Tuesday, September 10, 2013

Wombs, Work and Well-Meaning Wealthy Women

[A bit of sisterly advice by guest-poster Candace Makeda Moore, MD, along with a bitch-slap for those elite American women in positions of privilege and authority who drive women toward higher education and careers and, in so doing, are condemning most of them to a lifetime of debt servitude and childlessness.]

I have read many recent articles of supposedly sisterly advice for women from people in authority. The fact that this advice comes from people who are women themselves (e.g., Sheryl Sandberg et al.) makes it sound realistic. Much of this advice does make some sense—for wealthy, good-looking and otherwise privileged women. For the rest of us, I’m afraid we are being lied to.

This is not conspiracy theory: I don’t think that these supposedly wise cultural elders are telling us nonsense in order to advance the capitalist cause of turning most of us into commodified units of production. Nor do I think that cabals of sexist patriarchs are conspiring to keep intelligent women down. However, I do feel that the much hyped conversation in the mainstream media aimed at women, most recently under the theme of “having it all,” could use a few voices speaking the realities of life in America’s not-so-fabulous ZIP codes. My own personal experiences in this area have made me certain that well-meaning people are driving not only a rather insipid conversation but also terrible policy. I can serve as an example of the result: I am a woman on a path to childlessness, driven by biological reality and financial constraints brought on by conforming to expectations about success in American society.

The one moment of my medical education I remember best did not happen at a patient’s bedside or in the lab. It happened when, while looking at an Ivy League medical school that had accepted me, I asked some uncomfortable questions about repaying the student loans they proposed. I pointed out that the numbers simply did not make sense. The financial aid officer, then a late-twenty-something single black woman, said to me: “Well, people... by the time they need to pay these off, they marry someone with a real job.”

If I were more naïve, I might have wondered to myself: “If working as a resident doctor didn’t qualify as a real job, then what on earth possibly could?” But I already understood, from my experience, the tacit ethnocentrism by upper-class whites that is the norm in the American higher education system. In a way, I must congratulate such people on their total color-blindness and class-blindness, but I must point out that they are, unfortunately, reality-blind as well. I meet well-meaning people like this all the time inside helping professions. One recently told me about how I “chose a career” as opposed to marriage and children. It never occurred to her that my choice was to attempt survival in a capitalist market economy, as every generation of women in my family has done since the end of slavery. I was tempted to point out that I “chose” a career over being a maid and make-up saleslady like my grandmother, and that this was the extent of my choice as a black woman of limited means. Eventually my medical studies took me to Israel, where I found it easier to accept the incorrect assumptions people made about me.

My personal feelings towards the American academy include bitterness. Any establishment that puts people in up to 6 figures of debt that they often have no hope of ever repaying should be considered predatory. But I believe that problems inside the American academy are just a piece of a puzzle that, when assembled, presents a picture of a fundamentally flawed and distorted society. It is my feeling that the American educational system is particularly punishing for women, because here the ever-inflating expectations collide with biological reality.

In Israel I saw how policy and attitudes have made a huge difference in helping women combine work, motherhood and marriage. Israel is by no means unique in this: many (formerly) socialist countries were, in the words of almost every woman I have talked to who was from one of them, “ahead about women,” even if they were behind in nearly everything else. But America won’t be changing into some kind of feminist utopia anytime soon, which is why I am writing this article: I want women to know the truth.

It is well known that many American women, perhaps one in five, now leave their reproductive years childless, but not by choice. The structure of higher education and the workforce need not foster such a situation, and indeed does not in many countries. When I read that a leading academic like Marcia Inhorn of Yale is encouraging egg-freezing as a solution to these types of issues using the megaphone of CNN, I wanted to cry in despair. As a medical doctor, I know that there is no technological trick that can save most of us from childlessness without incurring an unbearable cost. That a leading academic would suggest that a generation drowning in debt should take on more debt, and an increased risk of cancer and other bad outcomes, shows just how badly American society is being shaped in terms of work and family. Moreover, such a suggestion would only worsen the situation of women who cannot find partners, because in many instances these women are least able to cope with the costs—both financial and medical—of such high-tech reproductive adventures. As a physician, I can assure you that reproductive technology, in its present state, isn’t going to save the majority of American women from having to make painful choices made necessary by bad policies.

