His long hair, goatee and mutton-chop sideburns hint at his years in rock bands in the 1980s, but Erny Papay hardly fits the stereotype of the irresponsible, risk-taking musician. Now in his 50s, his main gigs are quite wholesome: playing kids' songs at preschools, old-time tunes for retirees, and contemporary worship music at a Lutheran church. He and his wife, Karen, live in Monroeville, and have two grown sons, one of whom is also a professional musician.

Papay also juggles 60 students, teaching piano, guitar and bass. It takes a lot of lessons to cover the couple's health insurance premiums, which total $1,400 every month. He's considered taking the risk of not having health insurance. "But one of us seems to end up in the hospital each year," Papay says he calls it "the $10,000 visit to the spa.'"

Whether they're piano teachers or punk rockers, part-time or full-time, musicians have a tougher time than most when it comes to finding health insurance. According to a survey by the Future of Music Coalition, one in three musicians is uninsured nearly twice the 17 percent national average.

Like many lifelong musicians, Papay held a regular job for many years; as a chemist, he received healthcare benefits through his employer. When the company eliminated his position in 2001, music became his full-time job. For 18 months, he relied on COBRA, a federally mandated program that allows people to continue with their group health plan temporarily after leaving a job. Eventually, though, he had to look elsewhere.

Papay's current policy, through UPMC, is an improvement over earlier plans inferior coverage that cost him $2,000 each month. But the Papays cut corners where they can, passing up dental insurance, for example.

Papay's experience is not unique, suggests research by the FMC, a Washington, D.C.-based advocacy group. Its survey of 1,451 musicians found that most of those with insurance obtained it through employment outside their musical activity. And the more working hours you devote to your music, the less likely you are to have insurance. Of survey respondents who earn more than half of their income from music, four in ten are uninsured.

In some ways, a musician's challenges resemble those of any freelancer trying to obtain adequate, affordable coverage in a health-care system geared toward those with full-time employment. The FMC suggests musicians face "structural barriers" to obtaining coverage. Musicians often work on contract, "performing or composing for specific events, albums or projects." Without a steady employer, "[T]hey must seek out individual health insurance policies." And those are frequently far more expensive than insurance obtained through a group plan.

Kevin Erickson, a spokesperson for the group, says the group may take up the issue again, depending on how the Supreme Court rules on President Obama's health-care overhaul.

Even full-time, "professional" musicians are affected: 35 percent are uninsured. But for the most part, these are the lucky ones, members of a group that includes symphony musicians and others with relatively high, union-negotiated salaries and benefits. It's a group that also includes Erny Papay's 32-year-old son, Jeremy.

Jeremy Papay has spent nearly four years on the road playing drums for the Ringling Bros. and Barnum and Bailey Circus. Living in an RV, he drives to a new town each week to play several shows. The circus musicians carry a union card, and their employer provides competitive salaries, health insurance and other benefits.

The rest is here:

Health-care Blues