There are a lot of ways for families to be "fractured." In fact what I had in mind, from personal experience, was a 19 year old whose parents were alcoholic and who had thrown him out. Judith Andre, Ph.D. [log in to unmask] Professor (517)355-7553 Center for Ethics fax: 353-3829 C-208 E Fee Hall Michigan State University East Lansing, MI 48824-1316 USA ________________________________ From: Feminist ethics and social theory [mailto:[log in to unmask]] On Behalf Of Alison Reiheld Sent: Monday, November 10, 2008 9:07 PM To: [log in to unmask] Subject: Re: health insurance - kids etc Folks: I'll note that Judy is usually very careful in her phrasing, and that she said parents in fractured families often have trouble getting their actS together. I interpreted that as follows: parent A may have act together, parent B may have act together. But parents A and B cannot get their paper work in line with the state such that red flags don't go off when one or the other (or both) apply for aid for their children. I will note that this is another way in which parent-dependent healthcare, even when not employer-provided, favors intact heteronormative families. In this case, I think it's largely bureaucratic rather than deliberate: all paperwork is more difficult with parents living in separate households as any child of divorce can attest who has had to fill out a FAFSA (for college financial aid) or other parental-income assessment tied to federal and state aid. What's more, state aid privileges people who know the system: a friend of mine who has just applied for social security disability is a lawyer who has been on the other side of advocacy and aid applications for a very long time; she has said many times that if she didn't know exactly how it worked, she would never have known to keep copies of all correspondence (an expense she could barely afford), take notes on phone conversations, get the names of case managers, call the case manager's supervisor when nothing was moving, follow-up even after the length of in action would make a normal person think the application had been rejected, etc. Only through her intimate knowledge of the system, she thinks, did she eventually make sure her application was fully considered, and then was able to feel confident pushing even further when the checks did not start arriving as they should have. At any rate, perhaps I am now misinterpreting Judy's comment. But I thought the 's' in "get their acts together" to be significant in avoiding the interpretation Rebecca took from it, which would indeed be objectionable. And the point about the difficulty of applying for state aid for dependent children is well-taken, I think, from both Rebecca and Judy. Best, Alison Alison Reiheld History, Philosophy, & Sociology of Science Lyman Briggs College Michigan State University Co-editor, Questions: Philosophy for Young People [log in to unmask] From: Feminist ethics and social theory [mailto:[log in to unmask]] On Behalf Of Rebecca Kukla Sent: Monday, November 10, 2008 3:07 PM To: [log in to unmask] Subject: Re: health insurance - kids etc Yes, Judy, this is all true - except the part about Canada not being exciting :-). But of course individual health insurance in the US is way too expensive for middle class families, not just poor or near-poor families. Middle class kids are not eligible for medicaid and generally rely on their parents' employer-based insurance. So medicaid, even to the extent that it works, doesn't help with the issue that started this discussion, which is whether it should be treated as an unfair perk that employees with kids get extra health benefits that cover them. Also, I am a bit troubled by the language of parents 'not being able to get their act together' in your message. I am not sure we want to assume that adults in 'fractured families' are less responsible or on top of things, rather than that they are facing larger obstacles, more legal and regulatory ambiguity, and huger piles of red tape. Having lived most of my life in Canada and a bunch of it in the US, I can say with certainty that there is nothing - not one little tiny thing - that I find better about the US system. The Canadian system wins on every possible parameter I can come up with, including even those on which it is usually attacked, such as wait times to see specialists and choice of doctors. It was hard to get on the roster of primary care docs in Ottawa but that seemed to be a very local phenomenon. I wish Obama had the political clout (and will) to just kill the employer-based system once and for all, but of course he does not. Rebecca On 11/10/08, Judy Andre <[log in to unmask]> wrote: In Michigan poor kids are covered through Medicaid - eligibility has to be established through the family, but the kids will usually qualify even if their parents don't. This lasts until age 21. With fractured families, however, who cannot manage bureaucracies, the kids don't get coverage because the parents can't get their acts together. Of course another problem is that many, possibly most, doctors and dentists don't take Medicaid, because the reimbursement is so low that it does not even cover their overhead, and - I believe - taking just a few Medicaid patients is not allowed. You either take all who apply, or none. Canada is obviously much better. As one writer said, Canada may not be the most exciting country in the world, but it's one of the best, in all the things we on this list care about. Judith Andre, Ph.D. [log in to unmask] Professor (517)355-7553 Center for Ethics fax: 353-3829 C-208 E Fee Hall Michigan State University East Lansing, MI 48824-1316 USA ________________________________ From: Feminist ethics and social theory [mailto:[log in to unmask]] On Behalf Of Lynda Lange Sent: Saturday, November 08, 2008 4:17 PM To: [log in to unmask] Subject: health insurance - kids etc As a Canadian I have followed this discussion with fascination. Marilyn observes that kids have no other way to have health insurance than via their parents' employer. On the contrary, if there is universal public health care, all kids (and adults) are automatically entitled to health care regardless of their caregiver situation. I imagine many of you (and most likely Marilyn as well) share my hope that Barack Obama will be successful in his plan to create health care for all U.S. Americans. Best, Lynda Lynda Lange University of Toronto at Scarborough Department of Humanities (Philosophy) 1265 Military Trail Toronto, ON CANADA M1N 3B5