Tuesday, January 27, 2015

"Noah's Dad" and What To Do About Down Syndrome

Trolling around Facebook -- as I'm apt to do when the crazy gets too crazy around here, I came across a woman's advice to abort prenatal children diagnosed with Down Syndrome. She was upset by this post by Rick Smith, a popular blogger and father of a son with Down Syndrome. Here's her letter:

"Just visited your site where you tell doctors how to deliver a Down diagnosis.

How dare you! You are obviously a right-wing neocon born-again determined to force your religion down the throats of others,

I have 2 normal children but, if one of them would be born with birth defects, I would have had an abortion and felt no guilt at all. To bring a child like that into the world is ridiculous and cruel. Some of them may be capable of leading a life and being self-supporting but most will not.

The reality is that such children will be a burden on taxpayers who have to foot the bill for irresponsible parents who refuse to do the right thing and abort the fetus ASAP.

I'll bet you are a conservative who hates big government and paying taxes yet have no qualms about taxpayers footing the bills for your child. Shame on you.

Obviously, I am pro-choice. Nobody has the right to force a woman to use her body as an incubator where she unwillingly donates her bodily organs for 9 months against her will and there is no reason to make her feel guilty about terminating a pregnancy.

I have never had an abortion but have gone to clinics with others who wanted to terminate a pregnancy. None of those women has ever regretted their decision and they have gone on to marry and have children when they were ready to do so.

Your attitude and attempt to influence a woman to give birth to a child who will be a burden on her and taxpayers for it's entire life is disgusting.

Why don't you focus on aid for single moms and feeding the children who are going hungry in this actual country instead of promoting ideas and theology that place a huge tax burden on the entire country. Does it not make more sense to pay for the needs of the children already here than to drag the country even into more debt by having children who will be a never-ending burden to taxpayers.

I am sorry about Noah. I'm glad you are happy to have him. However, in reality, he will probably never be self-sufficient and, after you and your wife are gone, he will be a burden to his siblings or to the taxpayers (or both) during his entire lifetime."

Wow, classy, right? To send that to the parent of a child with Down Syndrome? 

So my first thought was to dismiss all of her arguments based solely on their inclusion in such a poorly written letter. But I recognize not everyone believes ethics and grammar to be so closely linked. (No? Just me?) 

So here we go.

1. On calling people "tax burdens": 

This woman seems very pre-occupied with the idea of sweet Noah being a "tax burden," which I deduce to mean from her derogatory letter as someone whose life involves tax-payer-funded support. I wonder if she realizes that if she has gone to public school, even participated in classes for the gifted and talented, driven on public roads, visited public libraries or parks, or enjoys the safety of calling 9-1-1 in case of an emergency, then she also is a "tax burden." Shall we have aborted her?

2. On her willingness to abort one of her own children, if they had birth defects: 

It's too bad she doesn't live in Canada, where if she missed a birth defect diagnosis in utero, she could probably still chuck the newborn out a hospital window, if it weren't pretty enough. Actually, that's not fair. Her actual criteria for valuing a person's life is that they are "capable of leading a life" and "being self-supporting." Is there a timeline for being self-supporting? Does this need to happen, like, from birth? Or say, by the time they graduate college? (If so there are some delayed adolescents who should probably sign up for the receiving end of a firing line. I'd be first up.) What if someone loses both arms in a machine at their job, and can no longer be self-supporting? Shall we replace whatever government office processes disability claims with these sweet ladies?

The leading ladies in "Arsenic and Old Lace" invite lonely old men over for tea. They think the men must be miserable from their unfortunate circumstances of being both old and presumably lonely, so the aunts poison their guests' tea and bury the bodies in the basement.
3. On her "obvious" position as "pro-choice": 

I'm not sure her position is as obvious as she thinks. It seems she's as adamant to convince moms of special needs babies to drop-kick them to the curb (or just kill them in utero, whatever) as militant anti-abortion advocates are to tie up poor pregnant women till birth and then abandon them with no income, no healthcare, and a newborn. So she's right to point out there's a need to focus on aid for single moms (maybe married moms and single dads too?) and feeding hungry children, but it's a fallacy to believe being pro-life and anti-poverty are mutually exclusive. I'm sorry shitty right-wing politicians have made it appear otherwise. There are a great many of us who want both quality of life for moms and life for children in utero, and we believe both are possible.

