A Special Kind of Poverty

April 21, 2003 10:50 AM

A Special Kind of Poverty This great article appeared in yesterday's Washington Post Sunday Magazine. Its subject: the trials and tribulations of the poor seeking treatment for their infertility. I don't think I have to list the whole raft of issues this subject raises. As touching as it is thought-provoking.
posted by tommyspoon (77 comments total)

This quote sums it up: "Medicaid is not going to pay for someone to get pregnant who can't even afford health care."

These people should look at their bank statements and count their blessings that they don't have another mouth to feed.
posted by wrench at 11:12 AM on April 21, 2003

yes. in america, where money is the be all and the end all of measurement, "these people" really ought to know better. they should have known that the 'american dream' didn't apply to them. what a clueless bunch. why, i'll bet they didn't even have any capital gains last year. what schmucks. clearly thier parents should have been sterilized.
posted by quonsar at 11:23 AM on April 21, 2003

Survival of the fittest quonsar... simple as that.
posted by Witty at 11:30 AM on April 21, 2003

Brian Poole, 27, is a graduate student at the Milton S. Hershey Medical Center, the medical school for Penn State University. He and Amy, 26, are poor, close-to-federal-poverty-level-poor, a temporary student poverty but one that's acute and will last for quite a few more years, until Brian finishes his PhD program and post-doc training. Mornings, Amy works for a publishing company that pays her $11 an hour. Days, Brian does his research work. Nights, he works as an auditor at a Best Western motel. For their efforts they bring home around $1,700 a month after taxes, of which at least $170 goes to pay their tithing to the Mormon Church, and $750 goes to their rent in this two-bedroom walk-up, leaving them with less than $800 to get through the month.

The folks on Medicaid are not primarily who this article is about. For those who are self-employed, for example, health insurance that would cover infertility treatments is prohibitively expensive-and if one has a preexisting health condition, forget it.

My husband is self-employed, and I am no longer able to work because of a chronic health problem. My insurance (which was basically my very generous severance package) runs out next year. Lack of insurance is an easy crack to fall into, particularly in our area, where most jobs are lowpaying and even if insurance bennies are available they are unaffordable.

And because of the social changes that have made abortion available and single motherhood acceptable, it is incredibly hard to even be able to adopt.

We had our three when we were incredibly broke-they never missed a meal and are the joy of our lives. It burns me that many times money is made the equivalent of ability to parent well. I've seen too many kids from affluent families that are totally screwed up.
posted by konolia at 11:30 AM on April 21, 2003

As a poor person, I consider myself lucky that I don't have dependents to feed. It's a blessing. I don't have any capital gains either. A lot of my friends have paid to be sterilized.
posted by wrench at 11:34 AM on April 21, 2003

Survival of the fittest quonsar... simple as that.

interesting. so whatever mutation or accident of nature prevents fertility in this couple except in the presence of a cash infusion is simply mother nature obeying her own rules? and infertility in, say, the bush family, which requires no cash infusion to purchase expensive fertility drugs, is likewise simply darwin in action? so money itself, and the accumulation and distribution thereof, is a naturally occuring phenomena? the bloodlines of people with money are genetically superior? interesting, indeed.
posted by quonsar at 11:50 AM on April 21, 2003

Survival of the fittest quonsar... simple as that.

Most. Repugnant. Comment. Ever.
posted by Cerebus at 11:52 AM on April 21, 2003

That is correct quonsar. I wish I could say that infertility treatment weren't available for ALL. I would certainly take that over the opposite.

Most. Repugnant. Comment. Ever.

Oh I know... the truth is sometimes tough to swallow. Don't worry, there will be plenty of people here to comfort you.
posted by Witty at 11:54 AM on April 21, 2003

ALL = anyone
posted by Witty at 11:55 AM on April 21, 2003

It's so easy to be an ass when it's effectively anonymous, isn't it?
posted by Cerebus at 12:10 PM on April 21, 2003

Watch yourself, Witty. The concepts that you're tossing about so lightly have a very dark history. These are complex issues; your dismissiveness does not speak well of your understanding.

