Op-Ed

The Art World’s Health Care Crisis

Jesse Darling, Collapsed Cane, 2017, steel, aluminum, rubber,a and lacquer, 29 ½ × 23 ⅝ × ¼ in.

COURTESY THE ARTIST AND CHAPTER NY

Historically, health has been a central part of the artist’s narrative. The most famous examples are the most readily romanticized, like van Gogh’s probable, and Caravaggio’s proven, mental degradation and subsequent death from lead poisoning, or the loss to drug overdose of individuals like Basquiat and Prince.

Mental illness and drug addiction have come to function as a sort of value-added proposition in artists’ biographies, partly because such issues confirm the myth of the artist existing on the periphery of society. It seems easier to understand artists when they hew to a particular archetype of how they function on that periphery, whether as a substance-using psychonaut or a manic, gregarious painter—though the issue is not just confined to the celebrity-chasing segment of the art world.

Indeed, it seems fitting that one of the standard texts in art-theory circles of recent decades has been Deleuze and Guattari’s Anti-Oedipus, which fundamentally reinterprets a psychiatric disorder as the phenotype of the revolutionary vanguard. They write, “The schizophrenic deliberately seeks out the very limit of capitalism: he is its inherent tendency brought to fulfillment, its surplus product, its proletariat, and its exterminating angel.”

But the existence of these ideas in popular lore and theory belies a more systematic problem in how we think about health for artists, and mental health and addiction are only a sliver of the issue. Particularly in the United States, it would be wise to consider the health of artists as a sort of canary in the coal mine for the health of society at large. (One artist group, Canaries, formed primarily of artists with autoimmune and other chronic conditions, titles itself after just this idiom.) Artists, many of whom have atypical, irregular, or inconsistent employment, are particularly shut out from a U.S. health care system based almost entirely around work, and deregulation since the 1970s, matched with Silicon Valley’s propensity to call labor busting “disruption” or “innovation,” has now put a surprising number of people into similar predicaments. By some estimates, the “gig economy” now accounts for an approximate 34 percent of employment in the country, and it may grow to 43 percent by 2020.

The underlying irony of this is that artists, much like freelance or app-service workers, are often particularly in need of consistent health coverage. Many artists work with volatile materials in borderline unsafe conditions, not out of ignorance but from lack of access to suitable facilities. Artists are often among the first to use new industrial materials in ways they were not intended—meaning that a material’s Material Safety Data Sheet (MSDS) may not have applicable guidelines for use, or may not yet include key safety information simply because it isn’t yet known. The most famous case of this is the loss of Eva Hesse at 34 to a brain tumor that most art historians believe was caused by her use of fiberglass, latex, and polyester resins.

In New York, where many artists live and where real estate is prohibitively priced, I regularly hear of artist friends improvising when it comes to fabrication conditions. Even the immersive installation by the young, trendy artist that you see at a respected gallery was likely fabricated with hazardous materials in spaces without ventilation, or in the backyard of a friend’s Bushwick apartment. That this is to some extent normalized practice is not dissimilar from the fact of the health hazards faced by an Amazon Prime Now worker who spends their day dodging cars and trucks, breathing in exhaust, all the while receiving no benefits from their employer.

A Pervasive Issue

The underlying reality is that, for artists and workers in the art industry at large, health is a huge, unresolved labor issue. In New York alone, many galleries do not offer health insurance to their employees. In an email, Kerry Doran, a writer and independent curator, told me that she struggled to receive benefits from either of the downtown galleries where she once worked as a director. In one case she had been promised health care benefits after a six-month trial period, but the benefits were delayed again and again. “I spent the next three months asking my employer about the agreed-upon health care plan,” Doran said. “It felt like I was bargaining for what was guaranteed to me.” At her next position, she was hired with an understanding that she would have to seek her own health care coverage. “[By] that time,” she said, “I knew how rare it was for even full-time employees of galleries and art institutions to have health care.”

