I'm writing this in response to a post on Facebook. The discussion was the Affordable Care Act as some folks were speaking hopefully about getting insurance, others thankful they got much cheaper insurance. Then one thoughtful 20-something woman worried that her current plan is half as expensive as the new plan but doesn't meet the new requirements: "... but it has everything I need right now". I'm not presuming to know all the details of this person's life or to say that my observations are a direct answer... it just reminded me of my perspective when I was in my 20's.

It was in the early 1970's and I had my first job out of college. I was making $1.80 per hour (low even for the time) but I had health insurance as a benefit. Between my contributions and the employers it didn't take much to calculate what a rip-off it was. I was paying all that money that got me very little return. I really wished I could have that cash to live on. It was a thought, not a complaint, because, after all, this is the way things worked and there was nothing to be done.

There was another circumstance that may have been rather unique. Because the agency I worked for received federal funds and because the rules for Social Security were much different, we had the option of opting out of SS. YIPPEEEE! We got to take home that money and the agency didn't have to pay in either. Even then, there was talk that maybe Social Security wouldn't be there for us anyway, so why worry. We saw that as a big bonus, lucky us. If only we could opt out of health insurance when we really didn't need it.

By the time I was in my 30's some of the people in the agency started thinking about retirement (what's that???) and realized that since they weren't doing Social Security, maybe it would be a good idea to have a retirement plan with the same contribution schedule as SS would be. I could kinda see the value of saving and was making more than $1.80 by then, but it was still a bite. And we had a kids, so health insurance was starting to make a little more sense. Still paying more, but at least we got SOMETHING out of it.

Then we had a talk with an advisor for the retirement plan, reviewing our overall posture and drew attention to the "FUTURE". We finally started thinking a little differently. It was slow change. We were still really short on income even with both of us working and seeing the insurance costs and the buildup in our retirement plan we sure wished we could have some of that money that we "need right now". One time, we had an opportunity to tap into the retirement fund without "penalty" so we rationalized a little debt reduction. (Whew!).

Now, I'm 65. Over the years, health insurance has become more and more expensive and covering less and less. Still, we were generally paying more than we were getting... until my wife got cancer last year. Man, didn't see THAT coming. Right after that, the insurance coverage we had folded (nothing due to the ACA, mind you). I was on Medicare by then, but where was a 60-something woman with cancer going to get health insurance? Everything we need "right now" is a lot different than it was back then. She got insurance on the exchange. That will get her by until we can both be on Medicare.

Recently, I noticed something else... remember the wonderful days of not having to pay into Social Security? Now, my Social Security income will be less for the rest of my life (compared to what my wife gets). A lightbulb went on as we neared our fifties, and we started piling as much as possible into our retirement savings. Fortunately, we didn't hang on to that "right now" thinking any longer, because now it looks like we will be OK.

Paying more for health insurance now isn't exactly like putting away savings for the future... at least not on the individual level. But in the big picture, for the sake of the well-being of all of us, it really is the same. Health costs are still way too expensive and a lot more needs to be done. But the thing we are trying to do now (clumsily) is to spread the risk over a broader population (that's the purpose of insurance), stop all the hidden taxes of uninsured people in the emergency rooms and getting care too late and going bankrupt. Trying to make insurance cheap with flimsy coverage when we don't need it right now and then making it unaffordable when you do need it hasn't been working and never will.

Believe me, I understand how it was in my 20's to have to pay for stuff I didn't need "right now" when there were lots of other needs staring me in the face. Maybe, eventually, we can get to the point where we can have universal, single payer coverage like Medicare. When you turn 65 it is such a relief you can't imagine. Someday that sense of relief will be built into the culture for everyone. It's a bumpy road getting there.