Category Archives: Healthcare

Why Families are Feeling the Squeeze

A couple of weeks ago, the Los Angeles Times business section ran a short article on the cost of raising children, Children Don’t Come Cheap. Grand total for middle class family from birth to 17 was $222,360, which doesn’t include college tuition. “That’s 22% higher than the 1960 cost – adjusted for inflation – of $182,857,” the article reported.

Where’s all that extra money going? The common narrative implies that parents are throwing away “extra” money on gadgets and fancy clothes and big houses and even organic groceries or dining out more. Not so. The data continues to confirm what I wrote about in my book This is Not How I Thought It Would Be and in this blog post, Busting Stereotypes about Families and Money, using information from Harvard professor Elizabeth Warren.

It’s the increase in fixed costs that are eating up families budgets these days and making them feel like failures because they can’t get ahead.

  • “the report called child care and education expense ‘the most striking change in child-rearing expenses over time.’ Those expenses grew from 2 percent of total child-rearing expenses to 17 percent.”
  • “Housing was the most expensive expenditure in both time periods in the USDA report, and it increased in real terms over time.”
  • “A child’s health care expenses doubled as a percentage of total child-rearing costs from 1960 to 2009. It also climbed in real terms.”

It’s that triple threat of child care/education, housing and healthcare that is eating up family budgets.  Even two-income families today have LESS left over after fixed expenses than their parents did a generation ago. As a result, families feel even more pressure to get their children a good education to ensure their children’s economic future and in the process driving up the cost of housing near good schools and the cost of private childcare and education.

Food and clothing costs have gone down over time.

  • “Changes in agriculture over the past 50 years have resulted in family food budgets being a lower percentage of household income”
  • “a child’s clothing and miscellaneous expenses decreased as a percentage and in real terms from 1960 to 2009, due partly to ‘globalization.'”

How about you? Do you feel these pressures on your budget? Do you compare your family to previous generations and wonder why you can’t get ahead?

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Filed under Economy, Healthcare, Money

Lack of Paid Sick Days May Worsen Flu Pandemic

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Mandy Pillar, a nurse in Kansas, said students were coming to school sick because their parents had to work.

This issue of paid sick leave and families was on my mind this week as well. Our daughter was home sick with a cold for two days. My husband and I have the best of all scenarios: we’re both self-employed, can work from home if we need to, and grandma is five minutes away. So between working remotely and a day with grandma, the worst we had to deal with was the logistics of it all without missing time on our jobs. But I couldn’t help but think how difficult it would have been if we’d been faced instead with decisions like: Can we afford for one of us to take a day off? Which one of us? Can she make it through the day at school even if she’s sick?

There has to be a better way, for families and for our public health.

Steven Greenhouse of the New York Times writes:

Public health experts worried about the spread of the H1N1 flu are raising concerns that workers who deal with the public, like waiters and child care employees, are jeopardizing others by reporting to work sick because they do not get paid for days they miss for illness.

Mandy Pillar said when swine flu struck, her school in Wichita, Kan., was sending a dozen students home sick each day.

Tens of millions of people, or about 40 percent of all private-sector workers, do not receive paid sick days, and as a result many of them cannot afford to stay home when they are ill. Even some companies that provide paid sick days have policies that make it difficult to call in sick, like giving demerits each time someone misses a day.

Public health experts say policies like these encourage many people with H1N1, commonly called swine flu, to report to work despite official warnings from the government and most companies that they should stay home.

“For people who are really caught on a weekly income, if they can’t make a go of it, they might say, ‘I’m desperate. I’m going to do what I have to do, and I’m going into work even though I’m sick,’” said Robert Blendon, a professor of health policy at Harvard.

He warned that this might spread disease, and that these financially squeezed workers might send their flu-stricken children to school, infecting others.

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Filed under Career-Life Fit, Family Work, Healthcare, Workplace and Employment

A Twist of Fate Involving Google and Healthcare Reform

I had one of those moments last week when the stars aligned that I wanted to share and along the way share some things I learned about the looming healthcare debate.

On Tuesday April 21, around 1 pm I was working on promotion ideas for my forthcoming book, This is Not How I Thought It Would Be: Remodeling Motherhood to Get the Lives We Want Today. One of the things on my list was to figure out how to reconnect with Karen Kornbluh. Karen and I crossed paths in the first couple of years after we’d both had our first child and after we’d both read Ann Crittenden’s The Price of Motherhood and wanted to work on related issues. She was in DC and I was in CA but we spent time on the phone with a couple of other partners in crime and she ended up joining a group of Mothers & More members in a hotel room in New York one weekend in lengthy discussions designed to articulate the Mothers & More POWER Plan, an articulation of the issues Mothers & More wanted to tackle.

I’d watched Karen’s career at the New America Foundation, then as policy director for Senator Obama, then to candidate Obama’s chief policy director and the author of the 2008 Democratic platform. I wanted to reconnect to tell her about the book so I was googling her.

