Blaming poor young people
for america's poor healthcare
by aimee rickman
The logics have been laid out. The lame contests have been waged and won. Corporate-fueled media coverage has cognitively primed the populace so that they know what to expect. When America’s attempt at nationalized healthcare through the Affordable Care Act (ACA) crashes and burns, we will all know who will be to blame: young Americans.
More specifically, it will be the fault of the “Young Invincibles,” a term arrogantly coined for this group by the insurance industry.
Disagreement exists around who, exactly, should be considered “Young Invincibles.” While some define Young Invincibles as Americans aged 18 to 29, others cast a wider net, including those up to their 40s as members of this grouping.
Giving another entity a name is an act of power. Be it generations, subcultures, or marketing target groups such as “tweens,” aggregating individuals under an assumedly common title bestows upon them a gross ideological shorthand for making sense of these individuals. Despite its roving age limits, those involved in healthcare reform using the term Young Invincibles agree upon who members of this group are. Based on their age, Young Invincibles, importantly, have few health issues. They are inexperienced, literal, and unaware of how the world works. They think that bad things will not happen to good people trying their hardest. They are optimistic about their ability to land on their feet. They trust that things work out in life. They are widely portrayed as feeling they deserve to being treated well. They are youthful and naïve.
These understandings are built upon beliefs about adolescence in this country. Considered by some to be a biological period between childhood and adulthood, adolescence is also a sociocultural, and thus intentionally people-built, framing of non-adulthood.
Much like is the case with Young Invincibles, people disagree about the age bounding of adolescence. G. Stanley Hall “discovered” adolescence in 1904 on the heels of the Industrial Revolution as concerns heightened over protecting jobs for seasoned adult workers. In his discovery, Hall, a member of the Massachusetts’ National Child Labor Committee, named adolescence a “savage, pigmoid,” and tumultuous period of inherent social unpreparedness inspired by hormonal changes of puberty.
In this new adolescence, Hall proclaimed that young people required protection from society within family and other formal adult-led institutions, such as school. While much of Hall’s framing of adolescence received debunking in the later part of the century, his theories on youth remain widely influential to psychologists, child development professionals, and policy makers. For example, Hall’s “discovery” of adolescence fueled schooling efforts in the early 1900s that launched mandatory public education laws in 1918. It also backed legislation outlawing “child labor” as codified during the Great Depression.
Public schooling and curtailed child labor are largely understood as charitable, progressive efforts. But they are also part of larger economic projects of the State spurred on by social attitudes toward those defined as young. Indeed, the ways we consider adolescents continues to influence not only their treatment, but also wider policy efforts that involve them.
Bringing us to today’s attempts at health care.
Social understandings of Young Invincibles mirror dominant narratives that circulate about adolescents in US society. These narratives continue to echo Hall’s portrayal of those termed “young” as inherently unprepared for social involvement. They add to this message, though, in also portraying young adults as ignorantly idealistic, flighty, arrogant, rebellious, entitled, strong-headed, spoiled, and self-centered. We see these types of images of young Americans repeatedly in television shows and films. They flourish in forwarded articles complaining about the many problems with “young people today” and attempting to stress (and, thus, affirm) that others are so very unlike these entitled, jobless losers.
We know these stories about youth well in our culture. They don’t surprise us. And they will continue to not surprise us when these same narratives are called upon to make sense of the ACA’s failure to provide accessible health care and improved health outcomes for poorer, sicker Americans who have lacked coverage, as well as for all other Americans.
When the seemingly radical ideas that Americans deserve to be able to access medical services and that people with preexisting conditions such as cancer and diabetes should not be denied health insurance are no longer considered practical, it will be blamed on young people’s unwillingness to pitch in.
To do so, those citing "Young Invincibles" as culpable for our country’s inability to provide care for all will overlook data finding 18 to 24 year olds struggling in the economy with unemployment rates that recently hit unprecedented highs not seen since employment statistics began being collected in 1948.
The voices blaming youth for ACA not working will not mention that the US Census reported that the poverty rate has remained at over 20% for young workers aged 18 to 24 for more than four years, that the median salary of these young workers in 2012 was equivalent to what they earned in 1982, or that the poverty rate has risen for young people aged 25 through 34 since the official end of the recession in 2009.
