative minds, from mathematicians to photographers and artistic baristas. Shouldn’t Americans also place some importance on their country’s cultural position in the world?
The relationship between health insurance and economic freedom may be one reason the House minority leader, Nancy Pelosi, touted in 2012 that the ACA would allow Americans to quit their jobs and become “whatever”.
Becoming “whatever” doesn’t, after all, include only small manufacturing businesses – it includes an accountant becoming a comedian, a full-time steel factory worker becoming a poet, a tax lawyer opening an arts studio.
While the ACA’s effects on job-lock are not yet clear, the uncertainty of healthcare reform – coupled with the possibility that pre-existing conditions will be held against people by insurers – has left many people previously considering leaving salaried employment feeling trapped.
Expensive insurance rates for unemployed people are not the only concern. Drugs for chronic illnesses, from asthma to cancer, are hitting record highs in the US. Patients with a rare type of leukemia, for example, can now live a nearly normal lifespan with Imatinib, a kind of targeted therapy. The catch, however, is the drug can cost uninsured patients in America upwards of $ 145,000 per year – while in India a 30-day supply costs about $ 400.
Even with Obamacare, it’s understandable that people with insurance are terrified of leaving work to navigate the nebulous world of self-employment. If the ACA is repealed and pre-existing conditions lead to higher insurance rates, previous diagnosis of “chronic illnesses” from acne and anxiety to Crohn’s disease and cancer may prohibit people from obtaining health insurance at all.
Taken together, does it sound wise to strike out on your own in America just because you have creative talent?
Forcing people to remain employed for the sake of health has a high cultural cost: the cost of human creativity. This cost is, furthermore, not limited to the immediate workforce, but to future generations who will be raised to shun creative careers in favor of healthcare-providing employment.
Just imagine the absurdity of a parent convincing a talented child writer to plan for a career in public relations just because she has asthma, or a musically talented undergraduate switching majors to business just for a better chance at an office job.
Almost every European nation has signed the European social charter, which holds that healthcare is a human right. Combined with laws guaranteeing the freedom of movement of workers within the EU, this charter enables people from many backgrounds to work together, bringing innovation and creativity from one culture to many others. Why bother coming to the US?
Americans may be trapping the next William James, Herman Melville, or Bob Dylan in a cubicle: and for what? What cultural achievements are we costing this country by training future generations to aim away from their dreams only so they can afford exorbitantly priced medications? What could and should make America great is the freedom to follow one’s dreams, not a prison installed by unchecked insurance companies.
For America to really be great, it’s critical that people are given the freedom to be creative.
- Jonathan R Goodman is the editor of Cancer Therapy Advisor and a researcher at the City University of New York’s department of biology, where he studies cultural evolution