Posts Tagged ‘healthcare’
Tuesday, March 14th, 2017
On Friday, the U.S. Bureau of Labor Statistics reported the economy gained 235,000 payroll slots in February and upped its estimates for December and January by another 9,000 jobs. Over the three-month period, that means an average job growth of 209,000 jobs a month. Including the ups and downs, over the past 30 years, the U.S. economy has averaged job growth of about 126,000 jobs a month. So this current rate of growth would suggest a strong labor market. Further, workers who transitioned from being out of the labor force into active job search were 2.3 times more likely to land a job than to be stuck unemployed and looking. And unemployed workers were 1.3 times more likely to find a job than if they were to quit and drop out of the labor force discouraged. Over the year, average wages (not adjusting for inflation) rose 2.8%.
Watchers of the Federal Open Market Committee, the policymaking body of the Federal Reserve Board, are sure the FOMC will stick to its forward guidance and act to raise the fed funds rate; which is their tool for setting the tightness of monetary policy. Raising the rate signals faith in the strength of the recovery by the Fed; a strong sense the economy is nearing both its target for inflation and employment. And, it is likely, given recent statements from several Fed officials that these numbers may convince them that “normal” is just around the corner. But they are wrong.
Raising interest rates is a way to slow the growth of the economy. It is useful to prevent an economy from over-heating and setting price increases on a pace that would be difficult to reign in. If done properly, the Fed can guide the economy to a soft-landing, where it will sit growing at a rate just fast enough to stay at full employment.
Well, the problem is that is where the economy is now. Despite solid job growth over the past year, the unemployment rate has remained flat and annual nominal wage growth has remained steady at around 2.6%. As a simple arithmetic, if the number of jobs created slows, then the unemployment rate will have to rise, and wage growth will slow.
If the near term had great economic certainty, then it might be possible to agree that labor market might show more signs of tightening; rather than its present “goldilocks” state of flat unemployment and wages. But the near term has great economic uncertainty.
First, while wages are beginning to show growth, the share of people employed is still a significant distance from the share employed at the peak of 2007, which was below the peak of 1999. This means that household incomes have not caught up. A large share of the workforce is employed part-time, and while the recovery has seen mostly growth of full-time jobs, household incomes have not gotten back to full employment levels.
Second, a major driver of the real economy is the automobile industry sector. After over-correcting during the depths of the Great Recession and the historic collapse in demand, it has used the financial helping hand then-President Barack Obama lent, to recover and now reach record sales and a growth in employment and investment. But a substantial and rising share of auto loans have been made to African American and Latino communities using subprime lending tools. During the initial stages of the recovery, delinquencies on auto loans declined. But, beginning in 2016, they started to rise. And they continue to rise.
The purchase of new cars has increased the supply of used cars, so the gap between new car prices and used car prices has been rising as the price of used cars is falling. Delinquencies on auto loans began when the Fed began moving from zero interest rates, since the loan rate on automobiles is tied to short-term interest rates. Higher short-term rates will further increase consumers’ costs of buying a new car, increasing the wedge between new and used car prices.
The threat is that if job growth slows, it will first affect the African American and Latino communities, already showing struggles with the onerous terms of the subprime loans. Those communities need more time for the labor market to recover. The best solution for the economy is for their income to pick up pace and out run the debt. Income-led buying leads to healthy sustainable recoveries. Raising interest rates when incomes lead the recovery simply slow the pace of buying and encourage savings rather than spending. The worse solution is to have the debt out run their income. If delinquencies increase more, the auto market will get a greater flood of used cars, driving the price of used cars down further and increasing the gap in price between used and new cars.
Over the past six months, in fact, lending activity has become more stringent for new borrowers in the auto sector and for small business. Such a credit tightening is normally associated with an economic downturn; not a healthy growing recovery about to overheat. Higher short-term rates will only exacerbate that problem.
The problem is clear, at some point the new car market will go into recession; which means the auto industry will be in recession; which means the economy will be in recession.
Third, compounding the near term uncertainty, is the war that President Donald Trump has declared on the immigrant community. Fear and uncertainty are high in communities where many workers and family members are undocumented. These workers are fully integrated into our communities. They are wives, husbands and parents of legal residents and American citizens. These households live under a cloud. Fearing deportation, or legal fees to protect loved ones, millions of households are unlikely to buy new cars, or may be deciding to horde cash and stop making payments on cars that have been purchased. This is an uncertainty with a magnitude we have never faced, and therefore is too great a threat to ignore.
Fourth, the increase in people with health insurance because of the Affordable Care Act has meant job growth in the health sector at a faster rate than the rest of the economy. The current proposals of the Republican Congress to repeal the Affordable Care Act all will lead to a decrease in the number of Americans with health insurance. For this reason, the major hospital associations and the American Medical Association oppose the Republican plan. The threat to this market will have real repercussions on job growth in the one high-wage sector with fast job growth. And the wind down of federal Medicaid support to those states that extended health coverage using Medicaid will cause huge ripple effects on state budgets, which have not fully recovered from the drastic loss of revenues during the Great Recession. This will mean further pressures on recovering state investment in public colleges and universities.
Finally, the proposed budget cuts put forth by the Trump administration would gut public investment in education, housing and the environment. The austerity that has been proposed will cut federal jobs. And, just when the Medicaid cuts are going to hurt state budgets and so put more pressure to raise tuition at public two- and four-year colleges, the Trump administration is proposing cuts to Pell Grants and returning the student loan market to the more expansive private sector.