They will brush off studies reporting that more than 30% of American 18 to 31 year olds are attempting to save money by living with their parents, or that this country has not seen young workers moving home at rates like this since the mid-1960s.
When young people are blamed for the ACA failing, explanations will overlook the widening of economic inequalities within the US as CEOs of the 250 top corporations raked in 20% increases in their profits between 2009 and 2013 as the earnings and security of those who worked for them fell. It will not mention that the average CEO makes 354 times the median pay given to their workers, or that J.C. Penney’s CEO makes 1,795 times the rate earned by an average worker in his company.
It will not bring up that while Congress’ Securities and Exchange Commission began requiring public corporations to disclose this ratio under the Dodd-Frank law, they have decided not to address these clear statements documenting the widening gap between the rich and the poor in this country.
Those who point to the Young Invincibles as culprits will ignore the ballooning wealth of America’s top 7% of earners between 2008 and 2013 as the worth of 93% of Americans fell. They will pay little attention to the climbing profits being made by pharmaceutical companies and private insurance providers, and to giddily optimistic 2013 stock earnings and positive outlooks announced early on by health insurance giants Aetna, CIGNA, Humana, UnitedHealth Group, and Wellpoint.
These pundits will overlook the fact that insurance premiums that account for more than 10% of my family’s annual income on top of a $10,000 deductible for health care is not a welcome gift to any American. And they will overlook that the ACA was built upon the understanding that a massive number of young, healthy, uninsured (oh, and also poor) Americans who were not likely or able to buy insurance must pay into the plan in order for the whole scheme to work, and for it to avoid going into a well-publicized “death spiral” that comes complete with its own vibrant imagery.
When this feeble stab at healthcare fails, none of this will matter to those who are hired to give us the news about our realities.
When US citizens are forced to pay high premiums to receive mandatory healthcare coverage, the high fees will be attributed squarely to young people. When policies involving huge deductibles on top of monthly payments are presented as reasonable, this logic will center around the failure of young people to want to help the rest of us. When the quality of care in this country does not improve under the Affordable Care Act, the reason given will not be the poor and nepotistic planning done by the ACA architects who are supposed to represent us. Those who explain the eventual, and certain, failure of “ObamaCare” will speak little to its origins as Massachusetts’ Republican “Romneycare” plan, to the unchecked profits earned by healthcare providers given permission to charge what they will for required coverage, or to the lobbyists whose pressure removed the public option from the table early on in health care deliberations. It will not be attributed to any of these things.
No. These topics will not be raised, as they call attention to structural issues outside of the individual that impact our lives. And, if Americans are taught to do anything, we are taught to work hard and to believe we are all given a fair shake at winning the game. We do not think about capitalism, economics, and power in US society. But we do think a lot about youth. And acknowledging that young people are unreliable and fallible while pointing to them as a tangible source of our problems in life? That’s about as American as it gets these days.
The ACA’s expectation for young people’s buy-in is severely out of touch with economic and social realities experienced in the US. But this will not matter in the meltdown. Massive amounts of Americans under the age of 40 will not purchase mandated health care coverage in 2014 because of economic inability. When asked, some will explain their inaction as directly guided by fiscal constraints. But, most others, well-versed in America’s belief in classlessness and in bootstrapping, will cite more obtuse reasons silently inspired by pride and a fear of being seen as poor, such as disinterest or even rebellion. Whatever the reason, Young Invincibles’ failure to purchase healthcare through the Marketplace will fulfill deep-seated expectations we have been taught to hold about adolescents: they are narcissistic, self-centered, unreliable, and, thus, unprepared and unfit for societal involvement. This will be enough explanation needed for most people to make sense of this national crisis.
When the ACA dies, it will be blamed on the unwillingness of Young Invincibles to be team players and, once again, on their inability to prove that they are able to be adult enough to think about anyone other than themselves.
We won’t be surprised when young people are blamed for our country’s continued refusal to provide its citizens with health care. And for that, we will all continue to lose.