The recent Supreme Court decision in Harris v. Quinn dealt a blow to public sector unions and the labor movement in the US. To recap: workers who belong to public sector unions pay dues. The union is obligated to represent and bargain for all workers, including those who aren't members, with those non-members under the union's purview required to pay "agency fees" designed to cover the cost of bargaining for their wage improvements and other benefits. The plaintiff in the case, Pamela Harris, and her anti-union partners at the National Right To Work Legal Defense Foundation who scour the country looking for litigious opportunities to diminish organized labor, argued that it was unconstitutional for non-members to pay such fees since they might be used for political activities that workers didn't agree with, even though there are guidelines in place that regulate the use of such funds.
Though payment of agency fees was not thrown out entirely by the court, the decision narrowly focused on home healthcare workers and sided with Harris in a 5-4 conservative majority. It was deemed unconstitutional for non-member home healthcare workers to pay such fees since they are only "partial" public employees. Keep in mind that even though such work is performed in private residences, it's paid for by the state through Medicaid reimbursements. Compulsory payments that allow the union to effectively bargain are now akin to a restraint of free speech. The First Amendment was weaponized for anti-union politics.
The demands of domestic healthcare work go largely unrecognized or underappreciated as a skill, let alone a public health imperative. It is work where physical and emotional labor meet and where soundness of judgment is critical. With the Baby Boomer generation in the US entering advanced age, institutional resources are about to placed at an all-time strain. Home healthcare workers and caregivers are vital. They're also some of the most vulnerable domestic workers in the US. The demand for care has not increased its compensation. The court's decision is part of a continuing devaluation of caregiving and health work in domestic spaces. The home is, as the Supreme Court majority seems to believe, not really a true workspace. As the wider war on women in the US continues, the spatial segregation of work upheld in Harris sets the groundwork for exploitation. "Women's work" of the home is seen as incompatible with more traditionally recognized public sector work. The affective and seemingly immaterial work that accompanies healthcare, the cleaning, nurturing, and difficult-to-quantify intimate moments are often attributed as some natural element of a "feminine" condition and not one of rigorous training and education. Domestic caregiving has lingering unwaged connotations and it's the ideal target for those who advocate against organized labor's attempts to valorize such work. Evelyn Nakano Glenn, in her brilliant work on caregiving, Forced to Care: Coercion and Caregiving in America, notes:
"Despite the increased commodification of in-home caring labor and reliance on paid caregivers, paid caring has not been included in the "modernization" of labor relations. It has continued to be treated as part of the private family realm rather than as part of the market. As capitalist relations have penetrated more and more into social relations, there seems to be an even greater desire to preserve the distinction between home and market, and to maintain the home as a private refuge from market values. By virtue of its location in the home, caring work, whether paid or unpaid, is treated as though it is governed by altruism and status obligations. As a result, paid domestic workers suffer various forms of exclusion from benefits and rights accorded other paid workers." (149)
Some domestic caregivers are not covered by parts of the Fair Labor Standards Act or Occupation Safety and Health Act. The vast majority are women, many of whom are immigrant women, and woefully underpaid. Studies have shown that unionization of these workers was responsible for increases of wages over the last few years along with a marked reduction in turnover. If it's unconstitutional to compel certain workers to pay union fees, is it also unconstitutional to compel unions to advocate for free? Battles fought and won by unions have consequences for all workers, not just those who claim membership. There are also ramifications for family members caring for their own relatives who are regarded as health workers in the eyes of the state. They may be subject to less money from Medicaid in the future if there is a continued effort to exclude them from the larger pool of organized public labor, those with the greatest bargaining power to counteract exploitation.
And the structural realities of home caregiving run deeper than the ruling. Health work of the kind that is now regarded as "partial" to serving the public interest is often the only recourse for people who don't have much choice in the job market as others, especially immigrant women. The commodification of care is closely aligned with patterns of im/migration, globalization, urbanization, and racial histories of labor. Service-based economies are dependent on movement of workers from developing countries. The provision of caregiving in many urban centers in the US is largely dependent on immigrant workers. Filipino women, for example, comprise a major demographic in the nursing infrastructure in the United States. There is a cyclical relationship between US foreign policy and its military presence in the Philippines, the subsequent rearrangement of economies this causes, and US desire to resolve nursing shortfalls by encouraging Filipino nurses to migrate. This is but one example. There are prominent associations between ethnicity and domestic work, and dominating stereotypes in the US often dictate what is and is not appropriate work for many immigrants seeking to support themselves through caregiving. The down and dirty elements of healthcare rationalize its low status and its "appropriateness" for working class immigrants. This kind of environment compounds labor disputes and creates a guiding narrative that naturalizes the underpaid nature of caregiving work in the domestic sphere.
With their duty of fair representation, unions present a strong conduit to unite workers and aim to resolve longstanding gender and racial imbalances in wages. The Supreme Court ruling coupled with ongoing devaluation of care work contributes to a horizontal segregation of labor and undermines worker power. As unions struggle to find a new model that addresses the realities of "free rider" workers opting not to pay union dues despite continued advocacy on their behalf, there is now a renewed push in many states to trump up the benefits of formal union membership. Caregiving work in the home needs to be accorded with the recognition it deserves, and with real economic returns that sustain its workers.
Jason Huettner is a Blogs Editor for Warscapes.
Image via 1199SEIU.