Sunday, June 22, 2014

"Squirmy"

When does adulthood begin? There are the articles regularly placing it older and older, according to the latest neuroscience. The 'the human brain only stops developing at' articles, according to which I, at the tail end of 30, am probably too young to be making any major life decisions.

But the real ambiguity is the one surrounding college students. We've decided that they're too old to live at home but too young to pay their own way. If 60% of 20-somethings and early-30-somethings are getting financial help from their parents (how I read the relevant, startling paragraph), that's not a phenomenon that can be dismissed as impacting only the rich. Certainly if you consider that those not receiving help are probably clustered mostly on the older end of that range. The way the economy is now structured, it's unlikely that a 20-year-old, especially one in school, is entirely financially independent. That exceptions exist, or that many managed this in a different economy, is a distraction.

But we still have this notion of 18 as adult. And it's this tension that leads to messes like the one described in this week's Social Qs:

I am the mother of a 20-year-old college student who is still on our family health insurance plan. I was confused about a benefit statement we received regarding her visit to the gynecologist. The insurance company told me the charge was for fitting her with a diaphragm. I am not sure if this is correct, but my husband and I disagree whether it’s appropriate to discuss it with her. Thoughts?
Philip Galanes answers the question in a way that almost makes sense, until you remember that the child in question is 20:
Of course you should talk to her! What are you waiting for — your daughter to hit menopause? If you suspect the bill is incorrect because your 20-year-old is not having sex, let me assure you that you are probably wrong (statistically speaking). And whether your daughter likes it or not, it is your job as a parent, along with her father, to insist on a running dialogue about her emotional and psychological readiness for all kinds of adult activities she is on the verge of undertaking — including sex. 
As with many important talks, this one may be squirmy to start. So, whichever of you is better at intimate chatting should sidle into her bedroom one night, and ask her sweetly about her love life: “Anyone special?” And no matter what your personal views of premarital sex, let her know that you just want to help her make the right decision — for her. Feel free to wax poetic about waiting for true love, but for God’s sake, make sure she knows that a diaphragm will not protect her from sexually-transmitted diseases. Now, get to work, Mom!
A 20-year-old looking for contraception is, one would hope, informed enough to know which forms do and don't prevent STDs. If she's gone to a doctor for said contraception, seemingly the doctor would also discuss this with her. 20 seems sort of ancient to be learning the facts of life. A conversation about this with one's 10-year-old might be "squirmy," but with one's 20-year-old, it's squirmy in the same way as it would be squirmy for any adult to discuss any other adult relative's sex life. A 20-year-old should feel comfortable going to her parents in a time of crisis, but what, in this case, is the crisis? This seems like a case of an adult behaving sensibly.

More to the point: isn't doctor-patient confidentiality supposed to be a thing? Again, maybe there would be some emergency situation where that would have to be breached, but does a 20-year-old getting contraception count as such?

But it's the parents' insurance! They are paying for the diaphragm, so they have the right to... what, exactly? It *is* an awkward situation. It's now appropriate (says the government!) to stay on one's parents health insurance until 26, as well as quite possible to be employed without benefits. So the health information of generally functional 25-year-olds is open information for their parents. Should the parents happen to be writers of overshare (and who isn't these days), they're thus free to spill not only anonymously, to advice columnists, but in any public forum they desire. 'My Millenial Child Has Herpes,' coming soon to a magazine cover near you. But back to the matter at hand: 20 is at one and the same time too old to ask for a parent's permission (or owe an explanation!) for something so private as contraception, and too young to deal with this truly independently.

The answer I always lean to, for this sort of thing, is the one that will rile my libertarian readers: get the state involved. For people of limbo age, in higher education or the lowest, most precarious rungs of employment, basic living expenses and health insurance should come from the government. The parents (and non-parent adults) are still paying, yes, but in tax dollars. This would apply not to children, but to those in whichever age range we determine is both definitively adult and realistically tough to be 100% self-supporting at in our economy. Maybe 18-22, maybe 18-25. This would accomplish two things. First, it would level the playing field at a time in people's lives where this is especially key, but also especially possible to address. (An equal playing field within the childhood home is, for obvious reasons, more complicated.) Second, it would take away the awkwardness around children owing not just society but their parents specific behaviors as adults. Because it's not exactly that the 20-year-old's mother is wrong to want to pry, but that society should be structured in such a way that this would be considered outrageous.

