Big Changes & Adulting As Hard As We Can: A Friday Chat

Ester: Hello!

Nicole: Hi! This is where we usually say “happy Friday,” but today is not the right day for that.

Ester: No, indeed. Although ever since I gave birth on 9/11, now three years ago, the day has been kind of resignified for me. The bathroom was filled with balloons this morning and there were flowers on the kitchen table — you know? Toddlers take precedence over history.

Nicole: Well, I can definitely say Happy Birthday to Babygirl and Happy Birth Day to you. Are you having a party?

Ester: Yes, this afternoon! Which is also weird, and at least one set of her friends (twins) can’t come because their family spends today mourning a loss, but it was the only time that, for various reasons, made sense. So … cupcakes. Anyone who’s feeling sad and wants to be cheered up should drop by and watch the children play for a while.

Do you do anything to mark the day?

Nicole: Four years ago a group of musician friends and I put together a They Might Be Giants cover album called Mink Car Cover. TMBG’s Mink Car was originally released the morning of 9/11, and at that time it was the only TMBG album out of print (it’s back in print now, and I’d love to claim credit for that, although I know it probably has nothing to do with me).

So we recorded this cover album where we covered every song in Mink Car, and we’ve been donating the proceeds to the FDNY Foundation ever since. That means that today I logged in to the Mink Car Cover accounts, figured out how many sales we’d made since our last donation in June, and gave the FDNY Foundation some more money.

Ester: Aw, that’s lovely! Such a great way for worlds to collide.

Nicole: It’s been fascinating to watch how everyone’s career has grown since we put that album together. We “grew up,” in a way. It’s like each of our lives started to take this shape and direction. It’s something I’ve been thinking about this week as part of the apartmenting process; moving into a “real” one-bedroom instead of a studio or… um… the floor… is like making a commitment to myself as an adult and a professional and a person who is going to have a stable career for a while.

It is also a huge financial point of no return. Yes? Do you feel that way about big decisions in your life?

Ester: It is a commitment to yourself. I joked to you on HipChat that you should register — you could use a registry, to help you set up a real, grown-up person household, way more than many engaged couples do. There’s something nice about your community coming together to say, in effect, “We support your big life-altering decision and here’s our contribution, a toaster.” But you’re doing it on your own and that is even more impressive. I know it must feel somewhat anxiety-producing, and yet, Nicole, you are so practical, and so on top of things. This seems like not only the logical but the appropriate and best next step. Congrats on all of that, really.

And yes, ha, big financial decisions. Lots of people contacted me after my Atlantic piece announcing my pregnancy went up to say “Good luck!” but also “ha, good luck — my pregnancy on mediocre insurance cost me [zillions of dollars].” No one said it wasn’t worth it but yeah. Sobering.

Nicole: I’ve got that song stuck in my head now: “NO-body SAID it was EA-sy…”

And also super congratulations to you, and I am very excited about New Babychild! I feel like with insurance you’re going to pay no matter what happens. I’m still always grumbly after I go in and do the copay and think it’s over, and then a month later I get a bill for some test.

Ester: I had an appointment with my midwife yesterday, and it was my favorite one who I feel most comfortable with, so when she asked if I had any questions, I didn’t ask about whether it was safe to eat peanuts or get my nails done; instead I was like, “Yeah, so, I have bargain basement insurance. What tests and procedures can I safely skip?”

She was really great about it. She leveled with me, made a few notes in my chart, and didn’t make me feel like some bad-mother cheapskate at all. In fact, she said that remembering that not everyone wants, or can afford, the fullest compliment of tests and such is good for her and her colleagues — it helps them be better practitioners, to focus on the individual.

Nicole: I love it. We don’t need everything just because it’s available. That’s a really smart way to look at healthcare, or at least it feels like it. I don’t know enough to know for sure, but it feels right in my gut, which is where the truth is supposed to sit.

Of course, I’ve lived a “make-do” life for so long that it may just be an internalized philosophy.

Ester: Totally. And I am somewhat conflict averse, so when I go in for tests, and the business-like people with the clipboards are like, “Great! Now come back in two weeks for more tests!” my impulse is to nod and not make trouble by asking questions.

But I have to make trouble, or I will very much regret it later. It is hard though with doctors and such. It’s natural to assume they know what’s best and they wouldn’t recommend something if it weren’t necessary or important. And yet they can get into patterns the same way everyone else can, and they too need to make money. If they can bill the insurance company for running sonograms every two weeks, and make good money, what’s their incentive not to do that? Even if the person-with-the-womb doesn’t need the sonogram in any technical sense?