American women also need to know that our country's adoption system is a bureaucratic nightmare run for the benefit of administrators, lawyers and social workers. Some women may incorrectly assume, as I did, that although they are giving up a normal chance of childbearing by pursuing a career, they will be able to easily create a family through adoption. The adoption system is a machine that works well for administrators and lawyers who want to get rich, but it doesn’t actually work all that well for prospective parents or parentless children. The number of laws around adoption grows every year. Depending on which state you live in, these laws regulate everything—from where the exits in your home must be to what kind of adult relationships you can have if you ever want to bring home a baby… and, mind you, the biological parents can often snatch that child back without having to meet such stringent requirements.

The only reliable way to get to bring up a child seems to be to make one yourself: an activity that isn't yet entirely controlled by an army of greedy lawyers. Yet many well-meaning people will tell you what my psychologists, psychiatrists, school counselors and other people in authority told me in one form or another over and over. “Don’t be promiscuous, stay in school, work hard, and then later you can have everything you want…” Well, that method might work for men. If men stick it out in the rat race, and make all the right moves, they may at some point bring home the kind of money it takes to support a family. At what point men aim to start a family is changing because, thanks to technology (Viagra and Intracytoplasmic sperm injection) that has become fairly cheap, they can achieve their personal dream of starting a family late in life, even though this delayed fatherhood certainly isn't good for anyone. As fatherhood gets pushed later and later the risks for the children, from genetic problems to an untimely yet predictable death of a parent, get higher and higher. Most men are smart enough realize that they would create serious issues by delaying fatherhood beyond a certain point, but many women do not seem to realize they will have no such choices until it is too late for them to ever build a family.

The typical narrative running through the heads, or at least out of the mouths of many of our cultural elders is that women can make choices to “empower” themselves by avoiding childbearing and focusing on a career. I know many such women who were, as a result trying to conceive at 40, faced odds that were against them. The poor ones like me are in some sense lucky because at least they won't be wasting unspeakable sums of money on fertility treatments that are only guaranteed to make some health care administrators very wealthy, but probabilistically unlikely to actually help them. The wealthy “successful ladies” may be going down for easily about quarter million dollars of medical expenses, a near death experience from ovarian hyperstimulation syndrome and, of course, a whole lot of disappointment. This is the scenario that actually played out for a close friend of mine. Ironically, it is my debt from medical school that has helped me avoid such a fate, so I walk around surprised and saddened as my colleagues belittle women smart enough not to do much in terms of marketing their labor and start a family while they can.

Many doctors, as well as other professionals I have worked with, are empathetic, caring people. The problem is that they are also delusional. They have fixed beliefs about what the correct choices are for women in terms of when to have children, and these beliefs are simply false. They incorrectly assume that all women have nearly endless choices in how they design their lives, because we live in a culture that perpetuates the myth of infinite choices in spite of their obvious absence. For most of us, American life is not an endless buffet stocked with delicacies; it is more like a run-down corner convenience store in a ghetto: lots of choices, but surprisingly uncontaminated by anything nutritious. Nonetheless, we American women are being fed myths that we can do whatever we want with our lives, and that upward mobility is probable, if not guaranteed, with hard work. For typical women—ones who aspire to one day start a family—these myths are simply not true. Fertility treatments, just like nannies and affordable quality daycare, exist only for the privileged few.

My colleagues often make lots of assumptions about women who choose to bear children early in life. These assumptions boil down to the idea that these women are not only deeply irresponsible but also illogical. I often have to remind my colleagues that teen moms and welfare moms are far wealthier than they are by virtue of the fact that zero is a larger number than the large negative balance of student debt most of us carry. Women who refuse to take on educational debt and have children instead are often better off than hard-working achievers in terms of sanity as well.

Any objective cost-benefit analysis of when and how to have children is difficult to accomplish. Can you really put a price on the joy of having children? On the other side of the equation, American universities put an exact price on having a chance at professional success. The prices are often well above what any normal woman can afford without spending half a lifetime servicing student debt. Women should keep in mind that there seems to be no end to how far down the hole America is willing to throw people as they struggle in vain to climb up the socioeconomic ladder. The Wall Street Journal ran a piece this year about one of my fellow doctors who ended up over half a million in debt as a result of her medical education. The most disturbing aspect of her story was that it could happen to any of us… scuttling down the halls of the hospital, going the extra mile for patients... accidentally ignoring calls about student loans. An usurious late fee here, a missed payment there and the quarter million a typical doctor takes on in student loans suddenly becomes over half a million. The 41-year-old doctor told the reporter that she and her boyfriend were delaying having children. She probably said this sarcastically, given her professional knowledge of how female fertility declines with age. Or perhaps she was not sarcastic but resigned to going through egg “donation.” Maybe she will be willing to help (or exploit, depending upon how you look at it) a woman almost as poor as her present self. Such medically risky “donations” are often a desperate move by young women hoping to pay down—you guessed it—a student loan. What these young “donors” are not told is that they may well be damaging their own hopes of ever having children. Short of getting into the ethically tricky, not to mention financially difficult, proposition of “donor” eggs, most women have a limited number of options in terms of how they create a family life for themselves.

