Friday, January 04, 2008

Health Insurance: The Young & The Old

Betsy McCaughey discusses proposals to have government mandate that everyone buy health insurance. This is a policy idea that seems to have a pretty prominent position in the political agendas of several presidential candidates. There is an interesting implication of such a public policy:
The first myth is that it's fair to make everyone pay the same price for health insurance. It is not: For young people who rarely use health services, this is a rip-off. If people in their 20s paid attention to politics and voted, politicians wouldn't dare try this.

According to the latest Census data, 56% of the uninsured are adults aged 18-34. True enough, forcing them to be a part of a same-price-for-everyone insurance pool will likely bring down premiums. These young people generally need minimal health care ($1,500 a year, on average, according to a Commonwealth Fund study).

In most states, (but not New York and Vermont), young adults who buy health insurance are charged premiums that reflect their low medical needs. A 25-year-old man can buy a $1,000 deductible policy for a quarter to a third of what a 55-year-old man has to pay. (In Manchester, N.H., a 25-year-old man pays $156 per month, while a 55-year-old pays $542 for the same policy, according to

Both the Clinton proposal and the bipartisan congressional proposal prohibit insurers from giving such price breaks to the young. Their mandates would force the young to subsidize the heath tab for the middle-aged generation. This subsidy would come on top of the payroll tax younger people already pay to support today's Medicare recipients. This is contrary to a fundamental American principle. This nation has always believed in making life better for its children, not exploiting them.
I used to think, when I was young and naive, that there was just such a "fundamental American principle." But, then, sometime in my recent past, I decided to try to understand the social security program. After cutting through all the political rhetoric about social security it is quite clear it is a program which uses government's power to tax to take income from young workers in order to give it to old retired workers. Of course, social security is a program that has been around for some time now. So, I no longer think America holds to such a fundamental principle, and it seems to me the proposed health insurance mandates continue what is now a pretty long tradition of government taking from those who are younger in order to give to those who are older (and often these transfers are also from those who are relatively poor to those who are relatively wealthy).

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