‘Invincible,’ uninsured

Despite what the Census Bureau reported last month – that the numbers of uninsured Americans fell slightly between 2006 and 2007 to about 46 million – the health care access picture, to say nothing of its quality and cost, is bleak. The report, for one, did not take into account the economic downturn.

That aside, one of the fastest growing and largest groups of uninsured is the “young invincibles,” individuals between the ages of 19 to 29. This is a group that numbers 13.4 million.

While college students are the subgroup most likely to be insured – under parents’ plans – they eventually become college graduates. There the picture gets ugly, as only about half, by one study, are eligible for coverage through work.

The term is misleading, too. Surveys have found that contrary to the implication, “young invincibles” do not necessarily forgo health insurance by choice but are forced to because of cost.

Perhaps the moniker “young indifferent” is more apt. Except for a dreaded STD, a drunken visit to the ER or an unplanned pregnancy, most probably don’t think too much about getting sick or requiring a great deal of health care services.

The uninsured still get care, via emergency rooms for one. But such care can be expensive. When bills remain unpaid, the rest of us pick up the tab, in the form of still higher premiums and fees. Thus even if insurance status seems an incomplete measure of access, the numbers certainly still matter.

The Institute of Medicine’s conclusion following a study on the uninsured: They get worse care and die earlier. One study estimated that up to 18,000 adults die prematurely every year from lack of insurance.

It is true that our age group tends to be the healthiest, but salaries tend to be lower, too. And consider this: One study found that uninsured automobile accident victims – young people are particularly susceptible to such unpredictable traumas – were 37 percent more likely to die as a result of their trauma.

Some of the causality is admittedly murky, but the associations are pretty clear, common sense even.

But such associations – even the economic implications of an unhealthy workforce – are not nearly as troubling as the apparent belief that the criteria for determining those who get quality care – or care at all – is purely and disconcertingly economic in nature.

This criteria works well enough with cars and televisions, but health care is no consumer product. The way we decide to answer the question of who gets help in preventing and curing disease reveals the mechanisms by which we appraise human life.

Among others, those of you who are preparing to graduate and enter the workforce with your insurance status up in the air, reform debates no doubt already had your ear. Or they will very soon. And unless the rest of us are OK with the idea that only certain people should get help in staying healthy, maybe they should have our ears as well.