Did I have "depression," as the psychiatrist initially wrote on the Anthem form? Or did I have "depressive symptoms," as she later clarified? In the shrouded world of insurance underwriting, these semantics seemed to determine my rating and premium. Yet I don't think many doctors realize the power of their word choice. And the pregnancy articles failed to mention that entertaining the idea that I needed help for PPD—even once—would have far-reaching repercussions. No one explained that my $250 appointment with a psychiatrist would constitute a grave risk to an insurer and cost my family thousands of dollars in raised premiums. Or that my low health-insurance rating could also adversely affect the cost and benefits of other kinds of insurance, such as life and disability. The postpartum depression awareness campaign to which Shields laudably devotes herself has worked in part. But knowledge of PPD leads to another baffling and difficult condition: being punished for advocating for your health.
This past February, I became eligible for Anthem's Level 3 coverage because a year had passed since my appointment with the psychiatrist. Still, my coverage continues to cost more than twice as much as my husband's. I won't be eligible for his Level 1 rating until 2009, and only then if no depression or other malady arises in the interim. To understand where our money is going, I Googled Larry Glasscock, Anthem's CEO, and learned that the company's "significant growth" reportedly grossed him upwards of $40 million in cash bonuses and stock awards in 2004.
Years ago, when I was in middle school, I used to draw braces on the gleaming white teeth of models in teen magazines. Since my struggle with postpartum depression, I like to conjure up my 12-year-old self, along with a splash of the late artist Jean-Michel Basquiat. In my fantasies, I swoop down on the piles of pregnancy journals in doctors' offices, sail onto the sets of talk shows, and hover above the handouts given out in childbirth classes. When I come across the line, "If you're depressed, seek help," I write, with my can of orange spray paint, "BUT PAY FOR IT IN CASH."