Nice Work

Three cheers for health care reform. It isn’t enough, but it is more than we’ve had. And in case you were wondering just how bad we’ve had it lately, I submit to you this graphic reminder. The Center for Economic and Policy Research’s Hye-Jin Rho and John Schmitt analyzed national data for Health Insurance Coverage Rates for US Workers, 1979-2008.

Their report shows that US workers’ rate of health insurance coverage declined by 10 percent over the past 30 years (ahem, just as women’s share of the workforce has been increasing) and low wage workers (with higher concentrations of women workers) have been losing more than anyone else: The rate of low wage workers with no health insurance has more than doubled to 37 percent in 2008.

And that’s a pretty graphic reminder.

–Virginia Rutter

See this beautiful woman. Like many remarkable women—including GWP readers—she is smart, competent, skillful, empowered, full of grace. But things happen, and our energies get focused in ways that we can’t always control, and they did for her. Helene Jorgensen is a labor economist formerly at the AFL-CIO. In 2003 she caught Lyme Disease–an infectious disease spread by a tick bite–while hiking in Montana after an academic conference.

Even though Lyme Disease’s symptoms include (among many others) exhaustion and difficulty focusing, Helene has written a riveting book, Sick and Tired, about dealing with her illness while navigating our irrational health care system. She’s a PhD in economics and has written a page-turner that got a starred review in Publisher’s Weekly.

Along the way, Helene’s book highlights the ways that women in particular can be bullied and jerked around (and not believed, especially with hard-to-diagnose illnesses). At one point, for example, Helene’s doctor was convinced that she had syphilis (after 10 years of very stable marriage). While we are all hassled by “not being listened to” in the health care system, there is the additional experience of having her voice discounted as a woman. Helene’s book is just out this month, and I asked her what is on people’s minds at her recent book events. Here’s what she told me:

1. We often don’t know how to do it, but sick patients must become consumers and shoppers. Helene explains, “If you are really sick and need medical care, the last thing you want to do is to call a bunch of doctors and haggle over price, as if you are a tourist souvenir shopping in Cancun. Even so, if you don’t have health coverage or your plan does not cover certain services/drugs, it pays to price shop. Pharmacies charge very different prices, and discount pharmacies such as Costco and Sam’s Club are significantly cheaper (and you don’t even have to be a member to fill prescriptions).

“Many health care providers are willing to negotiate lower prices. A 2008 study found that 66 percent of patients who negotiated with their doctor lowered their costs; and 70 percent who negotiated with hospitals got a better deal. With the rise of high-deductible health plans, patients are increasingly expected to act like consumers. As I discuss in the book [pp. 42-43], it is envisioned that high-deductible plans will lower health care costs as patients-as-consumers will shop for the highest quality of services for the lowest price, and providers compete for patients by increasing efficiency. But patients do not make good consumer decisions. After all who wants to go to a discount surgeon? (Patients use price as an indicator of quality.) Secondly, patients don’t have the medical expertise to make good decisions.”

2. Doctors can have mysterious conflicts of interest. According to Helene, “There is a huge controversy over the treatment of Lyme Disease, and two standards of care have been developed. When I was first diagnosed, I was referred to an infectious disease doctor at a leading research hospital. I assumed that I was going to get the best of care. I was terribly wrong. Patients often don’t get the best of care because of doctors’ conflicts of interest, such as consulting and investment arrangements with drug companies, health insurance companies, medical device companies, laboratories. In the book [p. 45] you can read the story of spinal surgeons who invested in a spinal device company, and the return on their investment was dependent on how many devices they implanted in patients. Here’s the catch: As a patient, it is almost impossible to find out what conflict of interests your doctor has.”

3. Health care reform is crucial. Helene explains that “private health insurance companies do not make money off sick people like myself. Republicans want to increase competition in the insurance market, but no amount of competition will make patients like me profitable. The Democrats’ plan calls for setting up insurance exchanges and banning discrimination against pre-existing conditions. But that is not going to make insurance companies want to insure sick people. Insurance companies will continue to engage in all the same tactics they use today to get out of their responsibilities to pay for medical services for sick patients. Health insurance companies regularly deny coverage for covered services, in the hope that patients are too sick to contest the denial. Since patients who are the sickest also have the highest medical bills, this is a very effective way for insurance companies to shift costs onto patients.“

4. Empowerment is key. Helene is a “sick and tired” (literally) heroine of empowerment, and while she’s interested in changing our health care system, she also has advice about how individuals can help themselves. She explains, “You have to educate yourself about your medical condition. You have to demand the best care from your doctor, and if you are not getting it, find a new doctor; and you have to fight your insurance company to pay for your care. This is very hard to do when you are sick, and having a support system is important. A woman at my talk yesterday suggested that if you don’t have family or friends who can help you, your local church (if you have one) may provide such support.”