I make no blanket prescriptions for women, because we are all individuals in different situations. Some women genuinely do not even want children, although I suspect this lack of desire may often be an outcome of a culture that prizes material possessions over relationships. My prescription My prescription is for anyone, especially people in positions of authority, who dare look down their nose at the fertile young women who choose not to get into what the mainstream deems a successful lifestyle. They need to seriously rethink their definitions. “Empowering women towards success” really means “coaching women towards living in crushing debt while minimizing their reproductive capacity.” Their prescription for success is in fact a prescription for sterilization through debt.

If you let go of the myth that there are infinite possibilities open to all women, you might not only make better choices in your own life, but also become a bit more understanding of the different choices made by all kinds of women throughout the world, who are healthier, wealthier and happier for it.


Cindy Shirar said...

Thank you!

This is another incredible guest post. Dr. Moore points out a tragic truth. It's sad that, the way things are structured in our forget-taking-humanity-into-account "system," we've made the hurdles to raising (or even starting) a healthy family virtually impossible to overcome. The pursuit of an education (especially with ensuing crushing debt) and career is enough to extinguish anyone's willingness to bring children into the world for fear of digging a deeper financial hole, or worse. (The stress alone would stomp out the libido of a rhinoceros anyway--LOL!)

It's so clear things are falling apart when things are so backwards and screwed up. Nothing is about taking care of people. There is no support for families in our "system," quite the opposite as this post points out. Nothing but exploitation. People raise families at the risk of the health of their young ones and the sanity of those raising them. Those of us who embark on the family rearing journey in the United States are brave, hardy souls, blind, foolish, idealistic or crazy (and probably a little of all those).

I can say this as the full-time, employed mother of (soon to be) four children...who happens to carry a hefty student loan balance herself!

Thank you for the great guest post by Dr. Moore, Dmitry!

Cindy Shirar

Harry J. Lerwill said...

Wonderful article, thank you for sharing that on your Blog, Dmitry.

It never occurred to me that wage peonage, besides driving both adults in a household to work in order to survive, is also an effective brake on population growth. Only those wealthy enough to have a care giver at home can really afford to procreate.

Stacy said...

Dear Dr. Moore,

Thank you so much for having the courage to say publicly what so many of us know, but are punished for saying!

I have a master's degree, six-figure student loan debt, and two children who are my saving grace. It took me a while to figure out that the educational racket was not going to work for me, but fortunately I still had my fertility and I had stubbornly refused to neglect my family, friends, and intimate relationships while I studied. I guess I'm a slow learner. . .

Today, my children are 21 and 16 and healthy (knock wood) and I realize how fortunate I am and how easily things could have been different. It is true that we have made material sacrifices, but when I talk with others who followed a more conventional path, I know that I made the right choice for myself.

Please, please continue to talk about this and spread the word as wide and as far as you can to as many young people as you can reach. I will do this, also.

George Oprisko said...

An excellent post! I could not have said it better myself! Left out is the all or none aspect of US Medical education wherein one can pass medical school, pass the required exams, yet not land a residency. No residency, no career as a physician, no career as a PA either, because all states only permit those who graduated from PA programs to take the PA exam and be licensed, and no state permits MDs to serve as PAs to board certified physicians for any length of time, afterwhich they can practice as unspecialized GPs.

We at PRI have advocated National Service for all, wherein the top 15% would be offered full bore scholarships after 2 years service and the next 25% technical training after 4 years service, and all who complete the entire 6 years of service would qualify for a "GI BIll" covering books and tuition for tertiary education.


k-dog said...

Candace sees delusion and the fixed beliefs that betray its presence. She sees well meaning people, cultural elders spewing poison. She sees them patching logic as needed as they roll along, rigid wheels in the American class definition academy. An academy which awards doctors big debt in a works expecting doctors to make out big. A works fueled by faith in infinite prosperity and infinite growth.

