What the Affordable Care Act Gets Wrong

Poor form to be contrarian following a week liberals can’t stop celebrating, but count your blessings I’m done writing about golf. For now at least. I always reserve my right to tap my inner Alan Shipnuck.

Thursday night near the end of another spirited training ride. Soft spinning on North Street, two friends and I head for home. One is a well-to-do 59 year old who just retired. His very nice lake home is paid for and he and his wife just returned from another trip to Europe. Euro vacations aside, as his threadbare cycling gloves illustrate, he’s actually on the frugal side. He says he can afford the vacations because of the gloves. Decades of having made very good money no doubt help too.

“You’ll never guess what medical plan I’ve signed up for,” he says. “No clue,” I replied. “Medicaid!” “Wait, you’re 65?!” “No, I’m 59, that’s Medicare. I was surprised to learn I qualify for Medicaid because I have no income now.”

Quick google search. Medicaid is “a U.S. government program, financed by federal, state, and local funds, of hospitalization and medical insurance for persons of all ages within certain income limits.”

I was stunned. He told me a person can make about $20k/year and still qualify for Medicaid. He hardly has any capital gains because he hasn’t sold any assets for a long time. Apart from his international vacations, I’m guessing his expenses are minimal and he’s living off of savings that he previously set aside. I’m not sure how he’s sheltered his wife’s income.

Then he tells me the adult son of a mutual cycling friend is also getting “free” Medicaid despite the fact that he has a very large trust fund that must consist of tax-free municipal bonds.

Undoubtedly, if my friends are doing this, so are other high wealth/low income people. Especially those whose income stems largely from tax-free municipal bonds. Why isn’t anyone writing about this gigantic loophole and what we should do to close it?

More generally, why does the Affordable Care Act (ACA) use income as it’s sole reference point instead of some combination of income and wealth? The same can be asked about the IRS and college financial aid offices. When it comes to health care premiums, college financial aid, and taxes more generally, it’s far better to be wealthy than to have lots of income. Just ask Mitt Romney. My guess is, and I’d love a more tax savvy reader to enlighten us on this, IRS agents, ACA bureaucrats, and college financial aid officials are unable to determine people’s total wealth with any certainty.

Why not ballpark it though I wonder. If the government knew my friend owned his home outright, would it compromise his Second Amendment rights to privacy? How do we balance well-to-do people’s right to privacy with public policies that, through subsidies, take from those of modest wealth and give to those with considerably more?

Very Smart Writing on Teens

There should be a literary award for the author who writes most intelligently about teens. The person who best rejects mindless stereotypes and embraces their humanity. My nomination for this year, Rachel Cusk, author of a New York Times Magazine essay titled, “The Mother of all Problems: On Raising Teenagers“.

My favorite paragraphs:

But now my daughter’s friends encounter me in the kitchen, in the hall, with barely a word of greeting. They are silent; they look shiftily to the side. They move on fast, up to my daughter’s room, where the sound of talking and shrieking and giggling resumes the instant the door is closed. Quickly they forget I am there; when occasionally they emerge for reinforcements and supplies, they talk in front of me as though I am invisible. Invisibility has at least the advantage of enabling eavesdropping: I listen to them talk, gleaning knowledge of their world. They talk with striking frequency about adults, about the people they now encounter in shops and on buses, the people who serve them in cafes or sell them things. They talk, less mystified, about their teachers. They talk about their grandparents and aunts and uncles. They talk about their fathers, usually with an experimental air of equality, as if they were trying on a pair of shoes that were slightly too big for them. But most of all they talk about their mothers. Their mothers are known as “she.” When I first heard about “she,” I was slightly puzzled by her status, which was somewhere between servant and family pet. “She” came in for a lot of contempt, most of it for acts of servitude and attention that she didn’t appear to realize were unwanted, like a spurned lover continuing to send flowers when the recipient’s affections have moved elsewhere. She’s such a doormat, one of them says. When I forget something I need for school, I just text her and she comes all the way across town with it. She’s so — pathetic. I don’t know what Dad even sees in her. Why doesn’t she get a job or something?