Also, the term "survival of the fittest" has a very precise scientific meaning. You might be aware of that meaning, and be using the phrase metaphorically. Then again, you might not. Either way, I would suggest that precise scientific terms make for bad metaphors.
posted by mr_roboto at 12:10 PM on April 21, 2003

Survival of the fittest is not a valid evolutionary theory, anyway. Witty, what you are advocating is more in the spirit of eugenics.
posted by monkeyman at 12:11 PM on April 21, 2003

Cerebus... I don't expect you to agree with me. But uh... yea. I don't think I'm being an ass at all. And believe me, the anonymity of the web has nothing to do with it. I suggest that your insult was made under the same comfort that you accuse me of. Save it.

mr_roboto and monkeyman: What should we call it then?
posted by Witty at 12:19 PM on April 21, 2003

Until we have universal health care in the United States, providing infertility treatments is a cruel way to spend a limited healcare budget.
posted by 4easypayments at 12:24 PM on April 21, 2003

Evolution - Most. Repugnant. Fact of life. Ever.
posted by y6y6y6 at 12:28 PM on April 21, 2003

Some more interesting comments from the author of the article in the Washington Post LiveOnline chat.

Thus far, though, all the people in that chat who think the way I do have come across as obnoxious jackasses, so it makes me wonder if my position is inherently evil. My instinctual reaction is that if you can't afford the fertility treatment, you probably can't afford the child, either, but I don't know what the real numbers are. It seems to me that $10K is a pretty small amount of money in the long term. I would assume that a baby is going to cost at least a couple of thousand dollars a year to raise, so if you can't manage to save that $10K in 3 or 4 years, you're not going to be able to afford the extra costs of having the child, either, even if the treatment was free.

On the other hand, 3-4 years is a lot of time to wait before starting fertility treatments, especially for an older couple. The wait would reduce the chances of success and make the whole process longer and more expensive. And maybe they can save $10K in a few years, but realize that they need to have that nest egg down in order to raise the kid, so can't spend it on having the kid. It just didn't seem to me that that level of thinking came across. Whether it really took place and the writer just didn't express it properly is hard to say.
posted by jacquilynne at 12:31 PM on April 21, 2003

if survival of the fittest was the principle moving force amongst humanity, there'd only be one of us left.
posted by quonsar at 12:34 PM on April 21, 2003

Sigh. I feel very conflicted after reading that article.
posted by padraigin at 12:37 PM on April 21, 2003

Perhaps they could set up a cyber-begging site. That way, whichever of their fellow taxpayers who want to help them can, but those who think this is a horrid waste of money won't have to be involved.
posted by ilsa at 12:38 PM on April 21, 2003

Where to begin?
How about: oh boo hoo.

Life deals you things unfairly, be it disease and the financial ability to afford treatment or infertility and the financial ability to overcome that. Notice how many of these women say they want a child because they have unlimited love to give. Most of the comments are about having children to fill a void or to placate friends and family. Perhaps therein lies the reason they are infertile.

I'm not saying that there aren't plenty of rich people who really should not be breeding, but if these women in the article looked at their lives, the universe is trying to show them something but they selfishly ignore that in pursuit of what sadly so many women use to define their existence -- motherhood.

I don't begrude anyone their pursuit of happiness, but spare me the "I just want the same opportunity as everyone else" line. Biology and genetics short-changed me a few things I would prefer to have.
posted by archimago at 12:42 PM on April 21, 2003

Survival of the fittest quonsar... simple as that.

Spoken like the generic 16 year old with DSL and ample spare time.
posted by y2karl at 12:46 PM on April 21, 2003

Witty: Oddly enough, you don't give your email address on your profile page. I do. I submit I am less anonymous than you as a result. Next strawman.

Let's cast this discussion in the right terminology: Witty et.al. are talking about Social Darwinism, a failed and ultimately immoral philosophy.
posted by Cerebus at 12:51 PM on April 21, 2003

Is having a child a right or a privilege?
posted by gottabefunky at 12:58 PM on April 21, 2003

What should we call it then?

I think the point is that the discussion cannot be summarized in any four words. Why do we need a pithy, reductive slogan? Let's have an intelligent discussion, instead.
posted by mr_roboto at 12:59 PM on April 21, 2003

Where to begin? How about: oh boo hoo... Biology and genetics short-changed me a few things I would prefer to have.

For example: empathy.
posted by jonson at 1:02 PM on April 21, 2003

You know, a lot of sperm banks actually charge more money for the genes of people who have PhD's or MD's. (Regular sperm generally costs around $250 a pop, and fancy-pants sperm generally costs around $350.) My partner and I have been searching for a donor and it is a little disturbing what a simple consumer transaction it can be to get the donor part. They even take credit cards, so you can have your smarty sperm at 15% interest!