23 comments:

caryatis said...

Wouldn't that just replace the ickiness of parents getting involved in adult children's lives with the government getting involved? Considering how many 20-year-olds are doing stuff that's either illegal or frowned upon by the public health establishment, it makes me nervous. What if 10 years later the 30-year-old wants to get a clearance and finds that telling the truth to her doctor about a substance abuse problem comes back to haunt her? Colleges are already kicking some students out because of mental health problems.

caryatis said...

I mean, why can't colleges just sponsor health insurance for students? It's a cheap group to insure.

Londoner said...

When does adulthood begin?

When bragging stops and humblebragging begins.

Once your children are mentally and socially adept enough to frame their successes as burdensome problems, show them the door ASAP. They're finally ready for the adult world.

Phoebe said...

Caryatis,

I think colleges do this, but that many students end up staying on their parents' plans because it's cheaper, easier, a better plan, or the way to stick with the same doctor(s). And with the new thing where you can stay on parents' insurance until 26, that's bound to increase. But yes, mandating that students use that insurance as vs. their parents' would be a way around parents finding things out.

As for it being worse if the state knows private health info. than if parents do... I'm not sure how having 18-22-year-olds on a national health plan (unrelated to their specific student status) would lead to schools knowing their health problems. And there also seems as if there'd be a higher bar for what would give pause to the state/future employers than what would scandalize parents. What if, rather than the diaphragm issue, there'd been evidence the adult child was gay? Or if the family are strict vegans and the adult child went to the doctor for being lactose intolerant? What if... I'm not coming up with anything that great, but the point is, there's a difference between what parents expect from their kids, even adult children, which is incredibly particular, and the stigma in broader society on, say, heroin addiction. Not that stigmas are so great either!

Plus, as I mentioned in the post, a parent is far more likely than a bureaucracy to pen a real-name, first-person narrative about whatever it was. Granted, few make cover stories, but blogs can be googled, etc.

Miss Self-Important said...

There seems to be some disproportion between problem and solution here: a massive and hugely expensive national program to relieve a minor discomfort experienced by a very small number of people. Not even all 18-22 year-olds or all 18-22 year-olds on their parents' insurance, but only the ones among the latter who 1) use their parents' insurance for risque(?) things and 2) want this fact hidden from their parents. This doesn't seem like a problem of sufficient magnitude to warrant a national insurance program for the demographic of not-quite-independent-adults.

If the greatest danger that such a program aims to avert is parental overshare, then I'm with Caryatis: the dangers of submitting possibly incriminating personal information to a federal gov't database is 1) probably greater than the danger of your parents publishing embarrassing info about you, and 2) doesn't guarantee that they won't do so anyway. It doesn't seem any safer to admit to the federal gov't that you're a heroin addict than to admit this to your parents (given that heroin is illegal, etc). And that's something your parents are probably going to find out anyway unless you essentially disappear into a gutter or something.

Phoebe said...

MSI,

It could be that I borrowed Ta-Nehisi Coates's strategy re: reparations - gave the extreme case to start the conversation. Except that what I'd like is actually more radical - for college itself to be fully state-funded.

I don't think parental overshare is the biggest issue here - tongue was in cheek. As earnestly as I rage against the phenomenon, I'll readily admit that most parents aren't aspiring cover-story writers. Also, I wasn't making a point about heroin addiction, but rather the sorts of legal, common-enough behaviors adults engage in but parents, for their idiosyncratic reasons, may not approve of. Such as getting a diaphragm.

caryatis said...

There's this:

http://www.theatlantic.com/health/archive/2014/06/how-getting-on-a-parents-insurance-can-lead-to-a-loss-of-privacy/373236/

The easy solution is to pay for your own birth control/insurance if you want privacy. Easier said than done, I realize...

Miss Self-Important said...

But why stop at state-funded college? Think about all the other ways parents can constrain their children's preferences beyond objecting to their reproductive choices. They determine where you will live, go to school, which religion you will observe, whom you will spend time with and how you will spend that time, etc. Why should children whose views on these questions differ have to put up with that? Couldn't the state fund alternatives to all these things too, so we'd never have to talk our parents unless we felt like it?

Phoebe said...