Candace would not complain were her debt manageable and a doctors big bucks reduced her loan irritation to the financial drain and pain of a magazine subscription. There would be nothing to complain about then. But the delusion that to the deserving success will always come is the faith of the land. Candace feels the machine of the academy sputter and cough and she expected it to work for her. But to expect that to the deserving success must always come requires belief in a horn of plenty. A certain acceptance of the delusion.

"If men stick it out in the rat race, and make all the right moves, they may at some point bring home the kind of money it takes to support a family."

At some point some men may and at some point some men may not. The may nots are with us. Life is not fair. Crude oil is now over $109 / barrel. We can all expect the number of may nots to be climbing very soon. People who took on debt risk may have a very hard time paying it back. At least doctors are always needed. In-sourcing hits them but licensing somewhat checks it. Not all professions are so lucky.

Pushing the 'having it all' myth is never seen as destructive. Pushing the 'having it all' myth is is seen as motivational and positive. A kick in the right direction. Consequences of taking on debt are minimized. To the winner the spoils, to the loser, we don't care. That's capitalism, caveat emptor. Candace finds life is not fair and she is not alone in her discovery. Life is choice and when consequences of our choices seem to defy justice we feel pain and confusion.

In spite of its impossibility we live in a culture which perpetuates a myth of infinite choice and equal opportunity. Empowerment becomes confused with entitlement and getting one's share of the goodies but when we are concerned about what were not getting we ignore what others are not getting.

As life is not fair my personal delusion is that we exist to help each other out and make it fair where we can.

Roille Figners said...

Rationally, it's an excellent idea to delay parenthood until one is mature & stable enough to be a good parent. Biologically, Mother Nature doesn't give a damn about any of that: Peak Fertility and Peak Horniness happen straight out of the gate, before you're even 20 years of age. The evolutionary advantages of that tendency seem obvious. And no one in a tribe or group under "natural" conditions, trying to preserve and perpetuate itself, would complain about the having of babies as soon and as early and often as possible.

So once again our social institutions are hopelessly out-of-step with reality. To the extent that you believe in these institutions and what they tell you, you will "succeed" in essentially parting ways with Mother Nature, in all the same ways in which those institutions already have done so. Welcome to Modernity. It does have certain advantages to it, but it does have this annoying tendency to present itself as the One True Way.

It took centuries for modernity to advance sufficiently to the point where it can successfully oppose, even part of the time, the Force of Nature that finds its expression somewhere in your pants. But millions of years of evolution can't quite be shaken off by a few rickety social institutions. And now one sign of the impending collapse of those institutions (and always the source of much moral hand-wringing in the banal press) is how the age at which women become pregnant keeps getting younger and younger. "Babies Having Babies." Well, the only reason the mothers are "babies" is because they're forced to rely on those same social institutions, which retard their development, but I digress.

Essentially the quicker you throw off those institutions, the better off you are. Sooner is better, but better late than never. Soon we'll all be throwing them off de facto in favor of whatever's coming next. I think after a while, teenage moms will be the norm and most professions will be defunct. Doctors will still be around, as will certain kinds of engineers, but they'll be trained in direct apprenticeships, not colleges, and they'll work for bartered favors or for the sake of being in an honored position within their communities.

Ryanaldo said...

The globalist agenda provides many economic dis-incentives to middle class and professional class people starting and raising families. It is a race to the bottom. However, there are 200 cable channels and tv on demand.

Ken Barrows said...

Once we get off the globalization kick, let the procreation commence! However, right now it's 350,000 births per day (and 150,000 deaths).

If you want kids, get off the consumer lifestyle, get off the "career."

escapefromwisconsin said...

I'll just leave this here:


deb98126 said...

Thank you Dr. Moore. I took the MCAT in 1999 with the full intention of going to med-school as a first generation college student and a black woman. However, after much thought and delay due to family needs I decided against it. I still have college loan debt, but at least it's not in the six figure range.

smalltownlib said...

