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Home Care Workers and the Future of Work

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The nature of work in the United States is changing fairly rapidly. Capital mobility wiped out millions of industrial jobs. Automation is eliminating the rest–along with many other job categories–with each passing day. Service work replaced much of this. But because this wasn’t seen as “real work,” including by many workers themselves, it remains low paid and highly exploitative, as if the real work of factory jobs wasn’t that way before unionization. But now automation is going to eliminate a lot of service jobs too. One area where automation is going to lag behind is care work. That’s a rapidly growing part of the economy. There are two prominent areas of care work–day care and elder care, though there are other categories as well. Both are horribly paid while also being tremendously expensive. This is an unstable and unacceptable situation. It’s rather amazing that we trust our toddlers and our aging parents to people so poorly paid that nearly any alternative makes more sense for those workers. Welcome to the logic of American life. Anyway, it’s simply unacceptable that care workers are so poorly paid. If we want to make the next decades of work paid well enough that we allow the workers to live dignified lives and take care of our loved ones effectively, it’s time to act now. Ai-Jen Poo, who has done great work on these issues for years, on what to do:

At Caring Across Generations, a national campaign to support caregiving in the 21st century, the values we believe in are care, interdependence and dignity. This means caring for our older generations, who are living longer than ever before due to advances in modern medicine and technology. It means recognizing and nurturing their interdependence with the caregivers — whether family members or professionals — whose love and hard work enable older people to age in place and connected to community. And all of our work is grounded in fighting for our collective dignity. We fight with and for caregiving families that are struggling to make ends meet, as parents support elders and children while holding down jobs. And we fight with and for people with disabilities, who deserve independence and support, and on whose decades of activism we are building on for a more caring future.

That is why we have teamed up with Maine People’s Alliance, a statewide membership organization of diverse Mainers, to imagine Home Care for All, a ballot initiative that would establish a home care trust fund to allow aging Mainers to stay at home, support family caregivers and invest in care jobs becoming good jobs.

For their own part, the caregiving workers that we rely upon to help support the care needs of families are faced with pressures of their own. Poverty wages, lack of access to benefits or a safety net, along with unpredictable or long hours all lead to high rates of turnover, and the instability of the workforce contributes to the overall insecurity of families who struggle to ensure their loved ones can age with dignity. Despite the home care workforce being the fastest growing workforce in the economy, the annual median income is just $13,000.

Home Care For All would make home care available to all Mainers. The fund would be governed by a board that includes representatives of all key stakeholder groups: personal care agencies; individual providers (who work independently or for a home care agency); and people receiving in-home care, or family members or guardians of such individuals. The fund would be paid for by partially closing a payroll and unearned income tax loophole for those with incomes over $127,000, as well as a small employer contribution, and would be accessible to all Mainers with disabilities or older adults who need assistance with one or more activity of daily living.

This is an opportunity to significantly address a real crisis facing millions of people in the US and to create a society that reflects our values. Rarely do we have policies that directly reflect what people need. The members of Maine People’s Alliance, together with a strong coalition of stakeholder groups in the state, are working together to ensure that the solution addresses everyone’s needs. Volunteers who collected signatures talked to voters in community centers, schools and transportation hubs, and shared stories of encountering family caregivers who wept when they heard of the measure.

This seems like an obvious issue that should be a top priority for all liberal policy making. The narrative is there–it’s about our babies and our aging parents. How can we not treat the people who take care of them with respect? Yet this issue largely remains the purview of activists and unions such as SEIU. It’s not a big part of our agenda. This is insane. Let’s change that. Reviving the universal day care bill that Nixon vetoed in 1971 is one start. It’s mind-boggling this hasn’t been part of the Democratic or even left agenda in decades. Creating a well-funded federal system of elder care is equally necessary, one that builds on the work Poo and others have done.

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