I got my girlfriend pregnant.
That is the key fact you need to know about me, and that one fact alone will probably tell many people everything they need to know. So, for example, if you’re a social conservative, you may be putting together a certain profile in your mind right now, a profile of someone irresponsible, possibly very young, possibly some sort of brown minority, certainly irrelegious. I, of course, am putting together a certain profile of you, too, and it’s probably equally unfair. On the other hand, my prejudices aren’t impoverishing families and incentivizing abortion. Not that I know of, anyway — feel free to write in.
Let me start again. I got my girlfriend pregnant. This happened in the usual way, which was surprising to everyone involved, because I had more-or-less determined, for religious reasons, not to have sex again until I was married. On the other hand, I was pretty sure right from the start that this was the woman I wanted to marry, we were both in our early thirties and not kids anymore, and I had had sex before. So there wasn’t a whole lot of upside to waiting. After all, it might be another six or nine or twelve months before we got around to getting married! (This, as you will see, turned out to be a radical overestimation.)
The other reason I didn’t hold to my religious pledge was that I had, over the course of a yearlong combat tour in Iraq, come to be much less sure that God was looking out for me and for the world. The reasons for this are complicated, but the bottom line was that wispy promises of an undescribed, if presumably glorious, afterlife had come to seem much less important than attending to my own happiness and the happiness of those around me.
(Also, if God really wanted people to remain completely chaste, He certainly arranged the world in a very odd way, setting up a system of perverse incentives that guaranteed that in a free society, even good, pious people would break the law. So I was left with the following possibilities: (a) God wants us to live in an authoritarian, puritanical society, (b) God doesn’t give that much of a damn about people having sex, (c) God doesn’t exist. (I suppose there’s a fourth possibility — that is, (d), God is not terribly competent. But to my way of thinking, that didn’t seem a whole lot better than (c).))
One more time, and I think I’ve got it: I got my girlfriend pregnant. We hadn’t been dating for that long, and though we knew right away that we loved each other and had already had many conversations about getting married — long, detailed conversations that we called “Contract Negotiations” — we were startled, dismayed, and, at first, in denial. We would lie in bed and say things like, “Well, what are the chances?” and “My period is often on the late side!” But in our minds, we replayed The Incident over and over again, and we were sure.
We were also sure because my girlfriend had been monitoring her fertility cycles. This is the ironic part — we know exactly when she ovulated. Unfortunately, an early temperature spike — she’d had a mild fever that week — led us at first to hope that we had missed the dangerous window and all would soon be well.
(My wife, looking over my shoulder just now, asked if I was going to blame the Taking Charge Of Your Fertility book for our pregnancy. No, I am not. However, gentlemen, a word about fertility monitoring. It might seem like a good idea — a sort of belt-and-suspenders backup to let you know exactly when your girlfriend is a vessel of guilt-free pleasure and when she’s a hot, ripe petri dish of potential reproductive disaster. First, I would say you shouldn’t think of your girlfriend in either of those ways — it’s not nice. But second — and please, please remember this — fertility awareness is to pregnancy what a missile shield is to nuclear war: an invitation to foolhardiness.)
What are the ideal circumstances under which one hopes to become a parent? We had asked this question many times while dating, and we had worked out quite a sensible series of answers: we had calculated the necessary family income, the careers which would be stable enough for a kid to a have a healthy childhood, what sort of livestock we hoped to keep on our small family farm in upstate New York… it was very detailed.
Unfortunately, we didn’t have any of that yet. When our gametes joined in glorious union, neither of us had a job. This was by design. I had recently finished a combat tour in Iraq as well as my commitment to the Army, and I was taking some time off. My girlfriend was just beginning to gain traction in the monster truck free-for-all of Hollywood screenwriting, which meant she had to spend all her time going to meetings and coming up with pitches, although she had yet to see dollar one from any of it. We had both saved a little money, and we had fairly low-cost hobbies (braising meats, reading things to each other on the internet), so neither of us had been worried much about finding a job anytime soon.
A half a dozen dollar-store pregnancy tests, of increasing levels of positivity, will, naturally, light a fire under your ass.