Thoughts that huge tax cuts to high-income households will offset a downturn in automobile sales, further disruption in the rising costs of college tuition or a dismantling of the health sector are irrational. We have lived through big tax cuts to the wealthy under former President George W. Bush. They were insufficient to pull the economy out of the 2001 downturn in any timely fashion; and, he had the help of low interest rates, a federal deficit swelled by tax cuts and war time expansion of military budgets, as well as a relatively healthy state unemployed insurance system. The current unemployment insurance system is greatly weakened and cannot provide the automatic stabilizer so vital to dampening a recession.
These all point to a real danger that the Fed may be a great threat to what is a more fragile economy than appears at the moment. The drive to be “normal” in a world that is clearly not normal, may put us in danger of a downturn that will be difficult to recover from given the instability shown in the White House.
Thursday, March 9th, 2017
Students and faculty at America’s colleges and universities stand at the confluence of many of the most troubled waters springing from the Trump administration and its corporate-driven, deeply divisive agenda.
It’s on these campuses that millions of young adults wonder whether they’ll still have health insurance if Obamacare is repealed. It’s here where those whose parents are undocumented immigrants may be forced to seek sanctuary. Hate incidents have spiked. The arts, science and intellectual freedom are under attack. Countless professors were ensnared by the administration’s ill-conceived travel ban.
This deluge is flooding a higher education system in which so many were already barely keeping their heads above water. Families can’t afford to send their kids to college, student debt has skyrocketed and faculty in precarious jobs are earning so little, many must rely on public assistance to make ends meet.
Maybe it’s not surprising, then, that college campuses are emerging as centers of resistance in these first weeks of Donald Trump’s presidency.
Today, nationwide, at dozens of colleges and universities from Boston to Seattle, students, contingent and adjunct faculty, their fellow working people and allies are standing up, teaching in, speaking out and reclaiming higher education for the public good. A national day of action is raising the banner of #CampusResistance.
At the University of Chicago, we are standing up for part-time faculty who struggle to pay for healthcare and are in danger of their losing insurance. Elsewhere across the country there are marches, rallies and teach-ins. The energy surrounding the campus resistance movement is real and growing.
As a contingent professor of Hindi and the executive vice president of a labor union, the two of us have different vantage points as we observe what’s happening in our nation and on our campuses. However, we see the same forces at work. New Secretary of Education Betsy DeVos is unqualified and wrong for the job, which she has clearly demonstrated through her attacks on unionized workers and support for commoditized, corporatized higher education.
But college campuses are inherently optimistic places. That’s why we can see past Donald Trump and Betsy DeVos. It’s why contingent faculty endure the challenges of the profession. It’s why graduate workers keep at it even when they are underpaid and overworked. It’s why students who wonder what kind of world they’ll graduate into are hitting the books harder than ever.
You can’t keep people down who are thinking about the future—their own and that of our country. It’s why students and faculty who joined or applauded as millions of women marched the day after Trump’s inauguration have turned their attention to what they can do right where they are.
What they can do—what they will do on today—is more than protest Trump, although it’s essential that we resist and oppose his agenda. Faculty and students will rise up to and stress how important a strong higher education system is to the well-being of the nation.
Americans deserve—and need—colleges that are gateways to a lifetime of opportunity for students. Institutions that are once again cornerstones of local and regional economies, providing good, stable jobs that can sustain a family. Places where children of immigrant families can pursue the American Dream without worrying they will be dragged away. Homes to robust intellectual inquiry that advances science and nurtures the arts, uncompromised by the pressures of partisan politics.
This is why we and thousands of others are a part of the #CampusResistance — today and beyond.
This article was originally printed on SEIU.org in March 2017 . Reprinted with permission.
Jason Grunebaum has been a contingent professor of Hindi at University of Chicago for 12 years.
Heather Conroy is an international executive vice president at the Service Employees International Union (SEIU).
Tuesday, November 15th, 2016
If President-elect Trump follows through on his campaign promises, millions of individuals-immigrants, religious minorities, people of color-face a very grim four years. One of the worst hit groups will be Americans with significant health costs. The Trump transition team published a brief summary of the incoming president’s health plan on its website, and the news is not good for the elderly, the poor, and millions of Americans with preexisting conditions.
Much of the plan is vague. Trump plans to “Modernize Medicare,” for example, an unclear statement that is likely code for Speaker Paul Ryan’s (R-WI) plan to repeal Medicare and replace it with a voucher system that imposes much higher out-of-pocket costs on seniors. Similarly, Trump says he will “Maximize flexibility for States in administering Medicaid,” a statement that is probably code for Ryan’s plan to either “require states to provide less extensive coverage, or to pay a larger share of the program’s total costs, than would be the case under current law.”
A central prong of Trump’s plan, however, is to repeal the Affordable Care Act and replace it with, well, not much at all. Trump says he will “repeal the ACA and replace it with a solution that includes Health Savings Accounts,” which primarily benefit the rich and offer little or no benefits to low and middle income Americans. Trump will “enable people to purchase insurance across state lines,” a coded phrase which actually means that he will eliminate state regulation of insurance which requires coverage of treatments ranging from mammograms to maternity stays to well child care.
And then there’s his proposal for people with preexisting health conditions.
