If you’re a boomer parent, there are likely to be many areas in which you and your millennial children just don’t see eye to eye.

Although you’re both part of the two largest generations in America, the age gap between you means that historical events have influenced you in very different ways. With the youngest millennials now at 18, and the oldest boomers at 69, finding common ground can be a difficult thing to achieve.

However, that doesn’t mean that contemporary issues don’t have a significant impact on you both—like healthcare policy. It can be difficult enough for members of the same generation to understand each other’s views on this hotly debated topic, let alone those with such an age gap between them.

The good news is that history is a great teacher, and can be used to help you understand your children’s views on healthcare. To do that, we’ll tap into a generational Guide to Healthcare Conversations created by MPH@GW, the online Master of Public Health program from the Milken Institute School of Public Health at George Washington University.

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The Influence of Demographics

Demographics play a big role when it comes to influencing healthcare opinions—as well as the social, political and economic climate that exists at any given time.

For instance, although you weren’t yet born when the Great Depression hit, your parents were probably raised in communities plagued by unemployment and poverty. These dynamics engrained a keen sense of fiscal responsibility in many of that generation—as well as a determination never to live that way again. Both World War II (1939-1945) and the Korean War (1950-1953) affected them as well, separating families and requiring many sacrifices to make ends meet.

On the heels of WWII, the earliest members of your generation started to emerge from their mothers’ wombs. Born between 1946–1964, Baby Boomers have been indirectly impacted by the events previously mentioned—and directly impacted by some of the most influential events in American history, including:

• Executive Order 9981—which abolished racial discrimination in the U.S. Armed Forces (1948)
• The U.S. Supreme Court’s ruling that segregation in public schools was unconstitutional (Brown v. Board of Education, 1954)
• The beginning of the modern civil rights movement (1955)
• The Vietnam War (1955-1975)—for which many Boomers were drafted.
• The passage of the Equal Pay Act to support gender equality (1963)
• The passage of the Civil Rights Act (1964)
• The passage of the Voting Rights Act that prohibits racial discrimination in voting (1965)
• The U.S. Supreme Court’s support for interracial marriage (Loving v. Virginia, 1967)
• The passage of the Equal Rights Amendment (1972)

If you see a common thread, you’re likely right. Many Boomers embrace empowerment and equal rights—and your influence has impacted the generations after you, including your millennial children. The birthdays for this now-largest generation span 16 years—from 1981 to 1997. Here are some of the important events that influenced them during this time and the years after:

• The appointment of the first female Supreme Court justice—Sandra Day O’Connor (1981)
• The invention of the World Wide Web (1989)
• The collapse of the Soviet Union and end of the Cold War (1991)
• The attack on the United States on its homeland (Sept 11, 2001)
• The beginning of the Iraq War (2003)
• The beginning of the Great Recession (2007)
• The repeal of “Don’t Ask, Don’t Tell” (2011)
• The removal of the ban on women in military combat (2013)
• The U.S. Supreme Court’s decision to give same-sex couples the right to marry (Obergefell v. Hodges, 2015)

As evidenced by these landmark events, the members of the millennial generation have spent their formative and young-adult years witnessing the transformation of the world in very significant ways: a long-time foe transformed to friend; the vulnerabilities of its nation exposed; re-entry into war for the first time in over two decades; the melting of an economy; new rights for women and members of the LGBT community; and a new paradigm for living enabled by the Internet.

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The Influence of Major Healthcare Policies

In addition to demographical, political and social dynamics, major health policies that were created throughout past decades may also contribute to generational differences of opinion. Policies in existence prior to the emergence of a generation create certain expectations. For example, your generation grew up with the benefits of Social Security already in place, but your parents struggled through the need for which it was created.  

