U.S. Gets a “C-” Reproductive Report Card

 According to the nonprofit Population Institute, The United States gets a grade of “C-” for its efforts to promote family planning and reproductive health. According to its “Report Card on Reproductive Health and Rights,” the country does a poor job of assisting its residents in obtaining essential family planning resources.

            The Report, released last year, gave nine states a grade of “F” while only 12 got a “B-” or better. Only Washington, Oregon, and California earned an “A”.

          What do all these letters mean? Reproductive health, as measured by the institute, is determined by four criteria, each broken down into sub-categories:

  • Effectiveness (30 percent):
  • Affordability (30 percent);
  • Prevention (20 percent);
  • Clinic access (20 percent).

          Effectiveness consists of teenage pregnancy rate and unintended pregnancies.

          Affordability consists of Medicaid availability for family planning, insurance that covers contraception, and funding for family planning clinics for low-income families.

          Prevention is broken down into two criteria: mandated school sex education and access to emergency contraception.

          The fourth criterion, clinic access, consists of abortion restrictions and protective legislation for clinic access. 

Color-coded map of states' grades

Population Institute Reproductive Health and Rights states map

         Title X (Title Ten) passed by Congress and approved by President Richard Nixon in 1970, provided low-income and uninsured individuals with access to family planning resources like birth control and preventive healthcare services. As a result, tens of millions of women who might not otherwise have had the option of limiting or spacing their pregnancies have been able to do so.

          “We’ve seen a lot of progress in the last four decades,” said Population Institute President Robert Walker in the report, “but we can’t take anything for granted.” Recent events, like legislation in Texas that restricts abortion clinics by requiring untenable operating requirements, concerns Walker. These
include such restrictions as requiring the clinic to be near a hospital or to have expensive budget-busting equipment in the clinic that would exceed any reasonable need for such facilities. “The U.S. still has an unacceptably high rate of unintended pregnancies, including teenage pregnancies, and yet family planning clinics in many areas are being forced to close, and schools in many states are using unproven, abstinence-only sex education curricula.”

          Fairness dictates we concede that some of the criteria employed in determining these grades are biased against those with religious beliefs that eschew abortion rights. But that still leaves a wide swath of heads-in-the-sand thinking in states that make it difficult to obtain abortions and are hostile to the availability of family planning. Among the most contemptible of these nexuses occurs when states like Texas attempt to close down Planned Parenthood locations because they provide abortions. The irony is that more than 95 percent of Planned Parenthood funding goes for services designed to help people avoid or plan pregnancies.

          According to Walker, the United States has a higher rate of teen pregnancy than most other developed countries. So while Texas (with a grade of D-) and New Jersey (C) have slashed state funding for family planning clinics serving low income uninsured folks, access to food stamps and unemployment insurance benefits are being hacked on the federal level as well. In other words, some families will grow larger while their ability to feed their most vulnerable members, the kids, will diminish.

          According to the Guttmacher Institute, in 2011 state legislators introduced about 1,100 reproductive health and rights-related provisions. Of those, 135 became law, tightening restrictions in 36 states.

          Let’s give this all some perspective. State legislatures dominated by conservatives tend to oppose the funding of family planning facilities, especially those that offer abortion or the so-called morning after pill. They also oppose generous contraception policies for teenage girls. These same legislatures frequently oppose health care reform, Medicaid and other benefits for those in the lower economic strata. Combine that with cutbacks in food stamps, and these states are whipping up a recipe for ipecac soup.

          Whether or not you believe that reduced population is a good thing, how can these anti-reproductive-health cohorts believe that their policies, or lack of them, are a good thing? Read more about these issues in our book, Enough of Us.

 

Should we Prevent Devastating Pregnancies? What’s Your Opinion?

            Adopting foster children can be an unending series of trials and tribulations. Maggie Jones’s “The Meaningful Life of a Supersize Family,” in the November 17, 2013 New York Times Magazine, makes the case in spades. The article profiles two families that have sacrificed the niceties of life in order to provide hearth and home for kids who most need it.  

            Misty and Jon already had four biological children. Even so, they discussed the adoption option and realized the $20,000 it would take to complete the process would overstretch their budget. But an ad on a Christian radio station about a new organization that was helping Christians to adopt foster kids helped change their minds. It opened the door for the Misty-Jon family (they didn’t want their last names used) to take in Denver County foster children, with the intention of adopting them. They were able to receive financial help including Medicaid and payment of therapy expenses.

