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Major life-changing events have a way of bringing things into focus. On March 5, my first child — a healthy baby boy by the name of Jose — was born, and I've been off work since then, only returning this week. Jose has changed my life already, and while it's far too soon to say he's changed my ideas about public policy, I will say that the reality of parenting does a great job of shifting priorities and highlighting certain key points.
Lots of parents (and non-parents!) no doubt will disagree with me about the points below. But for me, these are seven key political insights that the past 10 months have brought into focus.
1) US health care is the worst of both worlds
The genius of America's unusually high reliance on private health expenditures is on full display during the childbirth process. Show up on the labor and delivery floor with your wife having contractions and the first thing a nurse says to you is, "Can I see your ID and insurance card?" After an additional 18 hours of labor and a caesarian section, the new father gets to hold his baby briefly before he's instructed to head downstairs to the cashier to put in the deposit on the recovery room.
Yet in exchange for these indignities, you don't see any of the benefits one would associate with commercialization.
There are multiple hospitals in the area, but they don't compete to offer the best price. Indeed, there is no transparency whatsoever around the pricing of anything. Every treatment is presented as simply The Thing To Do with no discussion of cost or cost-effectiveness, of what insurance does and doesn't cover.
American health care is an unholy hybrid. The hospital is a place of profit-seeking and exploitation, but not of competition and bargaining. The doctors are salespeople and entrepreneurs, but the patients aren't customers. Within the strictures of this system, the Affordable Care Act is making a lot of things better. But the system is still completely absurd.
2) Regulatory mandates are worse than direct provision
Speaking of the Affordable Care Act, one of the nice things it does is mandate that insurance policies cover the cost of breast pumps. This is a sensible measure that will promote both public health and women's workforce participation over the long run. Trying to get society as a whole to pitch in to help nursing moms is a great idea.
Unfortunately, while you can force an insurance company to provide its clients with a breast pump, you can't force them to make it easy for clients to figure out how to get their free breast bump.
On the contrary, insurers have every incentive to make the process both obscure and cumbersome. If you're really bored one day, please visit Cigna.com and figure out how to claim the pump to which you're entitled. Stressed out and short on both sleep and time, I gave up and just ordered one from Amazon. Which, of course, is exactly what Cigna wants.
But you can't blame insurers for playing the game. Profit-seeking firms are gonna profit-seek. The issue here is a political culture that creates relentless incentives to hide costs as a way of minimizing taxes and government spending. The right way for the government to socialize the cost of breast pumping would be to tax people to pay for breast pumps. Then everyone who needs one could get one easily.
3) Society should value parenting
Motherhood and apple pie are said to be two things nobody in politics can be against. But the stark reality is that almost nothing in American public policy suggests our society values children or parenting. The United States of America has always been conceived of as an ongoing, multigenerational scheme — it's right in the constitution that the point is to "secure the blessings of liberty for ourselves and our posterity." For that scheme to continue, a large fraction of the country's adults need to have two or three kids. But public policy treats children largely as a kind of expensive luxury good rather than a social necessity.
The $1,000 federal Child Tax Credit, for example, is much less generous than the $7,500 federal tax credit for electric cars.
Don't get me wrong — I'm all for encouraging electric cars. I would like the planet to still be habitable when Jose is a grandfather. But I'd also like to see that planet full of flourishing people! The details of how to make parenting financially reasonable should be grounds for vigorous debate — what's the right balance between new spending programs and kid-oriented tax cuts? What's the balance between supporting working moms and supporting stay-at-home parents? But what's striking to me right now is how little the proposals currently on the table from the Obama administration or conservative proponents of family-oriented tax reform would really do to close the gap.
Having children isn't for everyone, and the childfree in many ways deserve more social validation than they currently get. But in concrete terms, parents and non-parents alike count on the existence of large and thriving future generations to make retirement feasible. That means we need to make parenting financially feasible.
4) Women should be able to get abortions
After watching my wife gestate my son for nine months, I am 100 percent certain people who go into pregnancy with anti-abortion ethical priors come out of it with the strength of their convictions increased tenfold. I went into it with different priors and have come out with my own pro-choice convictions increased tenfold.
A beloved baby is a miraculous thing, but pregnancy is at times a truly agonizing and awful one. It's a small price to pay for something a woman truly wants, but an enormous amount to pay for other people's questionable metaphysical notions about personhood. In a decent society it would be both safe and convenient for women of all socioeconomic backgrounds to terminate an early stage pregnancy on demand without facing judgment and hassles.
5) Parental leave is too important to be entrusted to employers
Vox Media offers new dads four weeks of paid parental leave. It's an amount of time that is simultaneously very generous by prevailing standards in the United States and woefully inadequate to the real needs of a new family.
At the moment, a major trend in Democratic Party politics is proposals to try to force all employers to offer at least some paid leave. It's a nice thought, but ultimately keeping leave policy in the hands of employers is a mistake.
As seen with the breast pump, no regulatory mandate can force employers to make it easy for citizens to enjoy their rights when doing so is financially inconvenient for them. And no regulatory leave mandate is going to cover part-time workers, contractors, small businesses, and other widespread employment relationships.
The right way to do parental leave is something like the way we do retirement. Having decided, as a society, that retirement security is important, we have established programs — Medicare and Social Security — that are financed by taxes and offer universal benefits. We should do something similar for parental leave so people can take time off without it becoming an undue burden on their coworkers and their career.
6) Immigrants are great
The benefits to the American economy of highly skilled immigrants are widely recognized, but the equally important contributions of less-educated immigrants are underappreciated.
One big arena in which this is clearly the case is child care, where foreign-born workers are major providers. These immigrants often have limited formal education but perhaps more practical experience and skills in dealing with small children than your typical US-born yuppie first-time parents.
The presence of such immigrant caregivers in the United States is a huge win for the world. It allows the immigrants to raise their living standards far above what would be possible in their countries of origin. It allows American babies to receive a higher standard of care than their parents could provide alone. And it allows highly educated Americans — especially but not exclusively women — to participate more fully in the labor market.
Letting more such workers into the country makes almost everyone better off. It is true that recently arrived immigrants might benefit from shutting the doors to further immigration, but that's a thin string on which to hang nativist politics.
7) Some problems require collective action
As a parent of a newborn, or even of a gestating fetus, you are constantly on guard to provide your kid with an optimal environment. Mom needs to take prenatal vitamins. Breast milk is better than formula. New cribs are safer than hand-me-downs.
But no baby is an island. I can filter the water my family drinks and make sure we live in a house with no lead paint. But there's nothing I can do about the fact that even decades after the introduction of unleaded gasoline, soil in urban areas is packed with old lead, which gets kicked up in dust and poisons babies' brains. For that matter, there was nothing parents of earlier generations could do about the fact that the cars on the road were spewing lead into the air.
Everyone knows environmental hazards are a real problem. But it's simply not possible for parents to tackle these issues on our own. We can buy BPA-free products, but only the federal government can make electrical utilities spew less mercury into the atmosphere.
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