Even rarer are the galleries that offer health insurance or full-time employment to their art handlers, couriers, or other preparatory staff. Clynton Lowry, the creator of Art Handler Magazine (which, beyond its recent popularity as an Instagram account, also hosts a number of essays on art and labor conditions), told me that he has worked as an art handler, artist’s assistant, and in a more general role at a small gallery, and did not receive health benefits in any of those positions. For art handlers specifically, he says, “We’re talking fractions” that receive health benefits from their employers. “If you consider that at least half of the industry’s art handlers/workforce are freelancers, then a large portion of the industry’s working professionals are without benefits.”

It is pretty much unheard of for a gallery to offer health insurance to the artists it represents. This is true even of major enterprises, despite the fact that talent in other creative industries like film and music receive benefits when they sign with large publishers or production companies.

I asked a number of friends and acquaintances who run or work for galleries about this, and have yet to find a case of a gallery providing health care for artists. One of these, a New York gallery director for an international blue-chip gallery, spoke with me on condition of anonymity. “I honestly haven’t heard of that happening,” he said. “When I worked for smaller galleries there was no way we could afford that, and now I work for [an international] gallery so maybe it’s a bit more complex. Since most of our artists don’t live in the U.S.A., they have state-supported insurance.” Because it’s a blue-chip gallery, he added, “most if not all of our artists make a sizable income off their art.” He also mused about the situation over his own health insurance: “I remember in the interview process with [the gallery], I requested they cover my health insurance and the room went silent. Someone, I think it was [the owner themselves], said, ‘Oh that’s right, the U.S. has horrible insurance plans—it’s abhorrent, we will absolutely pay for your health insurance.’ It was one of those moments that reminds you how insane our situation in the States is. Even when I was living in Berlin, my insurance was €30 [about $35] a month. Fucking unreal.”

This is not to single out the galleries: the problem is pervasive. The union for many MoMA workers, Local 2110, recently spent more than 90 days working without a signed contract, and only arrived at a new contract after a total 122 days of collective bargaining. While the union won key protections through negotiations, employees had seen their benefits cut in prior contracts, despite MoMA having one of the largest endowments of any art museum in the country—standing at around $1 billion as of 2017.

Daniel Fermon, the unit chair of Local 2110, told me about some of the protections the union won in this negotiation, and the importance of health care to the labor struggle as a whole. “We preserved that those with single coverage in the museum’s CIGNA insurance plan continue to pay $0 towards their premiums,” Fermon said. “Zero dollars. We’ve had that as a feature of our union contract for years. And lower-paid employees likewise do not even pay towards the premiums for family coverage. That we preserved as well. This is a big deal, especially for those working at the lower end of the wage scale.” He went on to say that they had also put in place “break points” to prevent the museum from unduly increasing premium costs for higher-paid workers with family plans, and secured important compensation for paid family leave. “This was something the museum did not want to do when we asked them early this year,” he said. “In collective bargaining and because of the unity and activism expressed by the employees, it worked out.”

“Health care is important to everyone,” Fermon continued. “It’s important for all citizens, including the unemployed and self-employed—art people as well as art illiterates, or those who don’t care one iota for art. Unions have historically fought for and continue to fight for universal health care . . .  in these horrible times, when Americans are being subjected to a systemic assault on the very existence of their unions—those unions who protect American constitutional and democratic rights for all Americans—the search for health care rights goes hand in hand with the protection and advancing of union rights.”

It’s Worse Than You Think

It’s safe to assume that, for the majority of people working in the art world—from artists, to directors of small gallery spaces to museum staffers—health care is an issue. What surprises me is how little we talk about this openly.

In New York, most of the artists I know, as well as most gallery staff—and even many owners—get their insurance through the state health care exchange created by the Affordable Care Act (or the ACA, colloquially known as Obamacare). In the art world, where there are many degrees of keeping up appearances and avoiding topics of labor or class, it is rare to hear anyone talk about how much their health care costs, or what their plan covers. Even a recent survey by the Creative Independent, which asked artists to provide information on their financial security across 50 distinct information points, did not include a single question that asked directly about health care.