Prior to Obamacare, one of the most vulnerable groups was people with medical conditions who neither qualified for a government health program nor received insurance through their employer. Insurance companies would deny coverage to these individuals for conditions as severe as cancer or as routine as hay fever.
The reason why is that covering people with such conditions is expensive. A health insurance plan is a pool of money. Consumers contribute to that pool when they pay their premiums, and they take money out of that pool when they become sick or otherwise seek treatment. That means that, if someone tries to join the pool who has a preexisting condition, the insurer will try to keep them out because it will cost more to insure them than they will pay in.
The Affordable Care Act addressed this with a trio of reforms—a requirement that insurers allow everyone in, subsidies to help pay for coverage, and a financial consequence for people who fail to buy insurance. The final of these three reforms existed so that healthy people would not forego insurance, forcing insurers to cover only the most expensive individuals.
Trump plans to eliminate this framework and replace it with “high-risk pools,” essentially, a special insurance program for people with expensive preexisting conditions. In theory, high-risk pools can work to provide health coverage with such conditions, but they are an inefficient way to do so. And they have reliably failed when attempted by states.
At best, high risk pools are a way to maximize the insurance industry’s profits while shifting the costs of our health care system onto the taxpayers. If the government takes on the burden of insuring the most expensive individuals?—?and only the most expensive individuals?—?then that’s a bonanza for the insurance companies because they will be left with a pool of less expensive (and more profitable) consumers. Meanwhile, the costs of providing care for the most expensive health care consumers will fall upon whatever new government program President Trump creates to manage the high risk pools.
But that’s actually the best case scenario for Trump’s health plan. Because high risk pools take on the most expensive health care consumers, they are expensive to maintain. And when states attempted to set them up in the past, they did not fund them enough to cover more than a fraction of what was needed. As one report explained when Sen. John McCain (R-AZ) proposed high risk pools during his 2008 presidential bid, these pools “have not been a viable alternative for the medically uninsured because of high premiums…and inadequate funding to subsidize the full cost of providing insurance to a high-cost population.”
McCain’s plan is informative regarding what a Republican proposal for high-risk pools is likely to look like. The Arizona senator proposed spending between $7 to $10 billion on these pools. But that would only cover a fraction of the Americans who would lose their health insurance if Obamacare is repealed. A national program “funded at $7 billion per year would cover only 875,000 people,” and that was in 2008. Alternatively, “even if participants had to pay half of their own premiums, as is generally the case today in state high risk pools, less than 2 million Americans would be covered.”
Obamacare provides health insurance to about 20 million Americans.
Of course, Trump’s proposal is vague on details and especially short on numbers. So maybe he plans to fund the high risk pools enough to fill the gap that will be created by repealing Obamacare. The likelihood that Republicans intend to replace a policy they denounced as socialism with what would likely be a significantly more expensive government program, however, is small.
If there is any ray of light in Trump’s proposals, it is that he doesn’t appear to have set his eyes on pre-Obama laws that protect workers with employer-provided health plans that have preexisting conditions. Nevertheless, Trump is, in effect, planning to reinstate a problem known as “job lock,” where people in jobs that they would rather leave are forced to stay in them because it is the only way that they can obtain health benefits.
That means fewer people starting businesses, more people working into the years when they would rather retire, fewer jobs opening up for younger workers eager for new opportunities, and more people simply stuck in jobs that they hate.
On November 7th, it seemed like workers were finally free to take risks without having to fear that they would lose their health coverage. Only a few days later, that freedom is likely to disappear.
This blog originally appeared in ThinkProgress.org on November 11, 2016. Reprinted with permission.
Ian Millhiser is the Justice Editor at ThinkProgress. He is a skeptic of the Supreme Court, hater of Samuel Alito, and a constitutional lawyer of ill repute. Contact him at firstname.lastname@example.org.
Tuesday, June 23rd, 2015
Judge Jerry Smith is a deeply conservative judge. He once voted to allow a man to be executed despite the fact that the man’s lawyer slept through much of his trial. He’s a reliable vote against abortion rights. And he once described feminists as a “gaggle of outcasts, misfits and rejects.”
So when Judge Smith writes an opinion protecting women’s access to birth control, even when their employer objects to contraception on religious grounds, that’s a very big deal.
East Texas Baptist University v. Burwell is a consolidated batch of cases, handed down on Monday, involving religious employers who object to some or all forms of birth control. These employers are entitled to an accommodation exempting them from federal rules requiring them to offer birth control coverage to their employees. Most of them may invoke this accommodation simply by filling out a form or otherwise informing the federal government of their objection and naming the company that administers their employer health plan. At this point, the government works separately with that company to ensure that the religious employer’s workers receive contraception coverage through a separate health plan.
Several lawsuits are working their way through the federal courts which raise the same legal argument at issue here. In essence, the employers claim that filling out the form that exempts them from having to provide birth control makes them complicit in their employee’s eventual decision to use contraception, and so the government cannot require them to fill out this form. So far, every single federal appeals court to consider this question has sided with the Obama administration and against religious employers who object to this accommodation.
Few judges on any court, however, are as conservative as Judge Jerry Smith, a Reagan appointee to the United States Court of Appeals for the Fifth Circuit whose law clerks frequently go on to clerk for the most conservative members of the Supreme Court. Nevertheless, Smith makes short work of the claim that the fill-out-a-form accommodation burdens religious liberty.
