Invincible? Try Broke . . .

From today's New York Times:

“My first reaction was to start laughing — I just kept saying, ‘No way, no way,’ ” Alanna Boyd, a 28-year-old receptionist, recalled of the $17,398 — including $13 for the use of a television — that she was charged after spending 46 hours in October at Beth Israel Medical Center in Manhattan with diverticulitis, a digestive illness. “I could have gone to a major university for a year. Instead, I went to the hospital for two days.”

In the parlance of the health care industry, Ms. Boyd, whose case remains unresolved, is among the “young invincibles” — people in their 20s who shun insurance either because their age makes them feel invulnerable or because expensive policies are out of reach. Young adults are the nation’s largest group of uninsured — there were 13.2 million of them nationally in 2007, or 29 percent, according to the latest figures from the Commonwealth Fund, a nonprofit research group in New York.

Almost a third of all uninsured . . . that's a lot. I've always wondered where this idea of the "invincibles" comes from, because I find it to be a supremely misleading term. The first time I remember reading about it was in an article for New York Magazine:

There was a time when a health plan symbolized something—you were making it—but now benefits are scarce at many levels. For the young who don’t luck into a job that offers coverage, a certain outlook becomes inevitable: Premiums are a fortune, you can barely pay your rent, you rarely need a doctor, you decide to gamble. It’s a state of mind so common, in fact, that the insurance industry has a name for it: Ondrejcak is one of the “young invincibles,” those who, betting they can get through their twenties relatively unscathed, “choose” to go without insurance. They are the fastest-growing segment of America’s uninsured population.

Here's the thing, though, the term implies an arrogance - a willful choice to forgo health care because one is young and statistically unlikely to require anything more than a few antibiotics once in a while. But most every person described in these types of articles - and certainly every person I know within that age demographic - who lacks health insurance does so not out of choice, or a sense of invincibilty, but because their job fails to provide it for them and the cost of purchasing an individual plan is too high.

Even in this latest New York Times article, the one interview subject designated as representative of the "invincibles" states plainly that insurance was just too expensive for him to rationally consider it an option:

Of course, there are those who do feel invincible, like Eric Williams, who is 24, unemployed and currently in the middle of a six-week snowboarding adventure in Wyoming, Montana, Colorado, Utah, British Columbia and California. Mr. Williams said by cellphone near Bozeman, Mont., that he looked into buying health insurance before he left, but abandoned the idea after being unable to find anything for less than $400 a month. Instead, he is just trying to be careful, though not always with success.

If he's unemployed, how could he possibly afford to pay $400 per month for health insurance? I know that health care usually ranks 3rd or 4th (pdf) among the top issues of concern for my generation, but that doesn't mean it isn't a problem. News outlets shouldn't down-play the seriousness of the situation by implying that health care is a luxury that arrogant youth are voluntarily casting aside. Twenty-somethings are the most uninsured demographic in America. Not by choice, but by necessity. Entry level jobs don't provide it, and today's job culture, where one can change jobs up to ten times before you hit 30, has created a business climate that fails to provide for employees to the same degree as companies did when our parents were our age. Add in the fact that individual insurance plans that are worth a damn are so expensive as to be out of reach of millions of young people, and you've got a huge problem that needs fixing.

This new plan by Governor Paterson, modeled on similar plans in a dozen states, seems like a good start here in New York, but as the article indicates it is clearly insufficient. I think we're going to need to see something done on the national level from the congress and the Obama administration:

Gov. David A. Paterson of New York has proposed allowing parents to claim these young adults as dependents for insurance purposes up to age 29, as more than two dozen other states have done in the past decade. Community Catalyst, a Boston-based health care consumer advocacy group, released a report this month urging states to ease eligibility requirements to allow adult children access to their parents’ coverage.

“There’s a big sense of urgency,” said Susan Sherry, the deputy director of Community Catalyst. She described uninsured young adults as especially vulnerable. “People are losing their jobs, and a lot of jobs don’t carry health insurance. They’re new to the work force, they’ve been covered under their parents or school plans, and then they drop off the cliff.”

If Governor Paterson’s proposal is approved, an estimated 80,000 of the 775,000 uninsured young adults across New York State would be covered under their parents’ insurance plans. That would leave hundreds of thousands to continue relying on a scattershot network of improvised and often haphazard health care remedies.