Steep rises in health insurance premiums are crippling small Irish businesses and putting workers’ health at risk.
“We were trying to pull a rabbit out of a hat every year,” says Sean Keogh, originally from Templeogue in County Dublin.
Keogh runs an IT consultation and repair firm in New York, Computer Solutions Provider, Inc. “It literally went up 15 percent or 20 percent a year. It was monstrous.”
In the past five years, the situation has got worse. Keogh has had to drastically downgrade the insurance plan available to his employees, and he leaves it up to them to pay for it.
Co-pays went up, services were trimmed. His firm saved some money, but workers’ medical coverage suffered.
As the U.S. government debates ways to improve the health care system, small Irish firms are struggling to insure their employees. To cope with mounting premiums, they pare down what their plans offer, dropping eye-care and dental, and providing basic coverage only.
The deductibles are high, and more of the costs fall to the employee. Yet the benefits stay the same or are less.
The rates of increase in insurance fees vary, but regardless of provider, they tend to be big.
“The last raise was 10 percent,” says Larry Sullivan, president of an electrical and lighting company in Long Island City called Conserve Electric. The company pays insurance for managers, while a union covers employees. Every six months, the premiums go up.
“They’re getting ridiculous, the charges,” Sullivan complains. He is meeting a new broker next week to see if he can get a better deal.
“It couldn’t be much worse. It’s getting tougher and tougher and tougher for small businesses to survive,” he adds.
Health insurance is becoming a bigger issue all the time, according to Gerry O’Donoghue, a certified public account and financial planner based in Mt. Kisco, New York. He gives advice to businesses and individuals, and says about a third of his clients are Irish.
“It’s gotten worse in the last five years, at a faster rate. I believe it’s only a matter of time before some of my clients don’t offer the benefit,” he says.
Businesses’ inability to offer good healthcare also puts a strain on relations with workers, who blame their bosses when their co-pays increase. But with insurance premiums running at between $500 and $800 per month for individuals, and double that to cover families, there’s often little that bosses can do.
“It’s not because they’re trying to pocket more profit for themselves,” O’Donoghue says. “They’re trying to survive.”
Hardly any of the small firms he knows can afford to pay insurance costs for all their employees, Sullivan says. But few of those contacted would speak on record. Their silence is because of shame, Keogh suggests.
“People are embarrassed. They think they’ve failed their employees. If you grew up in Ireland, you’re used to having nearly a national health service,” he continues. “People feel real bad about it.”
Employees feel bad too. Sarah (not her real name) works in a bar in Woodside. She’s 27 and has lived in New York for seven years.
She has never had health insurance, and most of her friends don’t have it either. The deals employers offer are not much better than what you could find yourself, she says.
And she is legal. “I have papers and I still don’t have health insurance,” she says.
To see a doctor costs Sarah between $120 and $150 per appointment, and a prescription is an extra $65 on top of that. That’s just for a routine visit.
Trips to specialists would cost much more. When Sarah’s friends are unwell, they go to the hospital, and if they’re really sick they fly home to Ireland.
The lack of access to proper healthcare is harming the Irish community. Siobhan Dennehy, executive director of the Emerald Isle Immigration Center in Woodside, confirms that both documented and undocumented Irish immigrants lack health insurance.
Illegal immigrants tend to get jobs in construction or bars and restaurants, industries that didn’t traditionally offer insurance. But many legal Irish immigrants work in small firms that can’t provide it any more either.
Without insurance, medical fees can be enormous, as everyone knows. Cancer has been a huge problem for the community, Dennehy explains.
“Hardly a week goes by that there isn’t some benefit to raise funds for people. People just hope they don’t get sick,” she says.
Many small business-owners cannot even insure themselves, and would-be entrepreneurs are choosing not to go it alone, fearing that they won’t be able to cover themselves and their families.
“There’s a history of the Irish being entrepreneurial,” says O’Donoghue. “The dream was working for your own business. But I have some clients who are choosing not to start their own businesses because they are worried about being without health insurance. A lot of the American dream is being held back.”
Mick, who did not wish to give his last name, is 33, and has lived in the U.S. for the past six years. He chose the entrepreneurial route, setting up a computer programming company with three other men. None of them have health insurance.
When Mick broke a bone in his foot two years ago, he went to the emergency room. He already knew it was broken, and the doctors didn’t do much to help him.
“They X-rayed my foot and gave me a wooden crutch,” he says.
Two years later, he’s still getting bills. “Added together it’s about $2,000,” he says. “That was the last time I went to the emergency room. I won’t be going again – unless I really have to.”
Mick would like to have coverage. “I would love to provide all the benefits for me and the other guys,” he says. “But I have looked into it. It’s not possible, we’re not making that much money.”