https://www.politico.com/agenda/story/2017/10/25/immigrants-caretaker-workforce-000556
Ted Hesson reports for Politico:
“One of the biggest future crises in U.S. health care is about to collide with the hottest political issue of the Trump era: immigration.
As the largest generation in American history – the baby boom – heads into retirement and old age, most of those aging boomers will need someone to help take care of them for at least some portion of their twilight years. Demand for home health aides is expected to outstrip the growth for nearly all other jobs in coming decades, with the Bureau of Labor Statistics projecting the number of home health aide positions will increase 38 percent by 2024. That puts it among the top five fastest-growing U.S. occupations.
So who’s going to do it? The question is one of the biggest uncertainties looming over not only the health care, but the labor market overall. Health policy experts have been raising the alarm for some time: No matter how you look at it, the United States is going to need a lot more caretakers and home health aides. And we’re going to need them soon.
Right now, immigrant workers fill a significant share of the formal and informal caretaker workforce. In health care overall, immigrants (both legal and undocumented) make up roughly 17 percent of workers, on par with their representation in the broader labor force. When it comes to home health care, however, that figure is considerably higher: about 24 percent, according to the nonpartisan Migration Policy Institute.
There’s a reason foreign-born workers take so many home health jobs: they’re low-paid, low-skilled and increasingly plentiful. Barriers to entry are low; a high school degree is not usually a requirement and neither is previous work experience. Much caretaking comes from family members, of course. But with families getting smaller, more Americans living alone and chronic diseases growing more complex, a lot of that care in the future will need to come from professionals.
The job also isn’t easy. Home health aides can be tasked with bathing and feeding clients, cleaning the person’s house, driving them to doctor’s appointments and even helping with trips to the bathroom. It’s one of those occupations that comes to mind “when people say that immigrants do the jobs that Americans don’t want to do,” notes Patricia Cortés, an assistant professor of markets, public policy and law at Boston University’s Questrom School of Business.
Bianca Frogner, an associate professor at the University of Washington School of Medicine, said the low barriers to entry make it a natural fit for immigrants who are new to the U.S. workforce. “It’s easy to get into and they’re in high demand,” she said.
This is where politics comes in: The current move to curb immigration threatens to cut off the main supply of potential new workers to care for aging Americans.
Illegal immigration isn’t the issue. The home health care immigrant workforce is vastly legal. The Pew Research Center found that just 4 percent of nursing, psychiatric and home health aides are in the country without legal status, based on an average from 2005 to 2014. Some home health aide positions require certification, which may drive down the ranks of undocumented immigrants in those positions.
The question for the health care system is what will happen to the flow of legal immigrants. Trump and immigration hawks in Congress have endorsed a bill that would cut legal immigration in half over a decade. The bill would also refocus the immigration system to prize better-educated and more highly skilled immigrants — potentially choking off the supply of lower-skilled workers who are the likeliest candidates to fill the home health aide jobs of the future.
In theory, native-born Americans could take some of those jobs, but there are reasons to assume they won’t.
. . . .
The strange thing about home health care work is that immigrants don’t appear to drive down wages, as happens in some other fields. If anything, they tend to push wages higher. Naturalized citizens who worked as nursing, psychiatric and home health aides earned 22 percent more than their U.S.-born counterparts, according to 2015 American Community Survey data analyzed by the University of Washington Center for Health Workforce Studies.
Lindsay Lowell of Georgetown University’s Institute for the Study of International Migration, said the wage phenomenon and the fact that the work is a natural fit for new immigrants make it a no-brainer: Immigrants are our best caretaking option for the foreseeable future. “You put all that together,” Lowell said, “and I think it’s a good thing.”
************************
Read the complete article at the link.
In a sane system led by competent individuals with the common good in mind, this would be a “no brainer.” Legalize the existing undocumented workforce to provide some “upward and sideways” mobility to staff these jobs in the short run, while expanding legal immigration opportunities for these positions in the future. More legal immigration would also contribute to the tax coffers and add needed workers to the Social Security contribution base. Moreover, it would conserve considerable Government funds now being squandered on counterproductive immigration enforcement and unnecessary detention, as well as relieving the pressure on the overwhelmed Immigration Courts. That, in turn, would free up enforcement resources to concentrate on removing serious criminals and shutting down international smuggling cartels.
However, when policy is driven by bias, prejudice, and irrationality, as with guys like Trump, Sessions, Bannon, Miller, and the “RAISE Act Bunch” the results are a lose – lose.
PWS
10-28-17
The median age in the USA today is 56 years old and it will escalate rapidly the next 10 years as we baby boomers crowd the 70+ exit ramp to our lives. Demographics are Humanity’s version of compound interest which Einstein said was the most powerful force in the Universe.
The misanthrope xenophobes who support either Trump’s or Bannon’s paths to ethnic cleansing, would rather have American Democracy die, than accept new Americans who look and sound different as neighbors in the American commonwealth.
