healthcare

The Harvard Institute of Politics has released their latest round of youth polling. The numbers are already being headlined that youth still support Barack Obama even as they disapprove of his policy goals. Nowhere is this dynamic more visible than healthcare. Polling this year has repeatedly shown youth to be among the most favorable constituencies for health reform -- no surprise given how many young Americans are uninsured.

Forward Montana, the young voter organization I helped found in 2004, made health care a priority in 2007 after our members and volunteers told us loudly that the issue was a priority for them.

So what happened? The answer, based on the data, is extremely unclear. Despite disapproving of Barack Obama's efforts on health care (44-52), the reality is that young people overwhelmingly support they components of reform:

• 60% favor requiring individuals have health insurance provided low-income Americans receive assistance to help pay for premiums.
• 57% support a public option to compete with private insurance companies.
• 76% want health insurance companies to be required to extend coverage to Americans with pre-existing conditions.
• 63% favor an employer mandate.
• 59% want to fund the system through a surtax on wealthy Americans.

So where's the objection? Good question. It may be the speed with which Congress has tackled the problem. It may be that Republican misinformation is playing a role (Dick Morris is bragging about successfully turning young people agains health reform after all). It may be something else. Frankly, the data set is too limited to tell.

What do you think?

On Thursday, October 29, over 20 organizations (including my employer, Advocates for Youth) that work across the spectrum of global health advocacy and practice came together on Capitol Hill in partnership with the Congressional Global Health Caucus to offer support and recommendations for Members of Congress and the Obama Administration on how to best realize the goals of President Obama’s Global Health Initiative, announced last May with the release of his Fiscal Year 2010 budget request.

During the briefing, Rep. Betty McCollum (D-4-MN) (Appropriator and Founding Chairman of the Congressional Global Health Caucus), Rep. Diane Watson (D-33-CA) (Member of the House Foreign Affairs Subcommittee on Africa and Global Health) and Rep. Jan Schakowsky (Democratic Chair of the Congressional Women’s Caucus) spoke to their commitment to the United States’ engagement with the rest of the world through investments in global health.

Rep. Watson put this messaging in context when she noted that throughout the war in Iraq, the United States has spent approximately $15 billion per month. “You do the math,” she said, emphasizing the disparity between our expenditures on military engagement overseas and our expenditures on global health (which are by no means small, but in comparison to the military, are quite meager). Rep. Watson stressed the need for the United States to engage with the world not with a gun but with a supportive hand, noting especially the need to “train and educate young people,” while Rep. McCollum noted the need to offer young women access to education and health care services so they can make responsible decisions for their future.

These points could not be more important to note in the entire reshuffling process that’s occurring right now in U.S. foreign assistance—from the Quadrennial Diplomacy and Development Review (QDDR) at the State Department, to the President’s Study on Development (PSD) and the President’s Global Health Initiative (GHI) at the White House, to the re-write of the U.S. Foreign Assistance Act of 1961 being ambitiously undertaken in the House and Senate. With so many moving parts, all with the intent of ensuring that U.S. engagement with low and middle income countries is responding to so-called “21st-century challenges,” policy makers must seize this opportunity to engage the world’s three billion young people under the age of 25 in their efforts to make the United States’ foreign assistance have a sustainable and deeply-seeded positive impact for the long term.

The engagement of Millennials in the United States in the future direction of U.S. foreign policy and global health policy is crucial. Young people in the United States, especially students, many of whom have taken to degrees or minors in international affairs and/or global health, have been a driving force in raising the profile of global health policy and programs among fellow Americans in recent years. (See organizations such as the Student Global AIDS Campaign, Global Justice, University Coalitions for Global Health, Globe Med, among many others.)

In addition to those studying the subjects, according to the Chronicle of Higher Education, the number of American students studying abroad increased 150 percent from 1996 to 2006, and the number remains on the rise (though it has been constrained by a decreasing dollar value and increased higher education costs). Further, others fortunate to secure financial means to do so have participated in international volunteer trips and have contributed to development of healthcare infrastructure and provision of services in their volunteer work. Having been privileged enough to study abroad myself, this experience can transform one’s notion of what is “foreign,” making it clear that no matter where one was born, without health, it is very difficult to fully realize one’s dreams or one’s rights.

For many Millennials, it should be noted, these opportunities—both to study international affairs/global health and/or participate in study/volunteer/work abroad programs—are out of reach, due to any number of obstacles. And for many young people, the challenges faced by their local community—ranging from lack of access to education, healthcare, and civic engagement, among others—can be more pressing than anything beyond our country’s borders.