We are of different circumstances so it was important to understand your post. I am female, caucasian, 61 years old and a lesbian with a spouse (I live in Washington state). I live in an agricultural valley that also has a major north-south interstate running through it so there also good sized towns. I am a medical social worker who has a couple decades of experience working for Hospice and I now work half-time at the oncology clinic (my spouse is a retired nurse).
I have to agree with K-dog - life does not have much to do with being "fair'. Things are not working well for many, many people in America, not just for women or the educated with debt. Women who have not taken on education debt, whether they have a partner or not, are working jobs with little reward financially or intellectually. In most 2 parent families both parents have to work to pay the bills. Both parents work so they can scrap together adequate health insurance for the family and try to save a little for retirement. Young mothers on welfare may be free of debt and soul-sucking employment but have the burden of parenting with very little money and few other resources, which can have its own stress and bitter disappointment. Then there is the guy whose "career" in construction has disappeared. High male unemployment is creating social problems that will take at least a generation to recover from. And we haven't even mentioned the suffocating debt and lost hope one has if struck down by a major illness!

As I said, we have different circumstances. My generation did not have the crushing debt. I did not feel my biological clock ticking. But I am damn glad I have college and graduate degrees so that my spouse and I can live on my half time earnings and her Social Security if we are frugal. Full time jobs and benefits are fast becoming luxury items to the middle and working classes.

I wish you well. My own doctor works just part time and is the single mother to two adopted children, so she took her own situation and made her choices. Who knows what the future will bring once this unsustainable post-industrial culture is past. Will there be a renewed sanity to our existence or will we have to live out our dystopic fears? Our choices, though limited and not always "fair," will be the stuff our lives are made of.

Jamey Hecht said...

Thanks for a timely and incisive essay, Dr. Moore. In support of your observations about American academia as a sinkhole of debt peonage, cynicism, and bad faith, here's a "modest proposal" about how people of the 99% might manage to get some enjoyable learning done outside its gates:

a. In the past 30 yrs., a caste of administrators has usurped control of higher education. Using the ideology of free-market fundamentalism, a cadre of management professionals has garnered to itself the lion's share of revenues (from skyrocketing tuition costs, which these same admins initiated), and political influence (from contributions, corporate partnerships, and cronyism).

b. As a result, the profession is over 50% "part-time" faculty who teach twice as much as do their "full time" colleagues, for a fifth of the pay, with no benefits. That percentage is growing all the time.

c. A certain kind of distance learning program (but by no means all distance learning programs) has contributed to the outsourcing, downsizing, de-skilling, and degradation of the professoriate. These are based on the use of mandatory pre-recorded courseware content; over-regulated syllabi; and wages that are even further below the poverty-line than those you're paid for adjuncting live.

a. In "good" schools, as few as 10% of those who teach undergraduates are tenured faculty; since tenure is a vetting process, this seems disadvantageous to the clientele since they pay to be taught by persons who are unvetted in this regard, many of whom still lack the PhD and are quite new (sometimes, utterly new) to teaching. Tuition costs are astronomical at such institutions.

b. Wherever you go to college, online or live (but especially live), the cost is huge. Little of it goes to the people who do the actual teaching; it goes to pay enormous salaries to presidents and provosts and deans. Their job is to raise money and spend it on everything except paying faculty or lowering tuition. Construction projects, stock schemes, personal enrichment, sports arenas, endowment building, whatever. That's why tuition is so high.

A Modest Proposal for a New Model University of the Humanities


To read the rest, see:


Paul Chefurka said...

I am moved to comment this way:

The world is overpopulated by at least 50% (according to Ecological Footprint calculations) and possibly by as much as 1000% if true sustainability is desired. Seen in that light, complaining that the burden of one's participation in the most ecologically damaging economy on the planet reduces one's chances of adding to its human overload as well, strikes me as somewhat parochial.

sv koho said...

Thank you Dr Moore for a thoughtful and painful expose' if you will, of the evils of excessive debt assumption. That is really the tacit theme of the post. Would Candace have written this if she had little to no debt? Does she deserve some blame for freely choosing to go into debt? She made the choice to incur debt. I also am a doctor and when I was looking at a medical career, loans were plentiful but I made the decision not to borrow. I had no parents to help me but I was able to find ways to avoid getting into debt. I worked first, used the military programs and was very lucky to be working on a commercial fishing vessel which hit a goldmine one summer with a huge catch and high fish prices. Luck helps. But when my kids came along I told them they would not go into debt for college. Period. I told them they would do as I did and go to college choosing the best they and I could afford. I wanted to go to Stanford Medical School(and got tentative acceptance) but the cost was prohibitive so I chose a far cheaper state university. It was the same for my daughter. Berkeley and Boulder were her dream schools but I said No to their high costs. A real vale of tears for a while. She followed my path and snagged a 4 yr academic system at our state university and graduated without debt. Abetted and supported by a bloated mismanaged Federal loan program, the higher education lobby has become a bloated predatory bureaucracy gorging on its victims while making false promises with women sadly paying a higher ultimate price.

tphyahoo said...