The talk of these girls brings on a distinct queasiness. I think of the many women I know who agonized over work when their children were small, who curtailed and compromised and very often gave up their careers, sometimes in the belief that it was morally correct and sometimes out of sheer exhaustion. Dad, meanwhile, is revered for his importance in the world. I hear them discuss, with what I am guessing is a degree of exaggeration, their fathers’ careers and contacts and the global impact of the work they do; unlike “she,” their fathers are hardworking, clever, successful, cool. They describe them as if they’d only just met them; they describe them as if they’d discovered them, despite the conspiracy to keep these amazing creatures hidden.

When the girls go home, they leave a scene of devastation behind them. The kitchen is strewn with dirty plates and half-eaten food and empty wrappers; the bathroom is a swamp of wet towels, capsized bottles, crumpled tissues smeared with makeup. The smell of nail varnish upstairs is so strong it could knock out a horse. I tidy up, slowly. I open the windows.

Six months later, my younger daughter, I notice, has changed. She has refined her group of friends. There are fewer of them, and the ones that remain are more serious, more distinct. They go to art galleries and lectures together; on Saturdays they take long walks across London, visiting new areas. My daughter has become politicized: At dinner, she talks about feminism, politics, ethics. My older daughter has already made this transition, and so the two of them join forces, setting the world to rights. When they argue now, it is about the French head-scarf ban in schools or the morality of communism. Sometimes it’s like having dinner on the set of “Crossfire.” I become aware of their verbal dexterity, their information, the speed of their thought processes. Sometimes I interject, and more often than not am shot down. This, in my own teenage years, would not have been tolerated, yet I find it easy to tolerate. They’re like a pair of terriers with a stick: they’ve got their teeth into the world and its ways. Their energy, their passion, their ferocity — I regard these as the proper attributes of youth. Yet inevitably the argument overheats; one of them storms away from the table in tears, and I have to go and talk her into coming back.

Strange as it may seem, they are still children, still having to operate bodies and minds that are like new, complex pieces of machinery. And indeed, at meal’s end, it is I who rises and clears the plates, just as I always have. It would be far too easy to gibe at the skin-depth of their feminism. Besides, I don’t see that anything has fundamentally changed in the contract between me and them. For the first time, I am glad of the flaws in our family life, though at times I have suffered bitterly over them, seeing in other people’s impeccable domestic lives a vision of stability and happiness I have absolutely failed to attain. But in this new territory, we perhaps have less to lose: no image is being defiled, no standard of perfection compromised. The traditional complaint about teenagers — that they treat the place like a hotel — has no purchase on me. In fact, I quite like the idea. A hotel is a place where you can come and go autonomously and with dignity; a place where you will not be subjected to criticism, blame or guilt; a place where you can drop your towel on the floor without fear of reprisal, but where, hopefully, over time, you become aware of the person whose job it is to pick it up and instead leave it folded neatly on a chair.

Epic Parenting Fail

Growing up in the 60’s and 70’s in Kentucky, Ohio, and Southern California, I enjoyed amazing freedom. When I was six, seven, and eight, I spent my summers swimming at a local pool and playing golf at an adjoining nine hole par-3 course. With my clubs outstretched across my handlebars I biked a mile plus to the course. No helmet, major road crossing mid-way, no problem.

I’d be gone all morning often returning in the afternoon with my mom and sibs. Thus the skin cancer. While Wonderyears Wayne brandished his legend on the 10 meter platform, I decided between Twinkies and HoHos.*

From nine to twelve it was pickup football EVERYday after school. Despite being built like a 3-iron, I just wouldn’t go down. An 80 pound Marshawn Lynch. We’d play on our spacious, fenceless, suburban Ohio lawns, or on especially rainy or snow days, we’d jog along a wooded trail to the Talmadge High School field where the objective was to win while sliding as far as possible in the muddy grass. On Friday nights in the winter I’d take the same trail to the gym to watch high school basketball games.

Fast forward to today, where my wife and I and our friends grossly overplan every childhood activity**. If you had asked my mom where I was at any given non-school moment, odds are she wouldn’t have known. That’s why she was caught off guard when a construction worker chased me darn near into our house after friends and I raised hell on his site. And that’s why, one spring, she threatened to “never take me to the Emergency Room again” when I called to tell her I cut my foot wide open while playing around barefoot on a just melted tennis court. Today, she’d be tarred and feathered for her laissez-faire parenting.

