Fertility Loans: When Hypothetical Meets Reality
There was an article on fertility loans in Slate a few days ago, and I barely paid any attention to it because my feeling was that loans are loans. There is a long line of people making their money off of my medical situation, and most of the time, it doesn’t bother me. I make my money off another person’s inability or lack of desire to string sentences together. They hire me to write for them, and I don’t see this as very different from paying my doctor to utilize his skills and medical equipment. And in regards to fertility loans, they are just one more fork in the pie. My body doesn’t work properly, and they’re willing to underwrite the possible solution so I can deal with the problem. And in exchange, I will pay them back for fronting the money now, and I will pay them extra for doing this for me.
Then I actually took the time this morning to read the Slate article and realized that it was slightly shadier than I thought on the surface. Some fertility doctors are taking kickbacks from fertility loan companies to send patients their way. I’ve heard of this happening with drug companies. I’m giving all my doctors the benefit of the doubt that they’re prescribing the best medication for my particular situation, and I have no problem with medicine representatives giving doctors samples and explaining how their medication works. After all, they are like a walking advertisement for the medication, and doctors may not know about a new medication or a new use for an old medication if they are not provided with the information. So visits from a drug company representative = potentially good. Kickback from a drug company so the doctor will prescribe their drug instead of the competitor even if the competitor is the better drug for that particular patient = abuse of the system.
And then it stopped being hypothetical, and the article got very very personal.
My doctor, who I think is an amazing physician — caring, kind, thoughtful, funny, intelligent — owns a stake in a fertility loan company. The one I was pointed towards when we returned to treatments and no longer had any insurance coverage for treatments. (We had decent insurance that paid for a few things the first time around, and we covered the rest of the bills with our savings.) So he was recommending that I take out a loan to cover my medical bills, and he owns a stake in that company and additionally makes money when I take out a loan with that company. In the article, he doesn’t see this as a conflict of interest, though I don’t recall him disclosing his connection to the company when he recommended it.
The option was presented to us to do with as we wished — we certainly weren’t pressured to use the loan company — but I wish that as the pamphlet was being handed to me, I was told, “I have to admit that I have a stake in this company, but I think they’re an upstanding lender and you may want to consider them.” Would my doctor still buy a stake in that company if he didn’t know that it was doing well? And knowing that he only collects back from his equity ownership if the company does well, does he have a vested interest to make the lender do well in order to make back his money? While this isn’t the same as him investing in a company that bets against me to lose, this feels a little bit too much like insider information.
We took a break from treatments a few years ago and have never returned. We took a break because our friends were losing their jobs left and right in the recession, and we were worried that we’d be next. When we were trying the first time around, we were willing to take on any debt. But now our financial decisions would affect the twins we had from our first round of treatments, and it didn’t seem financially sound to take money away from them for a chance to have a third child. It was an impossibly hard decision to make, and there were a lot of tears over the idea that while we had the means to support a third child once they were here, we didn’t have the means to create said third child, even though other people on earth create their children for free.
When it felt like the job world stabilized, that same mentality followed us into the stability. I didn’t have a great chance of conceiving with my own eggs years ago; and fertility only declines with age. We could try with my own gametes, but when the money ran out, the money ran out. We could pay for the more expensive shared risk program with donor egg, but part of my problem was the clotting disorder, and that seemed like a gamble with our money as well. And then we became deer in headlights, unable to move forward and unable to step back. We’ve been living in a non-decision for a few years now, batting around different ideas. Most of the time, it’s just something we don’t deal with, like that pile of papers in the corner of the room. We know it’s there, we want to deal with it, but then we can’t wrap our mind around the best way to proceed so the clutter just sits there, in our line of vision. We think about it all the time.
I read an article like this, and on one hand, I don’t care. In the end, all I want is my third child, and when I have that, I close the door on the clinic. They will not be part of my life forever, they’re just the vessel to bring our family together. I don’t need them to treat me nice; I just need them to do things ethically and in my best interests since they have my overall health in their hands. I don’t really care if they see me not as a human being but as a pile of money. Again, I’m not there to make friends; I’m just there to have a family. But I do need to state that I never got the sense that my doctor saw me as a pile of money. My doctor sat on the phone with me and gave me a pep talk when I was falling apart one afternoon at work. He treated me as an intelligent, important member of the team. So there’s the quote in the article, but there’s also the other side: that he was incredibly caring, never dismissed my feelings, and ultimately helped me conceive the twins.
The other reality is that if we went back, I wouldn’t have to take the loan; in fact, now that I know this, I could opt to use a competitive loan company. I can educate myself (actually, I think we’d all agree considering I wrote a book about infertility, that I’m pretty well-educated), and if my doctor’s recommendations for treatment don’t mesh with my comfort zone or he can’t explain why he is making these choices, I have the right to walk and find a clinic that will make the best choices for my body.
It’s easier not to deal with that clutter in the corner of the room; the corner of my life. I look at the situation, and I become so overwhelmed over the idea that I need to be this on-guard. I look at the twins and think about how I don’t want to miss out on one second of their lives in order to chase a third child. I don’t want to take anything away from them in order to put it into the possibility of someone else, even if I know that if that someone else were here, I would equally say that I can’t believe I ever thought about not doing everything in my power to bring them into our family.
Which leaves us still in the exact same place. Because articles like this Slate article don’t push us forward or back. They just leave us in the exact same place that we started.