            Their first foster children were brothers, Shon and Cory. They were told that the boys’ mother had dropped them off with a man who couldn’t care for them, and she never returned.

            Of the two, Shon had the worst time adjusting to his new family. He would lie in bed at night, head in hands, staring straight ahead until Misty left the room. He’d wake up in the same position in the morning “as if he were on guard all night.”

            Eight months later, as the adoption process was inching along, a caseworker informed Misty and Jon that Corey and Shon’s mother had just given birth to twins, a boy and a girl. They were dangerously premature at 24 weeks old. Each infant weighed one pound, and the county was asking for foster parents to

Premature ababy and mother.

10-week premature baby being held by her mother (this is not drug-related). Photo courtesy Polihale, Wikimedia Commons

cuddle the babies in the hospital. The boy died days before Misty and Jon’s first “holding” hospital visit, but his sister Olivia survived. Having severe heart problems, she was hooked up to a ventilator. After six months of driving 45 minutes every other night to the hospital to hold Olivia, Misty brought the little girl home, with a tracheostomy tube to help her breathe, a feeding tube, and full-time nursing care paid for by Medicaid.

            Another girl, Raena, was supposed to be a short-term placement. Her mother was on track to regain custody of the four-month-old, who weighed only 11 pounds. A relative’s boyfriend had shaken the child and thrown her into a bassinet, which resulted in two permanent brain injuries. When Raena’s mother lost her parental rights due to drug problems, Misty and Jon, who were caring for this special-needs child, “eagerly” began the adoption process.

            Maureen and her husband Christian heard the same religious radio ad as had Misty and Jon. They also had four birth children, and believed they had a calling to adopt foster children. The result was they adopted two boys. David and Ernesto’s birthmother was 16 when she had David. Thirteen months later, she gave birth to Ernesto, even though she tested positive for methamphetamine. Ernesto struggled with sensory issues: In one instance, he wrapped his torso in duct tape and in another, covered his head in Vaseline. He had screaming fits, hit his adoptive mother, and “grabbed her hair with both hands so that she couldn’t move.” Maureen rightly suspected that he had been exposed to drugs in utero.

             These stories lead us to ask the big question: Is it time to consider laws that prohibit unfit parents (drug addicts and child abusers) from repeating their traumatic, inhumane, and costly mistakes?  Progeny from parents who have no capacity to “think twice before making children,” frequently suffer sad and dysfunctional lives. The families who take in and take care of these children suffer too, both financially and emotionally. Society suffers by paying for services to dysfunctional parents and the children they sire. Citizens witness the cruelty to these offspring with horror, unable to stop the injustice. Why do our laws allow it? Can lawmakers and voters set boundaries that will actually save the yet unborn from a terrible fate?

          What do you think? We’d love to start some dialogue in this topic.

Lone Star State Deserves Another Star . . . for Mindless Abortion Policy

           The Texas legislature recently passed, and Governor Rick Perry signed into law, a bill that not only closes most of the state’s abortion clinics, it will also increase the number of babies born with serious birth defects. We have often pondered how a state with six of the 20 most populous cities in the country can be so regressive in its thinking.

Texas Governor Rick Perry

Texas Governor Rick Perry signed the anti-abortion bill

           On July 11, 2013, Darshak Sanghavi, a pediatric cardiologist, posted a column on Slate.com in which he answers the question, “Who Has an Abortion After 20 Weeks?” In a nutshell, here is how he answers the question: “Comprehensive fetal testing … (is) typically performed just before 20 weeks of gestation. Such scans are critical for uncovering major birth defects.” These defects include severe brain malformations, heart defects, missing organs and limbs, and other serious imperfections.

          Therefore, by virtually abolishing the abortion option at 20 weeks of pregnancy, Texas has almost guaranteed that mothers with fetuses that have traumatic defects, and who cannot afford to seek abortions in other states, are considerably more likely to need various forms of public assistance in order to care for their newborns. State taxpayers, in many cases, will have to bear the burden of care, particularly in light of Texas’s rejection of Medicaid expansion under the Affordable Care Act (Obamacare).

          So while those with money can hop a flight to, say, New Mexico or Colorado, to terminate a 20-week-plus pregnancy, those without the cash … you get the idea.