MSI,

The point here is to address the ambiguity of *adult* children being accountable to their parents. It's not ambiguous when minor children are.

Phoebe said...

Caryatis,

A very apropos article then! These aren't totally new questions - I was asking some of them in 2012 - but the question of insurance forms going home isn't one I'd thought about before that Social Qs.

And yes, finding one's own insurance as a post-2008 graduate is easier said than done. The system is now designed to encourage staying on a parent's plan. The relevant issue here, I think, is just how out of one's way one needs to go to be financially independent at any given age. There are always going to be individuals who are unusually energetic and independent, and others who are unusually... neither of those things. What matters is what the expected path consists of. If the norm is full independence, it's maybe fair to fault those who don't seek that out, barring disability or other extreme circumstances. But if it's just become normal to be dependent at 18, 20, 25..., then you have to look at this as a structural shift.

Miss Self-Important said...

I guess, but why exactly not? I take it that your concern here is with the ability of young adults (18+?) to exercise the autonomy which is their legal right at this age. In principle, everyone should have equal capacity to be unaccountable to others at this age, but circumstances allow only some people (those who strike out on their own and become self-supporting early, or those with trust funds) to be able to afford independence from their parents. You want to equalize this sort of independence from all adults by making people dependent on the government instead. But how is that promoting autonomy rather than just accountability to a different kind of parent- a more distant and impersonal parent, but still one with the same coercive power over you? Will guaranteed income or service arrangements for those aged 18-26 encourage more independence and a quicker transition to adulthood, or will it discourage becoming self-supporting? (If you limited this to free college, I'm not sure how that would solve the living costs and even insurance problem for those in college, or how it would account for those in this age group who don't attend college. Why should they be denied autonomy?)

And since what you're pointing to is a situation in which those who are legally autonomous have become highly dependent on the state, don't you undermine the principle of the age of majority in such a way that it's not really clear why 18 is such an important age, and why the government couldn't take over accountability duties earlier? At 16, or 13? If 18 turns out to be precisely the age when the state must come rescue you fro yourself, then how can it also be the age when you ought to be held responsible for yourself?

Britta said...

There seems to be some disproportion between problem and solution here: a massive and hugely expensive national program to relieve a minor discomfort experienced by a very small number of people.

As opposed to the massive and hugely expensive yet ineffective national program we have now? This conversation doesn't have to be about hypotheticals, because every other single industrial nation already has some form of national healthcare. Every single other one of those countries spends less and gets better results in terms of health outcomes. If the issue is privacy, let's see if French, British, German, New Zealand etc. young adults have privacy issues. Quick research suggests no they don't. This is an empirical issue, and the empirical evidence overwhelmingly supports national healthcare as a better system.

caryatis said...

"If the issue is privacy, let's see if French, British, German, New Zealand etc. young adults have privacy issues. Quick research suggests no they don't."

What's your definition of privacy issues? All those governments are known to intrude more in citizens' lives. (except New Zealand about which I have no idea.)

Miss Self-Important said...

Britta: So you think we should generally have nationalized health care, or that we should have national health insurance for 18-26 year olds on account of the diaphragm parental privacy crisis currently plaguing tens of American women?

Phoebe said...

My fault entirely, but we seem to have moved from the narrow question of what's to be done with an ambiguous life stage to the far greater one of how much of a role the state should have in society. Which... we're not going to agree on, let alone resolve.

As I see it, it's a problem that we both do and don't consider 18-year-olds adults. MSI, you write "the diaphragm parental privacy crisis currently plaguing tens of American women" as if this were a joke, but why? Why isn't it a problem if 25-year-old women are subject to the same parental control as 15-year-olds living at home? And this could cut either way - what if the parents are more socially liberal and are horrified that their adult child wants to remain pregnant? What if they're atheists who won't help pay for college if the kid goes to church?

We've tied adulthood to two things, financial independence and age. This wouldn't be such a problem if 18 were the approximate age people became financially independent - maybe some would do so later, or not at all, but most would. But as it stands, it's way too far off. This leaves nearly a decade between when one is an "adult" and when one is adult enough to have one's own health insurance. While I know libertarian-leaning people will disagree, I'd imagine that parents are typically more demanding than the state, and that if one's to be indebted to one or the other as a young adult, the latter is preferable.

Britta said...

