Generational Healthcare

The healthcare debate has really become a generational debate. It about the elderly vs. the young regardless of how anyone looks at it because if you look at most of the town hall meetings that took place last month than you will see that the turnout is mostly older Americans who are making the biggest ruckus. However when you look at any of the polls when it comes to healthcare reform and who wants it, it is clear that it is the younger residents of this nation that want healthcare reform especially a public option more so than elderly residents. Therefore it should not surprise anyone that perhaps the healthcare debate is a generational divide between older voters/residents and younger voters/residents because most of the elderly have healthcare while many young Americans especially those 18-35 years old don’t have healthcare. Then if we as Americans look at the number of uninsured Americans no matter if you believe it is 50 million which is more on the extreme side or 20 million which is on the modest side than you will see that many Americans even 36-40 years old don’t have healthcare as much as those 41-75+ years or older.

So with all of that said, many of us in this nation need to understand that healthcare reform isn’t easy because of the generational divide between social classes in this nation. In fact it isn’t about Democrats versus Republicans that are holding up healthcare reform but it is more so about the older Silent and Baby Boomers Generation versus the younger Hip-Hop and Social-networking Generation of Americans. This is what is transpiring when it comes to who wants healthcare reform and who doesn’t or even when it comes to what type of healthcare reform Americans want in this nation. The elderly fear healthcare reform especially when dealing with getting rid of some of the waste in Medicare and transferring much of those funds to pay for others to get healthcare is what many Americans are against. Nonetheless younger residents want a public option because many of them don’t have healthcare reform cause they are too old to be covered by their parents’ healthcare plans and perhaps they can’t afford healthcare coverage which is my case on both ends. Thus, the divide in the healthcare debate is truly generational more so than anything else and that is something many political pundits & analysis seem to ignore which discussing healthcare as well as the ruckus at the town hall meetings held across the nation.

Millennials, young Americans under 28, provided President Barack Obama most of his popular vote margin over John Mc Cain in 2008. Now their belief in the need to involve the federal government in comprehensive health care reform may become the President's most powerful argument in persuading Congress to deliver on that campaign promise this year. But to do so the President will have to overcome some serious differences between members of older generations in both parties, and in both houses of Congress, on just how accomplish that task. The Senate is almost equally divided between members of the Silent Generation, born between 1925 and 1945 and Baby Boomers born between 1946 and 1964. Recent elections have raised the percentage of Boomers in the lower house to almost three fourths of all members. Of course, partisan allegiance and local politics play an important role in determining a legislator's voting decisions. But the differing perspectives of these two "leadership generations" have already influenced each house's approach to the policy debates on a number of issues so far this year and are likely to do so again on health care this summer.

Democrats in the House of Representatives, for all of their ideological posturing, are actually led by members of the Silent generation, including Speaker Nancy Pelosi (1940), Majority Leader Steny Hoyer (1939), Democratic Whip James Clyburn (1940), Dean of the House John Dingell (1926), and committee chairmen such as John Conyers (1929), Pete Stark (1931), Ike Skelton (1931), Charles Rangel (1932), John Murtha (1932), James Oberstar (1934), Dave Obey (1938), Henry Waxman (1939) and Norm Dicks (1940). The parents of the "adaptive" Silent Generation protected, some would say smothered, members of this generation during the traumatic childhood events of their youth-the Great Depression and World War II. As a result members of the Silent generation are often risk averse as adults and tend to prefer the of bi-partisan compromises that John McCain, a Silent born in 1936, talked about so often during his campaign.

