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The Daughter Track

I’m not a fan of trend stories, but this one is interesting, even if it doesn’t actually reflect any major change: Women are leaving their careers to care for their elderly parents.

In another era, the task of caring for elderly parents often fell to the unmarried daughter who never left home and never worked for a living. But now, in a 21st-century twist on the 19th-century spinster, career women like Ms. Geist who have made their mark in the world are returning home to care for parents in old age.

They are embracing a filial role that few could have imagined in their futures and are doing so by choice. In fact, sociologists are beginning to give the phenomenon a name: the Daughter Track, a late-in-life version of the Mommy Track, a career downsizing popular with younger women.

Women, now as always, bear a disproportionate burden for elder care and often leave jobs, either temporarily or permanently, when the double duty becomes overwhelming , according to recent studies of family care-giving, women in the workplace and retirement patterns. Although there is no precise count of how many women have walked away from careers to care for their parents, more of them than ever are financially independent, unmarried or childless, which makes it more feasible than it might be for women with families at home. And never have more parents needed adult children to care for them, what with long life expectancy and disabling conditions like Alzheimer’s disease.


This is particularly interesting to me as I watch my grandparents get older — both of my grandmothers have now moved in with their daughters, one because of debilitating illness and one more out of convenience. My aunt in Seattle (where my grandma also lives) has retired to take full-time care of my maternal grandmother; my mom has taken time off work to help care for her; and my aunt in California has made multiple trips up to see her and give my Seattle aunt some time off. Their brother has good intentions, and has sent money and visited once, but hasn’t been a primary caretaker the way that all three of the women in the family have. As far as I can tell, there isn’t any resentment about that, or expectation that he would (and to be fair, he’s the only member of the family that still has kids at home).

Despite a growing number of men helping aging relatives, women account for 71 percent of those devoting 40 or more hours a week to the task, according to the National Alliance for Caregiving and AARP in a 2004 study. Among those with the greatest burden of care, regardless of sex, 88 percent either take leaves of absence, quit or retire.

I should make it clear that this isn’t necessarily a bad thing (it’s one of those things that, I think, is beyond classification as “good” or “bad”). It’s obviously not ideal that one gender is expected to devoting their entire lives to the service of others. But, not to get too cheesy, I think it’s valuable to not lose sight of what really matters in life — and while I hate to see things like caring for family become socially mandated for a group of people by simple virtue of their vagina-possession, the flip side is that it gives women the option of quitting their jobs or taking time off without too many people second-guessing them. I don’t think the same can be said for men. Imagine a 50-year-old man announcing in the boardroom that he’s quitting in order to care full-time for his elderly parents.

I say that partially because I hope that when my parents are older and need me, I’ll be there. I think it’s valuable to put family first — and I don’t mean that in the way that the “traditional values” crowd does, as code for a patriarchal family structure. But family, however you define yours, is the bedrock of your life — or at least for me, mine is. My parents sacrificed everything for my sister and I and worked incredibly hard to give us every advantage they could. Part of life, I think, is returning the favor later when they need it (even though, in my view, it’s not as much about “returning favors” as it is just doing what you do for people you love).

Of course, this article generally ignores the class issues inherent in the “daughter track” phenomenon (it is, after all, in the New York Times). A woman who is making a six-figure salary and has a 401(k) and a good amount in her savings account can probably manage to take a year or two off to care for her parents full-time. A woman who is working for $5.15 an hour and barely getting by herself, or who is still supporting her own kids, doesn’t have that privilege. And yet, a lot of women who barely keep their own heads above water do somehow manage to care for their elderly parents on top of everything else. I’d like to see an article on how they manage it — and what the parents of women who can’t manage it do.

I’d love to see a cultural shift in which men are just as willing (and just as expected) to be caretakers of children and the elderly, and where caretaking and traditional “women’s work” are valued as highly as traditional men’s work. That’ll be real progress.

UPDATE: Amanda, The Countess and Echidne have more. All very worth reading.


77 thoughts on The Daughter Track

  1. i was wondering as I read this today whether it would get a mention in Feministe. I felt nothing but admiration for the women featured, though of course, was mindful of the fact that at least one of them admitted that because she’d spent so long on the “career ladder” she could afford to quit the job and not have money worries.
    With regards to the ‘class’ issue, perhaps in other families the parent generally comes and lives with the child, so the child can continue to have job/look after any kids they might have/etc.

  2. I find it interesting that both the article and Jill were blind to the presumption that it is correct and proper for aging parents to place the burden of care on their children, rather than their own resources.

  3. I don’t know that Jill presumed anything, rather she stated that SHE would personally want to take care of her parents when they are older and if she can (“I think it’s valuable to put family first … My parents sacrificed everything for my sister and I and worked incredibly hard to give us every advantage they could” – emphasis on the I and My).
    I don’t think there was any presumption that everyone would want to do this. Especially if people have had difficult relationships with their parents (abusive situations etc) which I can imagine would make things different.
    I don’t know about your pension plans in the States but here over the other side of the world, they’re pretty crummy. So I imagine having someone to help out if you can’t afford to put yourself into a comfy yet expensive rest home (over here they can get v pricey) would be nice.