          But wait – there’s more. Less reliable tests are available at earlier than 20 weeks. There’s just one drawback: they are less reliable. So let’s say a doctor tells the expectant parents that their baby may be suffering from anencephaly (in which a major part of the brain is missing), but that it’s too soon to tell for sure. The parents are now in the position of deciding whether to gamble on a healthy baby or, alternatively, to abort the fetus because they cannot emotionally and financially afford to cope with a severely disabled child. If they opt for the latter, they may be aborting a perfectly healthy fetus.

          Is this what Texas lawmakers were intending? Our guess is they either gave it little (or no) thought, or they were more concerned with mollifying the folks who might vote for them.

          According to Dr. Sanghavi, approximately one-third of all women in the United States will have an abortion by age 45. One reason is that about half of all pregnancies are unintended, to no small degree because birth control is not foolproof – 5 percent of women on the pill get pregnant each year.

          Every year “in Texas, about 85,000 women have an abortion,” explains Sanghavi, “of which only about 1,000 are performed after 20 weeks of gestation.” That’s a little over 1 percent.

          Of the 400,000 babies who are born, “16,000 have a birth defect of some type. Of these, about 700 have major brain defects, 600 have major chromosomal disorders, and the rest have any number of other birth defects.”

          In the first chapter of our book Enough of Us, we discuss at some length the possibility that pregnancies will end disappointingly, if not in total disaster. It seems to us the lawmakers of Texas are determined to increase the odds of such unfortunate outcomes.

          As the good doctor concludes in his essay:Pain Capable  Unborn Child Protection Act

          “In the end, restriction on late mid-term abortions may seem motivated by concerns about a healthy fetus; after all, the Texas bill was called the ‘Pain-Capable Unborn Child Protection Act.’ But a closer look strongly suggests that no matter what the legislators do, some fetuses and families will still be faced with a great deal of misery.”

          Many Texas politicians decry the intrusion of big government into our everyday lives. They may or may not have valid points to make. But this? These lawmakers are telling a significant minority of would-be parents to take a guess, decide whether to abort or not, and hope for the best. If not, they may be stuck with a decision that will mean disaster to both parent and child. Now, that’s big government intrusion.

The Latest Trend in Risks to Newborns – Part II

Last week, in Part I, we began this discussion of Judith Shulevitz’s The New Republic article, “The Grayest Generation,” in which she lamented the societal and biological risks of older parenting.

 

Men over 50 are three times more likely than men under 25 to father a schizophrenic child.

Fertility doctors do a lot of things to sperm and eggs that have not been rigorously tested, including keeping them in culture media teeming with chemicals that may or may not scramble an embryo’s development.

Commonly used, “Clomid . . . came out particularly badly in a recent New England Journal of Medicine study that rang alarm bells about ART [assisted reproductive technology] and birth defects,” reports Shulevitz. “ICSI (intracytoplasmic) sperm injection shows up in the studies as having higher rates of birth defects than any other popular fertility procedure.”

A child with trisomy-18

Trisomy-18 child. Photo: Emilyscookiemix.com

While she recognizes that women do not want to cut their careers short for the sake of having kids, Judith points out that if they don’t have children, they’re denying themselves s full life.

But older parents have emotional disadvantages. “Procrastinators” become members of the “sandwich generation,” caught between toddlers tugging on one hand and elder parents sharing the latest updates on their ailments. Elderly grandparents provide less support than their younger counterparts.

What haunts her about her own kids is the gamble of dying before they’re ready to set out on their own.

And these problems could proliferate if  “aging parents are, in fact, producing a growing subpopulation of children with neurological or other disorders who will require a lifetime of care. Schizophrenia, for instance, usually sets in during a child’s late teens or early twenties. [British psychiatrist] Avi Reichenberg sums up the problem bluntly. ‘Who is going to take care of that child?’ he asked, ‘Some seventy-five-year-old demented father?’”

The birthrate has dropped by a significant 45 percent around the world since 1975. By 2010, the average number of births per woman had decreased from 4.7 to 2.6.

While Shulevitz is making compelling arguments about older parenting, ones with which we agree, the goals of her arguments are where we part company. She makes the case that society needs to reform itself so that parents become parents at earlier stages of life. That way there will be fewer disabled children, more individuals to care for older generations, and enough workers to replace the aging people who will be better able to adapt to new technologies. She concedes that fewer people means less demand for food, water, land and energy.

