Report to Congress

Artists' Health Care Task Forces' 1994 Report to Congress
The following is an excerpt from the report (pp 11-18)

III Artists and the Economy*

Artists have often had to overcome preconceptions about the way they lead their lives from those who claim that they are merely looking for a handout from society.

--Ashley Ackerman
Spring 94


The Artists Health Care Task Force formed in December 1993 to address the fact that many Americans who work in the performing, visual and literary arts have not been seen in the national health care debate as a unique constituency with unique needs. The Task Force recognizes that artists are the back bone of our national culture and are also the creative force that fuels every aspect of the advertising world on which our society is so dependent. Without our creative thinkers, our economy and society would grow stagnant.

Many of the artists who perform or exhibit at our cultural institutions do not have health insurance and/or have income levels that are well below national averages. This section attempts to quantify and examine why professional art makers, one of our national assets, are a profession that has fallen through the cracks into the ranks of the "under served". Ironically today's funders of the arts in both the private and public sectors have shifted their focus to funding projects and/or organizations that directly help the under served or "low income populations". They seem to have ignored the fact that artists are one of those under served populations.

A. Perceptions/Realities of Artists
In the present day labor structure of the art world, living/contemporary artists of all disciplines-- with the exception of the few who have become "stars" -- can not earn a living from their work as artists and must have supplementary jobs to supply their income. Contrary to popular beliefs, the majority of artists do not receive grants-- public or private-- and the bulk of artists do not get paid adequately, if at all, for their creative work. The majority of artists must finance their art work with the income earned from their supplementary job(s).

A 1987 National Endowment for the Arts (NEA) study entitled, Artists, found that there was 1,503,000 artists employed as "full-time" artists ( an increase of 64,000 since 1986) and it stated that "most artists cannot make a living practicing their art and must do other work to survive." It should be noted that a 1989 version of the report stressed that the 1987 figure grossly underestimates the number of part-time artists in the country (Jeffri 99). Dancemakers, a 1993 NEA Report, concluded that most choreographers do not earn a living from their art: "Notwithstanding their high levels of experience-- on average almost ten years-- the surveyed choreographers spend twice as much time in non-dance jobs as they did in choreographic ones to supplement income. About 80 percent of the respondents had jobs in addition to their work as choreographers and 30 percent had more than one" (Netzer 17).

Often times, artists hold multiple part time jobs because there may not be any full time jobs available in their field or the full-time jobs available (either in their field or outside of it) are not "flexible" enough for artists to pursue their art careers. Some artists are part time faculty at a university or at several universities because there are not enough tenured faculty positions available. Part-time faculty salary is much less than that of tenured professors and usually does not include benefits-- such as health insurance. Performing artists need to have flexible work schedules to be able to attend auditions and call-backs. Performing artists who tour with companies must have jobs that are seasonal or allow long leaves of absences. Many artists work for "temp" agencies. Furthermore, the majority of "flexible" and part-time jobs artists take to support themselves usually do not offer health insurance.

Artists pay out a significant amount of their income to produce their art work. A 1989 survey on artists in ten different locations in the United States by the Research Center for the Arts and Culture, at Columbia University, found that approximately 80 percent of the artists earned "some" income from their art. Only 40 percent earned enough revenue from their art to cover the cost of producing their art. Fifty-five percent of the artists in the study "earned $3000 or less from their art work in 1988" (Jeffri 100). The Dancemaker report by the NEA had very similar findings on choreographers: "On average, the respondent earned $6000 from choreography (including $1,600 in grants) but had professional expenses of nearly $13,000, incurring an average loss of $7,000. This represents a 2 to 1 ratio of expense to choreographic income" (Netzer 16). Visual artists seldom get paid for showing their work in non-profit museums and galleries. If the artists do receive a stipend, it usually does not cover the full cost of producing the art and the time the artists must take off from their supplementary jobs to prepare and install the work. Commercial galleries take 50 to 60 percent commissions for the art work they sell, but they usually do not reimburse the artists for the materials used to make and present the work. Nor do the commercial galleries offer the artists they represent any form of health coverage. It should be stressed that performing artists also lose or forego wages for having to take days off from their supplementary job to audition, practice, and perform.

Artists' income does not commensurate with their education. The findings from the NEA's Dancemakers report and the 1989 survey by the Research Center for the Arts and Culture at Columbia University are indeed "bleak" given that they document the very low economic status of artists compared to their education levels (Netzer). Even though 77 percent of choreographers were college graduates and/or had advanced professional degrees, compared to 21 percent of the U.S. population over age 25, choreographers' income levels are astonishingly low (Netzer 15). "Choreographers' income is 34 percent below the median for women professionals in 1989" (approximately 73 percent of the surveyed respondents were women). According to Nezter, "over one-half of the respondents had less than $15,000 annually on which to live (after choreographic expenses); 29 percent had less than $10,000. only 12 percent of the respondents had annual net incomes of $30,000 or more" (Netzer 16). The Research Center for the Arts and Culture study found that 60 percent of the artists surveyed earned $20,000 or less in total individual gross income. Sixty-eight percent of the respondents in the Columbia study were highly educated with college degrees and/or graduate degrees (Jeffri 101).