We joke about naming our baby Visa or ordering him/her along with some kicky spring pants from AnnTaylor.com.
posted by pomegranate at 1:03 PM on April 21, 2003

I'm for intelligent discussion. I spend too much time wading through posts on the Craigslist Parenting forum by child-free advocates whose idea of advocacy is to come in, drop some nasty bomb about how wretched a woman's life becomes after parenthood and how all parents must, by definition, be evil environmentally unconscious SUV drivers whose only goal is to overpopulate the earth and bring their screaming brats to restaurants to annoy others.

I enjoy having my child. I have always thought that extreme fertility measures seemed pointless, that you should play the hand you're dealt. I still think that. But on the other hand...I enjoy having my child. I think I'm good at parenting her, so far. I wouldn't want to be the one to deny someone else the same opportunity.

But so much about the philosophy of medical care in this country would have to change in order for it to even begin to make sense to provide infertility treatment as a matter of course. For one thing, it would have to start making sense to provide any medical care at all as a matter of course. I certainly wouldn't recommend parenthood to someone who doesn't have any medical insurance at all, even if they could get it for the child once it's born. Parenthood, done properly, requires a lot of responsibility, and that responsibility includes a whole lot of insurance, medical and otherwise.
posted by padraigin at 1:07 PM on April 21, 2003

I concur.

Plus they could always, you know. [2 sep. links]
posted by Ms.JaneDoe at 1:09 PM on April 21, 2003

sperm generally costs around $250 a pop

holy shit! i'm gonna undercut everybody else and grab me some market share!

[whappa whappa whappa]
posted by quonsar at 1:11 PM on April 21, 2003

gottabefunky: It can't be a privilege. The instant you place child-bearing into that category, you must ask-- "From what authority does this privilege extend?" From there, we must discuss the mechanism of how that privilege can be revoked.

This opens the door to the State dictating who can and cannot bear children (and when, and how many, and in what condition), which is territory I should hope we fear to tread-- if only because of the examples of WWII Germany and present-day China.

So for lack of a better category, child-bearing is a right.
posted by Cerebus at 1:11 PM on April 21, 2003

jonson -- I empathize with people who deserve it. Infertility, despite what the author wants us to believe, is not a medical "problem" like lupus that insurance companies should be forced to cover. A medical problem is one that threatens one's physical health and/or restricts one from living a typically productive life.

Read the online comments jaquilynne posted. The author responds only to the letters that praise her and she still calls infertility a medical problem, comparing it to debilitating injuries.

Shameless.
posted by archimago at 1:13 PM on April 21, 2003

Survival of the fittest quonsar... simple as that.

Fascinating and humane ethical principle, Witty (whose age and email address status are irrelevant in a discussion of his obviously well thought out and historically benevolent ideas).

Perhaps, Witty, given your values, we could be a bit more proactive and just sterilize those who don't qualify for capital gains tax cuts, as an additional fiscally responsible, societal cost saving in line with the current Republican administration thinking on these issues. After all, one supposes in a certain literal sense that the rich ought to be the only ones reproducing, given the overwhelming experience they've gained in fucking the rest of humanity over from time immemorial.

In other news, my newsrag this morning notes the "possible" find of 500-600 million American greenbacks stuffed into Saddam Hussein's mattress. And there was some blurb about Enron's Ken Lay on the business pages that I simply glossed over in my eagerness to read about the upcoming auction of Imelda Marcos' jewelry.

All hail Witty's pinnacles of evolution.

~wink~
posted by fold_and_mutilate at 1:22 PM on April 21, 2003

jonson -- I empathize with people who deserve it

Seriously, though, don't we all? I mean, if we're the arbiter of who does and doesn't deserve it? Let's say I had no conscience whatsover for the woes of others, wouldn't I just be saying that they "don't deserve" empathy. Isn't, in fact, empathy all about putting yourselves in the shoes of someone you would have a hard time identifying with?

To be clear, I'm actually very much on your side in this issue, I'm largely against people having children, unless they are the most likely to be able to raise those children in a stable environment with good education & health care, and enough money to make sure the kids have the proper amount of attention. I just feel like your statements are a sort of agressive attack on these poor (not unfortunate: poor, as in not having a lot of money) people who only want what wouldn't be denied them if not for unlucky genes.
posted by jonson at 1:22 PM on April 21, 2003

it's time to cease taking witty seriously, and favor him with the sort of treatment he himself would dole out to spics, niggers, nips and towelheads.
posted by quonsar at 1:33 PM on April 21, 2003

As a father of three great kids, I know how much joy children can bring, along with all the work. But I'd hesitate before backing taxpayer-funded fertility treatments for people who want children but can't even afford to care for a puppy.
posted by sacre_bleu at 1:40 PM on April 21, 2003

infertility a medical problem, comparing it to debilitating injuries.