Let’s start with the latter first. As we have written on several occasions, when societies move into the middle classes, their per capita consumption of food, water, land and energy skyrocket. Bigger homes, conspicuous consumption, wasted water, cars, heating and air conditioning; you get the picture.

It seems to us that there are three choices for the career-focused. Have your career or your kids. If you want them both, do as many others have done, and burn the candle at both ends earlier in adulthood. But making kids in order to provide preceding generations with a support system is selfish, reckless, and the world’s ultimate Ponzi scheme. We have to stop at some point. Are the projections of 10 billion-plus devourers of natural resources, clean air, and water by the end of this century not enough to scare the bejeezus out of us?

 

Oppose Abortion and Oppose Subsidized Contraception? It’s a Recipe for Disaster

Across America the righteous right seems to have no shortage of barriers in its arsenal that are designed to make it difficult, if not impossible, for women to obtain safe, legal abortions. When these very same folks also oppose government-sponsored or insurance-sponsored family planning (read: contraception) they fall into the category of biological Luddites.

As part of a study published last October 4 in Obstetrics and Gynecology, researchers at the Washington University School of Medicine in St. Louis gave more than 9,000 women and teenage girls free contraceptives.  Participants were 14-45 years of age, at risk for unintended pregnancy, and willing to start a new contraceptive method.

The number of accidental pregnancies fell to between 62 and 78 percent below the national average. Teens are at particularly high risk for unintended pregnancies and, therefore, abortions. The study concluded that free contraception could reduce the number of abortions in the United States by a whopping two-thirds.

When we hear the likes of former senator and would-be presidential candidate Rick Santorum as well as Catholic contraceptive naysayers, decry the idea of government involvement in the contraceptive “business,” it leaves us scratching our heads. We have no argument with the church instructing its adherents about how to deal with their own genitalia. That’s their business. But when you comprehend the realities of unwanted pregnancy, it seems to us that an ounce of prevention is worth a pound of cure; the “cure” in this case being abortion.

The research found that providing free, reliable birth control to women could prevent between 41 percent and 71 percent of abortions in the United States.

Three-quarters of the women in the study elected to use long-acting contraceptive methods like intrauterine devices (IUDs) or implants, which have lower failure rates than birth control pills. In the United States, IUDs and implants have initial costs in excess of $800 that sometimes aren’t covered by health insurance, making these methods unaffordable for many women. We can only guess that the insurers don’t want to fork over more than 800 bucks for each fertile female client when the insureds might be able to provide their own individual-use contraception.

IUDs

Copper (l) and hormonal intrauterine devices

According to lead author Professor Jeff Peipert, MD, “The impact of providing no-cost birth control was far greater than we expected in terms of unintended pregnancies. …We think improving access to birth control, particularly IUDs and implants, coupled with education on the most effective methods has the potential to significantly decrease the number of unintended pregnancies and abortions in this country.”

Health-care professionals insert IUDs and implants, which are effective for five to 10 years, and 3 years, respectively. They provide superior effectiveness over short-term methods. But only a small percentage of U.S. women using contraception choose long-term implanted methods for a variety of reasons, including expense and fear of implanting devices into their bodies. “Unintended pregnancy remains a major health problem in the United States, with higher proportions among teenagers and women with less education and lower economic status,” Peipert says. “The results of this study demonstrate that we can reduce the rate of unintended pregnancy and this is key to reducing abortions in this country.”

As for those who cannot see the forest for the trees, doesn’t it make more sense for state and federal governments to provide contraception, and to require insurance companies to do so for those low-income folks who are lucky enough to have coverage, than for the government to pick up the tab for pre- and post-natal medical care of mother and child?

In addition, we wonder what other burdens—like education, housing, child support services, and healthcare—such families, especially single-parent households, will impose on society. We say that regardless of the immediate financial costs, Enough of Us already inhabit this planet. So let’s cough up the 800 bucks every three or five or 10 years and save ourselves all the other potential costs.

 

 

 

 

 

 

Poor Parents May Encourage Failure in Their Children

                Should low income families have children? Many would say it’s unfair, even un-American, to preclude would-be parents from having kids before they climb a socio-economic ladder to the middle class. Should those who yearn for children be penalized because they might never earn a decent wage? There is no easy answer. But we, as a society, need to consider several issues.

