HEALTH CARE/Joan Retsinas

New Derring-Do for Risk-Takers

A memo to all the 20-somethings who yearn to leave the humdrum routine of safety. To motorcycle helmet-less, to play beer-pong, to bungy-jump, to backpack in exotic lands, to smoke all sorts of intoxicants – in short, to lose those awful constraints of adulthood, to soar, metaphorically.

Some of you – especially men – have looked at the Affordable Care Act with horror, seeing it as yet another expense foisted on your beleaguered generation by solons of your parents’ – and grandparents’ — generations. You have done the math: so much for premiums, versus a penalty – estimated at $95 a year. You’ve calculated into the math your invulnerability. And you have concluded: Health insurance is not worth it. I’ll never need it, never use it, never regret not having it.

The arguments from your elders have fallen on deaf ears. The “pool” of insured people desperately depends upon healthy people who won’t use the services. If everybody in the pool is sick, the premiums soar. The more “non-users” in the pool, the lower the premiums. Your parents and grandparents benefit when you enroll in a plan that – with luck – you will never need. But you are thinking egotistically, not altruistically.

So you have responded with the bravado befitting risk-takers: If I don’t need to buy it, I won’t. The high premiums are my parents’ problem, not mine. Maybe I’ll buy a hybrid life-insurance policy to get around the requirement.

Soon you will need to decide whether or not to enroll in a plan.

Meanwhile, I – admittedly an elder – offer a few cautions.

The riskier your lifestyle, the more you need insurance. If you yearn to motorcycle helmet-less, to play beer-pong, etc, you risk ending up in an emergency room. Even a broken leg – x-rayed and MRIed, seen by an orthopedic physician, with follow-up visits, maybe physical therapy – can cost thousands of dollars. Backpacking in exotic lands sounds great – but cautious backpackers get all the inoculations the Centers for Disease Control recommends. Or they risk ending up with exotic diseases, like malaria, yellow fever, monkeypox.

Even if you forswear all risks, adopting an almost Calvinist lifestyle, you still run the statistical risk not just of accidents but of sickness. Consider a few plausible scenarios. A drunk driver runs into your bicycle; your appendix bursts; your fever won’t abate until you get intravenous antibiotics. The result: huge bills. Admittedly, your risk of the big killer diseases grows higher with age: at 20-something, you are far healthier than your elders. For now, time is on your side.

Yet you should calculate that chance of a hospitalization, surgery, expensive medications, even routine preventive care into your math. The expense – hanging over you for years to come – could dwarf your already-mega student loans. You could end up shackled, financially and literally, to your parents’ nest. You want to lose the awful constraints of adulthood – but you don’t really want to return to the constraints of living with Mom and Dad.

Finally, in the end, time is not on your side. As you age, you will likely develop some of the maladies that beset your parents and their parents. Eventually you will need the ministrations of physicians, the services of therapists, the wonders of medications – even if now you jog, shun red meat, and do yoga. In short, you will need a health insurance plan that you can afford – one that twenty-something non-users have signed on for.

The Affordable Act is brand new. Right-wing pundits hope that hordes of twenty-somethings say “no,” that the resultant premiums soar, and that the Act vanishes. But twenty-somethings will need this Act, if not now, in a few years.

So, to the young men pondering the math of health insurance: Listen to your mother-surrogate. Look both ways when you cross the street and sign up.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, September 15, 2013