4. On people with Down Syndrome being a burden to their families: 

Well, geez, who isn't a burden to their families? Shall we abort the little girl who might become the crazy aunt? Or the little boy who will become an elderly man? Or perhaps we could just kill the kid who talks too much, because they'll drive everyone crazy on family road trips. I wonder if she realizes (probably not) that she's the overly-opinionated mean lady in her family, who thinks she knows best about everything, even to the point of who should live and die, and maybe -- maybe not, but maybe -- her family considers her a burden. I hope they love her anyway and invite her to Christmas.

Wednesday, January 21, 2015

SOTU 2015

Below are the thoughts that went through my head during President Obama's State of the Union address. The president's remarks are in red. My thoughts are in blue. 

Seven years ago, Rebekah and Ben Erler of Minneapolis were newlyweds... They were young and in love in America, and it doesn't get much better than that.


Our high school graduation rate has hit an all-time high. And more Americans finish college than ever before.

But higher education has never been more irrelevant to success in America than it is today. A high school diploma or college degree doesn't really mean anything.

We've seen the fastest economic growth in over a decade, our deficits cut by two-thirds, a stock market that has doubled, and health care inflation at its lowest rate in fifty years.

The stock market doubled, but retirement funds weren't magically re-filled. Health care inflation is at its lowest rate in 50 years? No way. I don't believe it. I just paid $25 for a single dose of Miralax at the hospital.

We know that more small business owners plan to raise their employees' pay than at any time since 2007.

I'll believe it when I see it.

Like millions of hardworking Americans, Rebekah isn't asking for a handout, but she is asking that we look for more ways to help families get ahead.

Yes. To take it one step further, we're not even looking for ways to get ahead; just staying afloat will be fine.

During World War II, when men like my grandfather went off to war, having women like my grandmother in the workforce was a national security priority – so this country provided universal childcare.

1. Your grandfather was in WWII? Cool. I didn't know you had military service in your background.

2. Our country provided universal childcare? Really? I hate that war is a greater motivator for social programming than just the existence of basic family needs.

Today, we're the only advanced country on Earth that doesn't guarantee paid sick leave or paid maternity leave to our workers.

I've stayed home several times, without pay, to care for a sick child. It kind of sucks all around. I've also had 4 babies without paid maternity leave. And Wally's gone back to work within 24 hours of each birth (within two hours of the last one), since he works at a job without paternity leave. We did the old-fashioned thing of saving up money before each birth and then living off of it. But paid sick days or provision for medical leave would have been nice.

Send me a bill that gives every worker in America the opportunity to earn seven days of paid sick leave.

You can't legislate being a decent employer. Businesses will find a way around anything, just like they did with the Affordable Care Act. Mandatory health insurance for employees working 30 hours or more? Cut them back to 29 hours a week. (We have personal experience on this one.)

The problem isn't full-time employees not having enough benefits. The problem is employers using part-time and contract employees to avoid having to provide any benefits. Even if legislation is passed that guarantees full-time employees seven days of paid sick leave, it's not going to help the low-wage positions that actually need this benefit.

And to everyone in this Congress who still refuses to raise the minimum wage, I say this: If you truly believe you could work full-time and support a family on less than $15,000 a year, go try it.

For real.

We'll still need more employers to see beyond next quarter's earnings and recognize that investing in their workforce is in their company's long-term interest.

Yeah, I'm tired of this "small businesses can't support all this bureaucracy" bullshit. It's not crazy to expect those who benefit from the good work of others to ensure a decent life for their workers. I watched the president of our company take international vacations with his extended family every year, spend hundreds of thousands in renovations on their second home, and still refuse a wage increase to employees.

That's why I am sending this Congress a bold new plan to lower the cost of community college – to zero.

I agree that skills training is needed for more jobs than ever. And high school isn't adequately preparing people. I like that this initiative would be open to people of any age and income. There's still much that needs to happen to improve our current education system.

And as a new generation of veterans comes home, we owe them every opportunity to live the American Dream they helped defend.


Tonight, I'm launching a new Precision Medicine Initiative to bring us closer to curing diseases like cancer and diabetes – and to give all of us access to the personalized information we need to keep ourselves and our families healthier.

Wait, what? He might as well have said, "And tonight, I'm launching a new Traffic Magic Machine to help us stop rush hour and give all of us everything we need to be. Next topic."

