There’s a quote from Dave Chase that I think about constantly:
“Imagine if a foreign country was causing this kind of collateral damage on our economy. We’d go to war in a second.”
He wasn’t talking about a military threat. He was talking about health care.
And the generation absorbing the most damage? The one just now entering the workforce, starting families, and trying to build a life in an economy that has quietly rigged the game against them.
If you’re an employer, this crisis isn’t abstract — it shows up every day as the young talent you’re trying to attract and retain. And how you structure benefits decides which side of it you’re on.
The social contract is broken
Scott Galloway laid it bare in his TED talk and essay “War on the Young”: we’ve broken the foundational American promise. Work hard, play by the rules, and you’ll be better off than your parents. For the first time in our nation’s history, that’s no longer true.
Today’s 25-year-olds earn less than their parents and grandparents did at the same age — yet they carry student debt loads that previous generations couldn’t fathom. Housing costs have multiplied far beyond wage growth. And health care? It’s become one of the single largest wealth destroyers for young working Americans.
The numbers paint a damning picture. Americans under 40 now hold just 7% of household wealth, down from 12% in 1989. Meanwhile, those over 70 control 30%, up from 19% over the same period. The federal government spends eight times more per capita on seniors than on children. We cut senior poverty nearly in half while child poverty climbed.
The United States ranks as the 10th happiest country in the world for people over 60. For people under 30? We rank 62nd.
We’ve created a future so unappealing that young people are opting out. In 1993, 60% of Americans aged 30 to 34 had at least one child. Today that number is 27%. They’re not meeting, they’re not mating, and they’re not building the families that power the economy, fund Social Security, and sustain the systems older generations depend on.
This isn’t just a cultural trend. It’s an economic crisis in slow motion.
Health care is the silent engine of this crisis
Here’s what most people miss: health care is the single biggest driver of middle-class economic erosion. Not housing. Not student debt. Health care.
Dave Chase has spent years documenting this reality. Health care is the primary reason 70% of American households have less than $1,000 in savings. Employers are spending more on employees than ever before — the problem isn’t stinginess. The problem is that every incremental dollar, and then some, has been swallowed by a health care system that operates with breathtaking inefficiency.
Health care spending is now the second-largest line item for most employers, right behind payroll. The average cost per employee has ballooned past $22,000 per year. And here’s the part that should make every business leader’s blood boil: at least 10% of that spending is estimated to be outright fraudulent, and another 20% or more is wasteful, duplicative, unnecessary, or even harmful.
Think about what that means. For a company with 100 employees spending $2.2 million a year on health benefits, somewhere between $660,000 and $880,000 is being lit on fire. That’s money that could have gone to wages, retirement contributions, or reinvestment in the business.
Instead, it disappears into a system that young employees are increasingly priced out of using — even when they technically have coverage. High deductibles, surprise bills, opaque pricing, and plan designs that punish utilization mean that many young workers are functionally uninsured despite having an insurance card in their wallet.
The generational wealth transfer no one talks about
Galloway makes the case that America has systematically elevated capital over labor. Since 1974, real median income from labor is up about 40%. The S&P 500? Up over 4,000%. Investment gains are taxed at lower rates than wages. Real estate can appreciate tax-free and be rolled into new investments indefinitely. Every structural incentive in the economy rewards people who already own assets and penalizes people who work for a living.
Health care amplifies this dynamic in ways that are uniquely cruel to young workers.
When premiums rise 7% to 8% annually but wages grow 3 to 4%, the math is simple: health care consumes a larger share of total compensation every year. Young employees who are early in their careers and earning less feel this compression the hardest. Their take-home pay erodes even as their employer technically spends more on them.