When you get somebody pregnant, however, the part of your brain devoted to arithmetic and accounting — you know, that dusty hand-cranked mechanism that most of us have put in the very back of deep storage and don’t even bother to haul out once a year in early April now that someone invented tax software — that part of your brain suddenly whirs to life, its keys clacking furiously, dribbling little receipt tapes from its serrated lips:
We were fucked.
We were fucked because we fell into a weird crack in the otherwise, I’m sure, solid asphalt of American health care.
Below a certain level of poverty, the state of California will help you have a baby through a program called Medi-Cal. Medi-Cal, like all state programs for ne’er-do-wells, requires you to fill out a ton of confusing paperwork and submit it to a hostile gatekeeper, probably (for demographic reasons that are unclear to me) a heavyset black woman. However, because we had more than $3,000 in the bank and more than one car, we didn’t qualify for this program. We pondered various schemes to hide our, uh, assets for a while, but in the end we decided that fraud and money-laundering were beyond us.
But because we were unemployed, we also didn’t qualify for the California Program For Contributing Members Of Society Who Just Need A Hand Up, Not A Hand Out — or Access for Infants and Mothers, as it’s officially called.
So we considered our options.
This last option really appealed to us. We were hardworking (you know, normally) capitalist Americans who didn’t really want anything handed to us. We wanted health care, and we wanted to pay for it. We were willing to fork over a certain number of Benjamins to a Kaiser or a Blue Shield or any other martially-named private company that was willing to cover our birth. (I had had Kaiser before, and as a healthy young man who never really used the service, I was treated very well.)
However, we quickly realized that insurers, very naturally, considered it something of a risk to take on a new client who was already pregnant. That is, they won’t do it. Consider it from their point of view. A woman who is already pregnant is very likely to have a baby, which is expensive — ten grand on prenatal and an uncomplicated birth would not be an off-the-mark estimate. If something — anything — goes wrong, the cost goes up. If there’s a cesarean, if the baby has to be put in NICU, if the mother has post-partum hemorrhaging and has to stay for treatment and observation, the cost goes up. A few hundred dollars a month in premiums over the nine months won’t begin to cover it. How long would it take them to recoup their money from you? A lot longer than you’re likely to keep that policy. It’s just not worth it for them. Pregnant ladies are money-losers.
Because we had already foolishly gone to Planned Parenthood and gotten a real pregnancy test just to be sure, we couldn’t pretend we didn’t know. (Tip for all you uninsured folks out there — never go to the doctor. It only screws you later when you try to get insurance.) Because we were unemployed and didn’t know when we’d have money coming in again, we couldn’t rely on trying to pay for a birth in cash. It was a pretty dark time. We didn’t think we’d be able to have the baby. It seemed like keeping a child — when we had no jobs and no prospects and were hardly sure we’d even be able to pay for ourselves — would be an act of monumental ego and selfishness.
I had always been against abortion — not in the way that leads people to block clinics and scream at pregnant teenagers, but in the sense that I always thought that I would never want any woman I might be involved with to have one, and would counsel anyone I knew to avoid having one if at all possible. Now, although this story has a happy ending, with a moral even the stern new German pope would approve of, I can only say that somewhere out there, in some alternate universe, is a nearly identical version of me who made a different choice. And I don’t blame that guy. Not at all.
My girlfriend had recently bought a giant white board for outlining screenplays. Since The Incident, however, all her creative faculties were engaged in Worrying About Our Apparently Doomed Future!! So we sat down in the kitchen of her apartment with the white board and outlined our options once again.
One possibility that came up was the idea of my joining the military again. I had been an Army intelligence analyst and Arabic linguist for 14 months in Iraq, and that was after three years of language school and a bunch of other training — I was a capable and experienced guy.
I contacted the Navy — I had read about direct commissioning of officers in the Navy Reserve, and I thought with a prior military intelligence background I was a good candidate. But the Navy recruiter for Los Angeles wasn’t really that interested. “It’ll be at least a year,” he said, his voice betraying a pretty obvious lack of enthusiasm for dealing with a prior-service recruit who wouldn’t count towards his monthly quota. “And you’d have to do all your own leg work. And you’d have to get a conditional release from the Army, but they only do those for three months at a time.”
“Oh,” I said.
“Of course, if you wanted to improve your chances, we might be able to switch you from the Army IRR — ” (that’s the Individual Ready Reserve, a kind of inactive status you stay on for a few years after leaving the service) ” — to the Navy drilling reserve. That would probably look good on your application and might make things go faster.”
