Memo to Lawmakers: Young Americans Demand More Health Care, Not Less

Feb 13, 2013Rahul Rekhi

President Obama's SOTU mentioned Medicare, but he still fails to realize that young people are ready for even greater investment in health care.

Last night, President Obama delivered a State of the Union address that outlined an ambitious second term agenda while touting a steadily recovering economy and asserting the need to strike a budget deal that preserves the generational promise of Medicare. What he did not mention, however, is an underlying but oft-neglected truth: that our national health care debate still neglects the needs, perspectives, and interests of young adults. The State of the Union may be stronger, but for young Americans around the country, its health requires a new prescription. This is perhaps most critical in two key but distinct areas: innovation and mental illness.

Consider, firstly, that the health reform debate—subsumed into the longstanding clashes on the federal debt and deficit—has lately centered on cost cutting. Thus far, such discourse has largely been framed as benefiting young Americans, those who, the argument goes, will bear the brunt of the nation's debt burden in the absence of immediate cuts to the federal healthcare budget. However, from a young person’s perspective, there exists compelling evidence for a converse narrative: public health care as an incubator for innovation. The safety net that health care provides actually emboldens young people to take risks, to try creating the next Facebook or Google, rather than play it safe for fear of being denied care in later years. 

Evidence of the critical role that public health care can play in entrepreneurship and innovation is plentiful in the research literature. For instance, a recent RAND Corporation study observed the prevalence of so-called "entrepreneurship lock": a phenomenon in which prohibitively high costs of obtaining health insurance as individuals preclude workers from leaving large firms that can offer subsidized premiums to strike out on their own. But we can also look across the Atlantic to see the catalytic properties of such social insurance—and the costs of not providing it—in action. For example, Sweden, a nation that possesses a social safety net among the world’s most robust, ranked 2nd globally on the INSEAD’s Global Innovation Index. The US, with comparatively meager public insurance, came in at a distant 10th. Such nations as Norway, Finland, Denmark, and Switzerland–hardly bastions of Randian self-sufficiency—also handily outstripped our own ranking on this measure.

This is not to say that public health care is the only factor that will determine the fates of Googles to come. But this data should prompt us to reformulate our rhetoric around programs like Medicare and Medicaid: not as hammocks, but springboards. We should not be focused on heavy-handed cost-shifting measures that merely limit the scope of coverage, but instead how to thoughtfully modernize the fundamental societal value that these programs provide. It is precisely this values-based approach to national health care financing that young Americans value most greatly, as attested to by thousands of students in the Roosevelt Institute | Campus Network’s recently published Government By and For Millennial America.

Arguably the most significant example of this false dichotomy between cost and value is mental health care. Much has been made of our healthcare system’s dismal performance on health indicators, but in no field does this ring truer than in psychiatric care. Yet what’s often overlooked is that mental healthcare is, above all, a youth problem, afflicting no demographic more than my fellow young Americans—my classmates, colleagues, and friends. Millennials, as a demographic, report rates of depression well above the baseline: almost 9 percent of 20-somethings in America are thought to have developed major depression, panic disorder, or anxiety. The shocking nature of this statistic is only amplified by considering that a full 75 percent of diagnosable, life-long mental health illnesses develop by age 24. Yet an estimated 75-80 percent percent of youth in need of mental health services do not receive any care.

But potential solutions abound, even for such a complex problem. If states are the laboratories of our democracy, mental health has proven no exception. Even while the U.S. lags nationally on mental health—rated a ‘D’ by the National Alliance on Mental Illness—states like Connecticut, Massachusetts, and Maryland lead the pack in developing thoughtful, innovative proposals to improve the quality and coverage of care. Moreover, a recent study out of UCLA in California demonstrates that sound mental healthcare can actually be a cost-saving measure.

Ultimately, progress on both of these fronts depends on whether our political leaders choose to prioritize young Americans across the nation. The health of an entire generation hangs in the balance.

Rahul Rekhi is a student at Rice University and the Senior Fellow in Health Care Policy for the Roosevelt Institute | Campus Network.

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