However, even these Millennials constitute part of the majority of young people who are making an indelible mark on the legal and philosophical and civic fabric of the U.S. approach to health policy through a strong belief in access to health care as a human right, not as a luxury good. According to a 2008 American National Election Study (ANES), “60 percent of 18- to 29-year olds support universal health care, compared to 48 percent of all other eligible voters.” In this sense, they are joining the leagues of young people around the world for whom healthcare is not perceived as a privilege, but as a right. This marks a sea change in American political thought and represents the emerging vision of the world that Millennials are building.

That vision for universal access to quality, affordable health care is the basis of the recommendations laid out by the civil society organizations at Thursday’s briefing. (The details of the briefing panel and the full report and recommendations made by the civil society group are available at The Global Health Initiative.) To date, U.S. financial contributions to global health have been larger than any other country on earth in absolute terms. Through U.S. leadership, our country has helped turn the tide in access to healthcare services, information, and education in many places on the planet.

But we have also faltered in a few ways as our global health policies and programs have evolved:

1. our policies regarding that immense funding have, in certain instances, fallen prey to petty battles for political capital usually stemming from politically controversial issues within U.S. politics—notably resulting in policies which limit provision of sexual and reproductive health care and which limit comprehensive sex education for young people;
2. global health programs are appropriated by Congress according to different issue sets and conditions such as maternal and child health, reproductive health and family planning, HIV and AIDS, neglected tropical diseases, healthcare workforce, etc. While all of these issue areas and specific conditions need particular attention, people’s lives, just like ours here, do not revolve around one health condition—and therefore we have to ensure U.S. global health programs are linked on the ground to provide integrated service delivery;
3. given the amount of money we spend engaging with low- and middle-income countries, the proportion of our funding spent on global health is but a miniscule fraction of what we spend on other efforts to engage with the world, especially the military. This does not mean military spending is not important, but that investments in global health aimed at the reduction of despair and empowerment of local individuals and communities may support and actually reduce the need for military interventions over the long term through constructing environments where people are not driven to violence for survival.

These faults are not unfixable. And in fact, a high-profile Senator from Maine said it well in reference to her vote on the proposed healthcare reform legislation in the Senate, “the consequences of inaction dictate the urgency of action.” Millennials get this. And we get that if we want our world to be more equitable, more secure, and more empowered when we’re no longer 18-29 year-olds, we have to act now to improve our policies and seriously invest in what works.

Originally posted on Amplify

Just a day after Erica Williams tried to set the record straight about young people and healthcare, we get this POLITICO piece entitled, "Young adults sit on sidelines of health debate." This title is a real shame, because the article chronicles many noble efforts by young leaders and organizations in working on healthcare reform. It's as if POLITICO came to the piece with the perspective that young people are not involved, instead of investigating the rich involvement on the ground and online. Like, the opposite of journalism. At any rate, what POLITICO may be getting at is that young people aren't visible to older Americans. Fair enough, but that's a two-way street. Erica wrote a great commentary on CNN.com, which is totally read by older Americans. She explains that young people don't want to get involved in the theater of politics.

Young people were such a vital force during the election, not simply because of their own voting turnout but because of their ability to reach out to their elders and persuade them. And what could be more needed now?

But if health care reform matters so much to young people and their voice is so crucial in the debate, why the silence? Why does it appear as if young people aren't interested in the debate that will inform so much of their future?

Well, if we are gauging America's overall interest in the debate by the aforementioned displays of partisan yelling, screaming and death panel-ing at some town halls, no wonder we think young people don't care. Those sideshows were a clear turnoff to a population that voted overwhelming for less partisanship and "drama" in its politics.

Or perhaps it is because this administration did little in the early stages of the debate to engage and activate a "fired-up and ready to go" base of young people that saw health care reform as a top concern at the polls. Obama rarely highlights the fact that reform would provide protections against price differentials that often result in discrimination based on age and gender.

As if to prove Erica's point also translates to journalism, the POLITICO article starts off with this bit:

Getting old and sick isn’t a hot conversation topic for much of generation Y, an age-phobic group that fights time with Botox, suffers quarter-life crises and actually hosts Over the Hill parties for 25th birthdays.

Does these ideas come from a national poll? A focus group of POLITICO interns? Who created Botox, anyways? And why does this characterization make no sense to me?