The federal Religious Freedom Restoration Act (RFRA) provides that the federal government “shall not substantially burden a person’s exercise of religion” except in limited circumstances. Applying this language, Smith writes in a unanimous opinion for a three-judge panel that “[t]he plaintiffs must show that the challenged regulations substantially burden their religious exercise, but they have not done so.”
The crux of Smith’s analysis is that the plaintiffs in these cases object to birth control, but nothing in the law requires these plaintiffs to do anything whatsoever involving birth control. Rather, their only obligation, if they do not wish to cover birth control, is to fill out a form or send a brief letter to the federal government — and neither of those things are contraception.
“Although the plaintiffs have identified several acts that offend their religious beliefs, the acts they are required to perform do not include providing or facilitating access to contraceptives,” Smith explains. “Instead, the acts that violate their faith are those of third parties.” Specifically, the plaintiffs object to the federal government working with an insurance administrator to provide contraception to certain workers. But the law does not “entitle them to block third parties from engaging in conduct with which they disagree.”
Indeed, Smith writes, if the plaintiffs in these cases were to prevail, it could lead to absurd challenges to basic government functions. “Perhaps an applicant for Social Security disability benefits disapproves of working on Sundays and is unwilling to assist others in doing so,” Smith explains. “He could challenge a requirement that he use a form to apply because the Social Security Administration might process it on a Sunday. Or maybe a pacifist refuses to complete a form to indicate his beliefs because that information would enable the Selective Service to locate eligible draftees more quickly. The possibilities are endless, but we doubt Congress, in enacting RFRA, intended for them to be.”
Smith’s opinion, in other words, should offer a fair amount of comfort to women whose employers seek to cut off their access to birth control coverage. Though there are signs that at least some of the justices would like for the plaintiffs in cases like East Texas Baptist to prevail, the fact that a judge as conservative as Jerry Smith rejected their legal arguments suggests that a majority of the Supreme Court will not embrace these lawsuits.
This blog was originally posted on Think Progress on June 22, 2015. Reprinted with permission.
About the Author: The author’s name is Ian Millhiser. Ian Millhiser is a Senior Fellow at the Center for American Progress Action Fund and the Editor of ThinkProgress Justice. He received a B.A. in Philosophy from Kenyon College and a J.D., magna cum laude, from Duke University. Ian clerked for Judge Eric L. Clay of the United States Court of Appeals for the Sixth Circuit, and has worked as an attorney with the National Senior Citizens Law Center’s Federal Rights Project, as Assistant Director for Communications with the American Constitution Society, and as a Teach For America teacher in the Mississippi Delta. His writings have appeared in a diversity of legal and mainstream publications, including the New York Times, The Los Angeles Times, U.S. News and World Report, Slate, the Guardian, the American Prospect, the Yale Law and Policy Review and the Duke Law Journal. Ian’s first book is Injustices: The Supreme Court’s History of Comforting the Comfortable and Afflicting the Afflicted.
Monday, October 13th, 2014
It’s already October and we are in full swing organizing, educating and mobilizing for Election Day. I am sure many of you are too with so much hanging in the balance!
Again, nurses find themselves in the familiar role of protecting and defending the ?Affordable Care Act. More and more evidence backs up what nurses already know–the healthcare law works. Thanks to the law, the number of uninsured Americans is expected to decline by nearly half from 45 million in 2012 to 23 million by 2023, according to a recent report from CMS actuaries. A new report from the Kaiser Family Foundation further shows the healthcare law is not only working for the millions who have coverage now, especially parents, but it is also working for the nation by slowing down spending on healthcare costs.
Nonetheless, the successes of the healthcare law does not mean the “Party of No” has given up on making Obamacare a polarizing issue in the midterm elections. Make sure you check out the 2014 Healthcare Law SEIU Member GOTV Toolkit to use for member outreach and education in advance of the election.
This blog originally appeared in SEIU.org on October 9, 2014. Reprinted with permission. http://www.seiu.org/2014/10/nurses-role-protecting-healthcare-law-more-critica.php
About the author: Dian Palmer has been a nurse for 25 years, and a member of SEIU for 17 years. “Before I joined SEIU, I was disgusted by the numerous abuses suffered as healthcare providers. We were forced to work for seven days in a row, required to do double-shifts, and had no voice in the workplace. I organized my workplace not for better wages, but because as a way to counter the abuses. Before SEIU, I thought we just had to deal with the hand we were dealt, joining a union gave us a voice and a platform to stand up for ourselves.”
Palmer is actively involved in improving working conditions and patient care. Currently, she is President of SEIU Healthcare Wisconsin and an Executive Board Member of SEIU. She is a member of the Milwaukee Chapter Black Nurses Association, and a Governor’s Appointee to the State of Wisconsin Minimum Wage Task Force. In addition, she serves as a member of the Democratic Party of Wisconsin Board, the UWHCA Public Authority Board of Directors and the Wisconsin Citizen Action Board of Directors.
Saturday, December 21st, 2013
Roberta Kenner works as a registrar at the Wyckoff Heights Medical Center in Brooklyn, N.Y., and is a member of SEIU Local 1199. In recent months she worked as a lost-timer for her local union–helping to sign up uninsured New Yorkers for affordable new healthcare options under the Affordable Care Act.
As part of Local 1199’s program, the Healthcare Education Project, Kenner and her union brothers and sisters spread throughout the city with Kenner’s team focusing on the low-income areas of Queens. Members of Local 1199 were able to knock on 134,000 doors and speak to more than 36,000 residents about the new benefits available under the law. And they got results. For those people they identified as being eligible for affordable care, nine out of ten pledged “Yes” to take action by signing up with the New York healthcare exchanges.