But when you do ask, the answers you hear are resoundingly negative. For those who are ill and have to maintain coverage, as well as for those who keep insurance for self-preservation, their health plans are a major source of frustration. The monthly premium is exorbitant, the deductible is absurd, and almost every year one or more of your doctors will no longer be covered by your plan. On one local artist listserve, I’ve lost count of the number of times I’ve seen the question “Any good doctor recommendations for ____ plan? My coverage changed.”

To make matters worse, that coverage is often much worse than some might realize. The ACA fixed some broken aspects of the health care system that came before it, but in its timidity it left gaping holes that insurance providers have not failed to take advantage of. On many exchange plans, a sudden cancer diagnosis can leave you paying out of pocket for critical chemotherapy drugs. On others, you pay out of pocket until you hit a deductible of thousands of dollars, after which you are still subject to high-percentage coinsurance.

Some diagnoses can leave you effectively without coverage. My partner, Beatrice, who is also an artist, was diagnosed with a rare autoimmune disorder at 19. Some of her maintenance therapies—which keep her alive, and let her, for the most part, keep her vision—are classified in a drug category called biologics, which are not covered by any ACA plan available to her, or to many others. This is largely due to a failure to mandate coverage for this category of drug under the ACA.

Some of the drugs in this category, like Humira or Rituxan, can cost into the tens or hundreds of thousands per year if paid out of pocket. This is not hyperbole. Beatrice’s own insurance statements show that the sticker price for one infusion of Rituxan—a drug that requires at least two infusions per year—is itself in the six figures.

While conditions like my partner’s are rare, there are still millions of people—including young people—in the United States who live with autoimmune conditions and depend on these drugs. According to the NIH, between 14.7 and 23.5 million people have autoimmune conditions. The American Autoimmune Related Diseases Association, a nonprofit advocacy group, estimates that this figure is closer to 50 million—in other words, about 15 percent of the entire population.

Autoimmune and other chronic conditions often result in a lifetime of treatment, and often come with a variety of invisible impairments or disabilities. For anyone expected to maintain work for their health care, this balance between labor expectation and ability becomes a particular paradox. Carolyn Lazard, an artist who has an autoimmune condition, writes in their essay “How to be a Person in the Age of Autoimmunity”: “Disease is not polite conversation, and at my age, a career—not wellness—is the expected goal.” She later adds, touching on ideas advanced by the defunct German activist group the Socialist Patients’ Collective, “When we are sick, we enact unintended resistance to an economic system that privileges efficiency over resilience.”

There is no reason that individuals in our community should suffer alone in this. Whether we become chronically ill at a young age or never have so much as a cold until late in life, everybody gets ill and everybody is at risk of an accident. We should be vocal in saying that health care is a human right, health care should not be denied to anybody, health care should not be tied to employment, and that until it is decoupled from work, health care is a labor issue that critically affects us.

As a community, we have also seen far too many unnecessary losses firsthand. The death of David Wojnarowicz was a tragedy. The death of Felix Gonzales-Torres was a tragedy. Artists and art workers occupy the margins of society only because of policies that systemically hold their identities to those margins. In the current health care system, some drugs aren’t covered simply because, for many insurance companies, it’s considered too expensive to allow an individual access to a lifetime of care. In the case of biologics, as well as preventative medicines like PrEP, why give continuous treatment when you know that if the individual dies you’ll never have to pay for them again? In other cases, lack of coverage is clearly the result of bigotry. It is simply unjust that so many young trans people have had to set up GoFundMe pages for gender confirmation surgery.

#teamcynthia

The campaign for a federal Medicare for All bill is one that we should be advocating for, and would have a profound effect on the art community. It would also mean getting on board with a long overdue response to health and economic disparity in the U.S. Even a Koch-funded libertarian think tank recently made headlines by releasing a study that showed that Medicare for All would be cheaper for the nation as a whole by $2 trillion. As of this writing, a new Reuters poll has shown that a Medicare for All bill would have the support of 84.5 percent of Democrats and 51.9 percent of Republicans.

In New York, there are key actions we can take at the local level to push health care causes right now, by supporting certain candidates in the state’s primary elections on September 13.