To Helene: Thanks for telling this story. To readers: Tell me what you think of Sick and Tired.

–Virginia Rutter

Sitting in the waiting area, topless but for a little robe, waiting to get my annual g-ddam mammogram last Friday, I listened to two women talking earnestly about Tiger Woods’ press conference as it blared on the t.v. “Nobody’s business”-lady debated with “sometimes it matters”-woman. They shared, it seemed, some common sense notion that having sex with another person outside of your marriage is always a problem of the worst kind.

As I later reflected on the topic, I did a Google search on infidelity and saw the American Association for Marriage and Family Therapy’s infidelity consumer update that starts with the words…”After the devastating disclosure of infidelity….” Made me remember: eighteen years ago my boss at the time–a family therapist–made the point to me that there are a lot worse things than infidelity. She wasn’t saying that because she was casual about formal commitments or marriage, or about, say, the impact of divorce on children. What she was saying is that, well, there are a lot worse things that happen in relationships than infidelity. You can make your own list–I have mine.

Now my uncle–also a family therapist–would disagree; or at least would pipe in with more detail. But what he would be likely to say is that it isn’t the sex or the affair that is the problem nearly so much as the lying, the betrayal. Whether you are having an affair or discover or suspect your partner is having an affair, the stuff that is painful is the stuff about toying with reality, toying with truth, toying with your life and the lives of others while holding all the cards. He would say it is no way to work on your marriage–or yourself.

But the betrayal thing is complicated, which takes us back to “what’s worse than infidelity?” There are lots of betrayals. “You weren’t supposed to be like this, you were supposed to be like that” … “I thought you knew me” … “I thought you liked me” … “I thought we had similar values” … these are generalities: but I bet you have your own particular stories you think of when I list those. The betrayals against a shared reality accumulate, alongside those everyday resentments about housework and money. When couples lose touch with each other and don’t face up to the minor betrayals, the mountain of betrayal looks big and painful. Screwing around is the least of it. But we get kind of sex obsessed when we hear about this one particular kind of betrayal. Instead of a novel, the sex-tinged drama becomes a cartoon.

I’m not saying that any of the affairs we’ve been served up as dark comedy this past year–John Edwards, Governor Sanford, Tiger Woods–are okay, or are not okay. I’m not saying that the affair you are having, or your colleague is having, or that you heard about, is trivial, or not trivial. But all the histrionics about the “devastating impact” of infidelity actually does marriage, or any other kind of intimate union, a disservice. It turns it into a one-dimensional experience about “ownership” and “entitlement.” Moreover, seen through this lens, marriage takes on all the righteousness of the homemaker/provider arrangement between the sexes. There is this massive imagery of the “wronged woman” full of traditional virtues.

Tiger is a puzzle. But in his press conference Friday, he was responding in part to the dehumanizing (and sometimes simple-minded) way we get worked up about infidelity. Tiger’s case lets us notice that our freak-outs about infidelity are also moments to check on what our own values and taken-for-granted ideas are doing to our relationships.

–Virginia Rutter

Ninety percent of working moms, and 95 percent of working dads in the US report work/family conflict–much higher than workers in other comparable countries. But of course. We work 11 more hours per week than we did three decades ago.  And, compared to other rich countries, we have fewer laws and policies regulating working time, including no federal laws on paid vacation, paid sick days, or paid parental leave. All this, according to a new Center for American Progress report by Joan Williams and Heather Boushey on “The Three Faces of Work-Family Conflict.”

I just got the report, but already there are two things I love about it: first, it focuses on social class. They separately analyze the reality facing three kinds of families: those who are low-income, those who are professionals and managers (one out of five families), and those in the “missing middle” – the 53 percent of families in between. Not surprisingly, work family conflict for those at the top–the ones that New York Times loves, loves, loves to write about in their mythological pieces on women opting-out and about how “daddy’s so baffled at home”–is different from families at the bottom or in the middle. By highlighting the differences by economic groups, the authors help us to recognize that, for example, our Family and Medical Leave Act–that gives people a “right” to unpaid leave–is a policy that only benefits families who can afford it.