We celebrated winning WWII by ending Depression era austerity when our superior industry unscathed by war returned from making weapons to supply consumers wants.
And we had lots of kids, many of us were named “Linda”, the #1 girls name from 1947-52, after the release of a hit song named, “Linda,” by Jack Lawrence in 1946. American women averaged 3.4 babies born during the post-WWII period. And Boys, let’s not kid ourselves. It’s the finished product that women do, BABIES, that counts.
Then came the Pill in the 1970s. American women birthrate dropped to 1.4%. Way below replacement level. Abortion also became legal then. The USA was approximately 80+% “White”in the 1960s. The immigrants inherent optimism about their adopted country kept new Americans birth rates at the traditional 2-3 babies per woman, while others rapidly shrunk.
There was a small uptick when baby boomers had their own babies 1980-1990s. Baby Boom Echoes. But that’s run it course.
After 2 generations of different birth ratios between new Americans and our older national stock, approximately (1.5/2.5)x(1.5/2.5) you get a ratio of approximately 36%. That roughly corresponds with our 2017 birth rate between “Whites” and others (40%) once you account for the Baby Boom Echoes birthrate uptick.
And we keep intermarrying like true Americans always did. We are all mutts. My granddaughter is surnamed Gilchrist, Nolan’s is surnamed Rios. And despite my daughter having green eyes, sweet little Margot Gilchrist inherited Ryan’s brown eyes. And for those who fret, but claim it’s not racially motivated, 7% of last Census “Hispanics” now self-describe as something else, mostly “White”. Unsurprisingly since being Hispanic has nothing to do with the color of your skin.
But Miscegenation has always been the horrific national nightmare preached by White Supremacists, as well as the cleavage point with their neo-Nazi allies who mostly continue to hate Jews and “darkies”. i.e. Trump and Bannon because Trump supposedly has too many “globalists” a/k/a Jews in his administration and family (Jared). Other than that both Trump and Bannon apparently envision a grand Alliance with Putin’s Russia against demographic dis-empowerment.
And that’s why, to quote Lincoln at Gettysburg: “Four score and seven years ago our fathers brought forth on this continent, a new nation, conceived in Liberty, and dedicated to the proposition that all men are created equal. Now we are engaged in a great civil war, testing whether that nation, or any nation so conceived and so dedicated, can long endure. “
Almost all of the caring individuals who helped my late father on a daily basis while he was resident at Goodwin House Alexandria during the last nine years of his life were immigrants. While many “native born” Americans apparently believe that caring for the personal needs of the aged, sick, and disabled is “beneath them” as a career, it was apparent to me that in other countries and cultures taking good care of one’s elders and those in need is a time-honored and highly-valued tradition that folks are more than proud to follow. We could all learn something from those traditions.
I certainly was always very nice to the many wonderful folks who came through my courtroom in Arlington who were in the home or institutional health care business. I always told them how much America appreciated their efforts and that when I get to that point, I want the the best folks taking care of me!
As “Baby Boomers” age, more and more of us want to receive needed care in our own homes rather than institutions. But, I know from experience that finding well-qualified individuals to do that is very difficult. There just aren’t enough to go around, and they are always in high demand. That’s why the restrictionist proposals to restrict legal visas basically to Ph.Ds and CEOs is so dumb. We need legal immigrant workers at all levels of our system. Many of our greatest needs are not necessarily for “Nobel Prize Winners” but for “ordinary hard-working folks” with the skills (in the broadest sense of the word — even most of those whom we arrogantly classify as “unskilled” actually have skills — how long would most of us last in the picking fields, the apple orchards, the oyster shucking lines, or hanging from a building washing windows?) we need to keep out country and our society functioning at a high level!
And, opening up more numerous and realistic market-based channels for legal immigration would certainly be the smartest and most efficient way to reduce the incentives for undocumented immigration.
PWS
10-30-17
Back when the BIA was in the middle black building at Skyline in Bailey’s Crossroads (1979-1990) we used to hang out at Jerry/Gerry’s office and watch the immigrants clean the windows across at Black Building #1 dangling from 2-men roped platforms. Even before it was completed, the Skyline office complex claimed lives during its construction in 1973. See https://en.wikipedia.org/wiki/Skyline_Towers_collapse
Fortunately, we never saw anyone fall. But we still chuckle remembering when 2 of the cleaning people sent to clean our offices at Building #2vby the building lessor, Charles Smith, dropped their buckets and ran away when they saw the word “Immigration” by our door. Minimal Schadenfreude.
As PWS regularly points out, the short term crisis in American health care is too many patients (baby boomers) and a labor shortage. We want Tiffany but can only afford Walmart. So we’ve been doing what Walmart does, shop abroad. Except those workers we need are already here, no extra transportation costs. And they’re already doing their jobs. No extra training costs.
Demographically, the 1970s to early 1980s Baby Bust, after the Pill, dropped American fecundity from 3+ babies per woman to way below replacement 1.4 per woman. Immigrants filled the gap. Misanthropes want to deport the people who take care of us!