The Bishop and the Butterfly: Murder, Politics, and the End of the Jazz Age
    Michael Maiello's picture

    The Plight Of The Ultra Low Affluent

    In The New York Times today, Lori Gottlieb, a bestselling author, practicisng psychotherapist and contributing editor to The Atlantic Monthly worries, "Has Obamacare made it un-P.C. to be concerned by a serious burden on a middle-class family’s well-being?"

    In the column she describes herself as a middle class, self-employed single mother who lost her preferred health insurance plan as part of the Obamacare implementation and is being forced, without aid from subsidies, to purchase a more expensive plan that, by her telling, has features that she doesn't want at the expense of features that she did desire about her old plan.  Also, her new plan costs a lot more.  She is caught, she says, in the middle class conundrum where she makes just little enough that the increased premiums hurt but not little enough that the government will help her.

    Worse, when she complained about it on Facebook, her friends were not sympathetic.  I think this is bad news for Obamacare as people like Gottlieb have loud voices n our culture.  Winning people like her over should probably be a goal.

    The thing is, though, Gottlieb is not typically what we think of when we think of the single, middle class working mother.  She is a former television executive and is now a practicing pychotherapist in Beverly Hills  "Im.  Her book, Marry Him: The Case For Settling For Mr. Goodenough was a New York Times nonfiction bestseller and an Editor's pick.  I worked with somebody who wrote a New York Times nonfiction bestseller and the royalties made him a liquid millionaire.  Gottlieb conceived her son via sperm donor and artificial insemination, as a single woman.  It is great that we live in a world where people can do that if that is what they want to do.  It is also an expensive process and one that somebody as erudite and intelligent as Gottlieb would not have done had she not been pretty sure of her own financial security.

    I don't believe that Gottlieb is middle class.  She is more likely in the camp that my wife calls "Ultra Low Affluent."  If she had voiced her complaint that way, I would definitely be more understanding. 

    "I am wealthy," she might say, "But nowhere near as wealthy as more of my clients and just yesterday somebody driving a car worth as much as my house blew past me on Highway 1..."  But to play the working single mother card when she clearly makes so much more than the median income is just not fair.  I understand that L.A. is expensive.  I live in New York City, which is more expensive (and my city and state tax burdens are higher).  I have some sympathy, here.  But when somebody takes to the New York Times op-ed pages to claim allegiance with the proletariat, the editors at the Times need ask some questions.  The complaints of the affluent but not affluent enough for their tastes should not be lumped in with the concerns and struggles of public school teachers and the floor sales staff at Sears.

    Again, I sympathize with Gottlieb on some of the merits.  She now has a plan, she says, that will cover maternity even though she never plans to get pregnant again while it doesn't cover long term hospital care for her son, which is her main concern, and she is paying more for that.  No matter how much she makes, she has a legitimate gripe there and the law should not be so constructed so that it cannot be addressed.  The problem here is likely that Obamacare still leaves the details of the insurance in the hands of private companies.  Her gripe might be as much with her provider as it is with the government.  This is why so many of us wanted to cut the private insurers out of the process.  The government, we figured, could engineer a better deal for everybody.

    But we can't get to the details if Gottlieb exaggerates her penury.  Her goal here is clearly to make her high class problem seem more universal than it is.



    There are too many questions raised by her story her Mike.

    So she claims her costs will now be $5400.00 per year extra, but she says that without telling us about her past policy, how much it was and what it covered.  Was it just catastrophic insurance?

    Let's talk about the  cost of her in-vitro treatments, we know for a fact that she spent around between $10,000 - $15,000. She complains about having maternity coverage in her new plan, so presumably she didn't have a plan that covered maternity/pre-natal care, which means she paid for her pregnancy out of pocket, which indicates she has some extra cash lying around that most people do not have lying around. I am sure her insurance didn't cover her infertility treatments, because she doesn't mention she had comprehensive coverage. Well under ACA infertility treatments are covered at 54%.

    Mostly in her column, Gotleib is just complaining that people were not sympathetic to her. Waah. Too bad, we don't really know about her situation because she didn't share any facts with her reader about her prior coverage. Why is that? I presume she chose some crap catastrophic plan because she seems able to pay for the day to day cost of health care. Which means she can also afford a few extra bucks for a comprehensive plan that covers preventative care for herself and her child. The trade off of course is that poor people will now have access to care, that she has had access to without comprehensive insurance, which makes her fairly well off. 