Second, the report puts it all in our policy context: The authors explain that the lack of progress in the United States is a result of a conscious choice by our political leadership. Understand: the absence of work/family policies is policy. Let me quote from their executive summary:

“The United States today has the most family-hostile public policy in the developed world due to a long-standing political impasse. The only major piece of federal legislation designed to help Americans manage work and family life, the Family and Medical Leave Act, was passed in 1993, nearly two decades ago. In the interim—when Europeans implemented a comprehensive agenda of “work-family reconciliation”—not a single major federal initiative in the United States has won congressional approval. In the 110th and 111th congressional sessions, the Federal Employee Paid Parental Leave Act, which would provide four weeks of paid parental leave to federal employees, passed the House of Representatives—garnering support from 50 Republicans in the vote in the 110th Congress—but has not passed in the Senate.”

Worfamily conflict sucks. But Williams and Boushey’s report is awesome. So check it out.

–Virginia Rutter

Now for the 411 on “the new economics of marriage” –  a Pew study that is making its way through the media: To me the study is a good follow up on Heather Boushey’s “the new breadwinners” in A Woman’s Nation: The economic status of women has changed irrevocably, and our society generally accepts it. We rely on it too – women are breadwinners or co-breadwinners in 63 percent of families; and 43 percent of family income is from women.

Thanks to Pew, we see what this means for marriage and the balance of power and status. While 40 years ago, 96 percent of men earned more than their wives, today that number is 78 percent. Men out-earn wives, but less so than in the past. In terms of education, back in the day as today, married couples are most likely to have the same amount of education. But in 1970, whenever there was a difference in education, it was more likely to be men with more education (3 out of 10 marriages). Today, only 2 out of 10 marriages have men with more education…and 3 out of 10 have women with more education.

The question everyone is asking is how does this influence the “psychology of marriage”… by which I mean the principles that bind couples together, and the things that make marriages more likely to be happy and to last. The old wisdom is that traditional gender roles hold marriages together: in the past marriages with a more traditional structure were more stable. But that was in the past. With changing economics and culture, so the glue in marriage has changed too.

Well, it has been changing for quite some time. In the 1970s the research showed higher rates of depression for wives who were staying at home. By the early 1980s the more depressed wives were those who were doing a second shift–paid work and then work at home. More recently there has been evidence in how much more stable and satisfying are marriages where partners share housework–I mean really share housework, not this “helping” notion–but real sharing of responsibility for childcare, housework, and the administrative things of family life like list making, event planning, and gift giving. That’s the other change: men have been participating in their marriages differently, being more engaged at home.

The numbers show us that we are talking about narrowing the gender gap–at work, at home. This is a story of narrowing the gap between men and women, not of anyone losing ground–at least not men or women losing ground to each other. I did a radio call-in show with Joy Cardin this morning on Wisconsin Public Radio and the callers were talking more about their embattled families than any war between the sexes:  Where we aren’t narrowing the gap is figuring out how to create public policy–health care, day care, family leave, paid sick leave, paid vacation, or even reasonable banking policy that doesn’t sustain all sorts of inequalities that are bad for families (but I digress)–that gives these men and women the freedom to keep doing their jobs at home and at work without high levels of stress. The new economics of marriage is also the new psychology of marriage, and it has been around for a while. We’re talking about it more now, and creating more egalitarian marriages. Soon perhaps our public policies will catch on and help families as they really are out more.

-Virginia Rutter

You may have seen this: a little story about a girl-with-pen who was able to make a lot more money as men with pens. “James Chartrand” is the pen name for a woman blogger who reports she earned two or three times more under a man’s name than a woman’s.

In the year of the Shriver Report–you know, women hold up half the economy, make up half the work force, oh and also make up nearly half of union membership–we’re still struggling to get a host of humane work policies (uh, health care and “good jobs” with benefits) that isn’t just about material benefits.

The tougher part is the social psychological (and hard to measure) aspect of how “men’s work” and “women’s work” are still remarkably differentiated. As I’ve written here before, gender inequality is sneaky!

So is a lot of other inequality. James Chartrand isn’t just a man’s name. It is a white man’s name. The New York Times reminded us last month that “In Job Hunt, College Degree Doesn’t Close Racial Gap.” At 8.4 percent, the unemployment rate in 2009 for black college graduates has been nearly twice that of white college graduates (4.4 percent). An American Economics Review article highlighted how this works in their paper “Are Emily and Greg More Employable than Lakisha and Jamal?” In a field study, job applicants with “white sounding” names got twice as many call-backs as those with “black sounding” names. So, James Chartrand probably had more than just the advantage of gender.