The New York Health Act—the state’s single-payer bill—has passed in the New York State Assembly four times. It has most recently been held from passing in the State Senate by Simcha Felder (District 17, in Brooklyn, which includes parts of Flatbush, Borough Park, Kensington, and Midwood), who sits on the State Senate Health Committee. Felder is a Democrat who caucuses with Republicans, following precedent set by the officially disbanded Independent Democratic Conference, a group Governor Cuomo helped set up to deflect progressive legislation.

This year Felder is facing a primary challenge from Blake Morris, who supports the New York Health Act. (Morris describes being so frustrated with Felder’s positions that he joined a search committee for a candidate to challenge the seat; when the committee found none, he decided to run himself). Looking at other key races across the state, like the one for State Senate District 18, where Julia Salazar is running, the victory of candidates who support the act could make its passage an imminent reality.

In the New York gubernatorial race, Cuomo has paid lip service to the idea of—but not the legislation for—single-payer health care, and his campaign actively avoids the topic. When pressed on the issue in this year’s primary debate, he made it very clear that, despite the legislation’s popularity, he considers health care a federal matter and thus one he doesn’t wish to take action on at the state level. To anyone who has paid any attention to his political career, it is clear that he has no intention of signing the New York Health Act into law.

A recent analysis of Cuomo’s campaign contributions revealed that, since 2010, industries related to health care have financed him to the tune of over $2.6 million, segmented in the report by the following sectors: insurance, health professionals, pharmaceuticals and health products, health services, and hospitals and nursing homes. (And, to gallery owners who may have finally realized the rent is too damn high: the report found that his largest donors by far come from real estate. Since 2010, the industry has collectively provided his campaigns with over $12 million.)

Cuomo’s opponent, Cynthia Nixon, has, in contrast, made passage of the New York Health Act one of her top campaign goals from the very outset, along with a number of other important progressive initiatives. Her campaign has consistently advocated single-payer legislation that would support comprehensive care, including “dental, vision, and hearing; plus primary, preventative, and specialty care; hospitalization; mental health; substance abuse treatment; reproductive health; and prescription drugs and medical supplies,” and address important and underserved health needs like those of the trans community.

The passage of the New York Health Act would have a profound impact on the lives of millions of New Yorkers, set an example for an end to austerity politics, and provide momentum for the passage of a federal Medicare for All bill.

Solidarity

When creative industries that have not yet formed large unions or trade groups begin to do so, it is often suggested that their workers cannot be helped through typical organized labor efforts. But the unions around film and entertainment are some of the strongest remaining unions in the United States today. As the variety and precarity of creative labor increases, unions will need to play an important role in protecting workers.

Recent history also provides an inspiring but sobering example of art-worker solidarity on health care. To better understand local artists’ access to health care in New York, I wrote to the artist Marlene McCarty, an early member of the group Gran Fury. “When I moved to NYC in 1983 there was a downtown artists coalition you could join,” McCarty said, explaining that “membership allowed you to buy affordable health insurance through their group policy. The premium was very low. This gave many artists a modicum of peace of mind.” Unfortunately this didn’t last: “In 1985-ish the monthly premium increased from less than $200 to $1,200–$1,500. I was so shocked I called the insurance company because I was convinced they had made a mistake. To put this cost in perspective, I was paying $489 per month for a one-bedroom apartment with living and dining room. Such premiums were inconceivable, and artists were forced (corporate greed) to drop their coverage . . .  I would advocate that artists should be able to buy health insurance as a group.” McCarty summarized her concern by paraphrasing Gran Fury: “I’d say: Kissing doesn’t kill, greed and indifference do. Corporate greed [and] government inaction … make HEALTH CARE a political crisis … the public has been fairly vociferous concerning their demand for health care, but they have to keep the pressure on.”

Health care is an issue that affects all of us in the art community. Given the prevalence of art workers taking on a variety of roles throughout their careers, we should share an understanding of our common struggle. How many dealers had unsuccessful runs as artists? How many curators have unpaid invoices from an early life writing for art magazines? How many artists have faced economic hardship despite critical success? We’re in this together. We should act like it.

Artie Vierkant is an artist based in New York.

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