            In a column entitled “Profiting From a Child’s Illiteracy,” in the December 9, 2012 New York Times, Nicholas Kristof writes about anti-poverty programs in the Appalachian hill country of Kentucky that, ironically, work against children. If a child who qualifies for a monthly $698 Supplemental Social Security Income (SSI) because of an intellectual disability, attends literacy classes and learns to read, the youngster’s family will no longer collect that check. As a result, some poverty-level parents obviously don’t “go for broke.” Instead, they pull their kids away from their only hope for a successful future – the reading program. 

            Because of illiteracy, many kids from poor families remain unproductive as they reach adulthood. Instead of joining the military, which offers an opportunity for some young adults to escape the poverty of rural America, they stick around in “them thar’ hills” and depend on food stamps and disability payments. 

Appalachian cabin. Photo – SUNY Geneseo

           Kristof points out that about forty years ago, SSI was designed to aid children with mental retardation and/or severe physical difficulties. As time went by, the diagnosis that qualified young people for SSI became “fuzzier,” and less related to specific disorders. The resulting problem is that 8 percent of all low-income children in America now receive SSI payments. This amounts to $9 billion-plus and creates quite a burden on taxpayers.

Columnist Nicholas Kristof

The real shocker is that low-income families with questionable scruples have a stake in their children failing at school. Consequently, many of these kids become failures in life. They transition from the SSI dole they receive until age eighteen to collecting adult SSI benefits, and they become  stuck in a cycle of poverty. Due to their parents desperation to keep the SSI cash cow “milk” flowing, 1.2 million children across this country have essentially “learned” to fail.

            Adding insult to injury, because SSI is means tested – meaning benefits depend on family income – some parents avoid marriage in order to qualify for higher benefits. Yet, single-parent families produce five-fold as many kids growing up in poverty as do two-parent families.

            A mother of two who lives in the hill country told Kristof, that “her $500 car had just broken down and she had to walk two miles each way to her job at a pizza restaurant.” He says,“That’s going to get harder because she’s pregnant with twins, due in April.” Is it fair that she’s voluntarily bringing two more children into the world when their chance for failure might well trump their meager chance for success? Everyone must decide for themselves in this free country of ours. But there is much our society can do to stem this behavior to the benefit of all.

            We believe that government programs should be more proactive in discouraging poverty-stricken  young adults from making kids in the first place. Consider this:

  • Children from low-income families tend to do more poorly on tests, have lower graduation rates, and are less likely to attend or graduate from college than their middle-class counterparts. 
  • Poverty affects a child’s brain. When comparing the brains of children ages 9 -10, from both low- and high-income families, the prefrontal cortexes showed that the “poorer” brain was akin to that of a person who had suffered a stroke. Poverty also affects a child’s IQ and behavior.
  • Children who live in a low-income family usually suffer from malnutrition. In this case malnutrition means not eating enough healthy foods, or eating too many unhealthy foods. Parents stretch their precious dollars by buying cheaper, processed groceries. The results are obesity, vitamin defiency, and myriad health problems for the kids.

Let’s boil this down to a simple mathematical formula: poverty + illiteracy + single parenthood = stupidity. We agree with Nick Kristof – some of SSI funding should be diverted to programs like Save the Children, which work in areas where kids aren’t going to school and where parents are unable to read to their children. But we also believe that schools should be teaching our formula to kids before they’re old enough to get pregnant.

Not Having Kids Equals Degenerate Behavior? You Probably Won’t Believe

  Imagine deciding to take a gamble, but if you lose, that is if the bet goes wrong, an innocent party has to pay. In addition, just placing the bet is almost guaranteed to impact the planet negatively. Well, in his column, “More Babies, Please,” in the December 2, 2012 New York Times conservative columnist Ross Douthat (pronounced DOW-thut) exposits that by virtue of not making such bets American society is on the road to decadence.

Douthat is worried about America’s declining birthrate. “The retreat from child rearing is, at some level,” he proposes, “ a symptom of late-modern exhaustion – a decadence that first arose in the West but now haunts rich

Ross Douthat, photo- New York Times

societies around the globe. It’s a spirit that privileges the present over the future, chooses stagnation over innovation, prefers what already exists over what might be.”

This is flip-flop reasoning. And it most certainly is not “conservative” thinking. Douthat’s reasoning would make the Ponzi scheme of population growth the savior of the US economy and quality of life. He feels that because our nation has had a higher fertility rate than France, Japan, China and Brazil it is a superior economic powerhouse.

