Download e-book Caring for America: Home Health Workers in the Shadow of the Welfare State

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They were a part of the rehabilitation and care at home team but not considered as health care workers. In Chapters 2 through 4, the book discusses how the system developed with the state support as a hybrid public-private entity.

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Then, starting in the s, the government with Medicare rules, state subsidies, federal social services grants, job training funds and service contracts, boasted a for-profit industry in home care. The authors ably discuss how the cost shifting and privatization tactics of home care from all levels of governments, and the public ambivalence over paying for social services that should be provided freely by wives, mothers, and daughters, led to the emergence of home care sector with low-wage labour market and casualized employment. Chapters 4 and 5 show how states used the politics of budgetary crises of s and s, and restructured the labour market for care and the nature of the home health care aide job.

The home health care aides were excluded from legislative coverage. The sector increasingly used workers in independent contractor designation and created more and more casualized employment. The authors argue that this had broader implications with the practice spreading throughout the American economy, affecting workers in many other sectors. These chapters show many similarities with the developments in Canada and other industrialized countries.

I would argue that there are similar developments currently in the newly industrialized countries with the aging population and cost containment goals in health care. These chapters can be a particularly interesting read for the readers globally. In Chapters 6 and 7, the authors turn their interest to the unionization activities of these invisible workers. These chapters critically examine how the political environment of s and s in the US lead to a collective action of workers, care recipients, and voters demanding better wages and better care, and a new type of unionism for home health care aides with workers organizing under SEIU.

The authors discuss how the unionism of home health care aides originated in the domestic workers activism in New York and San Diego, farm worker unionism in California, public sector militancy, and community organizing of groups such as migrants. Finally, it makes a powerful argument that care is a basic right for all and that care work merits a living wage.

There’s No Place Like Home | Miller Center

At once a simple story of how a large and growing sector of disadvantaged women fought for dignity and the right to be treated as workers, it is simultaneously a subtle analysis of the tension between private needs and state intervention. This inspiring tale is, in important ways, the story of modern America.

Boris and Klein provide a powerful, deeply researched analysis of this burgeoning type of 'intimate labor,' past and present. Caring for America is a must-read for anyone interested in low-wage work, the labor movement, and the future of the massive and rapidly expanding carework sector of the U. Story: Immigrant Workers and the Future of the U. Labor Movement.

It is fundamentally an analysis of a fight for social and economic justice and a tribute to a workforce that has emerged out of invisibility and become a source of energy for a workers' movement operating both inside and outside organized labor. Boris and Klein introduce the reader to a decades old struggle for dignity which has witnessed twists and turns but in order to sustain itself must rely on its own energy rather than the good-will of outsiders. Engaging and deeply insightful, Eileen Boris and Jennifer Klein's Caring for America draws on historical record to make an irrefutable case for the social, economic, and political significance of carework.

Scholars, policy-makers, and all of us who provide or require care should pay notice. The study makes a significant contribution to labor history, welfare history, and the history of health care. Caring for America is thoroughly researched, sophisticated study by top scholars who have produced an important exploration of home health care in the United States.

Boris and Klein meticulously trace the role of government policy in the creation of home care as a low-wage occupation.


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In addition to its passionate yet sober prose style, the strength of the argument comes from the authors' particular perspective. While both are professional historians, they study home care work through the voices of worker activists who fought for justice. Thus, this text is as much a history of a social movement as it is a history of public policy.

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Indeed, the authors treat these two forces, policy and praxis, as dialectically related. And this dynamic, movement oriented character of the study reveals an authorial imagination as much sociological as historical.

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So did the home location. But because my work helps her to stay in her home, I am deprived of overtime pay. View all New York Times newsletters. It treated women who labored to support their families as if they were teenagers picking up some spending money. Conveniently, this exemption came just as home care became a growth industry, aided by changes to Medicare , Medicaid and other government programs. Beginning with the Omnibus Budget Reconciliation Act of , these programs funneled more public money to for-profit firms, generating a vast home health industry — with a tenfold increase in for-profit agencies during the first half of the s alone.

By the s, home care was the fourth largest occupation.

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This labor market growth made a mockery of the companionship classification. George W. Legal advocates for home-care workers subsequently went to court, but in the Supreme Court upheld the exemption by ratifying the role of executive agencies, like the Labor Department, in making such determinations. They do so while getting plenty of public dollars. States are reducing the hours an aide can spend with a client and targeting housekeeping for elimination. They are able to do so because there is a long history of dismissing housekeeping and personal care as not real work and because both providers and consumers of home care are stigmatized as clients of the welfare state.

Establishing the legitimacy of care as productive, necessary labor — a real job — would recognize the realities of both our aging society and our service economy. It would also begin the long-overdue work of updating labor standards for the workplaces of a new century.