The youngest have the lowest levels of medical coverage and the greatest support for more taxpayer-funded health care for the uninsured.

Overall, the nation split almost right down the middle, with 48 percent favoring Obama’s plan and 51 percent opposed.

But here’s the breakdown on generational lines:

• Americans age 65 and up: 38 percent support the president on this issue.

• Age 50 to 64: 46 percent support.

• Age 35 to 49: 41 percent support

• Age 18 to 34: 60 percent support.

Americans above age 65 know that allocation of tax revenue (or, rather, borrowed money) for Medicare competes with allocation of that same money for medical spenidng for younger cohorts. They do not want competitors because they do not want benefits cuts for themselves.

I think the emphasis on expanded coverage as a first step in health care reform is a mistake. Once government is on the hook to fund more medical spending the prospects for market reforms go down, not up. My fear is that we'll evolve toward a single payer system as more employers shift toward lower cost government-provided medical insurance. A single payer system will reduce the incentives for innovations and improved productivity.

What I'd like to see as incremental improvements on the existing private medical insurance market:

• Let the self-employed deduct medical insurance premiums from taxable income just as employers do with medical insurance for employees.
• Let employees opt out of corporate medical plans to instead by portable medical insurance. One shouldn't have to lose coverage if one develops a condition and then gets laid off. Another variation: let employees optionally pay more for a portable version of the employer's medical plan.
• While they have jobs let employees save pre-tax money in an account to use to buy medical insurance when between jobs.
• Make medical policy benefits more transparent. One shouldn't have to get seriously sick in order to find out what one's medical plan covers or does not cover. Insurance companies should be required to post detailed descriptions of what they cover and do not cover.
• Allow medical policies to be written to cross state boundaries. I can understand an insurance company may want to price based on residence address. But they should be allowed to compete across state boundaries so that one can move without running the risk of becoming uninsured. Perhaps insurance companies would provide policies that have price formulas for people who move. Or a policy could cover a group of states. Some states have cost-boosting regulations (e.g. with clauses that fund psychotherapy and other things put in by assorted special interests). But some groups of states could come up with common policy rules that would enable larger insurance markets.

We need more experimentation before making large national changes because we do not know what the real costs will be for a policy first rolled out at the national level. The US government has a number of ways to experiment. For example, it has the US military health system, the Veterans Administration, Medicare, Medicaid, the federal employees medical insurance program, and still other medical programs it runs. The federal government should use these programs to try methods to cut costs and improve quality and convenience. Lead by example rather than by dictates on the rest of us.