Thursday, June 23, 2016

Millennials Are (Not) So Different

Millennials get a bad rap.

If we believe conventional wisdom about them, they like to live with their parents, at least until they can move into their urban-center condo.  They hate to drive.  They're maddening in the workplace, demanding lots of frills and constant praise yet returning little loyalty.  They're hyperconnected through their various digital devices.  And, when they deign to think about health care, which isn't often, they want all digital, all the time.

There's some truth to the conventional wisdom, but not as much as you'd think.  A new study from Credit Karma flatly asserts that "everything you thought you knew about Millennials may be wrong," finding that they still have aspirations to much of the same "American Dream" as previous generations.  

It is true that living at home is, for the first time in recorded history, the most common living arrangement for U.S. 18 to 34 year-olds, with almost a third doing so.  However, millennials
 overwhelmingly still hope to get married and buy a house.  In fact, they accounted for 35% of home sales in 2015, and most of those were in the suburbs.  Two thirds of millennials already describe themselves as suburban.

It's not quite true that they don't drive; after all, three-fourths of younger millennials (ages 20 to 24) have drivers licenses.  However, that compares to over 90% thirty years ago.  Millennials are also buying cars at a much lower rate than previous generations. These shifts have been attributed to more online social and entertainment options, to high car prices, and to the availability of ride services like Uber.

As for those new demands in the workplace, maybe not so much.  Bruce Pfau extensively rebutted this notion in Harvard Business Review.  He cited a review of over 20 studies which concluded that "meaningful differences among generations probably do not exist in the workplace."  Their top priorities in their workplace are making a difference in their organization and in the world -- as they are for Gen X and Baby Boomers.  Contrary to popular belief, they don't even job hop more frequently than previous generations.

The hyperconnected part is certainly true.  Millennials are much more likely to have a smartphone,  and -- jawdroppingly -- on an average day they interact with it much more than with anyone else, even their parents or significant other.  No wonder they are more likely to be anxious or bored when they don't have access to their smartphones (although they're much more willing to unplug when on vacation).

Things get really interesting when it comes to health.  Millennials are often viewed as not very interested in health care, but it is the second most important social issue for them, right after education and ahead of the economy.

deep dive on millennials and health care by the Transamerica Center for Health Studies had some results that also don't necessarily fit the stereotypes:

  • Taking care of their health was tied with getting/keeping a job as their top priority.
  • 70% have been to a doctor's office within the last year, although for minor issues they're more likely to head to urgent care/a retail clinic.
  • 72% have a primary care doctor -- but only about a third expect them to coordinate all their care.
  • When it comes to getting health information, this supremely digital generation still relies most heavily on health care professionals and friends/family (especially their mothers!).
  • Having enough time with their doctor is their most important quality-related characteristic, over other features like technology .
  • While 77% rate their health care good or excellent, that is down ten percentage points from three years ago.  Half reported having some health condition.
There has been a dramatic drop in being uninsured -- 11% versus 23% as recently as 2013 -- but millennials don't like much about health insurance.  They feel much more informed about their health and how to improve it than they do about how to find health care services or their health insurance options.  E.g., 35% felt uninformed about health insurance options, versus 8% about their health.

Perhaps that is why two-thirds have never comparison shopped for health insurance.

Lastly, TCHS found that millennials rate affordability as the most important aspect of the health care system, but many don't find it affordable.  About 20% can't afford routine health expenses, even though millennials' median health expenses are under $100 per month.  Nearly half have skipped care to reduce their expenses.

Similarly, most millennials view monthly premiums over $200 as unaffordable; a third think anything over $100/month is unaffordable.  About 30% of the uninsured don't ever plan on being insured, but affordability is the problem, not invincibility.   Affordability is especially an issue for millennials because, on average, they are making less than their parents did at the same age, while struggling with record student loans.

If there is a key difference with millennials' health care, it may be in their emphasis on technology.  A report from Salesforce.com found that:

  • 76% of millennials valued online reviews in choosing a doctor, with 74% valuing online scheduling and bill payment;
  • 73% want doctors to use mobile devices during appointments to share information;
  • 63% are interested in providing data from wearables to their doctor;
  • 60% are interested in telehealth options in lieu of office visits.
Another recent survey found that 77% of millennials wanted to use technology to track their health, which was "at least" 10% more than older generations.  In fact, 55% of millennials with diabetes said they would trust a health app for advice over a health professional alone (although most said health apps actually helped them connect more often with their doctors).

It is perhaps no wonder millennials are turning to technology when it comes to their health.  They highly value face time with their doctor, but they may not be getting it.  According to the Salesforce report, 40% of millennials don't think their primary care doctor would recognize them on the street.

Many of us might suspect the same thing, and that should trouble us all.

When it comes to health care, as with many other aspects of life, it may be less that millennials are different in what they want as it is that they're quicker to adopt newer options for getting it.  The rest of us should learn from that, not shake our heads at it.

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