Similar findings on artists' economic statuses have also been reported in a 1986 study by the Boston Mayors's Office of the Arts and Humanities. More than half of the Boston artists, which included artists working in all the disciplines, earned between $10,000 and $17,000. Eighty percent of the city's 7,000 plus visual artists earned less than $22,000 each year. A 1994 survey of close to 100 artists by the Artists Health Care Task Force indicates similar findings. Fifty four percent of the artists who responded earned $20,000 or less in total gross income in 1993; twenty six percent earned $10,000 or less. Only twenty three percent of the artists surveyed earned over $25,000.

None of the economic studies take into account or quantify how may artists do not have health insurance or how much they pay in out of pocket expenses for health care.

B. Artists and Health Care

National Study
A 1991 national study conducted by the American Council for the Arts of artists of all disciplines entitled, Study of Health Coverage and Health Care Needs of Originating Artists in the United States, provides grim data on artists and health care. The American Council for the Arts study found that 30 percent of artists living in big cities are without health coverage. This is twice the national average (15 percent of the general population are uninsured). Eighteen percent of all artists surveyed in the U.S. did not have insurance. Of those who could not afford insurance, 55 percent are in the 36 to 45 age range. Thirty-four percent of the uninsured artists stated that they do not have access to a group health insurance plan. The study also revealed that an artist with more income derived from artistic endeavors is less likely to have health coverage, while 57 percent of the artists with insurance are covered by a plan obtained by an employer, the government or a parent. According to the study, 43 percent of insured artists are at risk of losing their health insurance as insurance carriers eliminate coverage through membership in associations such as artists' organizations or escalate prices for individual policies. When the premiums go up on such plans, many artists are priced out of the market.

C. Artists Health Care Task Force Findings
The findings from the March and April 1994 public hearings held by the Artists Health Care Task Force further clarify the problems artists had with the existing health care system. The Task Force found that:

Artists, in general, forego care. If artists do take advantage of medical care, they usually go when it has reached emergency or catastrophic conditions. Many artists fear not being able to pay for the medical care and /or fear being diagnosed with a pre-existing condition--thus possibly making them ineligible in the future for health insurance.

Often times, low income artists are not aware that they may be eligible for free care or care based on a sliding scale fee and a majority of those artists who are aware do not take advantage of such services because they do not want to take services from what society has deemed the deserving poor-- mothers, children and the elderly.

Like many of the working poor, artists noted that they were unable to pay for prescriptions and/or refills due to their limited discretionary income.

Many artists work part-time in order to have the time and flexibility they need to create their work. Often times, artists held multiple part-time jobs to make ends meet. The majority of these jobs do not offer health insurance.

Artists noted that their income fluctuates year to year, even month to month and mentioned that sliding scales fees or free care based on pay check stubs can be problematic. Their income fluctuation also proves frustrating when trying to pay medical bills-- since budgeting for the future or meeting payment schedules cannot be based on a fixed paycheck.

Artists noted that the majority of them do not earn enough gross income to deduct "out of pocket" medical costs from their taxes.

Performing artists, particularly dancers- noted that they often needed to seek alternative medicines, such as acupuncture and chiropractic care, which are not covered by many insurance plans.

Some artists stated that they do not qualify for health insurance because of pre-existing conditions and many said that they were "locked into" the jobs they have in order to retain health insurance benefits and/or because they had a pre-exisitng condition.

Some artists stated that they are employed by small non-profit organizations that operate on a "shoe string" and these organizations are not large enough to have a group plan and/or cannot afford to pay for health care benefits.

Almost all of the artists stated that they would be willing to pay for health insurance and health care but they have found health insurance to be economically out of reach.

Artists Stressed that they need a plan that is unrelated to work status and is affordable to those who have limited discretionary income.

D. Conclusions:
Even though artists are the creative energy supporting the culture industry, they are poorly paid and must supply their incomes by supplementary jobs. Often times, these jobs do not provide health care coverage. In essence, there is a dual labor market structure in the art world that profits from poorly paid artists. The "high wage" sector of the art world is dominated by non-artists, while the "low wage" sector is reserved for artists. The cultural industry of the United states is dependent on the poorly paid artists, "In fact the largest subsidy to the cultural life of this country does not come from corporate donors, the government, or from the patrons but from artists-- through their unpaid or underpaid labor" (Woodcock 126). Artists are the working poor of the art world and like most "under served" populations, their needs-- including the basic need of affordable health care-- have been ignored.

-- Kathleen Bitetti
Artist and Executive Director
Artists Foundation

ACKERMAN, Ashley. "Artists Evictions in a City that Doesn't Care" in ArtPoint. Boston: Fort Point Arts Community, Inc. Spring 1994. 3-7 &12.

COHEN, Sarah Foote. "Study of Health Coverage and Health Care Needs of Originating Artists in the United States" American Council For the Arts, 1991.

JEFFRI, Joan. "The Artist in an Integrated Society" in Public Money and the Muse-- Essays on Government Funding and the Arts. Benedict, Stephen. ed. New York: W.W. Norton & Co. 1991.

NETZER, Dick & Ellen Parker. Dancemakers. NEA report (#28) October 1993.

WOODCOCK, George. Strange Bedfellows- The State and The Arts in Canada. Vancouver: Douglas & McIntyre 1985.

1994 Kathleen Bitetti
*orginaly included in the Artists Health Care Task Force July 1994 Report to Congress
Co-sponsors of the Report: Boston Mayor's Office of Cultural Affairs, The Artists Foundation and Boston Health Care for the Homeless.