They borrow leftover prescription drugs from friends, attempt to self-diagnose ailments online, stretch their diabetes and asthma medicines for as long as possible and set their own broken bones. When emergencies strike, they rarely can afford the bills that follow.
In the parlance of the health care industry, an increasing number are among the "young invincibles" -- people in their 20s who shun insurance either because their age makes them feel invulnerable or because expensive policies are out of reach. Young adults are the nation's largest group of uninsured — there were 13.2 million of them nationally in 2007, or 29 percent, according to the latest figures from the Commonwealth Fund, a nonprofit research group in New York.
In dozens of interviews around the city, these so-called young invincibles described the challenge of living in a high-priced city on low-paying jobs, where staying healthy is one part scavenger hunt and one part balancing act, with high stakes and no safety net.
Most family insurance policies cut off dependents when they turn 19 or finish college, and many young adults start out in New York cobbling together part-time or freelance work with no benefits. To qualify for Medicaid:
A single adult can earn no more than $706 a month — less than what a full-time minimum-wage earner makes
Yet the average insurance premium for a single adult is $900 a month, according to a spokesman for the State Insurance Department.
"At this point, I can't really justify it monetarily," said Ian McElroy, a musician who moved to Bushwick, Brooklyn, from Omaha, last year. "It's not like I think I'm invincible, I'm 29, the world can't touch me. It's the very opposite of that. I've got to make rent and eat."
Source: Cara Buckley, "For Uninsured Young Adults, Do-It-Yourself Medical Care," New York Times, February 18, 2009.