  4. I find it interesting that both the article and Jill were blind to the presumption that it is correct and proper for aging parents to place the burden of care on their children, rather than their own resources.

    Yeah, it must have been the part where Jill wrote that she wanted to be there for her parents that tipped you off… (?!?)

    Well, I didn’t see any sort of presumption like that at all in what Jill wrote, and not in the article, either. Of course, I’m part of the Evil Liberal Conspiracy To Destroy The Traditional Family, so of course I wouldn’t see that. But it must be blindingly obvious to perceptive folks like yourselves, who have no ideological axe to grind!

  5. that’s why the “boomers” are beginning to be called the Sandwhich Generation: they’ve got young children and elderly parents to care for.

    And I’ll have to 3rd the others ’cause I didn’t notice any presumption on Jill’s part either.

  6. the flip side is that it gives women the option of quitting their jobs or taking time off without too many people second-guessing them

    Oh, for fuck’s sake. This is like the old argument that women were lucky to be stuck choosing either nursing or teaching, because they didn’t have to get their hands dirty in the trades.

    Sexism is sexism. It’s one thing to be more willing to take care of your parents and happening to be female, but why the need to dance around the fact that low-paid/unpaid care, and family care, somehow ‘naturally’ falls on women? Without even the excuse of breastfeeding that’s trotted out when arguing Mommy should do all of the childcare?

    and where caretaking and traditional “women’s work” are valued as highly as traditional men’s work

    That will not happen until men do it.

  7. Oh, for fuck’s sake. This is like the old argument that women were lucky to be stuck choosing either nursing or teaching, because they didn’t have to get their hands dirty in the trades.

    Well, yeah, I agree — I think the first half of the sentence made that relatively clear. I guess my bigger point is that I’m sick of seeing particular types of work being undervalued just because women do it. I’m not trying to say that women are lucky for being pushed into particular types of work. I’m not saying that caring for parents should somehow naturally fall on women. I’m saying that I think caring for others is valuable, important work, and that it’s thoroughly fucked that it’s underpaid and undervalued, but I’m glad I have the option to do it. I’m tired of a system that places what men do as the epitome of achievement, and I’m definitely growing tired of the idea that to be successful, women have to emulate whatever men have traditionally done, because that’s what’s good. I want to live in a world where I can take time off from my job to take care of my parents when they need me — I just want that world to hold men to the same standard, and to value my work as a caregiver as much or more as they value traditional “male” work.

  8. An interesting flip side is when my aunt, the only daughter of five children, decided to leave her company to work from home she offered to have my grandparents (one has cancer, the other is going senile and has heart problems) move in with her since she was in the best position to take care of them. My uncles and their wives work and have kids at home while my parents live in a town they hate. The grandparents flat out refused because she was a daughter. My dad explained it as one of the old Chinese traditions they still hold on to–daughters gets married off and join new family, sons take care of parents.

  9. I understood it as “sons take care of parents by marrying someone else’s daughter and daughter-in-law takes care of parents.” Is this an uncharitable stereotype?

  10. …and I’m definitely growing tired of the idea that to be successful, women have to emulate whatever men have traditionally done, because that’s what’s good.

    Of course, the ones that are most guilty of undervaluing the work of a caregiver (especially an unpaid caregiver) are those who espouse that very idea–in the name of feminism–by claiming that a woman choosing to be a full-time parent, homemaker, or caregiver is “wasting” her life.

    Radical feminism is true feminism’s worst enemy.

  11. Bo would rather not have to admit that it’s the traditionalist, anti-feminist notion that caregiving is good enough for women, but well beneath men–and that ‘radical feminists’ merely agreed with the traditional undervaluing of that kind of work, without also agreeing that women (being inferior) could safely be assigned it.

    I’m saying that I think caring for others is valuable, important work, and that it’s thoroughly fucked that it’s underpaid and undervalued, but I’m glad I have the option to do it.

    ‘Option’ is rather a strong word for it.

  12. This is particularly interesting to me, since I work in Personal Care. It’s a field which pays…not all that great. A bit more than clerical, in this area, which really isn’t much considering the role we play in society. And, of course, the vast majority of us are women.

    It is interesting to note how many of these people’s regular caregivers (I do homecare) are daughters or some other close female relative. It’s rare for me to see a son in that role.

  13. Feministe definitely rocks…..

    It’s truly amazing how our society, not to say we’re alone in this, has fucked up gender roles; that is to say there’s a lot of b.s. swirling around about what women should or shouldn’t do.

    I say: “Do what thou wilt shall be the whole of the law.”

  14. Jill, radical feminists have said that, on several occasions, and in several ways, that being a housewife/mom is not something to be valued. (hope a long blockquote works)

    Simone de Beauvoir: “No woman should be authorized to stay at home to raise her children. Society should be totally different. Women should not have that choice, precisely because if there is such a choice, too many women will make that one.”

    Shelia Cronan: “Since marriage constitutes slavery for women, it is clear that the women’s movement must concentrate on attacking this institution. Freedom for women cannot be won without the abolition of marriage.”