Ideally a national system for all would be a good idea, but we could start with a national healthcare program for 18-26 year olds. Honestly it's kind of win/win. The govt. insures young healthy people, young healthy people don't have to worry about health insurance at a precarious stage in their life, and I imagine that when it comes time for them to be dumped in the healthcare "free market" there would be a lot of political clamoring for universal healthcare for all ages.

Healthcare is a major hurdle to financial independence in the US. In other countries, less so. It's actually much easier to be independent at 18 if you are on a national healthcare system and if your public university education is relatively affordable. An 18 year old in Australia can earn enough money working as a waiter to pay for their education and not worry about health care. That isn't the case in the US. There are other reasons children aren't independent, but education and healthcare are not major hurdles the way they are in the US.

Miss Self-Important said...

"Why isn't it a problem if 25-year-old women are subject to the same parental control as 15-year-olds living at home?"
Legally, they're not. Parents can't stop you from making medical decisions for yourself after age 18 (unless you are incapacitated), including contraceptive decisions. They can try to persuade you to do things (and no state program can liberate you from their efforts to persuade), but they can't abort your fetus or refuse you a prescription for birth control. You may have to pay the co-pays or prescription costs yourself, but that would be true of state-provided insurance as well.

What can happen is that you might have disagreements with your parents about the right way to live while living with them. It seems to me that this could happen at any age however, and I just don't see why disagreements with parents at age 24 merit more state intervention than disagreements at age 14. Twenty-four year-olds have vastly more legal freedom from economic and physical coercion than 14 year-olds, whose parents can deny them birth control (though not in every jurisdiction). Twenty-four year-olds can legally leave, and they have far greater means of doing so. If complete independence from parents is their highest priority, almost all of them can make it happen, including the very poor, who have access to means-tested welfare. If it's a mid-level priority, below saving money on rent and insurance premiums, then that's their choice and they should work things out privately with their parents.

On the other hand, there is the more theoretical question of how we define adulthood. What worries me about your proposal is that you're trying to maintain the age of 18 as the definition of adulthood while undermining the grounds for thinking this age significant. The age of majority is always precarious b/c it's entirely an arbitrary convention, and there is no fundamental biological or political reason for selecting 18 over 21 or 16. But it's important to defend the legal convention, for reasons not worth outlining here. Our present uneasy understanding is some version of "with great power comes great responsibility" - you can vote and be drafted at 18, and you can in turn be expected to have the social/intellectual/physical wherewithal by 18 to find a means of supporting yourself if necessary. Most people don't do this immediately, but we want this to remain a possibility, hence our concern about things like the decline in jobs requiring only a high-school diploma. However, if we follow your advice, then what we end up saying is something more like, with "great power comes great benefits." If we substitute the current expectation of possible self-support with a universal program of state support, what remains significant about the age of 18 that merits special consideration? Why wouldn't exactly the outcome you hope to avert result from this move? That is, why wouldn't we start to think of 18 as not an age of independence but an age of particular precariousness and dependence, while taking 26 or whenever the state benefits end to be the real age of adulthood?

Also, you say, "We've tied adulthood to two things, financial independence and age." Individual financial independence is a very new definition of adulthood. Until recently, we tied adulthood to age (legally) and family formation (culturally). The implications of that are probably not related to this question, but maybe worth considering separately.

Miss Self-Important said...

Britta: Yes, so that was my point. If you just want national healthcare, the plight of 24-year-old diaphragm users on their anti-diaphragm parents' insurance plans is a pretty weak argument for it, not really worth making separately from the broad argument that the cost of things is "a major hurdle to financial independence," and it would be better if things didn't cost anything so that we wouldn't have to pay for them and jeopardize our financial independence.

Phoebe said...

MSI,

Re: your first point, yes, a 24-year-old can potentially be self-supporting. But what matters here is, at what age does one no longer have to self-sabotage in order to do so? An 18-year-old who prioritizes financial independence *might* choose some noble or impressive path (ROTC, starting a tech company, becoming a movie star), but is probably someone whose choice to work full-time at the Gap is not as wise a long-term move as going to college. Increasingly, the age at which one has to self-sabotage in order to be independent is increasing. I wouldn't have put it at 24 when I graduated, but times have changed.