Um, anything else on what this is, how it works, what it actually means?

In two months, to prepare us for those missions, Scott Kelly will begin a year-long stay in space. Good luck, Captain – and make sure to Instagram it.

Ha-ha, cool. I'm kind of ambivalent about further spending on space, but NASA gave us disposable diapers, which have made a tangible difference in my life. So, carry on, carry on.

But for far too long, lobbyists have rigged the tax code with loopholes that let some corporations pay nothing while others pay full freight. They've riddled it with giveaways the superrich don't need, denying a break to middle class families who do.

Argh. For real. I'm not actually looking for more tax breaks for the middle class. I'm really okay with paying taxes. But when I'm paying a higher percentage than corporations and the super-wealthy, it sets me off. Let's fix the tax code.

When the first response to a challenge is to send in our military – then we risk getting drawn into unnecessary conflicts, and neglect the broader strategy we need for a safer, more prosperous world. That's what our enemies want us to do.

I believe in a smarter kind of American leadership. We lead best when we combine military power with strong diplomacy; when we leverage our power with coalition building...

Yes, thank you.

In Cuba, we are ending a policy that was long past its expiration date. When what you're doing doesn't work for fifty years, it's time to try something new.

Awesome! Yes! It's about time!

In West Africa, our troops, our scientists, our doctors, our nurses and healthcare workers are rolling back Ebola – saving countless lives and stopping the spread of disease. I couldn't be prouder of them, and I thank this Congress for your bipartisan support of their efforts.

Yay for bipartisanship! (cue patriotic music in my head)

That's why we defend free speech, and advocate for political prisoners, and condemn the persecution of women, or religious minorities, or people who are lesbian, gay, bisexual, or transgender. We do these things not only because they're right, but because they make us safer.

It's okay if we only do these things because they're right.

Since I've been President, we've worked responsibly to cut the population of GTMO in half. Now it's time to finish the job. And I will not relent in my determination to shut it down. It's not who we are.

I like that. "It's not who we are."

We still may not agree on a woman's right to choose, but surely we can agree it's a good thing that teen pregnancies and abortions are nearing all-time lows, and that every woman should have access to the health care she needs.

Yes, absolutely. Even on the opposite side of this issue from President Obama, I can whole-heartedly agree with this. Way to find common ground.

Yes, passions still fly on immigration, but surely we can all see something of ourselves in the striving young student, and agree that no one benefits when a hardworking mom is taken from her child, and that it's possible to shape a law that upholds our tradition as a nation of laws and a nation of immigrants.

It might just be the post-partum hormones, but this made me tear up. I love the idea of opening our arms to everyone looking for a better life in America.

I have no more campaigns to run. My only agenda for the next two years is the same as the one I've had since the day I swore an oath on the steps of this Capitol – to do what I believe is best for America. If you share the broad vision I outlined tonight, join me in the work at hand. If you disagree with parts of it, I hope you'll at least work with me where you do agree. And I commit to every Republican here tonight that I will not only seek out your ideas, I will seek to work with you to make this country stronger.

Well-said. I hope it's not just more politic-talk, and they can actually get stuff done.

I want our actions to tell every child, in every neighborhood: your life matters, and we are as committed to improving your life chances as we are for our own kids.

Let's speak this to the children in every womb also. Get women the support and resources we need to care for the children we conceive. Don't make us choose between killing our babies and economic stability.

It got long-winded with all the obligatory soliloquies in closing. But who am I to judge for being long-winded?

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Monday, January 19, 2015

Am I Raising My Kids Catholic, Just As An Attempt To Have "Good" Kids?

I read this article in the LA Times, and had to ask myself, am I raising my kids Catholic, just as an attempt to have "good" kids? 

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Phil Zuckerman writes that kids of a secular upbringing are just as likely as their religious peers (if not more so) to become upstanding, moral citizens. Not only that, but their parents are portrayed as even more committed to helping their children understand right from wrong: 

- Vern Bengston, a USC professor of gerontology and sociology
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I hope I don't sound too surprised by this. Plenty of my kind, moral, non-religious friends can prove the whole Catholic thing isn't even necessary to have nice kids who make good decisions. 