But I lived. More than that, I flourished, because I was allowed to learn from bonehead decisions. Today, parents are squelching their kids with hyper-organized activities and constant monitoring. Recent research reveals that on average, even today’s college students text and/or talk to their parents twice a day. Co-dependence trumps independence.

Why the over-involvement and constant contact? My hypothesis is an irrational media-fueled fear of childhood abductions. My guess is there are the same or even fewer child abductions (per capita) today than in the 60’s and 70’s, but when they happen they get amplified in people’s minds as a result of cable news shows, People Magazine, and the 24/7 news cycle. By tuning into the media bullshit, we’ve helped create a false sense of unmitigated danger.

And so we end up with soccer leagues for three year olds and global position satellite devices for teens’ cars. And to what effect? Young people who aren’t passionate about much of anything because they’ve spent the bulk of their childhoods doing what their parent(s) have wanted them to.

Bethrothed and I talked this through on the way home from Seventeen’s last swim meet. It’s not a coincidence that she only swims in-season when adults expect her to. A friend of hers, an ace violinist, is sick and tired of playing the violin. Neither have ever been even close to the ER.

The GalPal and I have regrets, but also know there was a certain inevitability to our parenting approach given the “tipping point” created by our friends’ decision making. We tried to swim upstream one summer, honestly we did, deciding not to schedule any activities at all. Turned out few if any of our daughters’ friends were around thanks to a steady schedule of drama, sport, music, and dance camps.

If you’re twenty-five or thirty and just starting a family there is one escape. Buy a small farm. Raise animals and grow food. If your kids have to feed chickens, milk cows, and repair fences, they’ll spend far less time playing adult organized activities and facebooking (yes, that’s a new verb).

Of course there are legitimate things to worry about, for older children especially, alcohol and drug abuse, driving under the influence, and teen pregnancy. Minimize those risks by having dinner together, checking in regularly, knowing your children’s friends, and listening. Eliminate them by scheduling all of your children’s time, putting a video cam in their bedrooms, and monitoring their every move.

In the end, the choice isn’t entirely yours, in large part, it’s the families in your hood.

* in hindsight I should have said, “Hey girls, someday I’m gonna crush the Platform Primadonna at Ironman Canada.”

** kid you not, there are about eight parent committees to choose among if you want to help plan the class of 2013’s post graduation Senior Night

In Da’ Club

The title of a thumpin’ Fiddy Cent track.

It’s well known that adolescents place great importance on fitting into groups. It’s less well known that we never outgrow our need for affiliation. Our happiness isn’t contingent on being in da’ club, but in clubs, as the following experiences have recently reminded me.

Cycling up and down Washington State’s mountains. The roads we cycle routinely attract motorcycle and car clubs. No motorized vehicles for ten minutes then whoosh, whoosh, whoosh—twenty five Miatas, Nissan Cubes, or Christian Harley riders. Interesting how special interest groups form around a common interest—like climbing mountains on bicycles—or by driving a common car or motorcycle.

Working out at the Y. The Y is teeming with clubs including traditional aerobics, yoga, water aerobics, Masters swimming, 5:30a.m. basketball, spinning, and the retiree coffee klatsch.

Reading a Sojourners Magazine interview with Rebecca Barrett-Fox who wrote her doctoral dissertation on Westboro “Baptist Church” which just protested at our state capitol and local high school. Here’s the relevant excerpt: SojournersDid the actual church service resemble mainstream Christian worship? Barret-Fox—I saw a lot of circling the wagons, with sermons about things like Noah and the flood and how only eight people got on the ark. This church is the ark, so if you’re a part of this church you’re getting on. The sermons are actually very typical of themes addressed in Calvinist teaching: questions of how you know that you are in or how you know that they are out. Sojourners—So the attraction is the appeal of being part of the “in group.” Barret-Fox—Exactly. And I could see the attractiveness of that in a world that is fragmented and scary, especially if you are not okay with doubt or gray areas.