He takes no notice that our planet is going to an ecological hell in a handbasket, fueled by a population soaring toward 9 billion-plus in this century. Wealthy countries like the United States are the worst offenders because of their profligate consumption of materials and energy.

He makes the case that today’s babies will grow up to be tomorrow’s workers, entrepreneurs and taxpayers. But with fewer people, we would not need as many entrepreneurs and workers. Douthat is concerned about the worker-to-retiree ratio. He is worried about who will pay taxes in the years ahead. Let’s project this into the distant future. Will we need more babies or immigrants to feed the insatiable retiree hunger, ad infinitum? This is the essence of a Ponzi scheme. The global community of humanity will need to stop growing before we doom our own survival. If not now, when?

Human beings are currently consuming renewable resources like lumber and water at unsustainable rates. Mankind is depleting fossil fuels that will be unavailable for future generations without knowing whether today’s babies will have the know-how to develop non-fossil alternatives for airplanes, ships and a variety of other concentrated energy demands. With climate change wreaking havoc on weather patterns we cannot – at least for now—reliably predict water supplies and shortages.

If we limit our thinking to shortsighted issues like US economic competitiveness and producing future generations for the financial benefit of current retirees, we are doomed to fail. Ideally what would benefit Americans, along with everyone else, is enlightened political leadership that is willing to look the elephant in the room in the eye and ask, “What are we going to do about this thing – this enormous, ever-growing, ever more-consuming mass of humanity that is cannibalizing its own home?”

Certainly there are enough of us. In actuality, there are way too many of us. But let’s go back to that bet that an innocent party has to pay for. We are referring to the very act of procreating. It’s a gamble. One percent of American adults live incarcerated and six times that many spend time behind bars in the course of a lifetime. One percent have disorders on the autism spectrum. Add in mental illnesses, childhood and adult diseases, the expectation that one-third of Americans will have diabetes, and dysfunctional families raising unhappy kids. In other words, parents roll the dice and if the resultant baby comes up craps, it’s the kid who is the primary loser of the bet. We wonder how Douthat can have the chutzpah to call America’s decreasing fertility rate “decadent.” The decision to not reproduce is anything but selfish.

 

The Unfortunate State of Many American Children

Let’s stir things up from the get-go. Just as the best way to protect soldiers is to keep them out of unnecessary (read: most) wars,  the best way to protect children from lives of misery is to prevent them from entering such lives. We never anticipated that we would again see a time when America would be in such dire straits. And it’s usually the children who experience the worst of it.

President of Children's Defense Fund

Marian Wright Edelman – photo: Children’s Defense Fund

In a recent essay on the Reader Supported News Web site, Children’s Defense Fund (CDF) President Marian Wright Edelman lays out a frightening case for how bad things can get in still-rich America for so many unfortunate kids. The CDF has just released The State of America’s Children 2012 Handbook. It’s not a pretty picture.

Let’s start with the most dramatic. Guns killed kids in the United States in 2008-09 in greater numbers than all of U.S. military personnel who died in the wars in Afghanistan and Iraq . . . combined . . . since both wars began.

There are more than 16 million poor children in the United States, almost half of whom live in extreme poverty. How sad is it that homeless shelters, child hunger, and child suffering have become everyday facts of life since the financial collapse of 2008?

There are now 10 states plus the District of Columbia that have poverty levels above 25 percent. Twice a minute another child is born into poverty.

On this site and in our ebook Enough of Us: Why we should think twice before making children, we make the case that we Americans need to cut down on our baby making, or at least give it a lot more thought before creating new lives. And we would hazard a guess that if you are astute enough to be reading our blog, you probably think that you are not among those whose children are likely to fall into the dark hole of poverty.

Keep in mind that there were 1.4 million bankruptcy filings in 2009, more than 1.5 million in 2010, and another 1.4 million in 2011. Add to that mortgage foreclosures of about 3.8 million in each of 2009 and 2010 and another 2.7 million in 2011.

Add to that job layoffs and you can see how bearing children can be a risky business, even for many who think they can offer prospective offspring a secure and happy life. As we make the case in our book, even those who are born into comfortable middle-class families are far from being guaranteed happy, healthy lives.

