Poor Mojo's Newswire

CNN released a poll this morning showing that 50% of Americans support President Obama's health care plan while 45% oppose it. On a challenge this big those actually aren't bad numbers, though the intensity does seem to be leaning toward the opposition. But the more interesting numbers were below the toplines. There's a generational divide hovering around the age of 50, with most people younger than 50 supporting the president and those over 50 opposing him. It's an interesting number since -- not to put too fine a point on it -- people over 50 are disproportionately people who already have guaranteed single-payer government health care. Why that would be is a whole other question in itself. But my sense is that this is less a matter of experiences with health care per se than it is a 'mapping' onto the health care debate of the generational divide that characterized the 2008 election.

Half of the insured population uses virtually no health care at all. The 80th percentile uses only $3,000 (2002 dollars, adjust a bit up for today). You have to hit the 95th percentile to get anywhere interesting, and even there you have only $11,487 in costs. It’s the 99th percentile, the people with over $35,000 of medical costs, who represent fully 22% of the entire nation’s medical costs. These people have chronic, expensive conditions. They are, to use a technical term, sick. An individual adult insurance plan is roughly $7,000 (varies dramatically by age and somewhat by sex and location). It should be fairly clear that the people who do not file insurance claims do not face rescission. The insurance companies will happily deposit their checks. Indeed, even for someone in the 95th percentile, it doesn’t make a lot of sense for the insurance company to take the nuclear option of blowing up the policy. $11,487 in claims is less than two years’ premium; less than one if the individual has family coverage in the $12,000 price range. But that top one percent, the folks responsible for more than $35,000 of costs – sometimes far, far more – well there, ladies and gentlemen, is where the money comes in. Once an insurance company knows that Sally has breast cancer, it has already seen the goat; it knows it wants nothing to do with Sally.