Westboro isn’t a spiritual community, it’s a sociological one. Members have distinct identities—chosen hate mongers. The hate-filled rhetoric, signage, and protests are shared experiences that reinforce a distinct group mindset. Barret-Fox adds: . . . church members create a culture that makes it uncomfortable to leave, and that becomes a high hurdle. They’ll take you off the church rolls, so you are excommunicated, but it amounts to more than simply excommunication from church services; it is de facto shunning because, as one member has said, “We don’t have time to talk to people who aren’t part of the church.”

I’m not the clubber that more extraverted peeps like the GalPal are—church council club, Spanish book club, and a coffee klatsch among others. I have a small group of friends I run with a few mornings each week (known affectionately as the Baboons, after a homeless woman yelled angrily at us “You look like a bunch of baboons!” while we were running shirtless on a hot summer morning on 4th Street) and another that I cycle with a few evenings each week for half of the year. Add that to my list of oddities, the bulk of my clubbing takes place at between 7 and 24 miles per hour.

Suburban neighborhoods—where I’ve spent too much of my life—conspire against community. There’s the occasional neighborhood garage sale or July 4th potluck, but suburbanites are usually stuck driving to fitness centers, grocery stores, post offices, and the bulk of their small groups activities. We need more urban planning that promotes community—with walking and bike trails, parks, and small accessible stores and service providers.

Once safely ensconced in a group most teens forget about what it feels like to be on the outside. Too often, we don’t outgrow that either. One thing I’ve always admired about Betrothed is she’s always conscious of people who are new to church or a social gathering and she goes out of her way to introduce herself and talk to them. The world is a tad more humane and friendly as a result of her presence.

Once securely in a group, we tend to adopt specific behaviors to signal that we’re “in da’ club”. At my Iron-distance triathlon in late August, there will be a ginormous merchandise village at which nearly everyone of the 3,000 participants will load up on t-shirts, sweatshirts, jackets, visors, and all things fitness to “signal” they are “in da’ club”. Dig the sweatshirt—I am an Ironperson, you’re not. (To which the ambivalent clubber in me says, “Big whoop. So you’re well-to-do, over-exercise, and probably suffer from early onset narcissism.)

At Lutheran churches we sometimes signal we’re “in da’ club” by referencing all things Garrison Keiler and Norwegian. Numb to the fact that “inside references or jokes” make newcomers who aren’t Scandinavian feel less than full members of the community.

Self-important academics (sorry for the redundancy) are especially skilled at drawing circles around their clubs which are usually tied to specific disciplines. Among other methods, they create and use elaborate terms and acronyms that leave outsiders wondering exactly what the hell they’re talking about.

We should acknowledge our need for group affiliation and build neighborhoods that promote the formation and success of small groups. We need more people like my Better Half who are especially conscious of those not “in da club”. And we would be well served by reflecting more regularly on the ways our clubs sometimes exclude others.

Connecting With Teens

As a teacher, coach, father, person, I’ve always been pretty good at connecting with teens. Maybe for the following reasons:

1) I enjoy them, quirks and all. Well, the vast majority. I like their energy, goofiness, earnestness, naïveté. I don’t think of them as a separate specie that is up to no good. Sometimes I even abandon my peers, “cross over,” and sit with them at multi-family get togethers. Most teens rise to the level of adult expectations.

2) I look past outward appearances. I know they’re not going to look the same at 30. I don’t read much into funky haircuts, baggy pants, wild hair coloring, and piercings. Those things don’t reflect a lack of values, they’re just trying out different personas and learning to blend in with peers. One evening eighteen years ago, after a day spent exploring the Washington D.C. mall, my squeeze and I, with our one-year old daughter in tow, collapsed into chairs at a table at the Pentagon City Mall food court in Alexandria, VA. One minute later a group of about seven teens in black trench coats, with the requisite black hair, nail polish, and piercings started to settle into the table next to us. When they lit up, I walked over and calmly and respectfully said, “I don’t know if you guys saw the sign, but this is a no smoking area.” They apologized, got up and left. Exactly what I envisioned would happen.

3) I like some of the same aspects of pop culture as many of them. Which helps bridge the generation divide. Turns out many of Nineteen’s friends at the Midwest liberal arts college know the contents of my iPad. What a claim to fame, the geezer who likes pop music, hip-hop, and rap. Please understand though, I don’t listen to Eminem or watch Glee in order to bridge the generation divide. The “fake it until you make it” cliché does not apply to consuming pop culture in order to connect with teens. When it comes to teens and pop culture, fake it and forget it. The interest has to be genuine. It probably helps that my adolescent self is still alive and well. Just ask my family sometime, I’ve never completely outgrown my immature, stupid younger self. My arrested development helps me connect with teens.

