This may sound egotistical, but lately I have been wondering if members of the national media have noticed this blog. For three months I have pointed out that forcing every person in the country onto the health insurance rolls will overburden the healthcare system, creating shortages of care and even the rationing of treatment. Then last week I heard a report on a cable network discussing health care shortages resulting from health insurance “reform” legislation. The analyst echoed my point about the massive influx of new patients, then added that doctors on the cusp of retirement likely will decide to hang up their stethoscopes rather than deal with the red tape and bureaucracy of government-run health insurance.

The country already faces a shortage of nurses, and health care insurance reform will make the situation worse. For more than a decade, American nurse placement companies have been recruiting nurses from English-speaking countries around the world, including India, South Africa, Australia, and New Zealand. The main lure to foreign nurses was the higher pay that American hospitals were able to offer.

Government-managed health care in the United States is going to level the international playing field. Fewer nurses in foreign countries will see the advantage in coming to the United States. Other nations also facing shortages of health professionals will appear as inviting or more inviting than the United States. Competition for nurses will be fierce, and the United States will not prevail as it has in the past.

The other theme I have been sounding concerns the actuarial unsustainability of health insurance reform measures. This theme also was echoed last week. The media ran reports on a study by the Urban Institute that shows that the health insurance measure passed by the House of Representatives will increase the cost of health insurance of younger adults as a way of offsetting mandates of coverage and pricing for Americans over fifty years old. For example, a single person in their twenties or thirties will see their premiums rise by as much as $1,100 a year under the House plan. The reason? Rather than following the actuarial models of private health insurance, which calculates premiums based on likely expenditures, the House bill mandates that people over fifty cannot be charge more than twice as much as younger people. This, despite the fact that people sixty to sixty-four years are responsible for five times the medical expenses as younger people.

Reflecting this actuarial reality, older Americans currently pay premiums that are four to five times higher than young people. Or, to put it another way, young people are able to get the health insurance they need at quarter or a fifth of the cost of older people precisely because they are healthier and require fewer expenditures.

The House health insurance reform bill ignores this actuarial reality. It does not allow older Americans to be charged for the share of health services they use. To keep the system from going broke before it begins, the House measure forces younger people to pick up the tab for their elders.

This is not the first program disproportionately paid for by the young. Medicare, the government-run health insurance program for those over age 65, is funded mainly through payroll taxes on the middle-aged and the young. Likewise Social Security is not funded through a lifetime of contributions, as is often thought, but rather through the ongoing payroll taxes on younger workers. If the House bill becomes law, the budget for the entire healthcare system also will be balanced on the backs of the young.

Not surprisingly, the American Association of Retired People (AARP), the nation’s largest membership organization, 40 million strong, supports this cost-shifting scheme. An odd position to take, considering the organization’s credo is “To serve, not to be served.”

The actuarial shenanigans of the House bill would not be so menacing if there were a way for young people to opt out of the insanity. The House has seen to it that scofflaws will pay a hefty fine or even face jail time if they fail to sign up. Maybe Congress thinks young people are too busy listening to iPods to notice. I doubt it. I look for this text message to go viral among younger Americans: “Note to Congress: No way, we won’t pay.”