Kenner is proud of work she has done, and got to see firsthand how hungry people were for more information. “A lot of people know about the law, but they just didn’t know how to take the next steps,” she said. “And it was amazing to see their expressions change as the conversation went on. One lady went and grabbed a laptop and started signing up just as I was leaving, which really makes you feel that all this work is not in vain.”
This article was originally printed on SEIU on December 20, 2013. Reprinted with permission.
Author: SEIU Communications.
Monday, August 19th, 2013
For many seniors, growing older means facing new kinds of stress—such as fragile health, a tight budget on a fixed income, or the travails of living alone.
And for the people who care for the aging, the stress can be just as severe. When her client is going through a rough time, one domestic worker says she lives through every minute of it, too: “Sometimes we stay there for five days…and we don’t know what’s outside…You cannot leave the job.”
Stories like this one, recorded as part of a survey of New York’s care workers, form the invisible pillar of an evolving industry that is making the private home the center of public health, and in the process, reshaping our relationships of family, work, community and social service. Yet the home care workforce, which is driven largely by poor women of color, mirrors inequities embedded in the low-wage economy. At work, caregivers manage the lives of our loved ones while often facing exploitation and abuse, and after a long day of delivering comfort to vulnerable clients, many struggle themselves to cope with ingrained poverty their communities.
To open a conversation about the economics and ethics of caregiving, ALIGN (Alliance for a Greater New York) has partered with the national advocacy campaign Caring Across Generations, along with various community and labor groups, to study New York City’s more than 150,000 home care workers. The surveys and investigations published by ALIGN reveal structural problems in the industry and identify potential for reforms that work for those who give and those who receive care.
In New York, the home care industry is booming as more seniors opt to live at home rather than in institutions. Thousands across the city earn their living by taking care of seniors and people with disabilities. Overall, according to the study, the sector “will be the single biggest driver of employment in the city in the coming years.”
On a typical day in New York, these workers, mostly women of color and immigrants, act as both therapists and companions, managing medications, bathing and feeding, and helping seniors feel dignified even on the days they can’t get out of bed. On top of this, the workers have to negotiate with stressed families about hours and pay–and typically take home low wages that keep them and their families mired in poverty.
And yet it turns out that consumers and providers of care want the same things. ALIGN’ssurveys of New Yorkers, including both caregivers and care “consumers,” show strong concern about decent pay for workers, along with retirement and healthcare benefits. These labor conditions are many cases dictated by insurance companies and Medicaid, not by the families receiving care.
The fact that consumers and caregivers both recognize that labor should be fairly valued “really does challenge this zero-sum notion that good jobs and affordable care can’t coexist,” says ALIGN policy analyst Maya Pinto. “And it suggests that people understand the connection between the quality of care and the quality of jobs.”
The converse is also true: When workers are miserable, it shows up in their work. Nearly 40 percent of people receiving care complained that the quality of services was “fair” to “very poor.”
But from a workers’ standpoint, this is the consequence of a job that treats them poorly. One worker described her situation bluntly: “It is a very difficult job at times because there are patients who think the home care workers are slaves.” Workers reported being subject to verbal and physical abuse, sometimes racial slurs, on the job.
Nonetheless, many care workers feel deep devotion to their job—they just want to their labor to be appreciated and duly compensated. “I do my work well…and the person I care for is very satisfied with my work,” said one worker. “It is very dignified work but it needs to be paid better.”
A priority across all respondent groups was providing appropriate training and monitoring–indicating that workers, contrary to stereotypes, are not instinctively resistant to greater accountability and oversight, and that all stakeholder groups realize the depth and complexity of responsibilities involved in caring for vulnerable seniors.
One area of divergence between consumers and workers was the importance placed on career advancement. The issue was a higher priority for caregivers, especially domestic workers who serve seniors but lack the official credentials of “formal sector” workers—a category that includes certified “home health aides” and “home attendants,” and who are generally employed through an agency. Lacking the formal qualifications associated with specialized, better-paying positions, domestic worker-caregivers (who are disproportionately low-income immigrant women, both documented and undocumented) often remain stuck in the most grueling, precarious jobs.
Some of New York’s privately employed home care workers benefit from a recently enacted domestic workers’ “Bill of Rights” that provides stronger workplace protections and wage standards than does federal labor law. However, domestic workers overall, who include nannies and housekeepers as well as direct caregivers in private households, still suffer from poverty, discrimination and exploitation. According to ALIGN’s survey of caregivers’ household incomes, about nine in 10 domestic workers earn less than $25,000 annually, compared to six in 10 formal sector workers. That is, despite the strides that domestic workers made with the Bill of Rights, in material terms, they still lag behind those employed through agencies or with more formal credentials.
ALIGN recommends several reforms to ensure dignity for both caregivers and people receiving care. More training and certification options–such as programs equipping domestic workers with emergency medical skills–would expand workers’ access to more formal and higher-paying positions and lift up standards for the workforce overall. On a policy-making level, the report calls for a expansion of publicly funded insurance programs so care workers, many of whom cannot afford medical coverage, can safeguard their own health as they care for others.