By contrast, almost all of the House Republican leadership is from the Baby Boomer Generation. Boomers are the latest incarnation of what William Strauss and Neil Howe, the originators of generational theory, call an "idealist" generation. Members of this generational archetype tend to believe deeply in their own personal values and seek to use the political process to implement their personal ideological convictions for the whole nation to follow. Because the Boomer generation has been divided about equally between the two ideological poles and parties (half of them voted for Obama, half for McCain in 2008), America has experienced political gridlock for the past four decades. Boomers have spent a lifetime rebelling against the Silent Generation's belief in institutional allegiance and compromise and will find themselves once again having to accommodate the older generation's sensibilities if they actually want to pass legislation such as health care reform. Democratic Boomers will need to find common cause with the Silents in their party, while Republican Boomers are likely to emphasize their ideological differences from their Democratic counterparts. Republican Boomers will want to demonstrate their ideological commitment to lower taxes and a less active federal government. Moderate Democrats from the Blue Dog and New Democratic caucuses, who share some of these concerns with Republicans, are likely to be more willing to compromise on these issues with their Silent Generation leaders than liberal Boomers might want or be willing to.

In the Federalist Papers, James Madison said that the Senate would be a "necessary fence" against the "fickleness and passion" of members of the House of Representatives. Either George Washington or Thomas Jefferson was reputed to have called the Senate a "saucer" designed to "cool" House legislation. Whether the Senate was meant to be a fence or a saucer, in this Congress it often operates as a generational bulwark against the increasingly hot passions and partisan bulldogs who serve in the U.S. House of Representatives. The Senate has already played this role during this session of Congress. In the debate on the President's Recovery Act, Silent Generation Senate leaders forced the House to accommodate some of the demands of the Senate's most moderate members. During the course of that debate, House Democrats were able to prevail in the name of party unity on their Senate counterparts to accept a "rescission rule" in the budget resolution that would allow Democrats, if they so chose, to ignore the Republican minority and pass health care reform with only 51 votes. But even after that agreement, Silent generation Montana Senator Max Baucus (1941) has been determined to find a bi-partisan bill that his Republican counterpart and Silent, Charles Grassley (1933), can support. Meanwhile, Senator Chris Dodd (1944), thrust into the health care debate due to the illness and passing of Senator Edward Kennedy, has played the very typical role of those born on the cusp between both generations--seeking to find a solution that leans more to his ideological beliefs, but one which still contains an element of compromise for the other side.

But how this inter-generational interplay between the two houses and the two parties will actually play out in the health care debate will depend on how much President Obama uses his instinctive knowledge of what Millennials want to convince the Congress to get something done. Born in 1961, on the cusp between the Baby Boomers and Generation X, the President's generational style is hard to pin down. Liberal Boomers appreciate his idealism and commitment to economic equality. On the other hand, like many Gen Xers, Obama has sought to distance himself from the divisive, ideological debates of the recent Boomer past. At the same time, Obama's political behavior does not square with the harsh and cynical approach of clear-cut Gen Xers like Sarah Palin. Whether it's because of his unique upbringing in Indonesia and Hawaii, removed from the debilitating debates of the 1960s; or whether it's because his chief speechwriter is a precocious Millennial; or because of his intellectual tendency to search for consensus, President Obama's political style consistently seems to capture the very traits that his loyal Millennial supporters most admire.

Millennials are not interested in letting ideological posturing stand in the way of "getting stuff done," as Obama likes to say, especially in an area as crucial as health care. Like the members of other generations, virtually all Millennials (90%) believe that it is time that health care is made more accessible and affordable for all Americans. However, only a third of Millennials, in contrast to about half of those in older generations, are concerned about the impact of greater governmental involvement in the health care system (36% vs. 47%). And, Millennials are far less likely than older generations to prefer once again deferring health care reform to avoid higher taxes or larger deficits. The fundamental question that members of Congress from each generation, and each party, will needed to answer during this summer's health care debate as well as this fall’s was just how much they want to accomplish as opposed to scoring political points or pursuing ideological agendas. It's a classic question to which members of the Silent Generation are likely to respond with offers of compromise, even while Boomers on both sides of the aisle insist on what they consider to be non-negotiable principles. For Millennials, however, the answer is clear--reform the nation's health care system now as the next step in delivering on the kind of "change we can believe in" that their leader, Barack Obama, promised and now asks Congress to deliver.

