It has become conventional wisdom that the younger generation is utterly unique because of the way it uses new technology to structure daily life. Millennials value and live a kind of individualism unavailable to their parents. They don’t buy CDs anymore; they customize their playlists. They don’t read newspapers; they personally tailor their information environment. They are no longer a gullible demographic set for marketers to target; they are sophisticated consumers whose ability to collect and compare information forces companies to compete for their business more than ever before. And so on. They are, in short, the choice generation. They are more self-directed and capable of choosing their own path than perhaps any previous generation in history. Barack Obama, as we all know, successfully engaged young people in his presidential campaign by understanding all of this.
A Pew Research Center survey released last week confirms that the single largest generational gap between young and old in the United States is on the issue of technology. More than moral values, political beliefs, work ethic, and other key issues, it’s the use of technology that makes old people seem “old,” and young people seem “young.”
This raises perhaps the most important generational question of the current debate on healthcare in the United States. How is it that the people most accustomed to personal choice in every corner of life are the most supportive of the Obama plan, which reduces the role of individual choice? Or, another way of asking the question is, why don’t younger people demand more patient-centered healthcare reforms such as those proposed by the previous administration? A CNN survey earlier this month showed that while Americans are on the whole rather lukewarm on Obama’s healthcare proposal, a majority of young people support it. And a Gallup poll in July similarly showed that Americans aged 18–49 have a more favorable view of Obama’s proposal than older groups on every issue, from costs to quality to access.
There is often a subtext underlying much commentary on the younger generation, suggesting that its grasp of individualizing technology also translates into wisdom about the marketplace of life. On the Obama plan, however, they are the least worried about the massive government ownership and organization of healthcare. They seem to support a plan that would reduce rather than expand their ability to choose the kind of plan and treatment they would receive. Why is this?
One possible explanation is that the details of intelligent healthcare reform—namely, reform that optimizes the role of choice—are too difficult to understand or haven’t been explained adequately or both.
Another is that young people place a higher value on fairness and equality than choice, at least with regard to this issue. Young people in America seem especially attracted to ideas and policies rooted in fairness, and Obama’s plan simply sounds fairer to them than what we currently have.
A third possible explanation is that choice just doesn’t matter as much in healthcare. People just want the assurance of insurance. They don’t want to shop the same way they shop for mobile phones or TVs. But they only value that assurance up until it means radical government oversight and expense, and older people simply have more experience understanding what increased government means for their own taxes and quality of life. Young people haven’t grown old enough to be so suspicious of state-run things, and therefore they may value assurance over choice pure and simple.
I don’t know the answer, and while I suspect that all three play a role, if were a betting man, I’d put money on number one. Proponents of sensible healthcare reform know that legalizing healthcare purchases across state lines, changing the tax code, limiting mandates, promoting high deductibles, and so on, are difficult to explain in clear, compelling, and simple terms.
But if the public—and especially the younger generation—understood the benefits of choice-oriented reform compared to the plan Washington is currently peddling, they might support it more readily. Something akin to the level of public awareness that has been achieved on the issue of climate change is needed if the healthcare marketplace is to look anything like the everyday marketplace anytime soon.
Ryan Streeter is senior fellow at the Legatum Institute in London.