Since so many families struggle to pay the cost of community-based elder care, especially if they fall outside the income-eligibility bracket for Medicaid, the report recommends a more comprehensive publicly supported insurance program as an alternative to private long-term care plans. Noting that the current rollout of the Affordable Care Act and Medicaid overhaul present an opportunity for fudamental reforms in home care funding, ALIGN suggests creating a broadly accessible long-term care benefit that would be funded through payroll contributions, like Social Security.
The report also highlights why workers need not just laws but organization and collective bargaining power. In recent years, SEIU and the National Domestic Workers Alliance have organized tens of thousands of workers to win fairer contracts for workers and to press for reforms to extend labor protections for care workers. Meanwhile, some workers are changing how care is delivered in their communities by forming their own cooperatives.
ALIGN cites the worker-owned cooperative model as a system that can empower caregivers, by enabling them not only to share in the ownership and profits of the enterprise but also to access training, negotiate better working conditions, and “improve compensation for workers while keeping the cost of care relatively low.” One impressive case study is New York’s Cooperative Home Care Associates, one of the country’s leading cooperatives with about 2,000 workers, half of whom own a part of the business.
Despite the sometimes harsh conditions, Vilma Rozen, a 52 year-old home care worker, remains unshakably devoted to her job and embraces the challenges. “If you want to take care of elderly people, you have to keep your feelings very in touch [with] the person, because the elderly people in some cases are very alone and very depend[ent],” she says. At the same time, she adds, many seniors “suffer so much, because the home-carers, they have a very sad life, very underpaid… They don’t have happiness.” Rozen, a native of Costa Rica, says that if Americans want to place their elders in the care of attentive, dedicated people, “they need to change the system.”
Whether they give or receive care, everyone wants dignity–both seniors and their aides want to look forward to seeing each other every day in a relationship of mutual respect. The labor issues in senior care show the consequences of neglecting shared needs, but also open space for creating a fairer system of care, by making the home a more welcoming workplace.
This article originally appeared on Working in These Times on August 17, 2013. Re-posted with permission.
About the Authory: Michelle Chen is a contributing editor at In These Times, a contributor to Working In These Times, and an editor at CultureStrike. She is also a co-producer of Asia Pacific Forum on Pacifica’s WBAI.
Tuesday, July 23rd, 2013
While hospitals are better known for treating injuries than causing them, statistics show that for workers, hospitals can be a dangerous place. A new report put out by Public Citizen found that in 2010, healthcare workers (including hospital staff) reported 653,900 workplace injuries and illnesses. That’s approximately 152,000 more (a 432 percent higher rate) than the industry with the second highest number of injuries—manufacturing—even though the healthcare sector is only 134 percent larger than the manufacturing sector.
Part of the reason that healthcare workers’ injuries may have flown under the radar is because of the type of injury involved. Unlike manufacturing and construction, where injuries are more likely to result in death, healthcare workers mainly suffer non-lethal musculoskeletal disorders. The rate of musculoskeletal disorders among workers in the healthcare industry is seven times higher than among other workers—a trend that Suzy Harrington, director of the American Nurses Association’s Department for Health, Safety and Wellness, calls “alarming.” Although these conditions aren’t fatal, if untreated, they can lead to permanent disability.
The most common cause of musculoskeletal injuries for healthcare workers is lifting patients by hand instead of using a mechanical device. Yet while ten states, including Washington, California and Maryland, have dramatically reduced injuries by passing safe patient handling laws, which mandate that hospitals “furnish mechanical lifting and transfer devices,” no nationwide standard exists to protect healthcare workers.
Another major danger for healthcare workers is workplace violence. Workers in the healthcare sector suffer 45 percent of all incidents of workplace violence, and nursing home employees are especially affected, with seven times the average rate of injury from workplace violence. Violence in medical settings may arise from interactions with belligerent patients, who may be drunk, drugged or emotionally disturbed. Yet the Occupational Safety and Health Administration (OSHA) has never made a rule to require healthcare facilities to implement safeguards for their employees (such as metal detectors, security guards or even locked doors to isolate patients in guarded areas.) This is part of a larger problem: There are no federal OSHA rules requiring employers to ensure workplaces are safe from violence.
But workplace safety advocates say that OSHA’s particular lack of focus on the healthcare sector is symptomatic of the agency’s slow response to the shift to a service-based economy.
“OSHA has not been able to keep pace with the way the economy has shifted over the last 20 years,” says Keith Wrightson, worker safety and health advocate for progressive watchdog group Public Citizen. “The economy has shifted away from one that is industrially-based to one that is service-based. They are hardly any rules that directly affect the healthcare industry. We counted them out and there are only nine rules, but if you look at construction and manufacturing, there are literally hundreds—and rightly so, those industries are highly dangerous.”
OSHA, for its part, insists that it is very concerned about safety in the healthcare industry.
“Employers have the legal responsibility to provide workplaces free of recognized hazards. They must take ownership over this issue, and our role is to see that they do,” says Assistant Secretary of Labor for OSHA David Michaels. “OSHA has a variety of tools at its disposal to hold employers accountable for safety and health, and we are committed to improving safety and health conditions for our nation’s healthcare workers. Under this administration, OSHA has done more than any previous administration to address the issues that persist in this industry.”
In response to questions from Public Citizen, OSHA elaborated on these efforts, explaining that it has instituted recent programs “to encourage employers in hospital and healthcare facilities to reduce hazards. For example, Assistant Secretary for OSHA David Michaels launched an OSHA initiative to work with hospitals and nursing homes to recognize the close link between patient safety and worker safety.”
