Ai-jen Poo: Building universal family care

Text Ikaika Hussey
Art Will Caron

Ai-jen Poo is the director of the National Domestic Worker's Alliance and is Co-Director of an initiative called Caring Across Generations.

Summit (S): What brings you to Hawaiʻi now? What kind of things are you working on?

Ai-jen Poo (AJP): I've been to Hawaiʻi several times. It's one of my favorite places on Earth because—especially now in the political climate that we are in—it is wonderful to be able to come to a place that is as diverse as Hawaiʻi is, that is as global in perspective, and that is as rooted in culture as Hawaiʻi is, both in immigrant culture and indigenous culture. The aloha spirit is something that the whole country needs; I know I certainly needed it.

I worked here on legislation for domestic workers; for the women who go to work in our homes, caring for our children and our aging loved ones, and cleaning our homes so that we can go to work everyday and do what we do knowing that our domestic lives are taken care of. Hawaiʻi was actually the second state in the nation to pass a domestic workers' bill of rights. So Hawaiʻi has been really a leader in ensuring that some of the most vulnerable workers in our economy are protected.

As I was doing that work around the country establishing protections and basic recognition, one of the things that I began to realize was that this workforce is becoming increasingly important because more and more of us have family members who are growing old and living longer, and we want them to be able to stay at home and be a part of their families and their communities. The need for care is just exploding. And so I am now here in Hawaiʻi and few other states around the country working on legislation to help us take care of our aging loved ones—our elders—and to make sure that they have a dignified quality of life; and to make sure that the workforce that is responsible for ensuring their quality of life is able to live and work with dignity.

We have a major problem in this country where we really underpay and undervalue our caregivers—whether they are family caregivers or professional caregivers. Hawaiʻi is poised to become the first state in the country to reverse that trend. We passed a bill through the legislature this session, thanks to a campaign called Caring 4 Our Kupuna, that is about investing in our caregivers and supporting our families as they take care of our kupuna.

S: Can you share some numbers with us to put this into context? How many people are we talking about here, both in terms of the number of caregivers and the number of beneficiaries of that care?

AJP: Right now, because the Baby Boomer generation—which was this very large, very influential generation—is aging very quickly, every day 10,000 people turn 65 in America; every 8 seconds someone turns 65. That's 4 million people per year turning 65. And because of advances in healthcare and medicine, people are living longer than ever before. In Hawaiʻi, people actually have a very long life expectancy and we are looking at, by the year 2020, about 300,000 people will be over 65 here in the state. Hawaiʻi is a state that is aging.

It's potentially a great opportunity: the ability to live longer also means the ability to connect with your family longer, to work longer, to learn, to contribute, to love—all these opportunities, if we have the right support in place to actually take care of people and to make sure they have what they need to live healthy lives. And that's what this campaign is all about.

S: How many caregivers are we talking about, both professional and familial, that are taking care of this growing aging population?

AJP: There's about 4 million home care workers and caregivers that are providing elder care in the United States and about 52 million family care givers: people who are providing up to 20 hours a week of care for their family members on top of full-time jobs. It's a huge number of people that are dealing with the pressures of working and holding down a job and supporting family through earning a living and also taking care of loved ones. Managing that pressure is one of the main pain-points that working families in this country are dealing with today.

At the same time, we also have this other phenomenon where millennials are entering their 30s and having children. There's 4 million babies being born every year with really no childcare infrastructure either to support families. So you end up with this sandwiching effect on the millennial generation, where working age adults are being pressured from both sides by the demands of childcare and elder care with no infrastructure or support.

S: Let's imagine for a second that we could scrap the whole system and redesign it. What would an ideal series of social nets look like?

AJP: Our vision is for something called universal family care, where every single working age adult in this country would have access to a fund to help them afford childcare, elder care and paid family leave. So it would be a new type of social insurance like social security or medicare. It would be available to everyone; we would all contribute to it and then all benefit from it. It would prevent the kind of economic disasters that can happen when a family member is diagnosed with a serious illness like Alzheimer's and needs care. Or the kind of disaster that happens when somebody has an accident and develops a disability and is unable to work.

There are all kinds of disasters that—when families are already working paycheck to paycheck—an accident or a stroke or a disease diagnosis can really put them under. Whereas if we had this kind of a fund, it would support people in being able to both take care of their families and work too, which is really what we need in the 21st century.

S: It would be funded through some variant on the payroll tax while the person is working and then they can draw on it over the course of their elongating life?