Hi Makeda! I really enjoyed your blog post.

According to


adoption costs range from $17k-$42k to adopt a black male child at the budget end, to $25k-50k to adopt a white female child at the high end.

That's a lot of money - about one year at a high end school - but pregnancy is expensive too, and risky even for people in their reproductive prime. Historically, which is to say before modern medicine, there was a 1/100 death rate according to


Maybe adoption isn't such a bad deal.

Or maybe more childlessness among the educated is the ecological price mother nature makes us pay for better health care which now makes pregnancy essentially riskless.

(As a side note, I think even historically if you didn't die from pregnancy, there is a statistical chance you would live a bit longer for hormonal reasons.

http://answers.yahoo.com/question/index?qid=20071017085207AAkU19J )

Anyway, it's complicated.

Bottom line, if everyone has as many children as they wanted, overpopulation would result and we would eventually have to cull the population with famine or war. We may already be at that point according to the declinitarians.

Everyone should not be having kids, and it's important for us to transition to a society where we support the childless and don't scorn them, even if they are frustrated overeducated women that now regret they followed some script that didn't include children when they were at the fertility peak. So what? There's always some problem and cause for heartbreak.

It's possible to have a meaningful effect on a child's life without being either a parent or an adoptive parent. There is the auntie role, there is fostering.

It will all work out in the end.

Cosmos King said...

I agree with the article in all particulars, even though I think the story is more complicated even than the good doctor describes.

I believe it was Saint Reagan who cut federal funding to the states for higher education, enslaving future generations to at least a decade of student load debt.

Similarly, the baby boom generation was called the "postponed generation" because of the extra decade it took to gain traction in the working world. Too many boomers competing for the same job, you see.

Most boomers did have children, but not at the level of their parents' generation. That extra decade provided some breathing room, time for the hormones to die down, time to think.

If student debt, coupled with fewer employment options because of automation, globalization, advances in software, and because older people are forced to keep working past retirement age, is giving young people time to think about parenthood, that may not be entirely a tragedy.

Some people may discover -- as my wife and I did -- that they don't really want children after all.

George Oprisko said...

I know both Systems Engineering Consulting, and the Medical profession from the inside. Those of you who believe MDs are extremely well paid, need think about a few things:

FDIC bank examiners with BAs in accounting and no CPA earn $170,000/yr for a M-F job 8-5 with an hour lunch, full benefits, including pension, medical care, etc.

As a consulting Systems Engineer I. 20 years ago pulled down $120,000/yr. I have a PhD, but what was material, was my skill set.

I have seem many jobs on offer for Board Certified MDs, that offer $80/hr for 7 - 12s; that's seven twelve hour days in a row.!

There are many studies which show that is is physiologically impossible for a human to conduct critical descision making for longer than 6 hours per day, with breaks!

Yet hospital after hospital offers jobs demanding 12 hour stints!

Further to the point, an MD must go to medical school for 6 years, after which they must complete 3 years of residency to start their careers.

I could make the point that the current crisis in rural medicine is a direct consequence of the Student Loan Crisis mentioned. Most MDs simply can't afford to locate in small towns, because the patient base is not large enough.

Then there is the problem of third party payment of medical fees. Most MDs who take assignment, get $0.30 on the dollar, AFTER 120 days!

This is why I am counseling my wife to go into private practice in a rural underserved area using a Direct Primary Care (membership) model, in which patients pay an initiation fee to join and pay dues monthly. The patient gets unlimited visits at no co-pay, gets tier 1 & 2 meds, and all tests as part of the package. Patients can also get low cost major medial and travel coverage through the group.


Ave said...

sv koho :since you completely missed her point, you also quite logically missed the point about how you're the kind of person that keeps perpetuating the fraud.

Actually I can't think of any better illustration of the kind of people she's writing about than you blaming HER for being the victim of the scam. At least you were decent enough to stop short of calling her stupid.

In case you miss my point as well : don't change, it's great to be you !

Paul said...

@Paul Chefurka

If human overload is one's overriding concern, then isn't it parochial not to kill oneself?

de amateureconoom said...