Nicole: Plus there’s the “lost work time” aspect of the whole thing. You pay twice, for going to appointments that are not strictly necessary.

I’d be really interested in learning how much the birth and medical industry has changed in just the three years since Babygirl was born. Are there more tests? More appointments? More technological ways to check up on you? More costs?

If only I knew someone who wrote for various publications about pregnancy and finances …

Ester: Ha. Yeah. Well, last time around, I had a very different health insurance situation, and it was my first pregnancy, so I just kind of let the OB-GYN have her way with me. Not that it was just one; it was whichever doctor was currently in the fancy-pants Upper East Side office. And then I got tired of it. All the tests, the scans, the constant appointments. That’s why I changed to the midwives in the first place.

And the midwives are great! More low-key, less tech-obsessed. But it is funny how I’ve gotten caught up, to some degree, in a similar whirlpool of scans and such, all done out of this other more elaborate pre-natal center in Bensonhurst that the midwives referred me to. I guess most of their patients want them? It feels a little like one can’t escape. Or at least, you have to make a real effort to.

Nicole: Well, yeah, if you don’t get the newest 3-D ultrasound picture, you are going to disappoint THE ENTIRETY OF FACEBOOK. And if you don’t get the newest and fanciest test, YOU DO NOT CARE ABOUT THE HEALTH OF YOUR CHILD.

Ester: Right! And yet none of it is presented as optional. No one asks if you want anything. They simply tell you, “Make an appointment to come back in two weeks for more.” Except I guess the 3-D pic, of which I have *not* availed myself, and I’m fine with that, thanks. Those look so creepy. Like, I wasn’t even moved by Avatar in 3D. I doubt I’ll be impressed with a shot of my own womb.

Nicole: It isn’t for you, Ester, it’s for the rest of the world. That is like the theme of pregnancy, at least from what I understand by reading The Mid and the NYTimes Motherlode section.

Ester: Well, in that case, the rest of the world can either screw itself or get a Kickstarter together to fund its desires. I’m going off the grid, baby.

No, that’s a vast overstatement. I am canceling my next scheduled visit to Bensonhurst, though. My midwife said I could, that nothing that’s supposed to happen is that important. It feels so freeing to know that! I never would have known had I not summoned the courage to ask.

Have you ever had to deal with health insurance or medicine this way?

Nicole: I have been very lucky, health-wise. With the exception of my foot surgery back in 2006 or maybe 2007 (hard to remember the exact date), I haven’t had anything that’s required more than a GP. I generally go to Minute Clinics for my checkups, or to confirm that yes, I do have pinkeye, and I need the prescription for the drops.

I love Minute Clinics and their equivalent because they are so binary. You walk in with a single question: “do I have pinkeye?” “do I have strep?” “is my blood pressure normal?” and you walk out with an answer.

Ester: That is terribly useful, yes. How much do you pay for those visits?

Nicole: Generally just the copay, if it’s in-network (and of course the one test that is never covered). All of the health insurance providers I’ve had have highly pushed these quickie visits over taking the time to go to a larger office. Don’t know why. Maybe it benefits them too?

Ester: Seems like it benefits everyone. My health insurance has an option where you can speak to a doctor on the phone for free and I’ve done that once or twice. They can’t tell you if you have strep but they were pretty helpful when I had bronchitis this winter, even if all they could really say was, “Not much to do about that. Rest and take care of yourself.” At least I didn’t have to spend time trekking to a doctor to get the same rx.

Nicole: They are doctors, though — right? But yeah, it’s great to get the “I have a short-term ailment and need a quick diagnosis” treatment. I even went to the walk-in clinic after I got hit by the car. I was all “Do I need to go to a hospital for any reason, or am I probably okay? Because I feel probably okay, but I’d like a confirmation.”

It would be great if they had those for expectant parents. The “I feel probably okay, but I’d like a confirmation” clinic.

Ester: There probably is some version of that! For people who have no insurance at all and few options. I am definitely grateful that I have a practitioner at all and I have some insurance, even if it’s so limited. The next choice is whether to bump it up once we can in January or choose what’s behind Door #3. But anyway, have a good / restful / meditative remainder of the day. And Happy New Year to all the Jews! My God, there’s a lot going on.

Nicole: Enjoy one thing at a time. Today is the birthday party for you and a massive grocery shopping trip for me.

Ester: Quite right. 🙂 Enjoy. And congrats again! We’re both Adulting as hard as we can.

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