According to Zuckerman's article, secular kids are actually more empathetic to others, ironically acting from a better internalization of The Golden Rule than their self-identifying Christian counterparts. And recalling my own high school experience, I can agree. My religiously unaffiliated friends were down-to-earth, genuine, and just plain likable. So what's with all our Sunday morning services and prayers before meals and family rosaries and Bible studies? (Besides the somewhat relevant issue that our kids just really enjoy that stuff.) 

There's something to be said for participation in a community of shared values. But tying morality to a single group of people is also dangerous, because all it takes is the crappy experience of a clique-ish youth group, yuppie parish, or dysfunctional family (aren't we all?), for someone to throw good values out with the fallible community to which they're affiliated. 

As one parent was quoted by the article: 

“If your morality is all tied in with God... ...what if you at some point start to question the existence of God? Does that mean your moral sense suddenly crumbles? The way we are teaching our children … no matter what they choose to believe later in life, even if they become religious or whatever, they are still going to have that system.”

Some might say, if the primary purpose of religion is to influence people to treat each other decently, then it can fade away into irrelevance, since secularism (arguably) has that covered. 

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Zuckerman refers to morality as a loosely-defined sense of treating others well, more than holding any particular positions on specific issues. And truthfully, if we could follow the OT prophet's advice, that God would rather we treat each other mercifully above anything else, then maybe all those other issues would stop being such, well, issues

The "seamless garment" concept of morality believes that every person, whomever from wherever doing whatever, has an equal value. It throws out ideas that healthcare is only for the rich, or violent crime is okay as long as it's in poor neighborhoods or third world countries. 

This description of Catholic morality* is rooted in the idea that God created people as inherently very good, so a person's worth is not dependent on their tangible skill sets. (Can they speak well? Did they attend a good school? Are they athletic? What is their earning potential? Can they breathe on their own? Are they attractive? Can they move their legs?)

But I don't think making moral choices, in and of itself, is the end purpose of life (though it might make for easier eulogies). I want my kids to live moral lives, because I believe it mirrors God. It's an opportunity for them to experience God in their everyday lives.

To treat others well, is to recognize their worth as God sees his creation. To choose the good of another, even over my own convenience or desire, is a participation in how Jesus loves humanity. 

So yes, I hope raising our kids in the Catholic Church will help them be "good" kids -- kind, generous and considerate, in general, moral. But ultimately, it's not the reason we show up for Mass each week. 

My hope in raising our kids Catholic is that they will experience and love the mystery of God incarnate among us. And then live out this encounter in their lives.

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*When I refer to Catholic morality,  please let me clarify that I refer to the teachings within Catholicism itself, not to any inherently secular political party that presumes to represent those teachings. 

Sunday, January 11, 2015

Salt Lake City! And Southern Utah! And Hey, The Grand Canyon Is Kind Of Close!

Salt Lake City was not anywhere on our bucket list of places to visit.

We had two free airline vouchers and a vacation window in mid-June, so I called American Airlines about six weeks in advance to check flights. Our comp tickets were the lowest of the low, because even with the availability to fly any time, any day of the week, we couldn't get to a single airport along the west coast, near any national parks in the northwest, not one of twelve airports serviced in Florida (TWELVE), and nothing along the eastern seaboard.

So three days and four phone calls and an hour and a half later on the phone with several American Airlines reps (the only way to book with these vouchers), I finally reached an agent who was as intrigued as I was frustrated by the challenge to get us on a flight to anywhere. She checked at least a dozen destinations without success, before throwing out, "Salt Lake City? I have two seats on a Wednesday morning flight, and two more seats to return a week later." 

We'll take it.

So two baby-mooners on a budget (twins due in 4 months), we booked a couple nights at a ski lodge in southern Utah ($65/night) followed by a super-cheap hotel room in Salt Lake City ($45/night) via Groupon. The ski lodge was beautiful. The super-cheap hotel room was under construction and under-staffed, and a little out-of-the-way, but safe, clean, and included complimentary "breakfast." A rental car for the week came to about $100, including taxes and fees.

I was so sold on Salt Lake City's low cost-of-living that I asked Wally to apply for jobs in the area. (Nothing's come up yet.) As it turns out Utah has a lot more to offer than just living on the cheap.

The more I researched stuff to do, the more convinced I was that we should just move there. It's an outdoor, active culture with family-friendly everything.

Park City Olympic Park

This is the site of the 2002 Winter Olympics.

Ski flying looks even more terrifying in person, staring down from the top of the launch. (Each ski lines up in one of those green tracks. See the video below of people with steep life insurance policies.)

