Shifting the blame away from greedy companies and our for-profit healthcare system onto young people living in economic insecurity isn’t going to win equitable healthcare for everyone.
This week, it is likely that more details will emerge about proposed state legislation to cement the Affordable Care Act’s mandate requirement. The law would impose penalties on Marylanders who do not purchase health insurance plans.
At a time when it is clearer than ever that National Improved Medicare for All is the only viable solution to our healthcare crisis, the bill would also carry the message that Maryland Democrats are too cosy with the insurance industry.
With many sources of healthcare funding under attack by the current presidential administration, proponents of the bill will argue that there’s no alternative: enforce the mandate or watch the healthcare marketplace fail.
We are repeatedly told that the reason why our healthcare system isn’t working is because healthy young people aren’t buying insurance. In order to see savings in the future and to curb health care costs for everyone else, the argument goes, young people need to be nudged by the mandate to pay up.
The trouble with this argument is that the reason why millennials aren’t buying health insurance has nothing to do with selfishness and everything to do with economics. While wages have stagnated for decades, living costs have skyrocketed. In 2016, more young people lived with a parent than a spouse. In 1976, 14.7% of 18-34s were living with their parents. In 2016, the number was 22.9%. This is according to U.S. census data: a study by real estate company Trulia two years ago gave a much higher estimate of 40%.
Millennials are tired of being called selfish. We’re told that our inability to buy a house is because we are buying avocado toast - not because housing prices are up. We’re called lazy and unambitious at a time when the challenges of setting up a successful new business have never been so difficult. We’re criticized for favoring bike lanes and public transit over parking lots and sprawl at a time when spending almost $9,000 a year on a car just isn’t an option.
At the same time, we hear stories about our parents, who paid their way through college by waitressing, who were able to buy houses, who had the security of being able to work for the same employer for decades. We are a generation that is being asked to pay more for less.
In the infancy of the new marketplace, it was hoped that premiums would be reasonably priced. That is not the case now, and with all but two insurers having pulled out of the MD Healthcare Connection, it is hardly a market at all. When your finances are scarce, none of the options given to you by the mandate look attractive. Do you spend $200 a month on a plan with a $5,000 deductible, $500 month on a platinum plan and stay with your parents another year, or do you pay $700 for no coverage at all? The mandate is supposed to lessen the imbalance between healthy and sick Americans paying into the system. In practice, it doesn't do much for low-to-middle income people ($25k-$50k annual income), who are more likely to pay the penalty than any other group.
I don’t believe in the “baby boomers screwed millennials” narrative. But if the Democrats decide to pursue that as their political goal in 2018, it will exacerbate an "us vs. them" mentality between the two generations that has been very convenient for political elites and the owning class. And maybe that's the point of all of this. The legislation probably won't even help the Democrats. But it will definitely be beneficial for insurance and drug companies.
The paternalistic cry that "the least you can do to help everybody else is pay money that you don't have in order to not have insurance - or you're selfish and ungrateful" is, like, 2017. As it is for everyone else in this country, millennials deserve more than being forced to pay money for something that most developed nations provide as a human right. National Improved Medicare for All isn't a luxury - it's something we deserve as human beings. And if we can get some avocado toast along with it, that would be super cool.
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