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Monday, September 21, 2009

Generation Y Disconnect over Health Care Reform

On the Brazen Careerist a millennial aka Generation Y aka anyone under 30, health care reform posts are more becoming more popular than posts about dating or sex. I recently saw a petition with a list of what Gen Y want from the health care reform. After reading the list, I saw the strong sense of social justice and call for equality. However, the proposed changes were for things that already exist that Gen Y doesn't use. There was a lot of bicycles for sea food.

In summary, the petition calls for affordable health insurance that covers preventive and reproductive services, an end to using gender to price plans, and ability to stay on parents' plans until they are 26.

With regards to using gender to price plans or charging women more because they get the bill when a baby is born, that is overdue change. 18 states have figured out that you need both a man and a woman to have a baby. With regards to mandating that dependents can stay on parents' plans until they're 26, certain employer groups provide that option. This would probably be a popular mandate for all since it adds more young people to insurance pools. Only issue is that employer-sponsored insurance is in flux so this may add a mandate to something that may go the way of the Arena Football League.

What's left in the petition is health insurance reform in the form of affordable plans with out of pocket maximums (a limit to how someone will have to pay) and preventive services. All of these things currently exist and are aspects of current health insurance plans that Gen Y doesn't want to buy. They're as popular as day old keg.

With affordability, Gen Y would pay as much for a health plan as a senior would for their Medicare premium. Even in McAllen, TX, with the highest medical costs in the country, a 25 year old could get a plan with out of pocket maximums, preventive services, and everything else for less than $100. You don't getter discounts than a senior, from health insurance to movies to early bird specials.

With preventive services, from a population health perspective, young adults generally don't need preventive services outside of women's health. When I requested my last cholesterol test (with cholesterol level under 200), the doctor told me that my cholesterol wasn't going to change until I turned 40 unless I adopted a West Virginia style diet. From a population health management perspective, those preventive services are best reserved for those who are older or with chronic diseases.

Given Generation Y has access to affordable insurance and a low need for preventive services, why is there a petition for this? The good news is that the petition is already successful. Even Senator Baucus's bill has a "young invincible" insurance option to entice Gen Y to buy insurance.

This is the disconnect. I see the interest in social justice in terms of everyone having insurance. However, I see no indication that Generation Y value insurance sufficiently to pay even the discounted rate. Insurance plans who have done market research see a larger interest in dental insurance because young adults generally use their dental insurance twice a year. The real issue with communicating with Generation Y is more about marketing the insurance plans as carriers with focused marketing campaigns do well with the same insurance plans that everyone else has.
The real Generation Y issue that I see is a better financial forgiveness process when something happens and they are hospitalized, need medication, or need a surgery, and they have no insurance. Hospitals and pharmaceutical companies have charity care programs that could be used to give young adults a second chance and not force the debt on them. Our rugged individualistic society may preach that no second chances and accountability but we also can be a compassionate society when we want to. If that fails, we can put on our ROI hats, an point out the fallacy in trying to get someone in their 20's to pay back tens of thousands of dollars in debt. After that debt forgiveness, it would be expected that the young adult would learn and carry health insurance (assuming they can qualify which is a gap).

Generation Y has been dispelling convention about the perils of job hopping or the importance of home ownership. That's why this conventional request in a petition surprises me. Young adults interaction with the health care system is deliberately infrequent. Address the problem prudently when it happens for that one time and remove that safety net if the same offender doesn't learn their lesson and remains uninsured. I see the social justince in affordable insurance for some parts of the country but for young adults, I see social justice in the form of debt forgiveness for a catastrophic event.

1 comment:

Anonymous said...

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