Cashing out

Health Care | As insurance costs soar, some patients and doctors turn to options that give them more control and responsibility | Lynn Vincent

Last fall, Anita Palmer faced a fork in her career path. A single mom of a 10-year-old son, Ms. Palmer had been working 20 hours a week as a media relations coordinator for Point Loma Nazarene University in San Diego. She was also nurturing a growing freelance editing business and dreamed of working from home and building her work schedule around the needs of her son, Benjamin. Her university job, however, paid 65 percent of their health-care premiums and, as Benjamin's sole supporter, Ms. Palmer worried about giving that up.

Then in October, Point Loma offered Ms. Palmer a full-time position. That meant more time away from her son and her editing business, but it also meant full health coverage. "I was at a point whether I could either accept the offer of a full-time job, or turn another direction and work toward 100 percent self-employment, trying to cobble together enough health-care coverage," Ms. Palmer said. "I would've preferred to work from home, 100 percent self-employed . . . but the determining factor was health insurance."