It is a medical problem. Is it one that needs fixing? That's the question.

I think infertility gets lumped in with things like orthodontics and laser eye surgery--If you want straight teeth, 20/20 vision without glasses, and babies--well, you should get some money, then. But it might be a little more complex than that.

Or, it might not be. Continue discussing.
posted by padraigin at 1:40 PM on April 21, 2003

Your forgot to call him a Nazi, quonsar.
posted by paddbear at 1:41 PM on April 21, 2003

Am I a scoundrel for just letting Genetics deal with it? I mean if your Genetic makeup is not conducive to spawn, why argue with it? If it is then good. This is the way we evolve folks.

In the Loooong run (got a single or multiple generations but hundreds of them) it works out to a better species (more able to adapt in its environ) then previous ones... Mutations tend to get weeded out or watered down..

Notice I do not mean let bieng rich or poor or deserving, just let fertility in general, be the guide.

Seems like we have a built in governor in the system already with out getting into this privildged, non privileged, rights, no rights issue....

And you always can adopt, unless you thing YOUR genes are better than mine, then you ARE to stupid to spawn....
posted by Elim at 1:42 PM on April 21, 2003

Part of the point of the article was that the people featured were too poor to adopt.
posted by agregoli at 1:46 PM on April 21, 2003

And you always can adopt, unless you thing YOUR genes are better than mine, then you ARE to stupid to spawn...

No, you can't always adopt. Women don't tend to give up their babies for adoption anymore (witness the onsite daycares that have proliferated at high schools nationwide), and the much-touted "special needs" kids that are just anxiously waiting for us all to come and love them and take them home, are hidden behind fences of red tape and bureaucracy, damn near impenetrable to most of us.

It's a lovely idea, but regardless of whose fault it is that it works this way now, adoption is not the easy answer we'd like it to be.
posted by padraigin at 1:48 PM on April 21, 2003

True, and that shouldn't be either...
But I'm poor too, So in this country I as Doubly Second class... Third maybe
posted by Elim at 1:49 PM on April 21, 2003

Well, the lovely thing about America is that being born poor doesn't mean you have to stay that way. If you feel as though you're perceived as second class, and it bothers you, you've got a way out thanks to the magic of capitalist democracy.

(and the ability to sell your shit on eBay)
posted by padraigin at 1:54 PM on April 21, 2003

Your forgot to call him a Nazi, quonsar.

It was a quote--did you bother to click on the link or were you quietly being ironic? God, perhaps we need a whole other level of emoticons.
posted by y2karl at 1:55 PM on April 21, 2003

For their efforts they bring home around $1,700 a month after taxes, of which at least $170 goes to pay their tithing to the Mormon Church

At least they aren't Scientologists, I understand that Scientology is really quite expensive.

Maybe they should pick a free, public domain religion instead? One with a GNU license?
posted by chrid at 1:56 PM on April 21, 2003

Well, you know, as Mormons they believe that they have a divine mandate to provide vessels for souls who await birth. And they also believe that if they're not tithing, they're sure as hell not going to get their prayers answered.

You can snark on their faith, but you should understand where they're coming from before you do.
posted by padraigin at 2:00 PM on April 21, 2003

Am I a scoundrel for just letting Genetics deal with it?

No, but do you think we should prohibit fertility treatments entirely?
posted by Yelling At Nothing at 2:01 PM on April 21, 2003

I don't think they can be prohibited now. But it's one area of science I almost wish we hadn't gotten so good at.
posted by agregoli at 2:06 PM on April 21, 2003

padraigin: Traditionally, the idea in this country has been that even if you're poor, you could work hard and make a life so that your children could still be better... Oh, wait.

Scratch that.
posted by Cerebus at 2:09 PM on April 21, 2003

metatalk thread about witty's uninformed racist ramblings and their obvious value to the universe.
posted by Ignatius J. Reilly at 2:09 PM on April 21, 2003

I pay for health insurance. My insurance company makes some very stingy decisions about how health care money is spent. There are limits to the amount of coverage available for life-saving medical procedures. The insurance company WILL NOT COVER you if you exceed these limits. In this case, you either pay for the life-saving procedure yourself or hope for some sort of help from a charity or government program. Or die.

If my insurance company cannot afford to save lives, why the hell should they cover outrageously expensive fertility treatments? This is the same as covering liposuction or plastic surgery -- these are elective procedures that have no real health-improving or -preserving value. These are vanity procedures.