An even newer American Sociological Review study makes the case even more clearly. In “Discrimination in a Low-Wage Labor Market: A Field Experiment,” Devah Pager, Bruce Western, and Bart Bonikowski report on sending out matched sets of job applicants–white, black, and Latino men, similarly well-spoken, well-dressed, and credentialed–for low wage jobs in the New York area.

The results? Whites received positive responses 31 percent of the time–twice as many as blacks (at 15.2 percent). Latinos, with a 25.1 percent call-back rate, did worse than whites but better than blacks.

The descriptions of the job applicants’ encounters that are enumerated in the article highlight what we keep hearing: there were few if any episodes of overt racism or bias. The job applicants in the study, for example, didn’t sense a pattern themselves as they went through the application process.

A lot of inequality is sneaky. And where there is gender inequality, I’m going to keep checking for other forms of inequality that are sneaked in along with it–especially class and race–because I don’t think we’re going to do much about any of it until we do something about all of it.

-Virginia Rutter

Follow the thread: The Shriver Report: A Woman’s Nation reminds us that women now make up half the workforce. And are breadwinners or co-breadwinners in 63 percent of families.

The report also reminds us that a lot of policy has not kept up with the definitive end of “separate spheres” and the caregiver/provider model of families. We all do market work, and we all need to find ways to care for our families, our children, and ourselves.

The report reminds us that now, more than ever before, we all need family friendly and more humane work policies. That issues like good (secure) jobs, adequate, affordable, and just health care, paid vacation, paid sick days, child care, and family leave aren’t women’s issues at all. They are human issues. They are workers’ issues.

How to get there? The word of the 1960s was plastics. The word for 2010 is unions. We don’t even have to invent them. They already exist. And they are changing. And there is opportunity just up ahead to help them change more.

A Center for Economic and Policy Research report released today, The Changing Face of Labor 1983-2008, documents that “over the last quarter century, the unionized workforce has changed dramatically…. In 2008, union workers reflected trends in the workforce as a whole toward a greater share of women, Latinos, Asian Pacific Americans, older, more-educated workers, and a shift out of manufacturing toward services.”

As reported in the Associated Press this afternoon, “Women are on track to become a majority of unionized workers in the next 10 years, signaling their growing clout in the labor movement.” Women make of 45 percent of union membership–up from 35 percent in 1983, according to CEPR’s report.

Lead author, CEPR senior economist John Schmitt, connects the dots: “When you have a majority of women in the labor movement, issues like work-family balance, paid sick days and paid parental leave become more important.”

And Change to Win head Anna Burger makes the message concrete:According to AP, Burger says, “Because of women, we don’t just talk about raising wages, but about creating family friendly workplaces with sick leave, child care, and family and medical leave. We don’t just talk about out-of-control insurance costs, but about the fact that women pay more than men strictly because of their gender.”

(Change to Win is a federation of five unions: Teamsters, Laborers International Union of North America (LiUNA), Service Employees International Union (SEIU), United Farm Workers (UFW), and United Food and Commercial Workers (UFCW). The AP article also interviews secretary-treasurer of  the AFL-CIO Liz Shuler.)

The hype is about how women will benefit unions–by bringing traditional women’s issues that are really about the well being of all of us into the mainstream. For more on how unions actually benefit women–in terms of wages, pensions, and health insurance–read this interview with John Schmitt from last year.

Next thread: EFCA (The Employee Free Choice Act). That’s how to turn the benefits that women bring to the union movement into benefits for all. Bring us some more good news, ya’ll.

–Virginia Rutter

Last week U of Chicago economist Casey Mulligan argued on the NYTimes Economix blog that paid sick days are an incentive for people to stay out of work–shamming sick days is the suggestion. Paid sick days, the argument goes, encourages people to stay out from work. Well, sometimes people can’t see the forest for the ideology, but help, alas, was on the way the day Mulligan posted.

CEPR senior economist John Schmitt, co-author of a report on paid sick leave in the US and Europe earlier this year, said not so fast! At noapparentmotive.org, Schmitt took issue in two ways: first, as his CEPR report, Contagion Nation, pointed out, the current system of no paid sick leave in the United States provides incentive for people to go to work sick. You see, if we measure cost, we have to measure the cost of a policy of no paid sick leave as well as the cost of some paid sick leave. You can read more about Contagion Nation at girlwpen here.

If that isn’t bad enough, Schmitt catches Mulligan on another sleight of hand. Mulligan, it seems, left off all the countries in the data set he was using that didn’t conform to his thesis that paid sick days are an incentive to stay out sick. As Schmitt explains, “Denmark, Germany, and seven other countries with more generous statutory paid sick days policies all have lower sickness absence rates than the United States. A really interesting question is: how is it that these countries are able to provide both guaranteed paid sick days and lower sickness absence rates? (And why didn’t Mulligan include these countries in his graph?)”