As we saw in the past few election cycles, young voters respond to candidates that speak about issues. I daresay that MTV/Facebook townhalls asked much more candid and pointed questions than what we've seen in the healthcare townhalls. Young people are taking the high-road, eschewing politics as usual, and doing what the American spirit does best - they are getting it done themselves. POLITICO is just adding to the theater by resurfacing memes about young people that I thought were done away with (but never will?).

Erica's last point about the Obama administration being slow to engage is true. Even while the talk coming out of Dem Congressional leadership is positive, it seems empty without action on their part. FM co-blogger Kevin once mentioned, "young people are not your free intern army," and Associate Justice Antonin Scalia said yesterday at the NCoC conference, paraphrasing Tocqueville, "In France, when there's a problem, the people go to the government. In America, they create an association." So, since our party leadership won't put the money or the time into energizing the young voter base around healthcare reform, it's a good thing Millennials are already taking up the cause.

The POLITICO article insists that there is a lack of youth energy, and the below excerpt is my favorite characterization of this point.

One D.C. health reform group representative described a recent health care policy conference where participants from youth organizations were literally falling asleep at the table.

“They’ve got a life ahead of them that seems 1,000 years long. ... They don’t believe they’re going to die. They don’t think they’re going to get sick,” said Center for Healthcare Decisions Executive Director Marge Ginsburg. “They understandably have very little health care experience to draw on.”

Ginsburg’s group tried to run a series of health reform focus groups involving 20-somethings but eventually told its recruiting company to stop taking applications.

“The fact is, they didn’t have much to say,” Ginsburg said, adding that a number of participants assumed most health care reform wouldn’t benefit them for years.

Young and old alike fall asleep at conferences, so I'll leave that aside. More to the point, there is a much more sophisticated outlook on healthcare than whether it will benefit you or not. In fact, young people know that healthcare reform will benefit them right way - their parents' health, as we learned from Roosevelt Institution's Rx Summit earlier this year. Family values are important to young people and they worry about whether or not their mother will be dropped from her insurance for a pre-existing condition or loss of employment. This issue of young people caring not just about themselves, but about their families, is something that is missing from the mainstream coverage of the health discussion. Furthermore, a youth-led group called Young Invincibles is working to combat the notion that young people can somehow do without health insurance (and healthcare reform).

Healthcare reform is full of human stories and policy details, and the point is that there are so many. Black and white frameworks don't do the discussion justice. Some journalists have fallen into that trap, or perhaps created it, restricting their perspective to their own bubble.

Many youth groups are demonstrating their great concern for HCR. Here's more: 80 Million Strong and Young Invincibles announce their partnership.

WASHINGTON 80 Million Strong, a coalition with more than 25 leading national youth organizations committed to creating new jobs and economic opportunity, and Young Invincibles, a nationwide engagement and mobilization effort aimed at involving 18 to 34 year-olds in the health reform debate, have come together to share the stories of young Americans struggling without adequate health insurance coverage.

46 stories are highlighted as part of the effort, one for every one million Americans who are uninsured.

“We know that bringing about meaningful change in our health care system requires us to confront the real stories of physical struggle and financial and emotional hardship faced by so many Americans,” said Ari Matusiak co-founder of Young Invincibles. “In advance of the President’s address to Congress, we are sharing the stories of young people who have suffered needlessly because they are uninsured, or who worry daily about losing the coverage they do have.”

According to the Kaiser Family Foundation, of the 46 million Americans without adequate coverage, young Americans ages 19 to 24 represent the highest percentage of uninsured individuals. In 2007, thirty percent of them did not have health insurance and an additional 26 percent of those ages 25 to 34 were also uninsured. Experts speculate that both of these numbers have almost certainly risen due to current economic conditions including high jobless numbers for young people.

“The state of the economy has disproportionately burdened young people – we are experiencing the highest rates of unemployment for young Americans ever. This reality, combined with already high rates of uninsurance in young adults, makes the need for a change in our health care system more important for our generation than for any other age group,” said Maya Enista CEO of Mobilize.org and co-chair of the 80 Million Strong coalition.

“We believe that a public option will not only provide access for 46 million uninsured citizens but will also spur entrepreneurship,” said Matthew Segal, the executive director of the Student Association for Voter Empowerment (SAVE) and a national co-chair of 80 Million Strong. “If young Americans do not have to depend as heavily on their employers for health coverage, they will be more inclined to start or test their own small business ventures, which in turn will create new market value and more jobs. Currently, less than 3 percent of Americans under 25 are self-employed but nearly 60 percent would prefer to be self-employed. We think this statistic is pretty telling in what health insurance reform would do to encourage free enterprise.”