Adopt. Pay for your own medically-assisted baby. I don't care about "natural selection" or any of the other red herring issues this issue brings up. For me, this is about money. If I pay into the insurance fund and play by their rules -- no elective procedures -- then everyone else should to. Making a baby doesn't automatically waive the rules. If you really want one, save some money and do it yourself.

No one owes you a baby.
posted by monkey.pie.baker at 2:24 PM on April 21, 2003

I'm not saying that there aren't plenty of rich people who really should not be breeding, but if these women in the article looked at their lives, the universe is trying to show them something but they selfishly ignore that in pursuit of what sadly so many women use to define their existence -- motherhood.

Aside from the very troubling class issues here, and the problem with locating everything only on the scale of monetary value, this argument -- and I've heard it before -- has always seemed to me to be misogynist. The other side of choice should be the freedom to have your baby, even if you should be poor, young, or single. I support choice, but I don't think this means that abortion should the only option for women; a culture that by and large hates children (regards them as expensive liabilities, for example, instead of human beings) tends to be a culture that hates women as well. Should poor couples have access to fertility treatments? The only criteria here, I think, should be: will they make good parents? Are they sane, loving, mature, stable, etc.? There's much more to good parenting than money.

I was young, poor, and one month into a relationship when I found out I was pregnant. Despite the unlikely looking prospects, all turned out well. Should I have been told that I had no right to raise a child because I needed to rely on state support for a couple of years? I've since paid back in income taxes far more than I ever recieved. People's circumstances change, life changes, money comes and goes. Freedom of choice should be exactly that: those who do not want children should never feel that they are compelled to have them, and those of us who did/do should be able to bring up our kids without social scorn heaped upon us simply because we "can't afford them".
posted by jokeefe at 2:35 PM on April 21, 2003

No one owes you a baby.

Well, nobody really owes me a prosthetic limb if I get my leg chopped off either, but I bet I'd really want one if it happened.

So it probably is with people who can't, for whatever reason, conceive naturally. I'm not saying they're right, I'm not saying that infertility should be something that is automatically covered under insurance policies (though it is on mine, not that I needed it).

But what you or I think should be gotten over, is another person's pretty big deal.
posted by padraigin at 2:36 PM on April 21, 2003

well put, jokeefe
posted by agregoli at 2:37 PM on April 21, 2003

And because of the social changes that have made abortion available and single motherhood acceptable, it is incredibly hard to even be able to adopt.

Which is why, of course, there are approximately a million children awaiting adoption in the US.
posted by five fresh fish at 2:37 PM on April 21, 2003

Who wants to email me? Why, I couldn't guess. But in an effort to make things fair for Cerebus... it's [e-mail] (at least one of them is).

Elim is on the same track that I am on this issue. But summing it all up in one sentence (whether accurately or not) was somehow ass-ish of me. So much so, that quonsar had to bring in a sarcastic comment I made in another thread that has NOTHING to do with this, in an effort to discredit my opinions even further. Cute.

I wish that the rich AND the poor could have an equal access to infertility treatment. But under the current system, they don't. The equal access I would hope for is NONE at all. I believe there's a reason that some people were struck with the awful reality of infertility. Messing with it is wrong to me. Creating a baby from where babies weren't meant to be created is wrong to me. I accept that there may be exceptions to the rule and that my "opinion" in this is certainly a sweeping generalization. But I'll take nature over a doctor any day.

metatalk thread about witty's uninformed racist ramblings and their obvious value to the universe.

Racist ramblings? Where? Huh?
posted by Witty at 2:42 PM on April 21, 2003

Which is why, of course, there are approximately a million children awaiting adoption in the US.

Yeah, you go try and adopt one, and see how easy that is. I spoke of this above. I'm sorry, and I don't know exactly who is to blame for it, but those kids who are awaiting adoption are pretty hard to come by, thanks to the extreme roadblocks thrown up by the system.
posted by padraigin at 2:42 PM on April 21, 2003

quonsar had to bring in a sarcastic comment I made in another thread that has NOTHING to do with this, in an effort to discredit my opinions even further. Cute.

you're doing a great job all by yourself, mate.
posted by sgt.serenity at 3:02 PM on April 21, 2003

Jokeefe has some interesting points, but I think it is entirely possible to oppose subsidized fertility treatments without being anti-woman, anti-poor, or anti-freedom.

I was young, poor, and one month into a relationship when I found out I was pregnant. Despite the unlikely looking prospects, all turned out well. Should I have been told that I had no right to raise a child because I needed to rely on state support for a couple of years?

