March 28, 2024

Bucks Blog: The Cost, in Dollars, of Raising a Child

In an article in the Your Money special section we just published about bulletproofing your finances, I wrote about one big money move that would be awfully beneficial to my bottom line: not having children. For all that we know about how expensive it is to raise a child, however, we don’t know exactly how much it costs.

So I decided to come up with an estimate, rough as it is, for what it would cost my spouse and me to have one child. I figure it would run close to $2 million by the time it was all over. How did I come up with that estimate?

The United States Department of Agriculture Department publishes an annual report on what families spend on their children, so I used that as a basis for some of my calculations and then tailored them to our own finances and geography. In 2007, The Wall Street Journal tried to improve upon the government figures, but some of the expenses they included seem based on the budgets of the truly rich, like furniture from Pottery Barn and bottled water delivery.

Without excessive expenditures, surely people like us could raise a child for more than the $435,030 the government estimates but less than the $776,000, $1 million or $1.6 million guessed at on the pages of the Wall Street Journal. Right?

I had hoped so, but my estimation of what my spouse and I might spend – and, crucially, what we might lose – having a child ended up being more than those estimates.

In order to be as conservative as possible, I stuck with the Agriculture Department’s figures for the cost of food, transit, clothing and miscellaneous expenses (personal care items, entertainment, reading materials) for children in a two-parent household in the urban Northeast with a combined income of over $103,350.

Those costs are higher in New York City, but our earnings are below the average for the category we fall in, and I wanted to be conservative in my calculations. But for housing, health care and child care I changed the numbers to be more specific to where we live. I used the average cost of full-time child care in New York City for the first few years, $12,750 to $16,000, according to the Administration of Child Services, and then reverted to the Agriculture Department numbers for child care and education until age 18.

My health insurance plan would charge us nearly $4,000 more each year for an additional dependent. Co-pays, prescriptions and other therapies could easily cost another $750 each year. At some point, our hypothetical child would probably have braces as we both did, which costs $4,000 out of pocket.

To estimate the cost of housing a child, I subtracted our rent from the rent we would pay to live in our neighborhood in a more suitable space — one with higher security, a more responsive landlord, reliable heat and better stroller-accessibility. Staying in our neighborhood and continuing to rent would keep our other costs in check, especially because of the quality of the public schools here.

Just as our parents paid most of our undergraduate tuition, my husband and I would want to help our child pay for college. To pay for half of the projected tuition at an average-price four-year public university would require we save $5,328 each year from birth to age 18, according to BlackRock’s college savings calculator.

And since we would probably not cut off our child financially once he or she reached the age of majority, I added the cost of the basics (housing, clothing, food, transportation and health care) between age 18 and 25, when the child would no longer be covered under our health insurance. Later in life, when this young adult has children, we will still spend money by supporting our grandchildren at a rate of $8,289 every five years, the average according to a MetLife study of grandparents’ relationships with their grandchildren.

Then there are the losses I would suffer as a working mother: half a year of forgone wages while on maternity leave and earning 73 percent of what men earn instead of 90 percent like nonmothers (or in my case, the equivalent fraction of my current salary) for the remainder of my career, according to a Columbia University study on the motherhood wage gap. This doesn’t include reduced benefits like 401(k) contributions, but it still adds up to over $700,000. The flip side of this equation is what economists call the “fatherhood premium,” which increases a man’s earnings about 4 percent.

Of course these expenditures and losses are not the strict minimum required to raise a child – not by a long shot. But if we were to have a child and do what most other parents do by trying to give this new little life the very best start possible, it would probably cost us $1.8 million including everything I mentioned above.

Then there are other sacrifices to mental health and perhaps fiscal health, too, albeit in ways that are hard to predict. Some of those disadvantages seem readily apparent, like lower marital satisfaction, higher depression rates, plus that “mommy track.”

So did you think about the cost, in dollars, of having a child before you decided to become a parent? Or do you find the whole idea of factoring in it at all to be odd?

Article source: http://bucks.blogs.nytimes.com/2012/11/13/the-cost-in-dollars-of-raising-a-child/?partner=rss&emc=rss

New Study Links Spine Product From Medtronic to Risk of Sterility in Men

Infuse is a bioengineered bone growth protein that has been widely used in spinal fusion procedures since 2002. The Infuse label notes the sterility-related complication as a possible side effect, but the Medtronic-sponsored researchers in published reports attributed that complication to surgical technique, not the product itself.