Andrew Leonard discusses the Schmitt response at Salon. He concludes, “Of course people, given an opportunity, will abuse generous benefits. But what explains the situations where they don’t?”

Over at Mother Jones, Nick Baumann was not so cagey in his post Economic Dishonesty. In response to the question, why the selective use of data?, he simply says, “Um, because he was being dishonest?”

I think that making working life humane for all people is a feminist issue, as the Shriver Report recently reminded us. To my mind, rebutting simplistic supply and demand arguments about work/life issues is a feminist act.

Weirdly, the New York Times has not run a correction. What a shame.

PS 11/3/09. NYTimes reported today on the concern among public health officials that lack of sick leave may worsen flu pandemic: “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.”

-Virginia Rutter

A year and a half ago Feministing reported about rapes occuring to women working for defense contractors in Iraq. The gist of the story is this: assaulted workers told, badgered, intimidated into keeping silent about vicious assaults on them.

One of the people who this happened to was Jamie Leigh Jones. She testified before Congress in December 2007 about being drugged and gang-raped in company barracks in Iraq. Her company, Halliburton, said that when she signed her employment contract, she lost her rights to a jury trial. The contract they offered forced her into having her claims decided through secret, binding arbitration. WTF?! She had no idea.

Fast forward to October 2009. Sen. Al Franken (D-MN) introduced an anti-rape amendment to a larger defense appropriations bill last week that (per talkingpointsmemo) would “prohibit the Pentagon from hiring contractors whose employment contracts prevent employees from taking work-related allegations of rape and discrimination to court.” Kind of minimum standard.

The amendment passed, 68-30, in the Senate. Because that is the right thing to do. Indeed, Jon Stewart profiled the case, pointing out that, “If, to protect Halliburton, you have to side against rape victims, you might want to rethink your allegiances.”

But, Huffington Post reports that someone not yet clearly rethinking his allegiances is Sen. Daniel Inouye (D-HI). He’s considering removing the amendment, and he has the power to do so. Explains HuffPo: “Inouye’s office, sources say, has been lobbied by defense contractors adamant that the language of the Franken amendment would leave them overly exposed to lawsuits and at constant risk of having contracts dry up.”

There is so much wrong with this I don’t know where to start. But I wanted to provide the update. Read this for info about contacting Sen. Inouye to tell him to support the Franken amendment.

-Virginia Rutter

Damn. The Shriver Report, out in the morning, already sounds fantastic. CAP explains: “The Center for American Progress, in partnership with Maria Shriver, has broken new ground with the publication of The Shriver Report: A Woman’s Nation Changes Everything. By taking a hard look at how women’s changing roles are affecting our major societal institutions, from government and businesses to our faith communities, the report outlines how these institutions rely on outdated models of who works and who cares for our families, and examines how all these parts of the culture have responded to one of the greatest social transformations of our time.”

You can read Gloria Steinem’s early Women’s Media Center review–she likes Kimmel on men’s stake in equality, she worries that the 50/50 workplace hasn’t created a safe and just world just yet, she has high hopes for change. At Time Magazine, they’ve posted the Shriver Report survey results with the headline, “The Argument about Women Working Is Over.” In a skillfully conducted poll, 76% of men and 80% of women agree that women and men sharing the work force 50/50 is “positive for society.”

In the coming days, much will be said–and the media blitz looks fabulous (Time Magazine cover out Friday; CAP President John Podesta and Maria Shriver on Meet the Press Sunday, Maria Shriver on Today Monday – Wednesday, Heather Boushey on MSNBC on Tuesday, and god knows what else)–but here are two early points that I want to celebrate tonight.

First, the survey finds–and recognizes that it finds–much more similarity than difference between men and women across a host of items. Just one example: Men and women have very similar life goals. We value security, fulfilling work, and children to a similar degree. The widest margin of difference? Women value religion more so than men.

Second, I love the way the Center for American Progress identifies their project. CAP has located the focus on the great labor market transition of the late 20th century as a human issue, not a gendered issue. Women are the movers–in this case moving into the workforce–but the movement is about all of us, men and women, and how we as a working nation can arrange our lives humanely and effectively.

For all the data and analysis, visit CAP’s project page “Working Nation: How Women’s Progress is Reshaping America’s Family and the Economy.“

-Virginia Rutter