The same holds true for millennials. The policies that your children view as the norm have been created by issues that your generation struggled through—and their generation is experiencing a similar dynamic. If you’re locking horns over healthcare policy, consider the context of the policies affecting each generation to better understand your child’s point of view:

Baby Boomers (Born 1946-1964)

• Existing policy: establishment of the National Institute(s) of Health (1930)
• Existing policy: passage of the Social Security Act (1935)
• Passage of the Hill-Burton Act to fund the construction of health care infrastructure (1946)
• Formation of the Joint Commission on the Accreditation of Hospitals to improve the quality of health care delivery (1951)
• Passage of the Dependents’ Medical Care Act, providing health care for wives and children of active-duty members of the armed forces (1956)
• Creation of the Federal Employees Health Benefit Plan (FEHBP) to provide health care coverage to all federal workers (1960)
• Implementation of the Migrant Health Act, the first federally-funded primary care program (1962)

Millennials (Born 1981-1997)

• Existing: The Supreme Court legalizes abortion (Roe v. Wade, 1973)
• Existing: The National Medical Care Expenditure Survey provides the first detailed data on individuals’ health care costs (1977)
• Existing: The Pregnancy Discrimination Act bans employment discrimination against pregnant women (1978)
• The Emergency Medical Treatment and Active Labor Act requires hospitals participating in Medicare to screen and treat anyone with emergency medical conditions, regardless of ability to pay (1986)
• COBRA allows employees who lose their jobs to continue with their health plan for 18 months (1986)
• The Health Insurance Portability and Accountability Act sets standards for medical records privacy and creates the ability for American workers and their families to transfer and continue health insurance coverage when they change or lose their jobs (1996)
• The Mental Health Parity Act mandates that insurance companies must treat mental health conditions the same as physical health conditions (2008)
• The Patient Protection and Affordable Care Act (ACA) is signed, requiring that all individuals have health care insurance by 2014 (2010)

 A common thread for healthcare policies created in the millennial generation relates to better access and more ease of portability for healthcare coverage. Bottom line? Millennials typically want to be empowered, informed, and free to make their own choices about employment and their healthcare coverage. Since boomers are often of a similar mindset—this may be common ground the two of you can share.

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Presidential Influence

Throughout the generations, healthcare policy is largely shaped by the presidential administration that’s holding office at any given time.

During the years that the Baby Boomers were being born, there were three different presidents in office: Harry S. Truman (1945-1953); Dwight D. Eisenhower (1953 to 1961); and John F. Kennedy (1961-1963). They influenced healthcare policy in the following ways:

• President Truman’s administration focused on healthcare infrastructure and quality;
• President Eisenhower’s administration focused on the healthcare needs of military families and federal workers; and
• President Kennedy’s administration focused on the healthcare needs of immigrants.

In the years following:

• Lyndon B. Johnson’s administration (1963-1969) focused on the development of Medicaid and Medicare;
• Richard M. Nixon’s administration (1969-1974) declared a “war on drugs” and supported health planning and resource development;
• Gerald R. Ford’s administration (1974-1977) supported transparency in healthcare costs; and
• Jimmy Carter’s administration (1977-1981) supported the rights of pregnant women in the workplace.

During the years that the millennials were born, there were three presidents in office: Ronald Reagan (1981-1989); George H.W. Bush (1989-1993); and Bill Clinton (1993-2001).

• The policies of the Reagan administration provided access to emergency care for all; transitional healthcare coverage after the loss of a job; and enhanced benefits for Medicare beneficiaries.
• The polices of the Clinton administration created standards for medical records privacy and the ability to transfer and continue health insurance coverage with a job change or loss.

In the years following:

• George W. Bush’s administration (2001-2009) increased access to primary health services; created a subsidized prescription drug benefit under Medicare; and supported a mandate to improve mental health care.
• Barack Obama’s administration (2009-2017) expanded insurance coverage and implemented an individual mandate to obtain it through the Affordable Care Act (ACA).
• Donald Trump’s administration (2017-present) continues to attempt to repeal and replace the ACA.

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Using History as a Tool

Although you may have difficulty understanding your children’s views on healthcare, history can help. Using it as a tool to gain insight into each other’s perspectives can enable productive and intelligent conversations about healthcare, while enhancing family communication. 

As a parent, it can help you to empathize with your kids—while providing insight into how future generations may approach healthcare in the years ahead.

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