Many of the stories that follow were posted on www.younginvincibles.org. They were uploaded and shared voluntarily as young people joined the online effort to mobilize in support of health reform. Membership to the site has more than doubled in the two weeks since its launch. 80 Million Strong and Young Invincibles encourage young Americans to continue to share their stories in an effort to encourage passage of comprehensive health reform.

Heather Box the Deputy Director of the League of Young Voters has a piece up on the Huffington Post I highly recommend: Young Voters Are Obama's Best Hope for Healthcare Reform.

It features Matt Singer a good friend of FM who, like many youth faced problems being uninsured.

"When Matt Singer was 19 years old he decided he needed a break from college. He left Whitman College and moved home to Montana, working part time to support himself. He was doing fine until one day when he woke up with intense stomach pain and had to drive himself to the hospital. Three hours later, after a CAT scan and blood tests, it was confirmed that Matt had a kidney stone. Young and healthy, he recovered quickly and was back at work the next day. One week later he received a $1200 bill in the mail for the hospitals services. "When I opened the bill my mouth dropped to the ground, $1200 was what I was making in a month!" says Matt Singer."

...
"A new SurveyUSA poll released yesterday shows that Singer is not alone in his call for reform. Singer's a member of the age group (18-34) that both expressed the strongest desire for reform and the strongest support for a public option. According to the SurveyUSA poll, 60% of those 18-34 support Obama's plan -- including 66% of 18 to 24-year-olds and 74% of 25 to 29-year-olds -- compared to 51% overall. "This is our generation's shot at real reform, we aren't going to let it pass us by," says Singer."

Go read the rest if you have a moment. And if you have a few more moments promote it on the social bookmarking sites like Digg, Reddit, YahooBuzz, and Stumble.

• Maegan Carberry of HuffPo argues that Obama's health care reform plans indicate the birth of millennial politics.
• The stats are in--teens aren't tweeting. Check out this theory explaining why they aren't.
• Check out another article on the tough job market for today's young people.
• Christian Science Monitor can't seem to get a grip on the context of the youth vote.
• Post-9/11 GI Bill: Providing the Opportunity Our Troops Have Earned.
• Boston Mayoral candidates are fighting for the youth vote.
• Check out this video on Textbooks4Change, an organization helping students raise money to repeal proposition 8.

• The Stimulist: Generation Y Has Grown Up.
• DC proposes Election Day Registration, targeting increase in youth vote.
• Want health care reform? Tweet your senator and share your opinion.
• Professor challenges students to disconnect themselves from social networking.
• Winograd and Hais argue that the Democratic Party's following among Millennials makes it a true majority party.

• Check out this entrepeneurship for Native American youth.
• Interesting note on government reform from Peter Levine - Congress is too small.
• The Lady Gaga Strategy: More unintentional hilarity from young conservatives. Condescending much?
• Young, minority voters surged to polls in '08.
• Reactions to Obama's press conference. What's your reaction?
• Ezra Klein on why youth should support capping the employer health-care exclusion.
• OFA Collects Health Stories. Who's Listening?

• It's Official -- Millennials Only Age Group To Increase Vote in 2008
• Winograd and Hais analyze health care reform from a generational perspective.
• E.J. Dionne discusses higher education in his latest column.
• David Brooks thinks highly of Obama's Community College Plan.

• Looking for an internship? Creative Commons is looking for an intern to work this summer
• Tamara Draut of Demos talks about youth and the economy in the NY Times.
• Find out how to turn your blog into a book
• Ta-Nehisi has a great take on the real meaning behind the 14 year old "wunderkind" at CPAC.
• How Huffington Posts's "Off the Bus" pro-am feature worked (and didn't) in reporting the campaign trail.
• 'Social Media is Here to Stay... Now What?': A great summary by Danah Boyd of her research on the growth and implications of social networks and social media. mandatory reading.
• NYT hires a Millennial (conservative) as their new columnist. Great day for youth voices in the media.
• Open Left and Daily Kos want to fund your grassroots project through a fellowship program.
• Power Shift outlines it's next steps coming out of it's 12,000 person conference and lobbying day on It's Getting Hot in Here.
• Metro Times reports on uninsured young people. It's a great article about the youth health care problem that focuses on the prohibitive costs of insurance.
• A youth movement has swept Indian politics as Prime Minister candidates target young people.
• Related Reading reports on the political involvement and reading lists of young people. Mike Connery has a nice quote in there. Very interesting read!