For healthy food and soil, we need affordable health care for farmers

By Steph Larsen

When we talk about local food, it means more than just proximity to a farm. We associate supporting "local food" with supporting specific values — such as family ownership, local control, small scale, environmental stewardship, community, and ecological diversity. These values are what motivate people to buy their food directly from the farmer who grows it.

The sustainable local-food system we are trying to build relies on an abundance of small, diverse, sustainable family farmers scattered all across the United States. For this kind of farm to exist, sustainable must mean more than environmental sustainability — it must also include economic viability. Farming is a dangerous and risky business, and it becomes a whole lot less attractive when a farmer knows that he or she is one fall from the hay loft away from losing their land.

We hear frequently about the need for new and younger farmers, but there are many barriers to attracting young people to farm in a way that will foster sustainable local food systems. One of them, however, looms bigger than the rest:

Access to affordable, dependable health care.

In order to attract more farmers to grow food for a sustainable food system, we need meaningful health care reform that addresses the needs of farmers, rural communities, and small business owners. The stark reality of health care costs for farmers, who often must purchase insurance as individuals and pay more for it as a result, is enough to make anyone waiver in their desire to start a farm.

Here are some statistics from a report by the Access Project:

  • While 9 in 10 farm and ranch operators have health insurance, nearly one-quarter (23%) report that insurance premiums and other out-of-pocket health care costs are causing financial difficulties for themselves and their families.
  • Those respondents who reported financial problems were spending on average 42% of their incomes on insurance premiums and out-of-pocket health care costs.
  • In addition, 44% report spending at least a tenth of their annual income on health insurance premiums, prescriptions, and other out-of-pocket medical costs.

The health care dilemma farmers face is getting some attention. NPR has featured several very personal stories of farmers struggling to embrace small scale, sustainable practices while also making enough money to support themselves. One such episode features a family with insurance discussing how much health problems cost their family:

Paula Floriano, a 43-year-old dairy farmer, lives in the California Central Valley town of Atwater. She and her husband, Paul, have two teenage kids. The couple and son Nicholas work the farm seven days a week, starting at the crack of dawn to tend their 125 cows...

Right now, Floriano pays about $1,000 a month for her family's health insurance — excluding dental or vision coverage. Her coverage pays for only a few doctor visits a year, she says. There's also a $10,000 deductible for medical care before insurance kicks in. With all these costs, Floriano says sometimes other bills have to wait. Insurance costs eat into the family's limited income, she says.

The problem has shown up in other regional papers across the nation too, such as the Bismark Tribune, Columbia (MO) Missourian, Delta Farm Press. The Great Falls (MT) Tribune reports:

Montana wheat farmer Dan Works felt so strongly about the impact that health insurance costs have on his business operation and family that he spoke out at a rural health forum held by Montana Sen. Max Baucus...

Works, who has been farming for 27 years, pays $9,000 a year for a catastrophic health insurance plan with a steep $5,000 deductible and 50% co-pays after the deductible has been reached.

"Those payments are a lot of money in anybody's realm," he said, "and represent more than 10 percent of my income."

During the presidential campaign, Barack Obama promised to reform the broken health care system, and legislators in Congress are starting to work on proposals. Coalitions like Health Care for America Now! are organizing, and they need you to show your support and push our elected officials to ignore the deep pockets of corporate insurance lobbyists and build a health care system that works for everyone.

Please get involved in the fight for health care reform. You can sign this Center for Rural Affairs petition calling for incoming Secretary of Health and Human Services Tom Daschle to make reforms that work for all of America; join, support, or volunteer for a group in your area doing health care reform work such as these members of Health Care for America Now; and of course, call your legislators and demand that they reform the health care system.

If local and sustainable food is the goal, health care reform must be included to get there. It's not only the farmer at the market you buy your eggs from that needs you. It's also the office assistant or factory worker who would love nothing better than to grow the food that feeds our movement.

With health-insurance reform, the tallest barrier between new farmers and their land crumbles.

Steph Larsen is currently the Rural Policy Organizer for the Center for Rural Affairs in northeast Nebraska, before which she spent three years in Washington, D.C. working with Community Food Security Coalition. She holds an MS in geography from her home state of Wisconsin.

Photo credit: Sticker image from the Irresistible Fleet of Bicycles, the revolutionary blog of the Greenhorns documentary and the young farmer movement.

18 Responsesto “For healthy food and soil, we need affordable health care for farmers”

  1. cookie jill says:

    Great post. Thanks.

  2. Eric Reuter says:

    Amen. 2009 will be our third year as a direct-market organic farm in central Missouri, and the first as full-time farmers. My wife is planning to leave her job (and its health insurance) this spring and join me full-time, and even as two young, healthy adults our potential health insurance premiums will be our biggest cost, and we don't even have kids. Outrageous and unsustainable. No one knows how many small farms fail or never get started because of this, not to mention all the other small businesses. True reform would do more for us than any subsidy or marketing initiative.