“Oh,” I said. “Where do they drill?”
“At the naval base in San Diego,” he replied cheerfully.
Maybe he can’t read a map.
I had a lot of bad things to say about my time in the Army, but grant them this, at least: they’re desperate. Eight years of constant, grueling warfare have made the Army desperate to retain every soldier they can. So about once a month since I had gotten out of the Army, they would call me — nice, solicitous Sergeants First Class, men and women used to barking orders who were now forced to remain calm and jocular in the face of, well, utter disdain from former soldiers who had finally thrown off the yoke, grown out their beards, and started smoking pot again.
And so it was that I found my rightful place. Home is the place where, when you have to go there, they have to take you in, according to Robert Frost, and apparently that was my relationship with the Army. I didn’t even have to call them — not long after the Navy gave me the brush-off, the Army called up of its own accord:
“So… how have you been?”
“Oh, fine, fine.”
“Are you… is there anything going on in your life?”
“No, not really — ”
“Because I’d heard… well… never mind.”
“Nothing, it doesn’t matter. Just, you know, I had heard something about you and the Navy — ”
“Oh, no. We were just — ”
“Because that’s fine! I mean, if you want — ”
“No — we were just talking. You know… just… talking….”
“So, uh… what’s up?”
“Oh, I just wanted to see how you were doing. You know. Hear your voice. I mean, we’re still friends, right?”
You know how the rest of that conversation goes. We got back together.
So I went back in the military. I’m grateful, every day, that that option was available to me. It most assuredly would not have been if I’d been one of the many thousands who had been permanently injured in combat or one of the tens of thousands each year who are forced out of the military for unavoidable medical issues or if I had ever had, for example, some sort of credit problem or a criminal record (even if not convicted). Or, you know, if I were some sort of homo, though I suppose then my chances of getting anyone pregnant would have gone way, way down.
So I got lucky. I got lucky, for the time being. If I stay lucky, I’ll always be able to provide for my family through military service. For now, I’m signed on with a Reserve unit of Korean linguists. I haven’t used Korean in about four years and barely remember how to say “My hometown is full of trees,” but they’re sending me back to school in the fall. I’m happy to be involved in America’s last cold war, keeping a suspicious eye on the Pipsqueak Premier of Pyongyang, but I have to say — this is ridiculous.
Our whole system of providing people health care in this country is ridiculous. I’m as much of a capitalist as anybody — in my twenties, I was even president of my own corporation — but Adam Smith-style capitalism fails miserably when it comes to health care. The reason is obvious — Smith was writing about tangible goods like corn and iron, and about the labor involved in producing those tangible goods. When I buy corn, I know how much I need, and the person selling it to me knows how much he wants to sell it to me for in order to recoup his labor costs. If he won’t give it to me at the price I want, I may go to another dealer, or I may buy less of it than I intended. And the market sorts this out pretty well so that things are about as cheap as they can be, but no cheaper.
With health care, though, you can’t be satisfied with buying less. If cancer treatment costs $200,000, you can’t say, “Oh, well, that seems expensive. I’ll walk around a bit to the other stalls and see if you decide to bring the price down a bit.” You say, “Yes! Give me the treatment! Here is my firstborn! She is quiet and well-behaved and could grow up to be a successful accountant!”
The easiest way to deal with this problem, of course, is by pooling risk through insurance. Everybody pays in, and those in need avail themselves of the service. Unfortunately, this is precisely where the free market in insurance — at least as presently constructed — completely fails us. Insurers naturally want to take as many healthy people and as few sick people as possible: healthy people pay money in, sick people take money out. Healthy people, meanwhile, may not have a lot of interest in paying for a service they’re not using, while the sick may be unable to afford anything but government insurance.
Obviously — and for fuck’s sake, let’s stop pretending otherwise — the simplest way to deal with this problem is to have one mandatory risk pool: everybody pays in, and the probabilities are spread over the largest possible population. And if you won’t listen to me, well, I’m just going to get you to underwrite my health insurance anyway, by joining the military. Your choice — I’m getting socialized medicine either way.
Here is a picture of our glorious backyard wedding. Trust me — it was cute. There were hamburgers. And pies. And dogs running around. It was a good time.
Anyway, now the adventure begins.