However, when it came to passing concrete rules regulating the musculoskeletal injuries that plague the healthcare industry, OSHA ran up against a major stumbling block: Congress. In 2000, OSHA passed a rule aimed at reducing musculoskeletal injuries by making employers adopt measures shown to reduce ergonomic injuries. But in 2001, a Republican-led Congress repealed the rule. OSHA has since attempted to use the general duties clause under the Occupational Safety and Health Act to cite employers whose ergonomic conditions present a clear danger to workers, but that poses a trickier legal case to make than if there was were a specific rule, and in the past two fiscal years OSHA has only done so seven times, according to the report put out by Public Citizen.
In response to questions from Public Citizen about whether or not the agency intended to issue a another ergonomic rule, OSHA said, “At this time, OSHA is not pursuing a rule on safe patient handling for healthcare workers. We continue to be concerned about this serious issue and promote sensible solutions through the NEP [National Emphasis Program] guidance and outreach activities. However, OSHA does not have resources to move forward on all rulemaking necessary to address all the pressing workplace health and safety hazards.”
Rules, however, are only the first step. For instance, while OSHA has rules in place to prevent healthcare workers from being accidentally stabbed, they still suffer an alarming 400,000 stab wounds a year from surgical instruments and needles. Public Citizen’s Wrightston says that such injury rates are unnecessarily high because OSHA, with its limited budget of only $565 million, has few resources—and what resources it does have are not focused nearly enough on healthcare workers, he says.
“OSHA has devoted relatively little effort to addressing the safety risks in healthcare compared to other highly afflicted industries,” says Wrightson. “For example, health care workers outnumber construction workers more than 2 to 1, but OSHA conducts only about one-twentieth as many inspections of health care facilities as construction sites.”
Indeed, statistics show that OSHA conducted 52,179 inspections of the construction industry in 2010, which employs 9.1 million workers and saw 74,950 injuries that caused workers to take at least one day off work. In comparison, last year OSHA conducted only 2,540 inspections of the healthcare industry, though it employs more than twice as many workers and saw 176,380 such injuries.
Some of the differential is due to the higher mortality rate for construction injuries, which cause five times as many deaths on the job. However, according to the Public Citizen report, “Even if fatalities were the only factor considered, healthcare inspections would need to be increased by about a factor of four to bring them into parity with construction sector inspections.”
Another gap in OSHA coverage, advocates say, was built into the agency’s NEP iniative, which was created in 2011 to focus on nursing home occupational safety—but not hospitals. “We want the National Emphasis Program to focus on hospitals. OSHA could do this right now with the swipe of pen,” says Wrightson. “The reason that they have not concentrated on hospitals is due to industry lobbyists.”
OSHA did not answer Working In These Times’ inquiries about why the National Emphasis Program (NEP) has not been expanded to target hospitals, but did point to its educational programs on workplace safety for hospitals.
Advocates insist, however, that Congress and OSHA must go beyond education to better enforcement and rulemaking in order to prevent injuries in the healthcare workplace. At the end of the day, advocates say, those that suffer the most from injuries to healthcare workers are patients.
“[Musco-skeletal injuries are] a primary reason healthcare workers leave direct patient care,” says Harrington. “We can’t afford to lose healthcare workers to injury and still meet rising demands for healthcare services.”
Article originally posted on Working In These Times on July 22, 2013. Reprinted with permission.
About the Author: Mike Elk is an In These Times Staff Writer and a regular contributor to the labor blog Working In These Times.
Sunday, April 14th, 2013
With 12 votes needed, only 11 members of the Philadelphia City Council were willing to override Mayor Michael Nutter’s veto of the sick leave bill. For the second time in three years, corporate interests defeated a measure that would allow more than 180,000 Philadelphians to finally earn sick days.
“I’m very disappointed,” said city councilman Bill Greenlee, who tried but failed to get the 12 votes needed to override Mayor Nutter’s veto. “I’m particularly disappointed for the 180,000 workers who could have had a benefit that other cities are providing.”
Instead of listening to the people of Philadelphia, Mayor Nutter sided with business interests: specifically the Philadelphia-based ALEC corporation Comcast, who spend more than $100,000 opposing sick leave in 2011 and is a big contributor to Mayor Nutter’s campaign.
“We’re not surprised the mayor vetoed this….he hasn’t exactly been a champion of workers,” said Philadelphia Council AFL-CIO Secretary-Treasurer Elizabeth McElroy. “The majority of the City Council and the majority of Philadelphians wanted this—it’s the right thing to do, and we’ll keep working on it.”
Comcast also contributed $3,000 to Councilman Brian O’Neill and $1,500 to Councilman Denny O’Brien, both who voted against the sick leave bill and refused to override Mayor Nutter’s veto. All of this despite the fact that 77% of Philadelphians favor the sick leave policy.
Not all hope is lost, however. Working America worked with a broad coalition to drive thousands of messages and phone calls to Mayor Nutter and members of the Philadelphia City Council. And while sick leave proposals move forward in Portland, Oregon, New York City and elsewhere, there will be more pressure on city officials as time goes on.
The fight isn’t over for bill sponsor Councilman Greenlee either:
“I still believe in and want to have earned paid sick leave in Philadelphia. So we’ll see what the future holds on that,” he said.
This article was posted on the AFL-CIO on April 11, 2013. Reprinted with Permission.
