Saturday, September 12, 2009

Generational Inequities

The USA already has socialized health coverage. It is called Medicare; it covers 45 million people, all senior citizens. It costs around $431 billion each year, and it constitutes 57 percent of all Federal health spending. Medicare is socialized health care that no one wants to disturb. Republicans who rail against the principle of government involvement stake their criticisms well short of Medicare entitlements.

The stark difference between Medicare’s coverage and how the rest of the population’s health care is paid for is a clear example of generational inequity. Those born in good times get advantages over those born in bad times. Assume the (fictional) average American. Born in 1900, you experienced the Great Depression and the Second World War. It was only in your fifties that things began to turn around. Born in 1940 in contrast, you were carried along on the great postwar expansion of economic growth, rising incomes, and new and extended benefits. If you were white it was easy to get a job and do well. Sandwiched between tough times, those born between 1935 and 1970 are the lucky generations.

There are lucky and unlucky generations. Generational inequity really kicks in if those paying for the elderly are unlikely to see the same benefits. Older adults are advantaged because they have publicly provided pensions, healthcare, food stamps, housing subsidies, tax breaks, and other benefits that younger age groups do not. What is more, the younger groups, for a variety of reasons, including the relative decline in USA wages and incomes due to globalization, are unlikely to receive the same level of benefits. Born in 1990 you are coming into a job market in the Great Recession, with well over a generation of stagnant incomes and increasing costs. To add insult to injury you have to work to pay for your elders to have privileged health care and generous social security payouts that you are unlikely to see for yourself.

The kneejerk defense of Medicare, while millions are uninsured and underinsured, is simply one more example of an intergenerational divide. Class, race and gender have long been identified as sources of difference, advantage and disadvantage. We also need to add age to that list.