Addressing The Heath Care Quagmire Head-On

Ron Spigelman posted an excellent article over at Sticks and Drones on 3/17/2008 which examines the frustrating issue of heath care benefits. The article is particularly thought provoking in that Ron examines the issue of health care benefits from the long tail perspective by focusing on the mid to smaller budget professional ensembles. In particular, Ron recounts some discussions he had with musicians of the West Virginia Symphony Orchestra while there recently as a guest conductor and that the conversation focused primarily on auditions and heath care coverage…

At one point Ron asks the million dollar question (paraphrased) "Is
it the responsibility of smaller budget orchestras to provide health
coverage for musicians who are physically present only 30- 60 days per
season and may travel between several groups across state lines?" It
was refreshing to see a conductor approach the issue with since
compassion and an equally sincere level of concern for addressing a
significant problem for the majority of professional orchestra
musicians (and I would add staffers at the bottom of the salary scale).

Since it simply isn’t feasible to get around the reality that
offering health care coverage to all musicians and staffers is not
always a viable option for small budget ensembles, it is possible for
board members and executive managers in these institutions to quietly
sidestep these uncomfortable discussions. However, some of Ron’s
suggestions to working around these problems are particularly unique
and among some of the first encouraging ideas to come along in some

Although all of his suggestions have significant merit
(especially doing everything possible to promote healthy diet while
traveling the Freeway Philharmonic) his suggestion to explore medical
services as a sort of gift-in-kind is particularly provocative:

We all look for sponsorships from hospitals and the
medical community, how about inquiring when asking for support on
whether doctor residents or any doctors (many of whom might be
subscribers) can donate any time to act as a ‘team doctor’ and even
make some regular time available gratis so a musician can visit if
there is a problem. Same goes for Dentists, even Physical

This suggestion made me think about a recent episode of 60 Minutes which focused on Remote Area Medical,
a charity which provides free health care, dental care, eye care,
veterinary services, and technical and educational assistance to people
in remote areas of the United States and the world. That television
segment captured my attention at the time and after reading Ron’s
article, it makes me wonder what exactly could be done to benefit those
inside this business who fall into health care coverage "gaps" (which
is a polite way to say they’re on their own if they get sick or

Ron goes on to suggest that a combined group of orchestras,
arts councils, the League, and the AFM could find explore options to
make health coverage more affordable. I think that’s an excellent idea
but the logistics all but guarantee that discussion would be slow;
consequently, I’ll go one step further: since it is likely that any
possible solution won’t emerge for some time it would be more
productive in the interim to put together a type of Remote Area Medical
service to address the urgent needs of musicians, staffers, and their
immediate family throughout U.S. professional orchestras.

Although the idea is just in the discussion phase, I think
there’s a real opportunity to establish a sincere effort within the
next year so what better venue to toss out the idea in order to get the
ball rolling than a worldwide blog post. As such, if anyone is
interesting in funding an initial study to determine need, logistics,
etc. please contact me directly. By this time next season, we might be
able to establish a mobile health clinic especially for uninsured (and
under-insured) orchestral musicians and staffers.

Take a moment to read Ron’s post the 60 Minutes
article and visit the Remote Area Medical website and then send in your thoughts and ideas.

About Drew McManus

"I hear that every time you show up to work with an orchestra, people get fired." Those were the first words out of an executive's mouth after her board chair introduced us. That executive is now a dear colleague and friend but the day that consulting contract began with her orchestra, she was convinced I was a hatchet-man brought in by the board to clean house.

I understand where the trepidation comes from as a great deal of my consulting and technology provider work for arts organizations involves due diligence, separating fact from fiction, interpreting spin, as well as performance review and oversight. So yes, sometimes that work results in one or two individuals "aggressively embracing career change" but far more often than not, it reinforces and clarifies exactly what works and why.

In short, it doesn't matter if you know where all the bodies are buried if you can't keep your own clients out of the ground, and I'm fortunate enough to say that for more than 15 years, I've done exactly that for groups of all budget size from Qatar to Kathmandu.

For fun, I write a daily blog about the orchestra business, provide a platform for arts insiders to speak their mind, keep track of what people in this business get paid, help write a satirical cartoon about orchestra life, hack the arts, and love a good coffee drink.

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3 thoughts on “Addressing The Heath Care Quagmire Head-On”

  1. As a musician in a group of per-service orchestras for a number of seasons, the search for affordable health care become something that took up a lot of my free time, as we sifted through the different options out there, and always kept an ear out for better plans.

    I eventually was able to find something that worked reasonably well for us through the National Association for the Self Employed, but continued to look for less expensive means of affording health care. We (fellow musicians and I) looked into other options, including forming a large enough group with other artists in the area, and the medical savings accounts that are available. One of the things that kept us from finding enough people was the number of folks who individually were in a similar situation, but had healthcare through a spouse’s company. We were close enough to a solution that I would encourage people to talk about it and see if something creative is possible in their area.

    It was one of the largest financial burdens I experienced during that time (along with self-employment taxes). I think covering this topic and finding some solutions would be one of the best things that could be done to help musicians that are currently not covered.

    Many thanks for the informative and thoughtful comment Michael. As a self employed individual I know exactly the sort of issues you’re describing and have looked into the self-employed health coverage solution.

    Although it ultimately didn’t provide adequate coverage for the rates offered I have discovered a few opportunities that aren’t well publicized. For example, in Maryland, Colorado, and Hawaii heath insurance companies are required by state law to provide exactly the same coverage options to self employed individuals (even those without any employees) at exactly the same rates they charge large businesses.

    Before moving to Chicago, my wife and I lived in Maryland and took advantage of this option. Perhaps unsurprisingly, it was not well publicized and the insurance companies didn’t go out of their way to make it easy to enroll (in fact you could only enroll during one month out of the year).

    I haven’t looked into those options in over a year but if anyone has some updated info on that issue, I’m certain all those impacted would be grateful. ~ Drew McManus

  2. I would very much like to involved in any effort. It could start with a survey to find out the number of musicians and staffers in each League orchestra who have to purchase their own insurance. I would think that since each orchestra reports to the league every year for their data and statistics dept., it would not be hard to accomplish this. It could even go one step further to ask the managements to report on the availability of medical care for visiting musicians and part time staff should the need ever arise. I suspect the answer would in most cases be the location of the nearest ER! Knowing the numbers would be helpful to start any action on this issue. I am going send links to our posts to the League today!
    Ron Spigelman

  3. I’m certain this will sound naive, but, here goes, anyway: why can’t all the orchestras of this country get together and make their health plan a collective one, thereby possibly lowering the costs because of the volume of participants?

    I’m not an expert on this but I do know that one of the primary reasons is each state regulates health insurance differently. If anyone out there is an expert and has a better answer, please send it along in a comment. ~ Drew McManus

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