We stopped to watch a summer kids camp practice freestyle ski jumping into the pool. This is when I realized that kids in Utah are in a totally different culture than our pampered little Texans. Sure we have summers of horseback riding, hiking, and swimming. But these 8-year-olds are strapped in full-on ski suits jumping into a pool deep enough to drown, and then swimming to the edge with three-foot-long weights on each foot.

Wally took a chair lift up to the top of the hill and zip-lined back down over the ski jumps. And then he got to ride in a bob sled. It all looked really cool, but being pregnant (with twins) meant I was stuck at the bottom listening to strangers' tell all their twin horror stories.

Downtown Park City 

Luckily, we visited their line-up of expensive Main Street shops during a cold rain, so after $12 sandwiches, we squinted and speed-walked our way back to the car, and the trip stayed on budget.

Grand Canyon National Park

This was straight-up terrifying. Never, ever, ever, ever, ever take your children here. Maybe occasional 3-foot chain link fencing was acceptable in 1919, but there's been a bit of erosion since then, and someone gets paid really well to bury stories like this.

Okay, truthfully, it was stunning. Grander than I expected. And the views from the restaurant on the north rim were beautiful.

Nonetheless, I'll never take our kids there. Because I love them.

Interestingly, even though the canyon is only 10 miles wide, it's a 220-mile drive from one side of the canyon to the other. So driving south from Utah, we tried to meet up with my brother, who lives in Flagstaff, Arizona, on the south side of the Canyon, but it was just too far to drive.

Brian Head 

Ski resorts in the summer are super-cheap, and we found a good deal on Groupon that came with a living room, kitchen, large bathroom, and bedroom. The on-site coffee shop, restaurant, and spa are open year-round, and there's lots of great hiking. For homebodies from Dallas, the views were stunning.

Bicycling is really popular on these winding, narrow mountain roads in southern Utah. But no one values the lives of cyclists very much (neither the drivers nor the cyclists). Every encounter turned into a game of chicken as we drove, with a tailgating SUV behind us and cyclists attempting to hold their own as we shared a lane of traffic on the freeway.

Speed limits are just suggestions. I think once the snow melts, it's just a free-for-all. Also, most 18-wheelers in Utah look like this, with extra trailers in a train behind the first:

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The scariest driving moment for me was a section of road with snow melted across half of it. This twenty-foot patch in the shadow of a mountain had me absolutely panicked. (I wasn't even driving, luckily.)

Snow in Utah in June

Navajo Lake

We took our rental sedan on a rocky side road to hike Cascade Falls, a trail so popular that no road signs exist and the turn-off is not on any map.

Cascading Falls
This trail revealed that I'm either the worst helicopter mom ever, or Utah parents don't love their children. I hugged the wall most of the hike, with a hundred foot drop-off as the alternative, but four-year-olds were running up ahead of me, with their parents slowly following, oblivious to any fear or danger. You can see the trail and drop-off along the hillside below:

The Menu

We checked out Diners, Drive-ins, & Dives for places to eat in Salt Lake City. So much good food! Moochie's Meatballs & More was obviously a local favorite, as there was already a line to the door for meatball subs when we arrived at 10:30 am. I embarrassingly held up the line trying to interpret their wall of sandwich options.

The Evolution of Moochies (clearly, Food > Art)
Maxwell's East Coast Eatery had an awesome Sunday brunch menu to go with their regular full menu. I took advantage of both, thanks to my pregnancy cravings, and enjoyed a yogurt parfait with pepperoni jalapeno pizza.

Temple Square

A beautiful city block in downtown Salt Lake City is dedicated to the Mormon Temple and affiliated buildings. We enjoyed dinner at The Roof Restaurant, which won my heart with an endless buffet and awesome views of the Mormon temple. (No coffee or alcohol, but with the pregnancy, I wasn't supposed to be drinking those anyway).

I imagine we felt about as out-of-place as Mormon visitors might at the Vatican. We were surrounded by beautiful landscaping and architecture and history, much of it foreign to us, but we could enjoy it in our own way. I couldn't get over how nice everyone was. Since we aren't LDS, we couldn't enter the Temple, but as we visited other buildings in the square, everyone was very welcoming. It was cool to see the Tabernacle, which looked familiar, since the annual televised Christmas special of the Mormon Tabernacle Choir is filmed there.