The idea, then, isn't to take an independent population and make it a dependent one. It's to be realistic about what the typical 24-year-old (or, more urgently, 18-22-year-old) *is* paying for on his or her own. Rather than having this odd limbo where parents both are and are not on the hook for supporting their semi-adult children, there'd be some bare minimum covered, evening the playing field for 22-year-olds whose parents can't or won't help them out.

Miss Self-Important said...

"Increasingly, the age at which one has to self-sabotage in order to be independent is increasing." What's the evidence for this? Or, what do you mean by "self-sabotage"? I understand that if you choose immediate post-high school employment over college, you might end up with lower lifetime income, an oft-quoted statistic (though the causation there is difficult). But does that mean that everyone should go to college to avoid self-sabotage? And after college, pretty much everyone has to seek full-time employment or more advanced credentials like an MD or a JD (whose financing assumes you are an independent adult with no money). In some fields, jobs are harder or take longer to find, but that's not true of most fields, and I don't see why you'd call searching for employment or starting at an entry-level job "self-sabotage." Even in the most difficult and least-remunerative fields like the arts, where many people have unrelated day jobs to stay afloat, are those jobs self-sabotaging? Or is it that people take jobs that they don't love? Were you sabotaging or supporting yourself in your first job out of college?

"Rather than having this odd limbo where parents both are and are not on the hook for supporting their semi-adult children, there'd be some bare minimum covered, evening the playing field for 22-year-olds whose parents can't or won't help them out."
I still don't see why 22 is THE time to do this. The cultural expectation that parents will pay or help pay for college is very strong, and there is a path of legal recourse for those whose parents refuse. The problem seems then to be not willingness to pay, but ability. But to try to "even the playing field" in that realm at 22 seems arbitrary - why not at 2 or 14 or 18 or 35? Wouldn't earlier playing field leveling be even more desirable, before options are foreclosed? The problem you're describing is simply income and wealth inequality, and I don't see a stronger case for state maintenance at 18 or 24 than any other age there.

I also still don't see how what you propose will strengthen our view of the independence and adulthood of 18 year olds. If that's already precarious, and we aren't sure that 18 year-olds are adults or in any way distinguishable from 16 year olds in maturity or capacity, then how will your proposal strengthen that view? It would demonstrate nothing about the capacities of 18-26 year-olds other than that they can accept state benefits, which is not a particularly persuasive mark of adulthood. Presumably if we gave these same benefits to 16 year olds, or started them at 26, the same would be true. All this demonstrates is that adulthood happens whenever the state decides to start (or stop) maintaining you.

Phoebe said...

By "self-sabotage" I mean that there's clearly a point at which being self-supporting is healthy and normal and expected, and at which it involves some approximation of running away from home. Someone gay whose parents don't approve might, for example, become self-supporting younger than otherwise, but this isn't a happy situation - independence! - but rather a case of someone being held back by adversity. Sometimes adversity ends up being a positive, but hardly always.

What I mean by the age rising is that many entry-level jobs have become unpaid internships. Including ones like the one I had after college. It used to be that people who didn't find jobs right after college that took care of rent and insurance were making a choice not to do that. That's changed.

"there is a path of legal recourse for those whose parents refuse"

How does that work? Is it only if an enrolled student's parents cut him off? I can't imagine you can sue your parents to go to a more expensive school.

Why 22 vs 12? Because it's easier, for one thing. Children live with their parents, so the only way to really, deeply change things would involve removing them from their homes, which is cruel as well as impractical. (Not that some - kibbutzes, British boarding schools - haven't raised kids that way.)

The hope isn't to solidify 18, which is, as you say, a construct, but to be realistic about who can do what at which age. Again, I don't see this as creating dependency, so much as acknowledging that dependency now goes past the age we pretend it does. That to thrive as a young adult, a certain amount of help is often-if-not-always needed. And I don't see how this would be more harmful to the few who manage full independence than the option of parental support now is to the 22-year-olds who could rely on their parents but don't.

Miss Self-Important said...

The kind of self-sabotage you describe is tricky. I'd think that most of the people who leave their homes early are coming from poor and/or dysfunctional families in the first place. They would seem to be precisely the people you'd want to target much earlier than 18 if you wanted to prevent self-sabotage, since by the time they're 18, they've usually foreclosed college for other reasons. Beyond not attending college, is there any other kind of self-sabotage that state maintenance would avert?