  3. Steph Larsen says:

    Thanks for your comment, Eric. I think your comment about farmers needing meaningful health care reform more than any other traditional "farm program" is key. I hope you and other small farmers are able to communicate this to your customers.

  4. This is dead on. We bought health insurance as individuals for almost two decades. By the end our family's health insurance, with a $10,000 annual deductible per person plus a $2,000 annual co-pay per person. When it exceeded half our income we dropped it - it was impossible to pay. We had been gradually increasing the deductible every year but at that point we were at the maximum and still couldn't afford it. At that point it was meaningless because it only would activate in an extreme disaster and we were paying $14,000 a year for the coverage.    Now we live and work very, very carefully. We do dangerous work in pairs. We do our own doctoring as much as possible. We eat "right" and do all those other healthy things hoping there won't be a disaster. If there is then we would have to sell land to pay.

  5. Glenda Neff says:

    Thanks, Steph!
    Affordable universal healthcare is top priority for farmers and all of us.  It needs to be a simple single payer system to avoid the bloating of costs - duplicative administration and profit requirements of multiple private insurers.   The Medicare Advantage Program is an example of how that happens.  We need to avoid making the same mistake with universal healthcare. Check http://www.healthcare-now.org

  6. Red Icculus says:

    As an entrepreneur, I have no qualms paying for my healthcare out of my own pocket.  Farmers should be no different.  I wouldn't expect others to pay for my health care just as I have no reason to pay for others health care with my hard earned money.

  7. Linda says:

    Whoa, Red!  Don't sugarcoat it...glad you can pay for your own healthcare out of your own pocket, just wish that everyone had the means for that or could actually get the coverage their families require, period...obviously, you've not needed anything too major in terms of healthcare itself, and you have a policy that you "assume" you'll have forever (barring anything that the insurance co. might decide could bump you off their 'We Love You and Your Premium, Red' list.  Access to affordable healthcare is the goal here, for one and for all.  If you REALLY want no more about this quagmire, read SOCIAL JUSTICE: THE MORAL FOUNDATIONS OF PUBLIC HEALTH AND PUBLIC HEALTH POLICY, Faden and Powers, 2008.

  8. Thanks, Steph, for highlighting this critical area that is preventing us from vibrant rural towns and a healthy nation.  Now also eliminate all potential farmers that have pre-existing chronic diseases such as diabetes because no insurance carrier will pick you up. The cost of insulin, test strips and needles will quickly eat up any marginal profits as a beginning farmer.
    I watched Sicko last weekend and felt ashamed as a country for not taking care of our citizens, but hopeful that just maybe this will be the political season for health care reform.

  9. Ali says:

    Whenever the subject of universal health care comes up, we always talk about its cost. We never, ever talk about what is lost by not having it. We never talk about the businesses that aren't started because people can't afford to leave their employer's health plan. We never talk about how new companies, and new ideas never really get off the ground because innovators can't afford to offer health care to the staff that can help take them to the next level. We never talk about the elderly parents who aren't cared for, the kids who don't get help with homework, simply because loved ones can't take the time they need without risking loss of coverage.
     
    Well, to be fair, Eric Reuter did, above. But I almost never about it elsewhere, about the vast potential that we lose, all the time, day after day. Would those things outweigh the cost? I have no idea. But I know this: plenty is lost. New farmers and healthy food is just one such thing.
    Red, I'm curious (genuinely, no snark here, I swear). Do you not support Medicare? Do you plan not to use it once eligible?

  10. Steph Larsen says:

    I think the climate is ripe for reform, but we also have to be vigiliant that it's the right kind of reform. For example, Montana Senator and Finance Commitee Chairman Max Baucus released a white paper on his ideas for health care reform. Here's a link to the paper.
    For example, we need to watch out for insurance companies requiring mandates but then fighting against a public program that will help bring costs down and make health insurance more competitive. The problem Debra brings up is also important...they shouldn't be able to turn people away for pre-existing conditions.
    As with most policy, it will come down to the negotiations and the details of the legislative language. There are lots of folks to help us all understand it, and one doesn't need every detail to push for reform that works for everyone.

  11. Eric Reuter says:

    Red,

    As a fellow self-considered enterpreneur, I could agree with you in theory. I would love to have my insurance priced solely on the risk the companies are taking on me (as someone whose life insurance application was at first denied because the company didn't believe the stats from the nurse's exam). But if you're going to advocate the free-market solution, you'd better do it right. Are you willing to support the ability of insurance companies to truly and accurate price risk by tracking your food consumption, daily exercise levels, genetic medical history, and to change your rates as needed to reflect the new risk as you age? Are you sure you'll have enough money to cover your entire life, even in your 90s as your body and mind break down, your bills mount, and the only thing standing between you and the gutter is the pocketbook you now hope will remain stuffed through the coming decades regardless of rising health care costs?

    Even if you're clean, healthy, and in all other ways an extraordinary physical specimin at the moment, are you willing to face the larger consequences in the society surrounding you when many who (even if through their own fault) cannot afford the health care that they need? Can you look a Coke addict in the eye and watch them die of diabetes because they can't pay for the care, even if it's their own fault?