In Conclusion

We took our little baby-moon trip just in time! I was about as big as could comfortably travel, even though I was cleared to travel through August.

19 weeks pregnant with twins, June 2014
We spent hours driving from Salt Lake City in northern Utah to Brian Head in southern Utah to the Grand Canyon in Arizona. Prior to our trip, my sister e-mailed a list of podcasts to download, and even sent us a CD of an NPR Snap Judgment segment on a girl who sent a stripper in her place to her ten-year high school reunion. But we haven't been able to finish a conversation since Joe was born in 2010, followed by Josh in 2011, so the hours of road-tripping in good company was just as fun as the sites and experiences!

Wednesday, December 31, 2014

Book Review: Working Mother

It's so offensive to me that a short story entitled Working Mother would be listed as historical fiction. Have Christian authors so little experienced the reality of moms working outside their homes that all they can write is fiction?

With the birth of my first child, I took 6 weeks off from a job that didn't offer maternity leave and then returned to work full-time. I couldn't understand why I was so tired. Plenty of women have babies and continue holding down a job outside the home.

Then I became the full-time working mom of a one-year-old and a baby, and I can't tell you much about those months, because all I remember is a haze of people and places and babies.

When I read the introduction and reviews for Working Mother, I just rolled my eyes at all the Christians saying nice things about what was no doubt a cheesy conjecture of a storyline, probably written like middle school fan fiction. The Virgin Mary working outside the home while the Holy Family lives in exile in Egypt? Oh please.

But this story is stunning. Shut my face up stunning. 

For me, there was something worse than leaving for a daily commute that left kids at the breakfast table, my mind wandering at work about missed first words and first steps, and those awful brief nights punctuated by sleepless children and occasional rest. 


Surrounded constantly by co-workers, babysitters, and kids, working an opposite schedule from my husband, I felt so much alone.

Working Mother is a simple storyline, insightful without being preach-ey or virtuouso. It doesn't reduce "God's Will" to whatever circumstances we hate but can't seem to change in a helpless, Pollyanna imitation of holiness. (There's not a single omniscient third person admonition to "Let go and let God," "Persevere in Prayer," or "Offer it up!")

In an attempt to pull myself out of the depressed isolation of full-time working motherhood, I stopped by our parish to see what small groups were available. There was a subset for "working moms" on the application, and I couldn't wait to meet other moms who would understand this life I was living.

A few weeks later, the church sent me a letter: two apologetic paragraphs informing me that the group I selected didn't actually exist, but they'd be in touch when it did. All my insecurities and frustrations were confirmed.

Erin McCole Cupp's story is so affirming to working moms, and really, to any mom who struggles with the idea that helicopter parenting is the ideal, that anything less than us-at-our-best-24-7 is eternally detrimental to our children.

Mary finds herself in a situation to best care for her family by working outside their home. I easily dismissed the plausibility of this entire premise, assuming Mary's motherhood would somehow be diminished, were she not directly involved in every moment of Jesus' life. But I was underestimating both a woman's role in her family, and the spectrum of ways God works through individuals and families. 

Tuesday, December 9, 2014

More Adventures in Healthcare (The Medicaid Experiment)

When I started receiving medical bills from two-and-a-half weeks of hospital bed rest, an operating room delivery of twins, and two weeks of NICU, I knew something wasn't right. 

From what I'd been told, Medicaid patients aren't responsible for any part of their medical costs, and don't even see their bills, but in the few weeks since bringing home our twins, I received calls and letters from the hospital, my ob-gyn, and the anesthesiologist, informing me that Medicaid had denied their claims.

Up to this point, we'd been using a healthcare co-op of sorts that's great for minor emergencies, for childbirth, and even for catastrophic events, but I just couldn't imagine recovering from birth caring for two new babies as well as our other kids at home, while compiling and processing medical bills and reimbursement checks, which is part of the co-op process. 

So I looked up Medicaid -- mainly out of curiosity -- armed with the sudden free time of mandatory bed rest (which incurred the unexpected partial loss of salary that prompted the curiosity), and I came to find out that our modest income, combined with the unique ability of the American healthcare system to bankrupt anyone, qualified us for Medicaid. 

I called Amerigroup, one of the private health insurance companies through which Medicaid disperses coverage, and asked if there was a problem. Yes, they informed me, there was. 