4) I make fun of myself and joke around more generally. I haven’t met a teen yet that doesn’t appreciate self-deprecating humor. They live in perpetual fear of others laughing at them, so when I’m making fun of myself, it’s a much appreciated respite from their normal “people are about to laugh at me” anxiety. Ten weeks into my first year of teaching in inner-city L.A. I was at war with third period U.S. History. The class could have tipped either way when one day I yanked down the large U.S. map attached to the front board and it flew off the hooks landing across my upper back. Without thinking I went full Dick Van Dyke, grabbing said map, throwing it to the ground, and stomping on it. They thought that was the funniest thing they’d ever seen. Since I was human they decided to give me a break. Over the remaining thirty weeks I built a nice rapport with those students.

5) I anticipate bad decisions and am careful not to overreact when they stumble. More commonly, adults are surprised and disappointed by teens’ mistakes. Then they assert their authority and hand out strict punishments. From this teens learn more about adult power than what they might do differently the next time they have to make a difficult decision. Error prone teens always appreciate it when adults take the time to listen, talk, teach, and individualize necessary punishments.


Happy b-day to my favorite tall, slender, pale, whispy blonde high school fashionista. A sporadic reader of the blog, right now she’s completely unplugged at church camp near the Canadian border. That means I can call her “pale” and write whatever I want.

I shouldn’t have, but I couldn’t help myself. Right before she ceremonially set her phone on the kitchen counter and departed for camp I naively asked, “What are you going to miss more, your cell phone or me?” Hope she doesn’t mind if I assume her on-line identity and jump right in to her friends’ texting torrent. Maybe I should update her Facebook page for her.

I’ve always been skeptical of conventional wisdom about teens. Yes, there’s her post-Katrina bedroom, shrugs and grunts over breakfast, and occasional attitude, but the big-picture parenting challenge is to remember that’s superficial stuff.

Scratch below the surface and ask her about her faith, the death penalty, her surviving middle school, her desire to live in another country by herself after college, the five (soon to be six) kids she regularly babysits, or her desire to someday have her own medium-large family.

She’s blossoming into an increasingly competent, thoughtful young woman with nice friends with whom she can be her quirky self. For instance, how many Sixteens rank their friends’ driving? To move up the list she advises, “Don’t be oblivious or careless.” Words to live by.

When it comes to 16, I’m proud of a lot of things including her work with young children and her remembering, when it comes to peer relations, what it feels like to be on the outside looking in.

Watching her blossom is a great joy.

Teach Friendship

Most friendships just evolve. Our closest friends typically end up being people with whom we share a common activity or interest. In terms of living emotionally healthy, constructive, fulfilling lives, nothing matters much more than who we become friends with and whether they inspire us to be better or worse people than we would be without them.

Because we aren’t as intentional as we might be about our friendships, we assume the young people we have responsibility for will just “find their way”. Experience is a great teacher, but parents, teachers, coaches, youth pastors, and other adults that regularly work with young people should explicitly teach friendship. Choosing friends that inspire is a learned skill. Just hope that those types of friendships naturally evolve at your children’s and your own risk.

Those were my thoughts while reading a nice one-pager by KJ Fields titled “How to spot an unhealthy relationship” in Group Health’s Spring 2011 NWHealth magazine. Thanks to Fields for providing a tool for teaching friendship. These are signs that a relationship may be bad for you:

  • You don’t feel respected or listened to.
  • The other person’s opinion is always the one that matters most.
  • Your feelings are belittled.
  • You act differently around this person, fearing disapproval or anger.
  • You feel worried and tense about the relationship, rather than enjoying it.
  • You’re always the one to make the effort or compromise.
  • Your values and beliefs are far apart.
  • The other person is overly critical of you, and frequently insults you.
  • You find yourself lying to hide information from the other person.

That’s a nice conceptual framework for dinner table, school, or youth group conversations with adolescents especially about peer relations in general and dating relationships more specifically.