As Edelman writes: “I hope this report will be a piercing siren call that wakes up our sleeping, impervious and self-consumed nation to the lurking dangers of epidemic child neglect, illiteracy, poverty and violence. It’s way past time for those of us who call ourselves child advocates to speak and stand up and do whatever is required to close the gaping gulf between word and deed and between what we know children need and what we do for them . . . . please educate yourself and others about the urgent challenges facing our children . . .”

While she makes the case that America must give its children the help and hope they need, we make an additional argument, and one that comes equally from a position of caring for the happiness of kids. Why don’t we discourage the idealized images of happy, laughing, life-enriching children in favor of presenting realistic portrayals of the downs, as well as the ups, of creating new lives?

Miss Edelman urges that every person make a difference “if our voiceless, voteless children are to be prepared to lead America forward.” We would add that we need to educate would-be parents of the pitfalls and responsibilities of parenthood. And we should start while they are themselves still in school.

The Affordable Care Act and Baby-making

How will American society pay for births to mothers who cannot afford to have children?

The current health-care “system” (hah!) is inefficient. That’s like saying heating your house with candles in January is merely inefficient. First, there is no system, at least not “a” system. We have lots of insurance companies skimming profits off the top and lots of people who can’t afford insurance premiums going to hospitals. That’s because hospitals provide services paid for by federal, state and county governments, meaning taxpayers.

Since doctors and hospitals like income, they frequently order tests that may be only marginally appropriate and then collect insurance fees. For instance, Ellis’s urologist likes to have him take a prostate PSA blood test and then come into the office so the doc can tell Ellis that it looks fine. Ka-ching! He could tell Ellis the news over the phone and not charge for an office visit.

One of the biggest criticisms of the current non-system is that rather than encouraging good health and illness prevention, it encourages procedures and visits. Health-care costs have risen 100 percent in the last decade.

"Obamacare"

Photo – law.upenn.edu

For the approximately 17 million folks who cannot afford insurance at all, the Affordable Care Act will expand Medicaid coverage starting in 2014 at a cost to the federal government of about $116 billion per year.

The cost controls built into the legislation are theoretical and experimental. These controls are based on the premise that about 30 percent of health-care costs are wasteful. In light of that, the law empowers a panel of medical experts to recommend reimbursements cuts to doctors and hospitals. There is also provision for evaluation of the effectiveness of various types of care.

It’s common knowledge that prenatal women should see their doctors to monitor the health of both the  mother and embryo/fetus. But lots of pregnant women are very young and/or poor. This frequently means they depend on the generosity of the state to pay for their care. Add to that the cost of birth and postnatal care. And if the baby is not well . . . well, you get the idea.

 Unfortunately for many families, policies frequently exclude maternity care for anyone other than the policy holder and spouse. That means a child of an insured individual may have to foot the bill herself. For more details on this click to the PBS News Hour site.

 According to the March of Dimes, the average cost for uncomplicated maternity care including prenatal care, a routine delivery, and three months postpartum care was $10,652 in 2007.

Teenagers, the report noted, are less likely to get early prenatal care, more likely to smoke and less likely to gain enough weight during pregnancy. Thus, they’re more likely to deliver prematurely, resulting in more complications, including a higher incidence of low-birth-weight babies. The medical costs for such an infant is nearly 10 times higher than for a baby of normal weight, the report found ($32,325 vs. $3,325, citing March of Dimes data from 2009).

There are many politicians who are trying to kill Roe vs. Wade, making low-cost or free abortions difficult, if not impossible, to obtain for the poorest among us. That would mean additional government expenses for the care and feeding of many unwanted children brought to term.

So how does the Affordable Care Act fit into this proposition? Bear with us. The act requires that beginning in 2014 anyone not poor enough to qualify for Medicaid must pay for some kind of insurance policy of their choice (from a select list on what are called insurance exchanges) or opt out of buying insurance and pay one percent of their taxable income as a penalty, and live without insurance. Those who opt out would be in the position of paying their own medical costs or “freeloading” off the government when an urgent situation necessitates their going to a hospital emergency room.

There is a quote circulating all over the news media from a self-employed woman in Texas: “I could much more easily afford a dadgum penalty than be saddled month after month after month with this kind of premium.” The woman, Laurie Tirmenstein, would only have to pay $250 annually instead of paying $1,800 for an insurance policy. Good luck to her if one of her kids comes down with a traumatic illness.

One way or another, the burden of low-income people bearing infants at the expense of our healthcare programs is scary. Some will get lots of care at almost no expense. Others will get very poor care, leading to the hazards of producing at-risk babies.