In the string of hits, up pops a mention of a speaking appearance she had scheduled to talk about healthcare reform. At Pitzer College in Claremont. 45 min from me. At, get this, 4:15 pm THAT DAY! I had to read the webpage three times to believe it. Then I emailed the contact to confirm it. And promptly jumped in the shower and hightailed it out to Claremont to see her.

So by a twist of fate, I was googling Karen at 1 pm, and sitting at Pitzer listening to her by 4:15. Can you imagine how ticked I would have been if I’d googled her the day after that??

I want to share the highlights of her talk, and relate it back to the connection between healthcare reform and the types of customized job structures that are best for families, companies and all employees. I was so excited to hear her frame these issues in a way so similar to how I’ve framed them in the book.

She started by talking about how broken our entire social insurance system is for the 21st century – that includes healthcare, Social Security, unemployment insurance and other core systems. Working America has changed so much she pointed out. From a Breadwinner/Homemaker family model to what she calls Juggler Families. From 40 hour a week/40 year family wage jobs  to 1/4 of workers in non-standard jobs.

She pointed out, as I do in my book, that employer provided healthcare happened in WWII because a wage freeze drove employers to offer health benefits as a way of competing for workers. A system that doesn’t fit our workforce today.

She explained that the cause of the looming federal debt is skyrocketing healthcare costs, not Social Security which is often trotted out as the villain. Reforming healthcare is inextricably linked to fixing the economy and the deficit. She shared that the administration views the financial crisis as having a silver lining because it forces us to deal with all this. Or to quote Rahm Emanuel, “Never let a serious crisis go to waste.”

She said that the administration had rejected the either/or thinking about healthcare. That we can have either cost or quality but not both. Either broad access or cutting the deficit. Either private insurance or affordability. Either employer based or universal coverage.

The model being proposed embraces both/and. If you like your current coverage, you keep it. At the same time, private insurers would be available along with a newly formed public plan that people could opt into and still receive the tax subsidy normally applied with employer based coverage. The public plan would in theory keep the private insurers honest and competitive in price. And if it was good, and lots of people opted into it, then we might move closer to a single payer system.

I’m simplifiying quite a bit and she talked about several other elements of healthcare reform, but that’s basically the idea at this stage. Several people in the audience pushed the single-payer system, advocated by Healthcare NOW, as the solution instead.

So here are my thoughts. First, while I like the principles the administration laid out to guide healthcare reform, an important one is missing. One of the missing pieces of the healthcare debate is how our current system reinforces the standard 40-50 hr a week job. That divides employees into two groups, one group with full-time jobs and access (at least a lot of the time) to health benefits and another group working non-standard jobs that are denied benefits by their employer and often can’t get private insurance either. Employers have an incentive to hire workers (especially low wage workers) into part-time jobs and save money by not providing benefits. Or they hire full-time workers and work them long hours since the benefits are already paid. Even employers who want to offer good jobs that are non-standard find their hands tied when it comes to providing benefits, even proportional benefits. (70% job = 70% cost of benefits  covered for example).

For an economy where non-standard jobs are increasingly common, where both mothers and fathers in particular want good jobs that still leave room in their lives to care for their children, and where boomers are “retiring” but may need or want to work at something less than full-time, this system just doesn’t fit anymore.

So while I’m glad that the principles for reform include making sure health insurance is portable, I’d want to add a principle that health care reform should: Encourage and support employers in offering a variety of job structures that fit their employees and their business needs.

Employers with workers on non-standard schedules shouldn’t be off the hook for either providing proportional benefits or paying into a system that those workers can access. Employers who want to offer customized job structures – which all the research says is good for the employer and the employee – shouldn’t have their hands tied by the healthcare system.

So, that means that for me, in the current proposed plan, having a public plan – and one that makes it easy for non-standard workers to access it – is an absolute requirement. At least then non-standard workers have an option to turn to and can ask employers to subsidize their costs. You can be sure many interests will fight the idea of a public plan, but for anyone who cares about seeing our workplaces come into the 21st century by moving away from the standard 40-50 hour job to customized jobs that work for everyone, be sure to speak up about the necessity of a public plan and requirements that employers and private insurers need to provide access to non-standard workers. Of course, a single-payer system could be designed to address this problem as well, but it doesn’t sound to me like that option is politically realistic at this time

Okay, off my soapbox and back to my time at Pitzer. After her talk, I caught up with Karen, who gave me a big hug. She was excited about the book and we talked shop for a while as I walked her out to her ride to the airport. I felt like I was meant to be in that room for so many reasons. I was thrilled to see a friend and hear about all the great work she’s been doing. The whole experience gave me a shot in the arm as I reach the final phase of edits to my book. And I got the very latest overview of the looming healthcare debate.

Thank god for google and a bit of fate on a Tuesday.

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