The caring precariat: Home health care work in New York City
Item
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Title
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The caring precariat: Home health care work in New York City
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Identifier
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d_2009_2013:3fdbf002243b:11851
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identifier
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12472
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Creator
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Polson, Diana,
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Contributor
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John Mollenkopf
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Date
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2013
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Language
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English
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Publisher
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City University of New York.
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Subject
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Political science | Labor relations | Public policy | Public health | care work | consolidation | home health care | informal economy | Managed Care | union
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Abstract
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Home health care sits at the nexus of several recent coinciding processes---the fraying of the welfare state, privatization and the externalization of social reproductive costs onto individual families. This dissertation examines the ways in which government funding and public policies structure service delivery and working conditions in the home health care industry in the nation's most populous city---New York City. This study augments in-depth interviews of policy elites, government bureaucrats, employers, advocates and unions with analysis of a new data set collected from hard-to-reach low-wage workers to explore the role of the federal, state and city government in creating and regulating contract arrangements that determine wages and working conditions of a low-wage workforce situated between the formal and informal economy.;Several themes emerge from this research. First, by examining the relationship between the formal, regulated, publicly-funded home health care system and the informal, gray market privately-funded home care system in NYC, I found that the state relies on the informal care economy (and therefore workers working outside of the regulated, formal system) to fill in the care gap created by piecemeal public coverage. Shifts in government regulation, funding and constellations of third party government move the boundaries between formal and informal jobs---in this case, growing informal work and putting more financial burdens on families. Second, this dissertation explores how a union, namely SEIU 1199, that had previously been unable to raise wages significantly for home health aides, was able to win, remarkably, a living wage by creating and then taking advantage of opportunities to revamp the home health care industry during a period when the State was looking to cut Medicaid. Third, the State, with the help of 1199, facilitated a reorganization of the home health care industry, which led to its consolidation and the growth of Managed Care (which many fear will lead to a decrease in hours of care for patients and less work for aides).
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Type
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dissertation
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Source
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2009_2013.csv
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degree
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Ph.D.
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Program
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Political Science