Not at all -- I'm more than happy to help you support the kid. I'm just not willing to pay for you to make it. I believe wholeheartedly in a social support network for people who have fallen on hard times. I don't think this support network should pay for fertility treatments. I like the idea of subsidizing food, education, clothes, and necessities for poor people who exist. I don't support spending outrageous amounts of money on fertility treatments for poor infertile couples. This money could be better spent in thousands of ways.

I've since paid back in income taxes far more than I ever received.

This is a fallacious argument -- there is no "running total" from which you add and subtract. I'm not going to be able to "cash out" exactly what I put in. By your logic, I am "ahead" of you because I paid while you withdrew, and we are both paying now. Benefits aren't that simple. But making the transition into the working world and being able to support your family is important.

People's circumstances change, life changes, money comes and goes. Freedom of choice should be exactly that: those who do not want children should never feel that they are compelled to have them, and those of us who did/do should be able to bring up our kids without social scorn heaped upon us simply because we "can't afford them".

Again, I think the government should be doing much more to support the working poor, especially poor children. But I don't think anyone should be subsidizing fertility treatments--not the government, not insurance companies, not private charities. And I don't think these two beliefs are mutually exclusive.
posted by monkey.pie.baker at 3:03 PM on April 21, 2003

Health care in this country is rationed according to your ability to pay for it. On an emotional level, I really feel for families who want children and are unable to have them. But I feel even more for children who can't breathe because they can't afford asthma medication, old people who can't afford to get heart medication, anybody who can't get in to see a doctor for a checkup. Some of those people die early because they don't get needed medical care. We aren't taking care of the people we already have here.

Scares me silly thinking about getting laid off and not being able to afford health insurance. It's rotten that this extraordinarily wealthy country(U.S.) can't get real about health care for everybody.
posted by theora55 at 3:18 PM on April 21, 2003

monkey.pie.baker -- fair enough. But:

This is a fallacious argument -- there is no "running total" from which you add and subtract. I'm not going to be able to "cash out" exactly what I put in.

My point here was one that others have made (in reference to the idea of the "american dream"): in a society like ours, blessed with social mobility, and the possibility that intelligence and hard work (not always, but often) will be rewarded, it can be a continual give and take -- a flux. People move across the line all the time. (That this is getting harder and harder to accomplish is fodder for another thread.) I feel for women who want children, and who can't afford the treatment that will allow a pregnancy, and I'm saddened by the contempt their situation seems to invoke for some here... I find I want to make snarky remarks about the immorality of private health insurance, but I'm not sure that Canada's Medicare covers fertility treatments either. At any rate, thank for your response, and you too, agregoli.
posted by jokeefe at 3:19 PM on April 21, 2003

Argh -- evoke, not invoke. [/inner grammar nazi]
posted by jokeefe at 3:23 PM on April 21, 2003

I find myself on a slippery slope, no matter which side of the issue I argue to myself. On the one hand, I adore my baby...and understand why people want one. On the other hand, I want to be able to send him to college, so I don't feel that I should have to pay for other people's attempt at having one. (Especially since we've both been laid off...and cobra insurance is more expensive than my house payment.)

We wanted a child for years...and had great fun trying to create one. But, after 6 years of infertility, we figured that we weren't going to have one, and we'd have to be satisfied with spoiling the children of others instead. We considered fertility treatments briefly, but it felt too much like meddling in the affairs of the gods...and I really didn't want a litter of children. One=good...Six, not so good. (For us. No value judgement implied about other people's choices.)

I understand how others may have reached a different conclusion than we did. But, in an environment where many ailments and conditions are not covered by insurance or state assistance, it seems to me that fertility treatments shouldn't be included either. That being said, I think that prenatal care should be a huge priority, as good prenatal care can significantly reduce costs and problems later.

And to answer a question posed above, I do believe that having children is a privilege, not a right.
posted by dejah420 at 3:33 PM on April 21, 2003

"So for lack of a better category, child-bearing is a right"

I totally disagree with this. Child bearing is luck. Luck that you and your partner both have functioning parts that work together to make a baby. That's it. It's not a right nor a privledge. It's just luck. And some are unlucky. And I do feel for those people. I really do. However, no one is owed a baby (like Monkey pie baker said.) At all. If you can't make one and unfortuantely you can't afford to make one in a non-natural way, that's just too bad. I would be IRATE if my money went to medicare for people who can't have kids to have kids and add more people to medicare.

What I keep thinking about the people who mortgage their life for a baby is, "what on earth are they going to do if the baby is sick?" They have no health care, they have no money, they have no savings. Is a child THAT important?