Dear Dr Moore,
I happen to live in a socialistic small Western European country and feel very sorry for you and your fellow Americans. Any university formation will hardly cost you 1500 usd yearly and medical bills over 2500 usd yearly will be refunded (cancer treatment, hospitalisation)
by our national health system.
I find our system pretty humain.
People can find good child care never over 300 usd monthly.
Seems like laywers and bankers are making a good living on the back of their population. I would definetly not envy your American life style. To me it seems like communism was not such a bad deal after reading Dimitri's blog.
Wish you a clear mind

Wim Lammens

de amateureconoom said...

I feel sorry for your situation.
Seems like my country (Belgium) is not such a bad deal after all.
Education close to "free".Child-care close to "free". Medical care close to "free". I also withold from your post that bankers and laywers are leading the high life.

Good luck and smart choice

Wim Lammens

Paul Chefurka said...


Parochial? Not if I can convince you to go first.

Seriously, that is the lamest comment that people can possibly make to those who mention that overpopulation might be an issue. There are serious discussions to be had on the topic, why not try it?

kountry mouse said...

Women have a variety of experiences that do not depend on their fertility. Most women don't think about their fertility because of societal norms that encourage promiscuity. Women in poverty have more access to birth control than cancer treatments. This post by the doctor is really about SEX and SEXUAL ACTIVITY and how the stresses of a particular lifestyle inhibit SOME people. MDs are required to be mental eunuchs when dealing with the public. It is somehow not supposed to matter whether you have a female or male gynecologist or prostate surgeon. It's been my observation that women do whatever they want with whomever they want and have always done so since EVE in EDEN. Look where that got ALL of us. Even the so called PURE lifestyles of a nurturing young family have its problems with debt. Everyone who exists acquires debt from just living every day. Qualifying one persons debt as being better than another persons debt because of the amount of figures and interest rate and ability to pay off is not a good way to go in any society. Modern society is realizing how much it costs to run itself (huge hospitals, huge colleges, huge box stores, huge houses, huge families). Acromegaly is a disorder in all its forms. Technically you could argue that babies are a parasite and women are risking their lives to have them.
A brave new world is something to be desired to make our lives more comfortable and sexually gratifying.

Paul said...

@Paul Chefurka

You did not just say human population was a problem. You told someone who is obviously hurting because of a messed socioeconomic system that her concerns are 'parochial'. To me it looks like you were just trying to be mean and broadcast your holier-than-thou position of childlessness.

For many, bearing and raising a child is THE most important thing in the world and is what gives meaning to their lives. And you know what -- it's completely normal. For almost all, living another day is desired. Also normal.

But both childlessness and killing oneself would help to reduce the number of human beings. You seem to be willing to call women who desire to have children unpleasant names because they are contributing to the problem of human overpopulation. Yet you go on consuming in this most ecologically damaging economy when you could easily reduce the human overpopulation by one. I guess you continuing to live is important to you.

To be completely serious: I am glad you have not chosen and hopefully will not choose the ideologically correct option of suicide.

Servelan said...

Having children is not mandatory.

There is no 'right to bear' in the Constitution; everyone makes choices that promote X at the expense of Y. You can neither have, nor do, it all.

yarnsalad said...

I am a woman nearing 40, have graduate education and tens of thousands of dollars in student loan and credit debt. I am child free by choice and not due to any pursuit of material possessions, as the author of this post suggested. I have been working poor my whole adult life and, while I often cite my massive debt as one of the reasons for not having a family, it is far from being the main reason. I know this article is not meant to pit one group of women against another - I daresay the opposite was the intention, and I certainly agree with the notion of white (male) privilege being the force that continues to prevent women from getting ahead. I am in the south where the gentry is still a strong force and makes me wonder if slavery ever ended here, other than in name.

Nils said...

You paint a quite depressing picture yarnsalad. If it's really "white privilege", then no one of you has any allies in this fight. The women who give out bad advice are white, usually married to white men of the same background and *THEY* are the ones who have (co-)invented the narrative about white privilege.

So first they give you bad advice, take your money, leave you out hanging and stir up racial tension. Now that they have difficulty collecting on the money they'll just again take it from the taxpayer so they've now stolen from you twice. These are your allies.

It's a new form of aristocracy, which might just be the stable condition of human societies...

Terrace said...

As a woman who was never properly socialized into having either children or "career," I am an enemy of Fate.

I Am.

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