Despite my indication otherwise on the 12-page application, supporting documents, and a follow-up phone interview, they had somehow dug up a record from 2012 that showed I was already covered with private insurance through Aetna. So rather than call me to check on the apparent disparity, they just denied all claims. 

I shook my head. Yes, in 2012, I was covered by private insurance through Aetna. But didn't their records also show that I was dropped from that coverage in 2012? No, they don't have that information. (But they can fill out an incident report and have their insurance team research it. Yes, please do that.

I called back the hospital, ob-gyn, and anesthesiologist to give them an update. They were surprisingly unsurprised. Apparently it's a thing for Medicaid insurers to automatically decline the first submission of bills. 

So while Amerigroup was working out whether they could dump financial responsibility on a two-year expired outside party, I tried to keep my blood pressure down as I read through the bills. Here are some highlights: 

Each day in the room: $2100.00
Each prenatal vitamin: $3.68
Each dose of Miralax: $25.00
Each time they listened to the babies' heartbeats: $766.00
The USE of the ultrasound machine: $1500.00
The doctor who used the ultrasound machine: $1500.00
A 10-minute consultation with a NICU nurse: $278.00
A 5-minute visit from my doctor to check my vitals: $275

The list goes on and on, mostly with coding and medical terms I can't interpret. But the Miralax is what I really can't get over. How did this 14-dose, $10 bottle of medicine get marked up 3500% when administered in a hospital? 

Did I do that math right? 71 cents per OTC dose versus 25 dollars per hospital dose?

I've been an advocate for a national healthcare system for years (note: not a national system that lines the pockets of private health insurance companies without providing any actual healthcare, which Obamacare seems to have inadvertently created, but an actual healthcare system). 

I was picturing something that could match the functionality of the postal service: slow, even when there's not a line out the door, but effective and affordable. And if you want something better, just stop by a UPS or FedEx store and pay a little bit more. 

But the bureaucracy we've discovered in Medicaid likens more to an unsolvable maze or never-ending roller coaster. 

It would seem I'm ungrateful, to complain about free medical care. But here's the problem, and why I have to validate my frustration and complain about Medicaid healthcare: it's not free. This crappy system is costing tax payers about 25% of our state budget! Our tax dollars are disappearing into a bureaucratic rabbit hole of paperwork, call centers, and ineffective checks-and-balances.

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We couldn't check out of the hospital until we scheduled pediatrician visits for our sons. It took nearly two hours of phone calls.

I called the pediatrician, but they needed the Amerigroup ID numbers for the babies. I called Amerigroup, since the twins had automatically been covered under me at birth, but they couldn't assign numbers. I called Medicaid, but the option to add a dependent to a plan wasn't in the five-minute options menu, so I waited in a 17-minute queue to speak with someone directly. I finally reached a representative who spent 20 minutes entering their names into the Medicaid system and adding them to the Amerigroup plan. I called Amerigroup back to confirm they had a record of the twins, and to get their insurance ID numbers. We spent another 15 minutes entering their pediatrician's information as the primary care provider on their account. I called back the pediatrician's office to provide Amerigroup ID numbers and schedule appointments. 

Two months later, I took the twins back for another wellness visit. Somehow, one of the twins had been dropped from Amerigroup and transferred to another insurer contracted by Medicaid. I hadn't even heard of this other insurance company, had received no communication from them, and worse yet, the babies' primary care pediatrician wasn't even in-network for this other company. 

Another hour working through the Medicaid roto-dial, calling Amerigroup then Medicaid then Amerigroup, and we get nowhere. The representative can't figure out how one of the babies was moved to a different plan, but they can't move him back, because there's a 90-day waiting period to change plans. (But they can fill out an incident report and have their special situations team research it. Yes, please do that.)

Two weeks later, I receive the first communication from Molina, this new insurance company that the baby was mysteriously and untraceably and irreversibly transferred to over six weeks earlier. It's a little paper insurance card that tears as I attempt to pull it from the perforations in the middle of the page. I give them a call. They won't reimburse me for the cost of the baby's two-month wellness check-up, because his pediatrician isn't in-network. 