AJP: Exactly. Initially it should be funded, I think, by wealthy people actually contributing more. We have unprecedented levels of inequality in this country. There's been a tremendous amount of wealth that's been generated over the last four decades, but everyday working people have not really benefited from that wealth: wages have stagnated for the 40 years and we're in a situation where 75 percent of the American workforce earns less than $50,000 a year.

The average cost of a private room in a nursing home is between $87,000 per year, on the low end, and more than $125,000 per year, on the high end. The math just doesn't work. We need a system where we are all contributing and we can all benefit. It would be sliding scale, and we think that people who are in a position to contribute more should do so. It's about the health and balance of our workforce.

S: How would that compare with another idea that has been gaining some traction internationally, which is universal basic income?

AJP: It's a related concept. In the 21st century, in the digital age, the nature of work has changed and we are no longer a manufacturing-based economy—we are in fact a globalized economy that's heavily service-driven. We used to have the kind of economy in which you could depend on stable employment for most of your life, with intermittent periods of unemployment, perhaps, in which you might apply for unemployment insurance. What we now have, instead, is a lot of people working temporary jobs, independently-contracted jobs, without access to a safety net, without access to benefits and basic services. We need to actually rethink the universal starting points that all working people and families have access to.

Of course we need to be creating good jobs. We have to make sure that the types of jobs in which we are seeing growth—like caregivers—are, in fact, good jobs for the 21st century. But we also need to put into place a new social contract that includes ideas like universal family care and universal basic income, so that everybody can actually expect a starting point that is fair and that allows people to have some quality of life.

S: In Scandinavian countries, their social nets developed at least partially as a result of amazing political organizing on the ground, and the creation of alternative institutions like credit unions and coops which then forced the government to create the now-amazing social democracies there. What processes do you see happening in the U.S. for instituting things like universal basic income or universal family care?

AJP: Several years ago, after Occupy Wall Street, I had an opportunity to hear the social movement historian Frances Fox Piven speak. What she was seeing in some of the activism that was happening on the ground around the country was, what she called, “precursors” to a really vibrant social movement that was on its way. She cited the Dreamers—the immigrant youth—who were engaged in activism, she cited the Fight for $15—the campaign to raise the minimum wage to $15, she cited Occupy, I'm sure she would include Black Lives Matter now, I'm sure she would include the movement that developed out of Standing Rock and water struggles around the world: she was forecasting a social movement so great that it would have the power to fundamentally transform our democracy the way the Civil Rights movement had done, the way the labor movement of the 1930s had done.

She was predicting that this social movement would be focused on addressing inequality in America and around the world. She also said that we would know it was coming when millions of everyday people actually started to take action; that it wasn't just the activists that we were seeing, but the neighbors, your hairdresser, the schoolteacher, the crossing guard—everybody—in motion. And I will tell you that I was in Washington D.C. for the Women's March on Washington and it was nothing short of what felt like millions of everyday people in motion.

I think what we're seeing now is a movement that's building not just against economic inequality, but also against political inequality and the fact that millions and millions of people feel that their voices are not heard and they're not being represented in American political life. I think that this is what it will take to actually achieve the social contract that we deserve and that will work in the 21st century.

S: What are your hopes are for the legislation that was just passed this session in Hawaiʻi? What will that achieve?

AJP: The legislation would create what is called the Kupuna Caregiver Fund and it is a groundbreaking piece of legislation—the first of its kind in the country—that would really invest in what we call the caregiving infrastructure. When we think of infrastructure—and there will probably be an infrastructure bill introduced in Washington at the federal level—we think of roads and bridges and pipes and fiberoptic cables but in the 21st century, when 75 percent of children are growing up in households where all of the adults are working outside the home, we actually need a whole new infrastructure to support people while they care for their families. We used to rely on women to stay home and take care of the kids and take care of their parents, but that option no longer exists. So we actually have to put an infrastructure in place.

And Hawaiʻi, through the Kupuna Caregiver bill, would actually become the first state to invest in that infrastructure, to invest in the ability of working families to keep their loved ones at home instead of putting them in institutions, and insuring that the workforce that is helping to support that is fairly compensated. It would invest in both the workers and the families.

It's about the value of caregiving. One of the reasons why I think it's so appropriate that Hawaiʻi be the first place to do this is that there is a tradition in these islands of caring for our elders; it is a part of the culture and it is something that the rest of the country could really learn from and, actually, has to adopt in order to create the solutions we need given the increasingly massive demand for elder care that we will experience in the future. If we continue to treat our elders as disposable and invisible, we will fail that impending test. Because Hawaiʻi already embraces that concept culturally, it could potentially create the breakthrough precedent of investment in this infrastructure that we need for the idea to be pushed through nationally.


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