Still some of the difficult financial choices facing uninsured Americans — whether to go to a hospital or tough out an illness, whether to pay the rent or pay doctor bills — confront young people who not that long ago had to worry only about buying gasoline or paying a cell phone bill. The age group of people 19 to 24 years old has the highest percentage of uninsured individuals, according to the Kaiser Family Foundation. Thirty percent of them did not have health insurance in 2007, a number almost certainly driven higher in an arid job market. An additional 26 percent of people 25 to 34 years old were uninsured, Kaiser found. As a whole, polls have found that adults under 34 are more supportive than others of President Obama’s drive to overhaul health care, though their views are hardly unanimous. For now, some of them are without insurance by choice, gambling that their youth will keep them healthy. But others, already dealing with medical issues, say that affording medical care is a near impossibility because they either have no insurance or have inadequate coverage. For a 23-year-old woman who graduated from Duke University in 2008, her efforts to break into the film industry mean a string of internships, none providing insurance. Nor can she afford insurance with her earnings from the jobs she has taken to support herself, including a position as a nanny and as a part-timer at a boutique.

But the woman, who asked not to be identified to keep her medical condition private, has HPV, a virus linked to cervical cancer. An annual pap smear and a colposcopy, a follow-up procedure to check for cancer, cost her hundreds of dollars. “Do I keep checking that or do I save some money?” she said. “Do I do what I’m supposed to do and pay for the next procedure? Do I opt out of it because I can’t afford it?” For some, landing a steady job does not necessarily translate into insurance. Kristy Weaver, 22, began working full-time as a certified nursing assistant at a nursing home in Crescent City, Fla., when she was 16. But Ms. Weaver said that the only insurance offered through her job “wasn’t worth what you paid for it.” When Ms. Weaver was 11, doctors told her that she had ovarian cysts. Last year, a specialist told her the only way to eliminate the problem would be to remove her left ovary, an operation that she was told could cost $6,000 to $10,000. Unable to afford the surgery, she began taking heavy doses of birth control pills the doctor prescribed.

“All it did was make it worse,” said Ms. Weaver, who is now a staffing coordinator at the nursing home. Ms. Weaver now has insurance through her employer, and said she has to wait 12 months before consulting a doctor about the cysts or else the insurer could designate the problem as a pre-existing condition that will not be covered. She has six months to go. “It’s a really throbbing pain,” Ms. Weaver said. “The first time I had an attack, I thought I was losing a baby. I couldn’t catch my breath. I was in bed for three or four days.” Now, she is about $5,000 in debt from her medical bills. “I can’t get a new car,” she said. “I can’t look at buying a house.” Instead of racking up medical bills, other young people decide to forgo treatment completely.

Others like Spencer Krasch, 19, had surgery last year for Wolff-Parkinson-White syndrome, a condition that causes his heart to beat rapidly, while covered on his father’s insurance. Now out of high school and working in a deli, he is uninsured and has discontinued routine check-ups. But recently, when Mr. Krasch, who lives in Temple City, Calif., was helping his girlfriend move into her dorm at Pomona College, he felt as if he was having a stroke, which he said doctors told him could be a complication of the surgery. “All of a sudden the whole left side of my body went completely numb,” he said. “My lips started twitching.” But he refused to let his girlfriend’s parents call an ambulance. “That would have been way too expensive for me to pay for,” he said. Instead, Mr. Krasch waited until the symptoms subsided.