Right now the economy is depressing the birthrate somewhat. But sooner or later that is likely to change . . . big time! If and when the economy recovers, low-cost health care could provide incentives for Americans to get back onto the birthrate bandwagon.

The question for us is, considering there are already enough of us, should we be creating a healthcare program that encourages people to procreate, who might not otherwise be able to afford pregnancy and postnatal care?

We would like to see some funds be made available to teach high-school students the benefits of waiting and acceptability of not having children at all.

 

Lots of students, costly education, and huge debt – California may be creating yet another model for the nation

          We recently learned that student debt in the United States has surpassed $1 trillion. What is a trillion anyway? Well, if you don’t know, it’s the same as a million people each owing a million dollars, or a billion people each owing a thousand bucks. In short, the people who owe this enormous sum are folks who attended an institution of “higher learning” (more on the quotes in a moment) and are now stuck with the bill.

          How did this happen? Regular readers of this blog know that we have discussed one major reason in our posts and in our book Enough of Us. If parents have kids and hope that their kids will one day go to college, they have to start planning for that eventuality. It makes our blood boil when parents of modest means don’t scrimp and save from the moment they become aware of the pregnancy. No smart phones, cable TV, or expensive gadgets. Forget the plans for upscale vacations or cars for the teens. That money belongs to the college-bound.

          We live in the Bay Area — San Jose, to be exact. While the state is in terrible financial condition, it’s still a great place to live (ah, the weather!). But many educators, experts, and other Golden State residents worry about the future of California’s two great state university systems.

          The education powers-that-be, including the governor and state legislature, are working desperately on higher education problems. The Cal Grant program helps low- and middle-income students pay for college. The state has formulated performance standards by which schools are eligible to receive funds that students borrow only if a quarter of the students they graduate are able to pay off their loans in a reasonable amount of time.  This standard is an indicator that the schools are graduating young adults with usable skills that lead to jobs.

          Unfortunately, not all so-called institutions of higher learning are what they purport to be. There is a spate of schools that promise advanced education and good jobs in fields where openings go begging. They advertise heavily on the Internet and TV. The problem is that they frequently draw their potential students from families that can’t afford to pay the tuition. Those students usually have to borrow from a variety of government-sponsored sources. According to California Assemblymember Bob Wieckowski, about 90 percent of these schools’ funding comes from Stafford Loans, Pell Grants, G.I. Bill Grants, and the state’s Cal Grants.

University of Phoenix Spokane Campus

          The companies that run these schools netted $3.5 billion in 2009 and paid executive salaries of $41 million. Wall Street ain’t the only place where the governments get played for suckers. So while the execs rake in the bucks, most of the students gain few useful skills, have trouble – if any luck at all – finding relevant jobs, and are now burdened with heavy debt. As Wieckowski puts it, “We can’t continue to shovel taxpayer money into shareholder pockets, instead of adequately preparing students for their careers.”

California Assemblymember

California Member of the Assembly Bob Wieckowski

          When Assemblyman Wieckowski introduced legislation this year requiring the schools to meet more stringent criteria in order to receive state grants,  the schools stepped up their lobbying efforts and managed to kill the bill in committee. The legislature never even got to vote on it. However, a coalition of reformers was able to make changes in the budget process when they cut grants for high-priced schools, raised graduation-rate requirements, “and cracked down on schools with high loan default rates.”

          In the meantime, both California State University and University of California systems, as well as the state’s community colleges, need more bucks. Perhaps with the reforms, there will be more state and federal financial benefits available.

          This brings us back to the opening dilemma. Why aren’t parents providing for their kids’ higher education? If it’s because they can’t afford the costs, how can they afford the kids? This raises questions like:

  • Did they have more children than they could provide for?
  • Did they overspend on indulgences while the kids were growing up?
  • Would it be more realistic for their kids to attend junior colleges and after graduating look for higher education opportunities?
  • Should the kids work part time to help foot the bill while attending school?

          And finally, when people who can afford to pay their share of taxes get significant tax deductions and a free K-12 scholarship for each kid, are we encouraging a system that is forever going to have trouble funding higher education? We go into this in some detail in Enough of Us. We need to consider whether or not we can afford to lower taxes for those families that will be asking the most help funding their children’s higher education.

          Think about it and weigh in with your opinion.