Tag Archives: uninsured

The Young and the Uninsured

Many Californians face the blunt edge of the health care crisis. Children, the poor, the elderly – these tend to be the faces of the inhuman abomination we call a “health care system” that gives a privileged few adequate care at the expense of those who cannot afford it.

Among the most rapidly growing group of uninsured Americans (according to New York magazine) are us young folks. Sunday’s Sacramento Bee profiles us Californians who are in our 20s and who lack health insurance – at least a third of us between ages 20 and 29, in fact.

We’re “ineffective as political sympathy-generators and are therefore typically viewed as a footnote to the debate,” as the aforementioned New York piece puts it. But as our numbers grow, and as we become more aware of the inherent failure of the insurance-based model, we are becoming some of the most ardent proponents of fundamental reform.

The SacBee article is especially valuable for helping to push back against the myth that we young folks who don’t have health insurance lack it because we think we’re invincible, are reckless and foolish. Instead, as the article makes abundantly clear, the problem is that we simply cannot afford health insurance:

Cyndi Rose is an administrative assistant at California State University, Sacramento, and hopes to finish her college studies one day.

The 24-year-old Carmichael resident makes $15 an hour, lives with her parents and prays she won’t get sick because she says she can’t afford health insurance.

Most of her friends, Rose said, are in the same bind….Rose dropped out of UC Davis a year shy of a degree after her money ran out. Now a temporary worker in the student affairs office at CSUS, she is not eligible for employer-based health insurance.

Until she turned 24, Rose was insured through her parents’ policy. She inquired about buying an individual policy but concluded the high-deductible, limited plans on the market weren’t worth the price – more than $100 a month.

“What’s the point if I could never see a doctor unless I was dying?” she asked. “Like the majority of my friends, it comes down to whether we want to keep our cars from being repossessed and paying down high-interest credit cards.”

The problem is twofold. First, we young Californians (I’m 28) have faced declining economic prospects this decade – middle-income jobs are difficult to find, and many of us, even we with college degrees, are stuck in entry-level or, in my case, part-time work that rarely comes with health benefits. We have enormous student loan debts, thanks to a state that has decided to abandon its commitment to affordable education. And we face a soaring cost of living – without any assets or decent income to pay for even those basic needs, let alone purchase a useless health insurance policy. The SacBee article notes that 2 of every 5 college graduates are uninsured within a year of graduation.

Second, health insurance is no guarantee someone will actually receive health care and instead is designed to enrich insurers by charging high premiums and providing little in the way of actual care.

Most of us young Californians badly want health care. For those of us who are currently “healthy” we’d like access to affordable dental cleanings, vision checkups, and the knowledge that if we have some kind of accident or injury we can see a doctor without it breaking our already strained budgets. We want to be able to begin living a healthy life, instead of neglecting problems that will really hurt us when we get older. We want to start families, but without health care, having a child seems like an impossible option.

But there are many young Californians who are not “healthy” – who have persistent medical problems that the insurers, through their greed, do not want to touch. This is the other major accomplishment of the SacBee article – showing that we’re not only unable to afford health care, but that many of us have medical problems that are going unattended:

Robert Heredia, 19, works about 30 hours a week making minimum wage as a bus boy at Centro Cocina Mexicana, a Sacramento restaurant, and attends Sacramento City College off and on.

He suffers from cardiomyopathy, a disease in which the heart muscles become inflamed and malfunction. Heredia has been uninsured since he turned 19, the age limit for the state’s Healthy Families program.

Since he can’t afford regular medical care and barely affords medication, the emergency room at Sutter General Hospital has become his doctor of last resort….

Three times since January, Heredia has been rushed to the emergency room with stabbing chest pain and gasping for air. The last time, he had to leave work while spitting up blood.

“I wish I could get regular treatment, but there’s no way we could afford it,” said Heredia, who lives in South Sacramento with his family. “It’s just something I’ll have to live with.”

Let me give you my example. Through my old job in Seattle I had health insurance that ran out October 1. Two weeks ago I got a letter from the insurer explaining to me my eligibility for COBRA coverage. It would cost me $220/mo, which was bad enough. But because the coverage is geared toward “in-network” providers located in Washington State, with no out-of-pocket limit and little actual benefits for going out of network, it would be of little value to me even if I could afford the premium, which I cannot.

As a part-time employee I’m ineligible for health benefits at my current job, and the prospects aren’t great that I’ll be hired full-time (unless state higher ed budgets suddenly balloon). The coming recession means that it’ll be hard for me to find a job with health benefits. At this rate, the only prospect that I’ll be able to find health coverage is when I get married next summer. I’m lucky – I don’t have the health problems someone like Robert Heredia has to suffer with – but dental, vision, and affordable emergency care are all beyond my means.

Young uninsured Californians like myself find the individual mandate plans, like those proposed by Arnold but also by Hillary Clinton and John Edwards, to be especially appalling. Part of the logic behind the individual mandate is that if we who are assumed to be young and healthy and just too reckless to spend our money on insurance are forced to buy it, insurers can affordably write policies for older, sicker people. Deval Patrick, the Democratic governor of Massachusetts, which just implemented Mitt Romney’s individual mandate plan, “blames “young folks” for not getting insurance because “they don’t think they’re ever going to be sick.””

But it really doesn’t work that way. The SacBee article quotes Anthony Wright, of Health Access California, whose analysis suggests Arnold’s plan won’t provide enough subsidies for us part-time and low-income young folks to afford health insurance. As Massachusetts has found, their  “universal” health insurance mandate has left out young people – CBS News estimated in August, after the mandate went into effect, that of the 230,000 who still lack insurance, over half – 130,000 – are young people.

It’s a tough sell because one of the cheapest family plans available, unsubsidized, with drug coverage, is $662 a month. When [CBS reporter Wyatt] Andrews talked to [young] contractor Roger Thompson, there was no way.

“I have no choice. It would be like another mortgage payment for my family and I can’t afford that,” he said.

Many of us believe, whether or not we see it as politically viable, that single-payer is the best kind of health care reform. As we young people face a lack of insurance, an ongoing inability to afford it and a health insurance industry that has proved it prefers to let people die rather than provide affordable care, and as we young voters show very strongly progressive leanings, we may well be the generation that finally brings California and America truly universal health *care* – care that isn’t dependent upon one’s ability to pay.

With help from folks in other generations, of course.