Can health workers get higher pay?

They are the most numerous and lowest-paid US healthcare workers: the 4.5 million caregivers who assist elderly and disabled people with such daily activities as bathing, dressing, feeding and toileting. Compared to other medical workers, they have the most frequent and personal contact with the elderly. That puts them on the front lines of the coronavirus pandemic.
Known in the business as direct-care workers, these paraprofessionals include certified nursing assistants, who work in nursing homes, and home health aides and personal-care assistants, who often travel between multiple clients.
Their median wage is $12.27 an hour, with home care workers making the least and nursing assistants the most. As the pandemic spreads, these workers are especially vulnerable and increasingly difficult to replace.
Don’t they deserve more money? The National Domestic Workers Alliance certainly thinks so:
But the pay isn’t low because the people who hire caregivers are greedy and mean-spirited. Neither is it because the work is easy or unimportant. It’s a much tougher problem. Caregiving is vital, but so labour-intensive that at higher wages, hardly anyone could afford it.
Consider some basic math. There are 8,760 hours in a year (8,784 this leap year). At $11 an hour, that’s $96,360. At $12.27, it’s $107,485. At $15 an hour, it’s $131,100. And that’s before the client pays for room, board and other medical care. About 16% of caregiver payments come from family budgets, while private insurance covers only 11%. The rest comes from government programmes.
Not everybody requires 24/7 care, of course, but many people do. “Need” is as much a matter of what people can afford as it is an objective criterion. For families deciding how to spend dwindling resources, it can be a matter of supplementing paid with unpaid labour, which can require cutting back on a family member’s own work hours. For state legislatures allocating the Medicaid money that covers 52 percent of long-term care, it means tradeoffs between elder care and hospital reimbursements or maternity care, not to mention schools and highways.
Direct-care workers are in short supply, with skyrocketing turnover rates. In 2018, the latest year for which data is available, the turnover rate among home health aides hit a new high of 82 percent, according to the annual survey by Home Care Pulse. The agencies and institutions that employ these workers aren’t just competing with each other. They’re competing with businesses such as Amazon.com that have been raising entry-level wages.
—Bloomberg

Virginia Postrel is a Bloomberg Opinion columnist. She was the editor of Reason magazine and a columnist for the Wall Street Journal, the Atlantic, the New York Times and Forbes. Her books include “The Power of Glamour.”