    Yeah, we don't know much about he previous plan.  She seems to imply that it was not catastrophe only but also notes that the new plan will cover her if she has "stage 4 cancer," though she is dismissive of that coverage, as people can be when they don't, in fact, have stage 4 cancer.  Well, I do hope she never has to use that new coverage, even if she's paying for it.  I also very much suspect that she is at least a liquid millionaire and a paper multimillonaire.  If only that were middle class!

    FWIW the personal pronoun count (I/+variations and my) is 48, or about 1 of every twenty words.

    Your characterization of her is spot-on.  Read this op-ed she wrote in 2000 -- it's exactly what you're describing:



    That one has 67 personal pronouns (I, my etc) in a 785 word essay. One every 11 words. Might be difficult to get it higher. Of course the title 'My Money, My Life' gets it off to a fast start.

    It appears her concern for her life, her money and her career are sufficiently passionate and intensely focused that no one else need bother.

    Wow, she outed herself.  And here I was feeling bad for not bothering to look up her real estate records...

    I guess she is not used to conforming to new rules.  She is now being treated like the lower classes.  So it hurts a little.  It is so much more stressful at the bottom.  I am sure she will adjust and remain a Republican.  

    Ultra low affluent.

    I don't believe that Gottlieb is middle class.  She is more likely in the camp that my wife calls "Ultra Low Affluent."  If she had voiced her complaint that way, I would definitely be more understanding. 


    The greatest line I have heard all month. hahahahahaahah

    I believe myself to be ultra low affluent.


    I can have all the canned spinach I can find and still find time for tobacco!


    I hereby render unto Destor the Dayly Line of the Day for this here Dagblog Site rendered unto you from all of me!


    Thanks for putting that op-ed in context.

    I kind of have more respect for people who just come right out & say that they don't think poor people have a right to access medical care, and they certainly don't want to pay for poor people to have it.

    This is worse than that. 

    Someone who's been on the NYT best seller list, with a wealthy family background, with the luxury of being able to choose to be a single mother, having the audacity to insinuate that she might have anything in common with working class widowed mothers, or middle class women raising a child alone because they needed to leave their abusive ex-husband...  And to use the the NYT oped section to whine about her facebook friends. 

    It's truly bizarre.

    And where are the op-ed page editors?  They assigned the darn thing.

    A defender at Gawker:

    "If insurance was meant to cover everybody for everything then it would cease to be insurance you smug Williamsburg f***bag."

    I also hate it when people confuse Bushwick with Williamsburg.

    Poll: Who's the More Horrible Media Troll, Richard Cohen or Lori Gottlieb?

    It's been quite a week for people writing what appear to be deliberately stupid editorials, but then, isn't it always? Earlier this week, the internet was in an uproar over Richard Cohen, Washington Post columnist and musty old bigot, who finds a new way to bum us out almost every Tuesday. ... And yet, try as he might, Cohen's entry into the Idiotic Editorial Hall of Fame doesn't totally eclipse this week's earlier entrant, Lori Gottlieb, who wrote a less openly offensive but in some ways, much more trollish op-ed in the New York Times on November 11. ... "Daring to Complain about Obamacare" is brought to you by the same lady who advocated marrying whatever schmuck you happen to be currently dating, since nothing is worse than dying old and alone and female.

    Uh, I think she just gave a point of view from a mid-40's single mom who wished she had been less picky and would have more contentment being with the non-perfect man than being alone.

    I knew one woman who's love-of-her-life died when she was younger. She married someone else and was with him for decades but was open about her 2nd husband not being the peak that her childhood sweetie was - but they had a nice long-lasting relationship with that acceptance.

    Anyway, I don't think it's really a guy's turf to be criticizing women for trying to find the balance of home and work over the last 40 years. In 95% of the cases they guy wasn't going to take care of the home bit anyway.  [yes, that's an Anna writing that article, but she doesn't seem to have read even the Atlantic piece. Oh, and her presumption that dumping her health care after her kid might be a little off-base if Gottlieb's insurance didn't pay for in vitro fertilization, which I doubt it did. And the "doesn't let her keep the plan she likes"? her new plan doesn't let her keep even her doctors or hospital. In short, a glib one-off op-ed on a slow day, mixing with Richard Cohen. What-ever, it's just a pile on - everyone will feel grand at drinks tonight.

    same lady who advocated marrying whatever schmuck you happen to be currently dating

    "The perfect is enemy of the good"?

