Lou Thomas is a great guy. Not just a talented bassist/guitarist/songwriter, but an all-around affable, intelligent dude that cares about his friends and others. Thomas is a part of the thriving music mecca that is Portland, OR. He works in a coffee shop a few days a week and lives paycheck to paycheck in order to devote as much time as possible to the bands he plays in, including the critically acclaimed A Weather, whose hushed, immaculate first album, Cove, was released last year to glowing reviews all over the web and beyond. Thomas also plays in the louder, lesser-known four-piece Chores, which is pretty much Everyband, USA, lauded for being both melodically adventurous yet 100 percent pretension-free in the comparatively small bit of press they’ve gotten so far. Chores also just released their debut LP, The Subtle Politics of the Public Hammock, on Field Hymns Records. Between the two, Thomas experiences a pretty full spectrum of what life is like for the small-time, struggling recording artist that lives for, but doesn’t make a living from, his music.

One of the under-heralded grassroots gems on the Chores LP is a song called “Noinsuranceland”, and you can probably guess what it’s about. A bike accident at age 15 left Thomas with a knee that would continue giving him problems over the years, though it had been years since the last sign of any ailment, up until one fine day in 2007 when he was walking through a Portland park and a little girl asked him for a push on the swings. “I stepped wrong on the mulch,” Thomas recounts in an email exchange, “fell over in pain, and passed out for a few seconds.” Broke and uninsured, he dealt with it as shrewdly as possible. He found a ride to the emergency room, skirting the ambulance fees at least. “This is where the story gets complicated,” Thomas says.

He needed to see a knee specialist who could order an MRI, yet without insurance, this meant Thomas was basically fucked. Fortunately, it turned out that his boss was just about to roll out a health insurance plan at the coffee shop, but not for a couple months. “So I saw the specialist, but then put off getting the MRI until the insurance kicked in.” He managed to get the ER and specialist fees reduced by 75 percent by being broke enough to qualify for government assistance and having the wherewithal to plow through the requisite mounds of paperwork. Even then, “It was expensive, but manageable,” Thomas says.

“It turned out I had torn my ACL and meniscus, a piece of which had lodged itself between my knee cap and my lower leg bone so that I couldn’t straighten my leg or walk correctly. For the first month or so, I couldn’t really stand up for very long, which made working at a coffee shop extremely difficult.” When the insurance finally started, Thomas got the MRI, had the surgery he needed, and was forced into an unpaid month out of work to recover. “At this point, I had about five different agencies sending me bills: The surgeon, the surgery center, the anesthesiologists, the MRI, the physical therapist. One bill alone, for the surgery center I believe, after insurance, was still about $6,000, which at first they expected me to pay in three months. (No one told me this until after the surgery. Even at the surgery, a receptionist told me they would come up with an affordable payment plan and not to worry.) When you make barely more than minimum wage, and just had to take over a month off work, paying over $2000/month in medical bills was not going to work out.”

Thomas had gone from the hopeless ranks of the uninsured to the accursed file of the underinsured, and not only was it a financial nightmare, but he was then paying his $80/month premium on top of it all. “So, while I was unable to walk, doped up as high as a kite on prescribed oxycontin and vicodin, I had to spend all my days calling up these billing agencies, pleading, screaming, crying, to get payment plans I could remotely afford. It was the most humiliating, degrading, bureaucratic experience of my life.” It took him a year and a half to pay it all off, and this, as we’ve come to understand from the myriad other stories we hear and read about every day, is actually a success story.

Without that health insurance, Thomas might never have been able to get the help he needed at all. Either that or the debt he incurred could have been literally 10 times worse, and he’d easily still be suffering under its weight today. Big picture-wise, most conservative estimates put it at around 15 to 17 percent of all Americans being without any kind of health insurance right now, which is a frightening reality to behold, let alone experience. Many more remain underinsured—that is, insured, but with a cheap plan with a deductible so high that any minor (depending on how you look at it) medical expense would likely have to be paid out of pocket anyway, and so they still can’t afford to go to the doctor. The situation, we understand, is intolerable, and yet what this means for the music community is actually far more staggering. This general 15 percent is comprised, after all, primarily of the American working poor, which is exactly the segment of society American musicians tend to fall into.

According to statistics provided by the Future of Music Coalition, 45 percent of musicians are uninsured. As for the slim majority that does have some level of insurance, only five percent receive it as a benefit of a job in music, such as working in an orchestra or as a session musician. The remaining 50 percent get insurance either through a day job or an individual plan paid for out of pocket, the latter being quite likely underinsured. Lack of access to health care is a ubiquitous plight throughout the music world; the numbers may be mind-numbing and the political arguments so coded and lingo-laden that it seems impossible to set foot anywhere near the debate, but the real-life stories are everywhere, in every genre, on every level of fame and/or obscurity. Most folks would say that Wilco is a pretty successful band, for example. Jay Bennett—multi-instrumentalist Wilco member for seven years before going solo—died just a few months ago from an accidental overdose of the painkillers he was taking to cope with the bum hip that he needed to replace but couldn’t, because his health insurance considered it a “pre-existing condition.” Tragically, Bennett, as an example, is hardly unique. Arthur Lee, of the seminal ’60s psych-rock group Love, died of leukemia in 2006, without health insurance and unable to cover his abundant medical expenses. Karl Alvarez, bassist for legendary California pop-punk pioneers Descendents, suffered a heart attack in 2007 without insurance, recovered physically but not financially; had to collect charity online and through benefit concerts. Rachel Carns, drummer of the Need and member of several other bands, currently has breast cancer, and little, if any insurance.