I call Medicaid, work through the endless options menu, and wait for the next available representative. She pulls up our case, sees there's a problem, can't help me with it, but will file an incident report and have their special situations team research it. I let her know that an incident report was filed two weeks earlier, but she doesn't see any record of it in their system. She's unhurried and unapologetic, and tries to reassure me: don't worry, because she's creating a new incident report RIGHT NOW. When will it be processed? She doesn't know. Will I be contacted? She doesn't know, but I should call back in two weeks to check. Is there anyone I can talk to that could do something about this? No. Can I submit a written account to go with the incident report? No. 

I began this Medicaid experiment as a competent, resourceful woman. But the experience has broken me. Somewhere between their unaccountable happenings, endless phone menu options, piles of unsolicited mail directing me back to their phone menu options, and helpful representatives that can't actually help at all, I've realized that helplessness can be as learned a trait as resourcefulness. 

It's good to be back with Samaritan Ministries, our healthcare co-op. This option might be paperwork-heavy, but at least someone takes my calls at the other end, and I can rest assured our money is supporting a non-profit that's transparent, affordable, and effective. 

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Thursday, November 13, 2014

They Should Offer a College Course Or Something For This.

All I wanted to do was take out the trash.

But the dumpster was three apartment buildings over, and it was 30 degrees out, and I knew I couldn't leave the sleeping newborn in the crib, because the whole place would inevitably burn down in the four minutes it took me to return. But he was sleeping. And the doctor had said not to take him out in public until he was 2 months old.

I bundled him up, awkwardly carried him with two bags of trash across the parking lot, and [thankfully] tossed the correct two out of three into the dumpster.

Anyway, parenthood's proven more a learned skill than an intuition of wisdom. I thought getting pregnant came with a blast of holy pixie dust, and whatever virtue it is that kept Mary from yelling at Joseph for falling asleep at the Nativity. 

The logistics of every day life and kids should be a course in college. A legit course, not some joke elective for those of us pursuing the MRS degree plan. (Yeah, I'll own up to that, as well as admit it was the dumbest use of college funds ever, perhaps secondary only to being a Communication Studies major. No, for real.)

Raising Kids could be a logic course for philosophy credit: is it more ethical to cut your grocery list in half and leave the store with a crying toddler, or just forge on, to the annoyance of other shoppers? What if it's two crying toddlers? What if it's the day before your husband's birthday and cutting your losses means no chocolate in the brownies?

Or it could be a dual credit course for statistics: discuss the probability that your three-year-old is actually having an emergency and must pee on a tree right off the sidewalk, or is just faking it, because peeing on trees is the coolest new skill in his set. (There's something about yuppy suburban bike trails that pushes preschoolers and pseudo-pro cyclists alike to want to show off.)

Then there's the logistics of having kids. Why are we even doing this? There are costs to consider. Sure you might be able to afford diapers today, but what about driver's ed, car insurance, college?! (Our four-year-old attends part-time Catholic preschool that's somehow four-freakin'-thousand dollars a school year. It's hard for me to grasp spending that much per year per kid on education, even though it's on the low end for private schools. Except now that I've used the F-word euphemism as a tuition descriptor, we might not be invited back. Problem solved.)

I've heard that caring for children is a way to holiness -- just as any vocation or life-calling, but I expected a kind of innate and instant holiness. It turns out that tiny, needy babies bring out my worst, and I'm not the calm, cheerful, easy-going, generous, thoughtful woman I can make myself out to be. (Fact: I'm super grumpy. Like, humorless to the core. Except with coffee, when I can at least muster up enough goodwill for dry witless wit about TMZ being the only real news source in America.)

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But even with kids revealing my worst, they're also bringing out my best. Our utter unpreparedness humbled me with our first baby. The health needs and care for our second baby emboldened me. The subsequent surprise of twins has caused me to abandon all pretense and search out our intentions and second-guess our expectations.

Everyone's striving for something better, to have a better life than our parents, that our kids will have a better life than us. But what do we mean by "a better life"? More stuff from Ikea? More prestige in our work titles? More house in our homes? I don't think most parents mean any of this. We mean happiness. We want our kids to be happy, and we fill their lives with all kinds of opportunity, experience, and stuff to make it happen.

A line from my favorite Rich Mullins' song keeps relaying through my mind -- "they worked to give faith hands and feet, and somehow gave it wings," alongside images of his family of seven in a car that seats five, and a line down the hall for the single bathroom in their house. But they were happy. 

And I'm reminded there's really no preparing for any of this. And man, it's not exactly the life we planned, but it's so, so much better.