The Stanford surgeon, Dr. Eugene J. Carragee, found that men treated with Infuse developed a condition that causes temporary or permanent sterility at a far higher rate than men who received a bone graft, another material that is used to fuse spinal vertebrae. He urged doctors to counsel men about Infuse’s risks. The study was posted Wednesday on the Web site of The Spine Journal, which he edits.

“It is important that men who are considering having children have the opportunity to weigh the risks of the various available procedures,” said Dr. Carragee, who based his study on 240 patients he treated several years ago with Infuse or a bone graft.

The type of spinal fusion at issue is known as an anterior lumbar fusion, a procedure performed on about 80,000 patients a year in this country. Infuse is used in about half of those procedures, and men make up about half of the patients who undergo spinal fusions. The sterility complication at issue in Dr. Carragee’s study affects only men, not women.

Among the 69 patients treated by Dr. Carragee who received Infuse, five men developed the complication related to sterility, in contrast to one patient among the 174 men who received a bone graft. The condition resolved itself in half of those six patients.

Two surgeons who were involved in the original Infuse trial defended their findings in statements, saying that not enough men had experienced sterility-related complications in their study to statistically link the problem to Infuse. The surgeons, Dr. J. Kenneth Burkus and Dr. Thomas A. Zdeblick, noted the complication in a medical journal article published soon after Infuse was approved by the Food and Drug Administration in 2002, but they divided those patients by the surgical technique used, not by whether or not the men had received Infuse.

In his Web article, Dr. Carragee questioned why the researchers had not broken out the patients in their study between those who had received Infuse and those who had not, a method that he said was a standard way to present clinical trial results.

In an e-mail, Dr. Zdeblick said Dr. Carragee’s study was of limited value because it reflected the results of a retrospective look at patients rather than a clinical trial. Such reports “are notorious for being misleading,” he wrote.

The new study is likely to intensify a debate over whether industry-financed researchers present study findings in ways that favor the interests of corporate sponsors. Dr. Burkus, who practices in Columbus, Ga., and Dr. Zdeblick, a professor at the University of Wisconsin, have each received millions of dollars from Medtronic in consulting fees or royalty payments.

Both men have adamantly insisted that those financial relationships have not affected their scientific judgment.

Nevertheless, in a commentary accompanying the new study, Dr. James D. Kang of the University of Pittsburgh wrote that industry support was one way to explain the different conclusions reached by Dr. Carragee and the Medtronic-sponsored researchers.

“There does not seem to be any rational explanation for these observational differences,” Dr. Kang wrote.

Dr. Dan M. Spengler, a professor and former chairman of orthopedic surgery at Vanderbilt University, who was not involved with the study, said it added to growing evidence about various risks from Infuse. “It’s just startling to me,” he said.

Marybeth Thorsgaard, a spokeswoman for Medtronic, based in Minneapolis, said the company believed that it had provided the F.D.A. and doctors with all available medical information about Infuse. Analysts have estimated that sales of Infuse reached about $900 million in Medtronic’s most recent fiscal year; overall company sales hit $16 billion during that period.

“You have to consider the totality of the data that has been presented, not how one study was reported,” said Ms. Thorsgaard.

Dr. Carragee’s report is not the first time doctors have challenged how Medtronic-sponsored researchers characterized the risks of Infuse in medical articles.

Since 2006, an orthopedic surgeon in Croatia, Dr. Tomislav Smoljanovic, has written more than 35 letters to medical journals questioning the claims. In their 2002 report, Dr. Burkus and Dr. Zdeblick reported that a major clinical study involving Infuse had found no adverse effects with the product, including the sterility-related complication.

Among other things, Dr. Smoljanovic and colleagues pointed out in letters that the Medtronic-sponsored researchers, while identifying that six men in their study had developed the sterility-related complication, had not identified how many of those men had received Infuse as opposed to a bone graft.

Last year, Dr. Burkus and his colleagues publicly disclosed in response to the Croatian physicians’ letters that five of the six men affected in their study had received Infuse. However, they have insisted that the figure was not statistically significant to link the problem with Infuse.

Dr. Carragee, the Stanford surgeon, said his Infuse study was prompted by a complaint he received from Dr. Smoljanovic about an Infuse-related article in The Spine Journal.

Dr. Carragee said he and his colleagues had posted their study online, ahead of the publication’s print edition, because of the public health implications of the findings. He said that forthcoming edition of The Spine Journal would be dedicated to complications involving bioengineered bone growth products like Infuse.

Article source: http://feeds.nytimes.com/click.phdo?i=92c23b8ab10c8262bc90e59bbbee0d9c