I had a spirited debate this morning over whether people under 30 are irresponsible if they stay uninsured. My answer: in the current system, heck no. Why?
-- People under 30 are most likely to hold down jobs that give no insurance. Internships, adjuncting, freelancing, trial period, all of it: as our economy weakens, benefits decrease, and the disproportionate victims of weaker benefits are new workers.
-- Individual insurance is considerably more expensive than employer-paid benefits.
-- People under 30 are healthier than people over 30; additionally, people under 30 feel more bulletproof than people over 30 -- out of innocence, they don't see the need for health insurance.
-- High-deductable catastrophic insurance is the biggest racket the insurance industry has going: when you take small premiums from many, and pay large benefits to very very few, it becomes extremely profitable to hire lawyers and deny coverage in the case of the few. Most people with catastrophic insurance never figure out just how little their policies cover, or how susceptible they are to shenanigans.
-- Many of the most serious health issues that appear between the ages of 20 and 25 are psychological or neurological: the onset of serious depression, schizophrenia, and bipolar disorder is all likely to take place. These are not only difficult diseases, often severely undercovered by private insurers, but they also make it less likely that a young person will go through the conflict and struggle that's required to get a policy in the first place.
-- A young person's insurance situation needs to be taken care of the minute their insurance through their parents (if they're lucky enough to have it) elapses, or else they can be rejected for pre-existing conditions (here, just as an example, is a letter to the editor from a young person denied a half-dozen times for having easily treatable skin conditions, the middle letter on the page).
It is not good that people under 30 often go without insurance, especially those who can pay for it -- but when given the choice between sinking large percentages of their incomes into exploitative and ultimately useless private health insurance, I can understand how a sense of invulnerability could make them forego insurance entirely. A public option -- something that would be affordable, and a plan that would promise that young people could get out what they put in to the system (as opposed to contributing to insurance company profits) would make a real difference.
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