    This is more a case of the meh is the enemy of the good.

    I'm curious about the reactive class attacks that come out first. She made 6 figures in California in 2000, so she must be affluent somehow. Which ignores that she might not make that money now (2008 wiped out a lot of that, including saved up wealth - I'm far away below my top salary in 2003), or how it relates to being self-employed, and other factors. It's just an attack because she's rich and unsympathetic.

    A quick look around notes she spent 4 of the last 5 years as a trainee and intern to be a therapist including eating disorders (she suffered from them as a kid and wrote a book about it). So those 4 low-paid or unpaid years might have wiped out any savings. Plus she had costs of an vitro birth. Plus she's raising a kid as a single parent. Plus she's living in California where costs tend to be exceptionally higher - I recall getting thinking how much money I'll have and then finding out rent prices plus getting my tripled insurance bill to over $2K a year and realizing I'd have to dump my car and take public transportation (a single traffic ticket and a fender bender screwed me. At one point with near 5-figures, my rent in the bubble was $32K per year for a pretty crappy place with leaky windows and ridiculous heating bills. Then I took over my own insurance for over $10K per year "thanks" to COBRA). 

    Her 2000 article about the not-quite-rich 5-figure income was about Silicon Valley. By 2006, average rent was $1360 and avg single family homes were $760K (the real estate crunch is back - the average sale price for a condo or townhome was $468,654, a whopping 39.39 percent increase from the $336,206 of November 2011, according to the Santa Clara County Association of Realtors (SCCAOR).).

    [ok, she's a writer - one of her non-fiction top selling books is an impressive #106,000 on the Amazon list, the other up-and-coming at #760,000 - not quite the top 50 of Dreams From My Father, but she can hope]

    As for health care, her yearly *increase* is $5400 after tax ($6400 pre-tax for self-employed?) - which is almost the *total* $5700 per capita spending of #2 most expensive health care country Norway. Her *increase*. And 84% of Norway's total is carried by the government (and pre-tax) so a typical person would pay $900 out of pocket.

    People attack her for her comment about maternity benefits and sex change, to ignore basic points, such as her new insurance screws her and her son on basics of long-term hospital coverage even while improving her coverage on things she'll never need. Yes, a 46-year-old should be concerned about losing long-term care - hopefully it's just an issue of "not shopping around", but ACA supporters should be concerned that normal people (even subtly affluent) are having trouble wading through new rules and new rates and typical insurance company gouging. A smooth transition & transparency is part of the plan, no?

    And yes, there might be some bitterness of paying for her in vitro fertilization out of pocket, and hitting the age where she could drop birthing expenses and then finding she'll pay for them anyway. Say I quit smoking to go into the non-smoker's pool and find my premiums will jump to pay for other smokers. And yes, these are tradeoffs we've been taught to make to decide what kind of coverage we want, whether we go for premium plans or the crappy non-insurance insurance...

    Anyway, don't expect to change anyone's mind, I'm just continually amazed by class cattiness in America, usually towards the slightly affluent rather than the grossly rich.

    And instead of asking again why we're paying so much when the rest of the world pays 1/3 to 1/2 the cost, we're attacking those pseudo-rich who complain.

    The objection is not that she is rich, the objection is that she characterizes herself dishonestly.  I don't think this is class cattiness.  If I had my way, Gottlieb's standard of living would be a floor in America.  The reality is that she is in the minority in terms of lifestyle and financial power.  She should, at least, recognize that when she complains.

    If she'd been ardent supporter of single payer, she might have a stronger leg to stand on. Also, the "new rules" aren't any harder to wade through than the old ones.

    She opposed single payer?

    I don't know. But is there anything in what she's written in which she says something to the effect of: "If only Obama had gone for single payer or even the public option, we all would have come out ahead."

    Her whole thing feels a bit narcissistic to me. We all need to think about ourselves, of course, but there seems to be no recognition or understanding of why these changes are taking place.

    One wonders if she'd have written this article if her insurance company pre-ACA had canceled her policy...or raised her premium...which they did fairly regularly...and, in fact, are doing now.