Even those who are in good health can quickly find themselves on the other side of the divide. Josh Pavlacky, 23, knows that all too well. As a graduate of a top liberal arts college, Wesleyan University, with a bachelor’s degree in studio art, he expected to find nonprofit work. Instead he is working as a dishwasher and running an art gallery out of his garage in Portland, Oregon. While in college, he was covered by the policy of his father, who works security at Costco. But now, he says, that coverage has ended and his family cannot afford to help him buy something else. So when Mr. Pavlacky got hit by a car while biking in May, he decided that a hospital visit was out of the question. Instead of seeking treatment, he had friends bring him prescription painkillers they had left over from procedures like having their wisdom teeth removed. “I was flipped over and fell on my back,” he said. “I had a bruise all down my leg and couldn’t walk for three days.” Mr. Pavlacky says he supports the president’s health care overhaul, and wishes Mr. Obama had pushed a public plan forward himself instead of turning the negotiations over to Congress and “bringing everybody into the tent.”

Young people are split on how the president is handling health care, according to a Quinnipiac University poll released Aug. 5, though they are more supportive than other age groups. In the poll, 48 percent of those ages 18 to 34 said “disapprove” while 44 percent said they “approve.” Still, 53 percent of that group said the president would do a better job at handling health care policy than Congressional Republicans, while 35 percent sided with the Republican lawmakers. Ms. Weaver, who voted for Senator John McCain for president, says she worried that a health care overhaul could make taxpayers finance a system that does not work. But she said she feels that politicians do not seem to understand what young people are going through. “It’s the people who are trying to make a foundation for themselves,” she said. “It’s so difficult for younger people who are just now starting.”

This is why the healthcare debate is a generational debate as well as an ideological debate. Now what I didn’t mention earlier is that some people in the millennial age group do worry about current and future taxes as well as the growing national debt and deficits because I am one of those. However, at the same time, I understand that many government programs usually don’t get paid for and President Obama wants to pay for healthcare reform by using current spending that is already out there to pay for. For instance the talk of using $500 million of Medicare to pay for healthcare reform is a good idea considering that that $500 million has been misused for all these decades although some might say why not redirect that toward Medicare in a better more sustainable way that won’t allow it to waste it or misuse the funds. That is a good argument but one problem I have always noticed when it comes to waste and spending in government is that if the government gives money back to a program that wasted it, it is only going to obey the government watch for so long and as soon as the government watchdog turns its head again, it will misuse or waste the funds again.

So many young people understand that this might be our last chance at getting some type of healthcare for many of us who don’t have healthcare. It is time that many in Congress who are not Generation X’s or apart of the Hip-Hip Generation yet alone the Social networking Generation understand some of the hardships that young people face when they don’t have healthcare yet alone when they can’t afford healthcare. We are only young for so long and many young people understand that some type of healthcare reform has to pass and while even some of us would love to see a public option including myself, we must understand that perhaps a public option might not happen but that shouldn’t discourage us from supporting healthcare reform. As long as the healthcare reform that is passed in Congress contains CPR-- Coverage, Prevention, Reform while making sure that CPR includes health insurance stability, affordability, quality, and patient choice than we as young people should support it. Now all Americans yet alone young people might not get covered without a public option but at least more Americans will get covered if the healthcare bill contains CPR-Coverage, Prevention, Reform- that includes health insurance stability, affordability, quality, and patient choice. This is essential to healthcare reform and this is the direction that our Congress and the White House should be heading in as they formulate the healthcare reform plan and bill that will lead us as a nation in a better direction.

This is what we as young people should push for and this is what we as young people should try to make sure that older generations understand are necessary in order to improve the healthcare conditions and system in this “Great” nation of ours. Now while there is a clear divide in healthcare reform amongst generations, it should not be the end of us as a nation getting some good positive healthcare reform that could benefit majority of Americans more so than it does now. This is the task of us as nation and this is one of the reasons why we are a “Great” nation because we find ways to compromise on issues such as healthcare in order to help the majority of Americans get healthcare. This is what we must do and why the generational divide on healthcare will not and should not stop us as a nation getting a good healthcare bill passed that contains CPR-Coverage, Prevention, Reform as well as includes health insurance stability, affordability, quality, and patient choice.