Again, children are not a right. It is luck, pure and simple.
posted by aacheson at 3:43 PM on April 21, 2003

jokeefe, there is a huge gap between not taking away the children of people who are too poor to care for them, and helping people who are too poor to care for them to have expensive medical procedures (which they are also too poor to pay for) so they can have them anyway.

The answer to your point about fertility coverage in Canada is 'it depends'. Health coverage is a provincial concern, not a federal one, so it would vary from province to province. Apparently, Ontario covers some limited situations, but other provinces do not.

Some are arguing this from a position of 'right' vs. 'privilege', but I don't think that's where the argument lies. I'll agree that childbearing is a right, where the state shouldn't be allowed to interfere in the process. But the state shouldn't be obligated to enable it, either. Compare it to, say, free assembly. The state shouldn't stop the anti-globalization forces from peacefully amassing outside a WTO conference, but they shouldn't have to buy a bus ticket to Seattle for every activist who doesn't have $100, either.
posted by jacquilynne at 3:43 PM on April 21, 2003

Poor people suck.
posted by xmutex at 3:45 PM on April 21, 2003

Just a thought - I wonder how many people with fertility problems pass them on to their offspring born with the assistance of technology. That dooms the next generation to only being able to breed with expensive help, as well, and so on ad infinitum...

I agree with several here who don't want to subsidize fertility treatments. There are too many unmet medical needs for people who are already suffering - do they matter less than potential babies? This is not a situation with unlimited resources, folks.

How about the people who are willing to pay for others to have children get together their own health insurance plan?

One thing I haven't seen mentioned is that infertility treatments often result in multiple births. How is a family that can't afford fertility treatments supposed to deal with triplets?

I think the way our society values some people ridiculously more than others is disgusting and based more on bullshit dominance hierarchies and in-groups than actual worth. Rich people aren't inherently "better" than anyone else, and they don't deserve more happiness.

I'm not sure what the answer is. The situation sucks. At least it sucks slightly less than having children you can't feed and having to watch them starve, though.
posted by beth at 3:57 PM on April 21, 2003

I'm not touching this discussion with a ten foot pole, but a quick pointer to those of you citing darwin: Remember that as soon as you have infertility treatment, the fitness penality of being unfertile mostly disappears. If anyone can get infertility treatment without any penalties attached, (curable) infertility no longer factors into the fitness equation.
posted by fvw at 4:02 PM on April 21, 2003

Life is economics. Everything is economics. Don't let your emotions get too much in the way of this: if a couple cannot afford to provide for a child, there really is no defensible reason to take excessive measures to provide them with that child; it would be doing both the couple and would-be child a massive injustice.

I realize this story pulls on the heartstrings, but once you strip it of its emotional pulls, you're left with what I think can be safely described as logical conclusion.

That's not imply that impoverished people should never be aided and many of the responses in this thread seem to make just that implication from similar points.

There is naturally a limit to everything and sometimes life just isn't fair.
posted by xmutex at 4:07 PM on April 21, 2003

It's pretty extreme to stretch the logic of "if you can't afford for your own care, you shouldn't take on the care of others" into "let's sterilize the poor."

The people seeking the treatments in this article want some kind of fulfillment in their lives and they think having a child is the only way to attain it. It isn't.

Anyway, I don't like fertility treatments in general for the reasons beth brought up. I certainly wouldn't want to participate in them personally. Thus, I see no good reason to use scarce public health care resources to pay for them.
posted by wrench at 4:24 PM on April 21, 2003

I have some of the same concerns as beth and wrench -- I always wonder what medical problems the children are going to end up with. I doubt there's much interest in the medical community to research the fertility problems of children who were artificially conceived, but I do remember seeing recently a =marginally= higher incidence of certain birth defects for IVF babies.

Scientific/medical qualms aside, I have religious problems with most fertility treatments. I'm a Roman Catholic, and I'm rather orthodox when it comes to the fertility teachings of the Church. For those who don't share in my religion, my main objection to many fertility techniques is that it makes people products. Children are described as some lifestyle accessory that people must have, and something it's legitimate in spending lots of money to procure. I do wonder why those who have no problem with IVF get all hot & bothered with reproductive cloning -- it's the next logical step. If it's okay to go to some of the lengths currently on the medical market to produce children, if it's okay to pick sperm donor, to genetically screen embryos for defects, to harvest another woman's eggs for implantation in one's own body -- what's wrong with picking a particular set of genes for one's child?

But that's getting away from the topic of the article. I think there's a couple different things going on here -- I have no problem with "poor" people having children; it's not necessarily expensive to take good care of children. One isn't a deficient parent if one can't send a kid off to Harvard in a parent-bought Honda wearing Abercrombie & Fitch.