    I have no sympathy for anyone single or married whose income is 90k a year or more who cannot make it. Period. If your income is that high and still you have to complain I suggest some serious time with a financial counselor and /or a therapist. Probably both.

    My retirement is just about 48k a year here and I do just fine thankyouverymuch.

    I eat well but nearly never out. I bake/cook all my meals. I have new clothes when necessary and a nice car. My duplex is nicer than most and keeps me warm in the winter.

    I can also pursue my interests.


    Maybe she has no retirement because she's been self-employed. And she had a kid late so maybe is trying to save for his college. Maybe she doesn't have a duplex - perhaps lost it in the mortgage scams or bursting housing bubble. She was a trainee and intern for 4 of the last 5 years - maybe her book income is a lot or maybe she makes median 60k a year.  If her health costs went up $5400 on $100k income (the 65th percentile in the new economy -   with self-employed taxes, that's some 7-10% of her takehome income - she might have been doing fine, but now not so much. And she can expect new copays plus  if they don't cover her traditional doctors and hospitals, she has a lot of worry both for treatment quality and cost.

    And you may be able to cook all your meals retired, but for a working single mom in LA, she doesnt have the cost savings of a paid-up homebody.

    Anyway, librrals not so sympathetic as they once were.

    World's smallest violin.



    The Bourgeoisie will ALWAYS chose comfort over reality !


    Wow, how quaintly retro, might as well be 1789 or the Paris communes 1871.

    I remember this homeless guy pissed because I didn't give me a buck, and he looked jealously at my primer-no-paint-beat-up 20-year-old van I'd bought for $400: "I know where *you're* coming from". 

    Yeah, that bourgeoisie be living high on the hog, drinking up dem Starbucks lattés and cadillac health plans. To the Bastille!!!


    PP you really touched me with that story.......Now.....I'm verklempt.

    Talk amongst yourselves Daggers...........

    Nice blog, Michael---and oh how I tried not to get hooked into this, I really tried, and nothing I say here will have been influenced by the the fact that I am divorced from an MFC in California which cost me dearly.

    The requirement for an MFC in California is two years' master's level work---and 3000 hours supervision; the last time I checked, another MFC having met those qualifications can qualify as a supervisor. The MFC is not the same as a clinical psychologist or psychiatrist. Is it catty to mention that 1 in 10 women in California is either a real estate agent or an MFC?

    100K a year? At $100 an hour, and I'd be surprised if it were that low, her practice is at best a half time job. Oh, that's right, all the parenting that must take place---as she explained in one article, she gives her kid forced choice questions.Great, right up there with telemarketing. I hope she remembers to deposit any cash which she may have received from non-insured clients---which leads me to what makes her article ( I dislike all her writing) so meaningless is that Obamacare will expand coverage for MENTAL HEALTH SERVICES for millions of people. So, assuming she has anything at all on the ball as a therapist, her practice and income should expand.

    "Now let's see, Mr. Mora, where do you think the anger issues come from---your parents, or your ex-wife?"

    I was never one to find making class war points as an interesting op-ed topic. (I will admit that I tend to go for the pushers of rising-tide-lifts-all-boats memes.)

    There's really only one thing I would like to point out after reading this whole thread, which I did reluctantly. I vaguely remember something about one of the original Obama campaign's main strategies: not to alienate the $150/200K-a-year crowd. And that doing that helped him win the presidency. Even though he was a black guy with the name Barack Hussein Obama and had no executive experience and there was a threat of a major worldwide depression.

    Edit to add: Only a short while ago, people like her were included as part of "the 99%." Whatever happened to that meme?

    I agree with you about alienating such people.  But I also think that people should make honest arguments. Gottlieb turns herself into a character (prototypical working single mother) in order to leave people with the impression that Obama is taking health care away from such people, or making it impossible for them to feed their children.  It's just not so.  A better argument for her might have been, "I do all right.  If I accidentally under-insure I am in a better position than most to be able to make up the shortfall."

    She like most people is one breast cancer or car concussion away from financial and emotional disaster. no, she doesnt owe us a disclaimer about how good shes got it in the us o' a. i agree with AA on the 99% - we almost had a unity movement.

    Mainly what comes to mind for me is that irritation with the views and attitudes of the bourgeoisie is nothing new.

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