    Look, as a very healthy, active farmer, I hate that my insurance dollars to go effectively subsidize the foolishness out there, and I hate that companies can't or don't consider most of the good choices that I make that minimize risk. But the alternative is just not practical in our society, and is frankly inhumane. I would support increasing companies' ability to discount for or otherwise encourage healthy choices (like the CSA discounts occuring in WI), but beyond that we start going down a slope that quickly becomes problematic.

    It would seem to me that, in a strange way, the most practical libertarian solution out there IS universal health care, because it establishes a level playing field that allows people the freedom to pursue their lives and businesses in whatever way feels best to them, without fear or illness, moving, or job changes. Far more freedom is lost in our current system than is gained.

  12. Well said, Steph. And very diplomatically put, Eric. You suffer fools far more ably than I.

  13. Julie Cummins says:

    Thanks for posting this, Steph. I am reminded of the movie about Wal-Mart, The High Cost of Low Price. For something like food, which we all need, you'd think we'd take better care of the people who are putting the wear and tear on their bodies to produce what we eat. Agriculture is always listed among the top hazardous professions, and even if 9 in 10 farm/ranch owners are insured, the number is far lower for their employees. Labor costs are so high already, so even when farmers would like to offer insurance to their workers, they rarely can afford to. Farmer/worker health risk is another of the hidden costs of cheap food.
    This is an ignorant question, because I don't know much about the insurance system, but could there be a group purchasing organization that offered policies for farm-related businesses? The Access Project report for CA was saying that premiums for individual insurance were almost twice as much as group policies through off-farm employment.

  14. Steph Larsen says:

    Julie,
    The idea of group purchasing for farmers has been floated, and there is a project in Wisconsin that did just that. Here's the link.
     
    Another idea that could help farmers, entrepreneurs, and other self-employed folks is a public insurance plan that competes with private insurance plans. Basically, it would be similar to Medicare and Medicaid that anyone can buy into - even employers. This way everyone could have the option of buying into a group.

  15. Sharon Hametz says:

    Julie,
    I was thinking the same thing while I was reading these posts, mostly because I bought into a similar system for awhile-- the Freelancers Union has a group insurance plan. It was a great plan, but it was still costing us about $7-8,000 a year, not as much as some other people were mentioning at the beginning of this thread, but certainly not small change.

    Oh, and Eric, can I quote you next time some libertarian starts ranting at me about the evils of single payer health care?

  16. bethb says:

    Health care is headed for a massive implosion if the system is not reformed. Just like bail outs and the now-critical global warming actions, we've waited until the 9th inning to show up. It's going to have to happen, and I do hope that we can make it a system that frees us all up to pursue self-employment, farming, or other career paths rather than being forced to cling to a job just because of health benefits — even as employees take on more and more costs of those.

  17. Jana says:

    I grew up on a farm. I have chopped cotton and pulled cotton by hand. We had little money because my dad (whom I loved a lot) was a poor businessman. We raised vegetables in the summer and canned and froze for the winter. As an adult, we have had hog farms. When large farm factories came into existence, we were forced to close the hog operations. 
    Today most people who farm and ranch, are bi-vocational. These people can receive health-care benefits from another business opportunity and farm on the weekend.  
    I think more than the cost of health care is the price of liability insurance. We have been sued by people that didn't even work for us. By the time we found that out, the insurance had already "settled" and guess who paid for that--we did!
    Those who think socialized medicine is good, must not have friends who have told them what it is like in Canada. When the money is gone, no matter how early in the year, those who seek help get no help.  Canada denies care to those with "self-inflicted" disease.
    In the US anything the government takes over costs more money than it should and the quality of the product is worthless. 
    Additionally, there is nothing wrong with a hard working farm family. You don't have to bike 40 miles a day if you do manual labor. It is good honest work, and can be very satisfying.... Children who have chores to do at home don't get into trouble. 
    Living on a farm without the government barking orders at them gives one a feeling of true freedom. The love for their land, the opportunity to live without government intervention makes up for the lower income.
    Another point I want to make it that those who freeload at the hospitals are the part of the reason that hospital stay is so expensive. Another contributor is law suits. People love to sue the doctor, who pays excessive mal-practice insurance.
    Finally, the EPA and Osha breathe down the neck of the farmer, which costs a lot of money to avoid fines. If one person in a business, is negligent and the inspector comes by--bam!--a $5000.00 fine.
    So, you can see that health care, liability insurance and government compliance make life for a farmer really undoable. Don't blame the whole scenario on health care; it is only one part of the picture.
     

  18. Loyd Johnson says:

    Steph's article is a great shout, but one hopeful
    dimension is envisioning that farmers of vegetables,
    fruit, grain, livestock...WOULD BE ABLE TO PURCHASE
    HEALTH INSURANCE....within two or three years of starting. Significant expense, I think, but PROBABLE.