"What I mean by the age rising is that many entry-level jobs have become unpaid internships."
But wouldn't state maintenance only exacerbate this trend? If as an employer I knew that none of my 18-26 year-old employees needed to be paid to work for me, why would I pay them?

"How does that work? Is it only if an enrolled student's parents cut him off?"
I believe you have to show that you are not a dependent of your parents. This is very difficult for federal financial aid purposes like Pell Grants, but institutions have more leeway in the disbursement of their own financial aid and can take individual situations into account. Ironically, I believe that one of the ways to demonstrate independence prior to 24 is to get married. Recalling the changing definitions of adulthood... You can sue your parents to pay for a more expensive school, and some people have done this, but it's a long and impractical route. Usually, you're looking for the school you're already at to evaluate your financial aid situation independently of your parents'.

"Why 22 vs 12? Because it's easier, for one thing. Children live with their parents, so the only way to really, deeply change things would involve removing them from their homes, which is cruel as well as impractical."
There is nothing forceful about this. If you give 16 year-olds enough money to pay rent, they won't have to live with their parents anymore. If they wanted to escape, they would now have the means. And those who prefer to stay put will get a lot of extra spending money. What's the problem?

"The hope isn't to solidify 18...but to be realistic about who can do what at which age. Again, I don't see this as creating dependency, so much as acknowledging that dependency now goes past the age we pretend it does."
Two questions: 1) if "what people can do at what age" changes with economic shifts, then wouldn't this be a moving target? Let's say the economy expands and 18 year-olds are highly employable. Do we roll back the program? Or, if it contracts and it becomes hard to find a job at age 30, do we expand the program to a universal minimum income? Shouldn't we just have a universal minimum income in the first place, to anticipate these shifts? 2) If what people are capable of is contingent on economic fluctuations rather than age, why should we continue to consider 18 year-olds to be adult in any sense? How are they appreciably different from 14 year-olds?

Miss Self-Important said...

Actually, to narrow rather than diffuse the argument, let me try this: it seems that you're concerned with three separate problems here that you want the state to remedy by providing some kind of stipend for 18-26 year olds. First, there is the problem of the "level playing field," which is income inequality. Second, there is job insecurity. Third, ability to pay for college. I don't see how any of these concerns are specific enough to 18-26 year-olds that giving them a guaranteed income solves any problems. (Btw, this is all bracketing the economic feasibility of this proposal.)

1) If your concern is to put young adults on a level playing field, starting at 18 seems like the worst possible option, since it would compensate for none of the disadvantages in educational attainment or well-being incurred by earlier poverty or hardship, nor for the ongoing advantages of a wealthy and supportive family. We might hope that it would enable the poor to be able to do some things previously unavailable to them, like rent an apartment in NY and take an unpaid internship, to use your example. However, I'd think that if every 18-26 year-old were given enough money to afford NYC rent, rent would rise correspondingly so that, once again, only those with outside income could manage. To address this problem, you'd want to address inequality at the beginning of life, not mid-way through. Universal minimum income or something like that, but not something exclusive to 18-26 year-olds.

2) If your concern is job scarcity and the way it jeopardizes independence, then this is definitely not a problem unique to 18-26 year-olds and I see no strong argument here for limiting it to them. Again, if existing unemployment insurance is not sufficient to compensate for job scarcity, then universal minimum income.

3) If your concern is college accessibility, then giving people cash will not guarantee that they use it to pay for college, so you need to attach strings. What I guess you'd want is state-funded college tuition, which you mentioned, but nothing for those not attending college. You could do this by either state tuition payments - the state pays tuition to whatever college you enroll in, be it Princeton or Phoenix Online - or nationalizing all the colleges. I don't think the first option has ever been done anywhere, and it seems like a road to massive college cost inflation since there would be no limits on what colleges could charge and no need for them to offset the costs of tuition with financial aid. (Similar to the relationship b/w insurance and health care costs.) The second option would likely be a disaster in the American context given the number of colleges the state would have to take over and the restrictions it would have to enforce on them once they become arms of the federal government.

So that in sum is my objection: I don't see any limiting principle here that would constrain your proposal to 18-26 year-olds and make it inapplicable to those younger or older. Given that, it's hard to see how it relates to anything about the definition of adulthood, or dispels any existing confusion about who is an adult.