Monday, March 14, 2011

Runny noses and class warfare

The Grape has yet another nasty cold, bringing his total illness tally during this interminable winter to about a dozen. And he doesn't even go to daycare.

There's nothing like having a cranky kid whose nose runs like the bathtub faucet, who wants to sleep for ten minute spells - in his stroller only - and who stages multi-day hunger strikes to remind me that despite my feelings to the contrary, I indeed get a lot accomplished on a typical day hanging out with the Grape.

All bets are off when he's under the weather. Today, the third day of his food boycott, I actually bundled him up and marched off to the mall food court. Usually a cheese quesadilla kids' meal from the local burrito stand would make his day. Today he got excited while I made the purchase, but by the time I triumphantly laid out his junk food feast on his tray, he was pushing it away and screaming, "No! No way!" Strangers looked at me with disgust. Look at that awful woman. Her poor kid probably just wants a nice piece of fruit. Something wholesome. Not that garbage.

I draw the line at explaining myself to random mall patrons. They probably wouldn't believe that the Grape had, just an hour earlier, reacted in an equally negative manner to six varieties of fresh produce, both Greek and domestic yogurt, whole wheat toast, pancakes with maple syrup, raisins and fresh mozzarella cheese.

Aside: Nobody told me that having a baby meant wasting so much food. I routinely pack the Grape's rejected meals in Tupperware to offer again later. But there's only so many times you can salvage the ruins of lunch from his tray. I hate throwing away food. Yet I now do so almost daily. There. I feel better for confessing that.

Anyhow, I am confident that the Grape's food court protest wasn't meant to communicate a frustrated desire for superior nutrition; he was telling me that he doesn't feel well and he is therefore pissed off.

But this will pass, hopefully within the week. And he won't starve so long as he continues to chug chocolate milk like it's the sole reason he was put on this earth.

I'm one of the fortunate moms who can thank my lucky stars for a healthy child.

With all the belt tightening and budget cutting being debated in Washington and every state in the union, it's getting more and more dangerous to get sick.

I honestly don't understand how people with seriously ill children manage, especially in rough economic times when health programs and other benefits for the children of the poorest of the poor are being eviscerated all over the country.

Today Lisa Belkin's Motherlode column (link on the side of this page) profiled the mother of a teenaged boy somewhere in South Carolina. He suffers from severe metal illness and no longer receives services from the state because of budget cuts. The mom in question had to quit her full time job as a public school teacher to supervise her son 24/7 because he's periodically violent and he has the decision making capacity of a much younger child. Not a safe situation on the best of days.

After a year the mom suffered a nervous breakdown. She committed herself to an inpatient mental health facility.

Because she knew that doing so would force the state to take her subsequently unsupervised son into a residential treatment program. It was the only way she could get him the help he needed.

The resulting cost to South Carolina's taxpayers will far exceed the amount the state would have spent on outpatient preventative care. Yet we can expect more unfortunate stories like this, since mental health programs in several states have been trimmed back to Reagan era levels.

Ten minutes down the road from us, hundreds (if not thousands) of parents strain their finances to the breaking point every year because their children have fallen ill. The Grape had a brief stay at Children's Hospital as an infant. Some of his ward neighbors weren't as lucky.

Many of the cancer kids, and those with severe birth defects, had traveled across oceans to see the specialists here in Boston. Many had been stuck in hospital beds for months. A few of their parents were wealthy beyond imagination; most were scrapping and stressing over paying the hospital bills, the accommodation bills for themselves and all the bills back home that don't stop just because life does.

Thanks to last year's (deeply flawed but better than nothing) health care reform legislation, insurers can no longer deny coverage to such seriously ill children. But the law includes no mandates for cost controls, which leaves millions of families one major medical event away from bankruptcy.

Which brings me back to the Grape. He had surgery as a four month old. Insurance paid most of the bill, all but a thousand dollars. Had they not, we would have been on the hook for somewhere north of ten thousand dollars. Which to most people is a lot of cash for an unforeseen emergency.

Medicaid might have picked up the surgical tab for a child in the Grape's shoes, but I wonder whether a Medicaid baby would have received the same attention during the long and frustrating diagnostic process.

Many of the best docs on the planet missed the Grape's problem. More than once. R. and I kept pushing back, telling them they had to be missing something, until months after the Grape started yowling in pain around the clock, a radiology resident witnessed a series of the Grape's pain episodes and took it upon himself to take a second look, further up the digestive tract that the GI's had told him to focus.

Ditto for my niece, whose orthopedist prescribed casts on both legs to correct an alignment problem during her first six months. My brother's family has good insurance. Parents of a baby with turned in ankles but without comprehensive medical coverage would be faced with an unpleasant choice: hope her legs resolve on their own or pay tens of thousands of dollars to fix a non-life-threatening but certainly life-downgrading condition.

This is a rich country, despite what so many Chicken Littles in Washington claim. The cost of borrowing has never been cheaper. If necessary, we should add to the deficit to pay for health care for children. But the thing is, I don't believe it's necessary.

A friend of mine shared this chart last week. It shows the costs of various spending cuts and increases currently on the table in Congress. Like any chart, it's imperfect. But even if you discount the estimates by a large percentage, its overall conclusions won't change:

Gandhi said that one can judge a civilization by how it treats its animals. I've always agreed with this sentiment, but lately I can't help but wonder: Perhaps we should judge our society by how we treat our children.


  1. And here in socialist Finland, my two weeks in the hospital, emergency c-section and three months of neonatal intensive care for our tiny preemie set us back a whopping 650 euros, about 1000 dollars. I am one happy taxpayer.

  2. 3 months!?!? All that would cost six figures here for the uninsured. Easily. I am curious as to how they arrived at the figure of 650 Euros... Is there a standard nominal day rate that adds up, or do they charge for certain "extras"?
    When my grandmother was in the ICU for several months in Finland, we got a phone bill but I believe that was it.

  3. And to be clear for foreign readers: the thousand dollars for hospitalization is in addition to monthly insurance premiums, which add up to almost $2000 a month for our family of 3! Yet much of the public doesn't want a public health care option due to costs. It boggles the mind.

    I doubt the increased tax costs to the average family, or any family, would amount to a $24,000 increase on their annual check to the IRS. And I would love to get rid of the insurance bill...

  4. The 650 euros (or something like that, I don't remember the actual figure) is the top limit that you have to pay for hospital care per year, the rest is free. Fees for children under 18 are lumped together with a parent. There is a day rate for hospital stays that adds up (something like 20-30 euros per day) but that's just for taking up bed space and eating their food; all medical care, operations, medicines etc. are free. This is for public hospitals; there are also private ones where you or your insurance pay for everything, but they mainly offer care for non-life-threatening conditions - cosmetic surgery, laser eye surgery and such. Neonatal intensive care is the domain of big university hospitals.

    As for your grandmother, I'm not sure how the system works with pensioners - maybe they get everything for free, or it's deducted automatically from their pensions.

    When Veera was born, I read a lot of books on premature babies. The American books cited six-figure numbers for several months in a NICU, but did helpfully mention that hospitals can give you a lifelong payment plan and not expect you to pay it all in one go...

  5. For the interested, here's a summary of the public health care charges in 2010:,404,4024,4023,6185