But the author never considers the possibility that perhaps no one should be able to buy fertility treatment. I wouldn't expect such a thought to pop up, though, in the land of Botox and liposuction.
posted by meep at 5:18 PM on April 21, 2003

Probably repetitive, but on this topic i cannot help myself.

First, for those of you who typically do not read the article and just scan the commentary, i would like to point out that the Penn State couple already has a child, and is sad not to be able to have another during their "temporary poverty." Their greed, and also the final example in the article, are the ones that drove me to post.

Yes, the full use of your human genetic potential is your right, not your privilege. However, IVF and other procedures are medically opt-in -- ie: "a privilege" that is, yes, available only if you can somehow afford it. Furthermore, babies aren't a privilege or a right. They are people. This article, the couples it interviews, and a lot of posters refer to them more like exotic pets or, to coin an example from the author, DVD players.

Furthermore, many of the couples in the story have simple financial difficulties which, if solved, would aid their baby-quest: a badly chosen health insurance policy, tithing, & high mortgage payments are key examples. The latter couple, who is now pregnant (and additionally has child from a previous marriage) says "We could be like a lot of people: Get ourselves a lawyer and declare bankruptcy. Get a deal with a finance company so we can stay here. But we're not that kind of people." It seems to him a real possibility that they might lose the house. Unfortunately, the article makes it unclear if this decision is out of pride or out of necessity, but either way the statement exemplifies a concept that is highly American in nature: feeling that everything is a right.

Though i fully agree with a lot of the negative commentary that has appeared in this thread, it is this assumption of the final two couples that turned me off to the article. In the case of the Mormon couple: they already have a child, they are in an area of Pennsylvania with limited employment opportunities, and they give 10% of their monthly income to a church. I refuse to even remotely care about their plight.

For these people to be held in comparison to Sam, a woman earlier in the article who has overcome adversity and has all-but exhausted her own resources, is disturbing. I don't mean to derail the thread, but though i feel for Sam and others like her, i would rather that our tax dollars be spent to keep people alive through better STD awareness and education -- $10k is enough to train student facilitators in a huge chunk of an urban school district to pass on appropriate sexual education to their peers. Chew on that one.
posted by krisis at 5:20 PM on April 21, 2003

When middle-class and wealthy people are infertile, they lobby Congress for better insurance coverage for fertility procedures...

What hopelessly lost liberal clap trap. The middle class and the wealthy postpone their child bearing years to further their education and careers. When they run into difficulty conceiving they can afford the best medical technology offers.

When the poor make no such investments in their future and then run into difficulty conceiving, it's just plain bad luck for them. It sucks to be poor. That's why people work to avoid being poor.

If this concept seems difficult to grasp, experiment by substituting the word "baby" for "cadillac".
posted by paleocon at 6:15 PM on April 21, 2003

least $170 goes to pay their tithing to the Mormon Church

Okay, so these guys pay 10% of their income to a religious group, and then complain about being poor?
Let their God help them, I say.
Maybe they'll figure out that they should have saved the money for a fertility clinic when they are 56 and to old.

And what the hell is wrong with this guy anyway? Does he really want to have a baby while going trough medical school? Are they NUTS!?

All in all, I'd like to paraphrase what quonsar said:
"Survival of those who are not suckered in by religion".

Maybe there's hope for humanity after all.
posted by spazzm at 6:38 PM on April 21, 2003

I mean "paraphrase what Witty said". Sorry.
posted by spazzm at 6:39 PM on April 21, 2003

What I want to say is this:
These people give money to their favored religion, and then complain about being too poor to get babies.

I think a great man/woman long ago said it best, really:
"You can't have your cake and eat it too."
posted by spazzm at 6:45 PM on April 21, 2003

The Final Word is This:

"STUPID PEOPLE SHOULDN'T BREED" - Skatenigs.

and most people of whatever economic class are stupid.
posted by jonmc at 7:52 AM on April 22, 2003

Interesting sidenote: Under ERISA (The Employee Retirement Income Security Act of 1974) and the ADA (the Americans with Disabilities Act), infertility is classified as a disablity.

See Bragdon v. Abbot, where SCOTUS held (2 links) that since a person with AIDS cannot reproduce, AIDS is a disablity protected under the ADA.

Somewhere in here is logic to make an argument that infertility treatments should be covered by health insurance, but my brain is too tired to wrap around it.
posted by lubricumlinguae at 1:03 PM on April 22, 2003