About the Author: Doug Foote is the Social Media and Campaign Specialist at Working America. He joined Working America in 2011 after serving as New Media Director for the successful 2010 reelection campaign of Senator Patty Murray (D-WA).
Wednesday, March 13th, 2013
UPDATE: UFCW union leaders in New England announced a tentative settlement with Stop & Shop March on 4, following marathon negotiating sessions over the previous few day. Details of the settlement are being withheld pending formal presentation of the new contract to union members for a ratification vote. According to the union’s special Stop & Shop web site, the union will announce a date for the ratification vote in a matter of days.
Union leaders and grocery chain managers are back at the negotiating table in New England today in a bitter and messy attempt to adapt existing health insurance programs to the new realities of the Affordable Care Act, a.k.a Obamacare. The negotiators—from the United Food & Commercial Workers (UFCW) union and the Stop & Shop grocery chain—face a March 3 deadline that could provoke a large scale strike or lockout affecting 40,000 workers.
Standing in the way of an agreement at this point are certain provisions of the Affordable Care Act set to go into effect in 2014, says Rick Charette, president of UFCW Local 1445, based in Dedham, Mass. Charette—who leads a coalition of five UFCW locals representing grocery workers in Massachusetts, Rhode Island, Connecticut and New Hampshire—says the problems appear intractable, and negotiators are desperate to find a solution.
“I’ve been around labor contract negotiations for 40 years and this is the worst I’ve ever seen,” Charette said in an interview this week with Working In These Times. “It’s a nightmare” that has been created not by corporate pressure to cut labor costs, but by the fumbling bureaucratic requirements of federal health law, he says.
Stop & Shop faces increased health insurance costs as high as $250 million over three years should all 40,000 UFCW workers continue receiving the same health care insurance benefits as under the current contract (which expired Feb. 17 but has been extended for two weeks), according to Charette. The increased costs are mostly created, he explains, when the Obamacare requirement that medical benefit caps be eliminated prompts insurance companies to raise rates to cover the greater costs.
“What is just crazy about this is that Stop & Shop is one of the few food retailers out there that has had good insurance for part-timers—most grocery companies don’t provide anything at all,” says Charette. “It punishes the companies that are trying [to do] the right thing.”
Stop & Shop’s proposed solution to the problem has been to eliminate coverage for thousands of part-time workers, but UFCW is not ready to agree to that, Charette says. “The theory is that part-timers are, by definition, low-income workers, and therefore they will qualify for government subsidies for individual health insurance under Obamacare. Well, that’s a nice theory, but what does that mean in practice for our members?” he asks. “Nobody seems to know.”
“When we backed Obamacare, we were told that if we had good health insurance and wanted to keep it, we could,” Charette adds. “What happened to that?”
The dilemma for the Stop & Shop worker is indeed a very real and vey difficult one, according to Ken Jacobs, chairman of the University of California, Berkeley’s Labor Center. The same pressures on the low-income, part-time workers in New England are being felt around the country, he says, and the issue will certainly rise in public prominence over the next year, as the 2014 deadline for elimination of caps approaches.
“This is sort a special problem that applies to part-timers who meet the government definition of low-income,” Jacobs says. “The unions that are going to feel it the most are UNITE HERE and UFCW, and some parts of SEIU,” he predicts. Since there is no Obamacare requirement that many part-timers be covered by employer-based insurance plans, many companies will take the path of least resistance and push these workers out into government-subsidized programs for the working poor.
“The issue of health coverage for workers in the food retailing industry has not been created by Obamacare—it has been at the very center of [grocery industry] labor relations for years,” he notes. The 2003 Southern California grocery strike—the largest of its kind in U.S. history—had its origins in health care insurance issues. “And look what happened there,” Jacobs says. “It was a huge strike and the workers lost a lot of their health care benefits.”
“At the end of the day, it may be better for everyone concerned” to eliminate employer-based coverage for most of these low-income grocery workers, says Jacobs. “If the cost is so onerous that the employer cannot compete, then subsidized individual insurance seems to be a logical alternative.”
Any resolution of the New England Stop & Shop insurance issue could set a national precedent in the grocery chain sector, adds Jacobs. Stop & Shop’s parent company is the Dutch-based international retailer Ahold, which owns hundreds of other stores in New York, New Jersey, Pennsylvania, Maryland and Virginia. Any settlement in New England could create a model for those other areas, he says, and a company-wide Ahold solution will, in turn, have a knock-on effect for other gigantic chains like Safeway, Kroger and Supervalu.
The potential national impact of the outcome of the negotiation has created intense pressure this week as the New England talks between UFCW and Stop & Shop enter a decisive phase.
Charette tells Working In These Times that the five union locals are planning on mass meetings across the region for this coming weekend. If a settlement is in hand, union leaders will ask for a ratification vote. Otherwise, they will ask for a strike authorization vote and prepare for a huge confrontation. The union leader confessed it was impossible to predict the outcome.
This article was originally posted on the Working In These Times on March 1, 2013. Reprinted with Permission.
About the Author: Bruce Vail is a Baltimore-based freelance writer with decades of experience covering labor and business stories for newspapers, magazines and new media. He was a reporter for Bloomberg BNA’s Daily Labor Report, covering collective bargaining issues in a wide range of industries, and a maritime industry reporter and editor for the Journal of Commerce, serving both in the newspaper’s New York City headquarters and in the Washington, D.C. bureau.