Self-employed, and going it alone.

By Jen A. Miller

I am a healthy 27-year-old woman with no preexisting medical conditions. I eat healthy, don't smoke, don't jump buses on a motorcycle for a living, steer clear of trans fats, and work out four days a week. Heck, I even medaled in my last 5k. I'm also self-employed, so to avoid medical Russian roulette, I buy my own health insurance.

To keep costs reasonable - at least what is considered reasonable in the health insurance game - my plan has a $10,000 deductible. This means that I pay for everything - doctor's visits, lab tests, prescriptions - out of pocket. The insurance company will start covering anything after I've reached the $10,000 mark.

Gee, thanks.

I hate to admit it, but I've not gone to the doctor because I couldn't afford it. I've waited out that rattling cough to see if it would go away on its own. I've wrapped my hands in bandages to see if my eczema outbreaks, which left open sores on my hands, would self-seal through over-the-counter lotions and perseverance. I've even skipped routine tests because to do so would put me, conservatively, $300 more in the hole. I don't play soccer anymore for fear of what one broken bone could do to my bank account. And I really like soccer.

To put it bluntly: It stinks being underinsured. Health care is my second-highest monthly bill - only to my mortgage - and still I feel like I can't see the doctor when I'm sick. Still, I pay my bills on time, both to the insurance companies and my doctors. And how am I thanked for it? With another rate hike - up from $373.27 to $429.26 a month for this year.

That's just to insure me in case disaster strikes. I'm not paying for Cadillac insurance here; the insurance company won't pay a dime until I cough up that $10,000 on my own first, of course, on top of $5,153.52 in premiums. (That's enough to max out a Roth IRA.)

I like my job. I like being self-employed, but as of this year, I can't stay that way. I've pored over spreadsheets, butted heads with my checkbook, and when I factor into this insurance mess increased property taxes, the rising cost of technology, and general inflation - all of which happen without freelance writer rates rising and in many cases, falling - I can't stay in the black.

Lest you think otherwise, I'm not one of those freelancers who sits in coffee shops sipping $3 lattés while writing maybe a short article for a start-up Web site before taking in a yoga class with her dog. I don't have a spouse to support me. I clock at least 60 hours a week to accommodate my workload. I write for magazines you find every month at Barnes & Noble. I even wrote a book. It's not unusual to see my office light on at 9 p.m., even when I first clicked it on at 7:30 a.m. I don't mind any of it. That's the joy in being self-employed in a job you love. But it looks like the unchecked rise in health insurance costs is going to be what puts me out of business.

I'm just one person. How many businesses are folding because of health-care issues? How many are putting the financial load onto their employees? And how many people are opting for the "cross my fingers and pray" deal?

I don't have an answer. I wish I did other than paying attention to whom you vote for your next president. I've tried negotiating a lower deal with my insurer, joined freelancer groups in the hope of a lower group rate. I even thought about roping someone into a quickie marriage in hopes of securing more affordable health insurance.

But until someone finally wakes up and addresses this national crisis, it looks like I'll be dusting off my business suit and looking for a job. That is assuming I can find a company that can still afford to offer insurance to its employees.