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Health-Care Reform and You

I did an interview the other day with Adam Waxman at WireTap. We talked, as you might imagine, about health care. One of his final questions was from a category of questions I get fairly often: What's in it for my demographic group? In this case, the demographic group was the young. But it could be the pregnant, or the poor, or the insured, or the self-employed. The answer, I think, is that health care is sort of uniquely ill-suited to that type of analysis.

The reason we have health insurance, after all, is because we recognize that the young will someday turn old, the well might someday fall sick, and the rich might someday be poor. The point of the health-care system -- and in particular, of health-care reform -- is that it will be around when an individual is poor and rich, young and old, sick and well.

Thinking of yourself as having a very distinct identity in relation to the health-care system -- and particularly as having whatever relationship you have right now -- is the wrong way to understand the situation. Health-care reform doesn't have a lot to offer a healthy young i-banker. But it does have a lot to offer an i-banker who gets fired and then develops treatable cancer. It might not have a lot to offer an insured columnist for a major American newspaper. But it has a lot to offer that columnist if his newspaper goes belly-up and he has preexisting conditions. If you're the type of person asking what's in health-care reform for you, then the answer is probably nothing, unless your situation changes. But your situation very well might change.

By Ezra Klein  |  August 10, 2009; 3:11 PM ET
Categories:  Health Reform  
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Comments

Ezra,

You make excellent points about what might be in it for the young people in America.

However, I think young people should be more concerned about the sustainability of the welfare system in America.

The US government has just embarked upon one of the greatest spending sprees in history.

Additionally, given the aging demographics, as well as slowing population growth, the burden on young workers is enormous.

Why would any young person support further expansion of entitlement programs? We cannot afford these programs in the long run.

Printing money is also a tax on savings, and could lead to a run on the dollar. Some smart investors like Julian Robertson are betting against the dollar.

We learned a lesson from the past ten years: households shouldn't spend beyond their means. In the future, we will learn another lesson: governments shouldn't spend beyond their means.

The Chinese ain't stupid, Ezra.


Posted by: RandomWalk1 | August 10, 2009 3:25 PM | Report abuse

The folks being recruited to shout down health care reform at "town hall meetings"
are the same breed of people recruited in Iraq to affix explosives to themselves, walk into meeings, and disrupt political reform there. There is no bomb or suicide here, but the rubble from the damage to free speech, the right to assembly, and democracy is in general is almost as palpable. Both tactics aim to thwart the democratic process and are indications of lost causes, paleolithic thinking, and a sense of nothing left to lose.

Posted by: MikeinMinnesota | August 10, 2009 4:30 PM | Report abuse

Ezra, this statement:

"The reason we have health insurance, after all, is because we recognize that the young will someday turn old, the well might someday fall sick, and the rich might someday be poor."

is based on an faulty assumption that a lot of people make regarding our health insurance system. Paying insurance premiums as a young healthy person helps enrich insurance companies, but it has NO bearing on the situation he or she may face as an older, unwell person. I found this out the hard way. After being insured as a child and an adult for over fifty years, it mattered not a whit to the few insurance companies who would even offer me insurance at prohibitive rates when the company I worked for folded and I had recently been diagnosed with a chronic (but manageable) illness.

Similarly, anyone who is not insured through their employer knows that insurance premiums rise dramatically from year to year based solely on the person's age. Essentially such policies are subject to renewal monthly, and every renewal is based on your current age and health status without regard to anything in the past.

Posted by: adagio847 | August 10, 2009 5:30 PM | Report abuse

Ezra, I see where you are coming from, appealing to not just where you are now but where you could be someday or where you will be.

But I would hasten to add that health care reform does have something to offer the young i-banker: asset protection. The dollars they are amassing can go away very quickly without reform. Maybe that will strike a chord.

Posted by: scott1959 | August 10, 2009 6:14 PM | Report abuse

Ezra,

the problem with these comments you make and many like them is the assumption that ALL INSURERS DENY ALL CLAIMS is just not valid. If so there wouldn't be a 2.3 TRILLION system in need of reform. You can't have it both ways. You can't have insurers denying all claims AND costs spiraling out of control.

Health insurance is just like life insurance. You don't buy it when you're sick you need it when you're healthy, in the event or when you become sick or die in life insurance's case.

Posted by: visionbrkr | August 11, 2009 12:00 AM | Report abuse

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