A friend wanted to talk about the new health care law. First he heaped damning praise on Obama for frankly admitting that the young are expected to help pay for the old. Then he joked about how the ACA mandates that policies cover maternity care, which was supposed to be funny because my wife is beyond her childbearing years.
He seemed unaware of the irony. Obviously, it's the only fair thing to do: if the young are expected to help pay for the problems of old age, then the old should help pay for the problems of youth, as well as the care and upbringing of the next generation.
Policies under Obamacare also cover contraception, prenatal care, vaccinations for various childhood diseases like mumps and measles, as well as HPV and influenza: many of those conditions affect only babies, children, and young women. Even if you have moral objections to contraception, you shouldn't stand in the way of other people taking responsibility to avoid accidental pregnancy. Childrearing is expensive.
Policies also cover the problems old age brings: degenerative orthopedic conditions, stroke, cancer and heart disease. But young people aren't immune to car accidents, sprained ankles, broken legs and tumors. My sister had brain surgery to correct an aneurysm in her twenties. A couple of years ago our friends' 24-year-old daughter came down with non-Hodgkins lymphoma -- at first they diagnosed it as mumps. She was cured and the family didn't lose everything they owned in the process, because she was still on her parents' policy, courtesy of Obamacare.
The whole point of health care policies is to spread risk among a large population. We all pay in to help everyone else out when they need it, and they in turn help us out when we need it. When the people who are young now get old, their kids will pay in to help them out.
Everyone will need some kind of health care in their lifetimes, much of it non-emergency. That's why insurance is really the wrong concept. Having a child shouldn't be something that you insure against; it's not like your house getting hit by a tornado. It's a normal and necessary aspect of life, something that everyone needs to happen, even if we ourselves are childless. We need all sorts of regular health care: flu vaccinations, dental exams, physical checkups, breast and cervical exams, and so on.
Instead of thinking in terms of a car insurance policy where we choose whether we get coverage for liability and not collision, we should be thinking of health care premiums like a membership at a health club: I might not use the tennis and racquetball courts, but I do use the gym and the weight machines. And if want to take tennis lessons the courts are there.
By trying to segment up society, pretending that we're all independent islands that should survive on our own, that we'll never face certain problems, we isolate ourselves and make the nation as a whole weaker. We also create smaller risk pools that are more likely to have financial difficulties.
The private health insurance model we have now is clearly flawed and inefficient. There are huge cost discrepancies in different areas of the country, and still not everyone is covered. Those are the problems we should be working on. Together, in good faith, to make it better, instead of using fear to score political points.
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