front cover of Good Jobs America
Good Jobs America
Paul Osterman
Russell Sage Foundation, 2012
America confronts a jobs crisis that has two faces. The first is obvious when we read the newspapers or talk with our friends and neighbors: there are simply not enough jobs to go around. The second jobs crisis is more subtle but no less serious: far too many jobs fall below the standard that most Americans would consider decent work. A quarter of working adults are trapped in jobs that do not provide living wages, health insurance, or much hope of upward mobility. The problem spans all races and ethnic groups and includes both native-born Americans and immigrants. But Good Jobs America provides examples from industries ranging from food services and retail to manufacturing and hospitals to demonstrate that bad jobs can be made into good ones. Paul Osterman and Beth Shulman make a rigorous argument that by enacting policies to help employers improve job quality we can create better jobs, and futures, for all workers. Good Jobs America dispels several myths about low-wage work and job quality. The book demonstrates that mobility out of the low-wage market is a chimera—far too many adults remain trapped in poor-quality jobs. Osterman and Shulman show that while education and training are important, policies aimed at improving earnings equality are essential to lifting workers out of poverty. The book also demolishes the myth that such policies would slow economic growth. The experiences of countries such as France, Germany, and the Netherlands, show that it is possible to mandate higher job standards while remaining competitive in international markets. Good Jobs America shows that both government and the firms that hire low-wage workers have important roles to play in improving the quality of low-wage jobs. Enforcement agencies might bolster the effectiveness of existing regulations by exerting pressure on parent companies, enabling effects to trickle down to the subsidiaries and sub-contractors where low-wage jobs are located. States like New York have already demonstrated that involving community and advocacy groups—such as immigrant rights organizations, social services agencies, and unions—in the enforcement process helps decrease workplace violations. And since better jobs reduce turnover and improve performance, career ladder programs within firms help create positions employees can aspire to. But in order for ladder programs to work, firms must also provide higher rungs—the career advancement opportunities workers need to get ahead. Low-wage employment occupies a significant share of the American labor market, but most of these jobs offer little and lead nowhere. Good Jobs America reappraises what we know about job quality and low-wage employment and makes a powerful argument for our obligation to help the most vulnerable workers. A core principle of U.S. society is that good jobs be made accessible to all. This book proposes that such a goal is possible if we are committed to realizing it.
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front cover of Who Will Care For Us?
Who Will Care For Us?
Long-Term Care and the Long-Term Workforce
Paul Osterman
Russell Sage Foundation, 2017
The number of elderly and disabled adults who require assistance with day-to-day activities is expected to double over the next twenty-five years. As a result, direct care workers such as home care aides and certified nursing assistants (CNAs) will become essential to many more families. Yet these workers tend to be low-paid, poorly trained, and receive little respect. Is such a workforce capable of addressing the needs of our aging population? In Who Will Care for Us?  economist Paul Osterman assesses the challenges facing the long-term care industry. He presents an innovative policy agenda that reconceives direct care workers’ work roles and would improve both the quality of their jobs and the quality of elder care.
 
Using national surveys, administrative data, and nearly 120 original interviews with workers, employers, advocates, and policymakers, Osterman finds that direct care workers  are marginalized and often invisible in the health care system. While doctors and families alike agree that good home care aides and CNAs are crucial to the well-being of their patients, the workers report poverty-level wages, erratic schedules, exclusion from care teams, and frequent incidences of physical injury on the job. Direct care workers are also highly constrained by policies that specify what they are allowed to do on the job, and in some states are even prevented from simple tasks such as administering eye drops.
 
Osterman concludes that broadening the scope of care workers’ duties will simultaneously boost the quality of care for patients and lead to better jobs and higher wages. He proposes integrating home care aides and CNAs into larger medical teams and training them as “health coaches” who educate patients on concerns such as managing chronic conditions and transitioning out of hospitals. Osterman shows that restructuring direct care workers’ jobs, and providing the appropriate training, could lower health spending in the long term by reducing unnecessary emergency room and hospital visits, limiting the use of nursing homes, and lowering the rate of turnover among care workers.
 
As the Baby Boom generation ages, Who Will Care for Us? demonstrates the importance of restructuring the long-term care industry and establishing a new relationship between direct care workers, patients, and the medical system.
 
 
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