What Do Millennials Want from the Health Care System?

Originally posted on March 18, 2014

The 18-34 year old segment of our population is large, growing and important in our society. They are 80 million strong. Their attitudes, beliefs, values and actions are re-shaping the way every organization, business and institution thinks about its future.

According to a Pew Research report released last week, Millennials are independents and skeptics: 50% have no political affiliation, 29% no religious affiliation, and 19% say they do not trust established institutions to do the right things (versus 40% for Baby Boomers).

Millennials worry about money. A study by the Investor Education Foundation of the Financial Industry Regulatory Authority concluded that their concerns about their auto, credit card and school debt trump other issues.

Most think economic stability should come before marriage and family life. Half who went to college have a student loan to repay, and one third moved into the homes of their parents at some point to make ends meet.

And they worry about the future. Paul Taylor’s The Next America: Boomers, Millennials, and the Looming Generational Showdown predicts economic battle between Millennials and Baby Boomers:

“Every family, on some level, is a barter between the generations…If I care for you when you’re young so you’ll care for me when I’m old…But many Millennials won’t be able to afford that…The young today are paying taxes to support a level of benefits for the old that they themselves have no prospect of receiving when they become old.”

Pew survey data supports his contention:

  • 51% of Millennials do not think there will be any money for them in the Social Security system by the time they retire.
  • 39% believe they’ll get reduced benefits.

So what do Millennials want from the health system? Their view is likely to disrupt how industry leaders operate their businesses and how policymakers make laws that govern its commerce.

Like the economy and financial matters, their knowledge about the health system is somewhat lacking in specifics, but their opinions are rooted in three strongly held beliefs espoused by the majority in their ranks who regard them as imperatives:

Make it about health. Millennials think the U.S. healthcare system is fundamentally flawed. They believe it is purposely geared toward the sickest and oldest, and structured to profit from their treatment. They want a system of health that balances resources for the young and healthy with compassionate care for the elderly and sick.

They want a system that pays for a blend of mind-body therapies, embraces healthy food, clean air and spirituality as central elements alongside medicines, and allows individuals to make choices at the beginning and end of their lives. They want a system wherein preventive health and primary care is holistic, widely accessible, and respected as a reflection of a community’s core values.

And they believe incentives should reward healthiness in lieu of volume for procedures, testing and drugs. They see a sick care system; they want a health system.

Make it simple. Millennials approach life through the lens of the micro-communities where they live, work and recreate. They are dependent on iPhones, NetFlix, iTunes and social media, and are pre-disposed against big government, big business, big religion, big politics and big healthcare.

They want a local health care system that’s simple: paperless, treatments that are necessary and easily understood, prices that are sensible and transparent, and caregivers who listen and connect.

Most prefer to pay a reasonable single payment monthly to cover everything–no co-pays, deductibles, premiums and out of pocket for what’s not covered. And many think a single payer, government run system might be more easy to navigate than the hodge-podge of programs and plans they see at work and in their community.

Make it accessible. Millennials think healthcare is a right, not a privilege for those of means. They believe basic healthcare should be the same for all; they believe profits should be subordinate to its purpose. They want ownership of their medical record, information about the clinical outcomes and financial incentives of their caregivers, and ubiquitous access to health information through their mobile devices.

They want services that are coordinated and a solution to the menacing gaps in care for those lacking insurance. And they want an end to the intramural jousting over the future of the health system between primary care and specialty clinicians, hospitals and private insurers, Republicans and Democrats, and other warring factions.

Last week, with a group of health executives, I visited the campus of Zappos in Las Vegas where 1500 Millennials live and work operating a successful online apparel marketplace recently acquired by Amazon. Its business is a means to an end; its purpose is to create a culture of connectivity and service that rewards individual and collective efforts that make their community happier, healthier, and productive.

Its Downtown Project is not about economic development; it’s about people living together to meet common needs including healthcare.

Millennials are not a homogenous population, but their voices about healthcare seem consistent and in unison. The Zappos faithful are not too different from the ranks of their youthful peers in every community in America. They are watching the journeys of their parents and grandparents through endless paperwork, inexplicable costs, non-responsive providers and insurance that seems geared more to profit than coverage.

They know the system of care in the U.S. is better for those with private insurance than for those without, and they know health reform is political quicksand for well-intended policymakers seeking to correct its fundamental flaws.

Health matters to Millennials. They want a health system that’s different than the status quo. Those who choose to dismiss their views as naïve or ill-informed should reconsider. This generation is reshaping the landscape in our society one industry at a time. It’s likely healthcare will be among them. And their imperatives about its future will be heard.

Paul Keckley, PhD is an independent health care industry analyst, policy expert and entrepreneur. Keckley most recently served as Executive Director of the Deloitte Center for Health Solutions and currently serves on the boards of the Ohio State University Medical Center, Healthcare Financial Management Leadership Council, and Lipscomb University College of Pharmacy. He is member of the Health Executive Network and advisor to the Bipartisan Policy Center in Washington DC.  Keckley writes a weekly health reform newsletter, The Keckley Report, where this post originally appeared.

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