    Betty Friedan: “It is better for a woman to compete impersonally in society, as men do, than to compete for dominance in her own home with her husband, compete with her neighbors for empty status, and so smother her son that he cannot compete at all.”

    Vivian Gornick: “Being a housewife is an illegitimate profession… The choice to serve and be protected and plan towards being a family-maker is a choice that shouldn’t be. The heart of radical feminism is to change that.”

    Betty Friedan: “Strange new problems are being reported in the growing generations of children whose mothers were always there, driving them around, helping them with their homework – an inability to endure pain or discipline or pursue any self-sustained goal of any sort, a devastating boredom with life.”

    Phyllis Chesler: “most mother-women give up whatever ghost of a unique and human self they may have when they ‘marry’ and raise children.”

    Andrea Dworkin: “Childbearing is glorified in part because women die from it.”

    mythago, you really should drop the “rather not have to admit” bullshit. Either debate my points or agree with them, but don’t ascribe to me the twisted view of humanity you imagine to be reality.

  15. Bo, you seem to have no problem ascribing a particular world view to “radical feminists”. You pretend that feminists invented the idea that housework and childrearing are demeaning. They didn’t. They simply stopped buying the notion that women were inferior. If housework and childrearing are beneath the dignity of men, and you stop believing that women are inferior to men–why, then, it’s obvious that housework and childrearing are beneath anyone’s dignity.

    As a former stay-at-home mom, by the way, let me suggest that if you really think we should value homemaking and caretaking, put your money where your mouth is. Encourage men to take up homemaking and the primary care of their children. Be a stay-at-home dad. Talk about “homemakers” instead of “housewives”.

    Because when all you talk about is how mommies ought to be at home, and pretending what’s honorable for women is not something men should ever think about doing, you’re indeed slinging bullshit. If you’re not willing to give up your paycheck and spend years changing diapers, why the hell should I?

  16. Oh thank God, I can disagree with Mythago here, and perhaps erase my shame.

    I’ve read the early feminists. The information is all right there, easy to find. And while you can certainly make allowances for overreaction and a natural desire to shake off all the patriarchy in one blow, it simply is not credible to assert that the first radical feminists of the 19th and 20th centuries did not have contempt and disdain for the role of mother and homemaker. The quotes outline the viewpoint and the biographies hammer it into stone with foot-high letters (in a nice light Gothic font). Every radical feminist? Probably not, though I can’t find any who had the balls to stand up and say “wait, this is too extreme.”

    Bo isn’t arguing that feminists invented this view. He’s arguing that they endorsed it, and, damn it, they did. You can acknowledge that (at zero cost to you) and move the discussion forward, or you can “did not did not did not!” for another hundred iterations of the “find a way to make it a man’s fault that women did something bad” game; your call.

    I value homemaking and child-rearing. If you want to have an argument with someone who says these things are valuable, and demand that they back that up with their actions, then let’s dance. I write from my home office, fresh (well, three hours ago) from my daily routine of doing, oh, say, 100% of the childcare. You want to talk about childrearing and homemaking? Let’s talk about it.

  17. it simply is not credible to assert that the first radical feminists of the 19th and 20th centuries did not have contempt and disdain for the role of mother and homemaker

    Then it’s a good thing that I never asserted otherwise, isn’t it?

    What Bo is mad about, and what you’re ignoring in your rush to erase your shame, is that I’m not arguing “Feminists never disdained housework and childcare”. What I’m pointing out is that they didn’t invent disdain for homemaking. They rejected the idea that women were inferior to men, and suited only for lesser, unpaid, supportive work. They didn’t take the next step and question the notion that men’s standards were the right one, that the “rat race” was a more noble and appropriate calling than raising a family, and so on.

    It’s simple logic: when certain jobs are simple, tedious, unworthy of pay, and fit only for the inferior sex, and you then strike out the idea that women are inferior, you’re still hanging onto the notion that running WidgetCo is valuable and changing diapers isn’t.

    And you can’t really blame them, when you consider that their experience with family life and homemaking was a little less, shall we say, enlightened. Erma “Radical Feminazi” Bombeck wrote a column about her husband seeing her crying with exhaustion one day, and offering to help her by making the coffee in the mornings; she pointed out that nowadays we’d roll our eyes at his thinking this was a big sacrifice, but at the time both he and she thought of this as a big deal, the kind of thing that would have his buddies jibing him about who wore the pants in the family.

    If you want to have an argument with someone who says these things are valuable

    I was a stay-at-home parent for nearly ten years, remember? If it would purge your shame, I can ask you about how many soap operas you watch while you lie around and eat bonbons, but I have to tell you, my heart isn’t really in it.

  18. Mandos, a lot of times it is the son’s wife who does a bulk of the work, but it’s also not uncommon for a son (married or not) to really be the one taking care of his parents (e.g. taking them to the doctor, spending time with them, feeding them, etc).

  19. mythagos,

    First, I’m not mad. You’ve not seen me mad. You wouldn’t like to see me mad.

    Second, my wife and I have split the childcare and homemaking duties in a whole bunch of different ways over the past ten years. Currently, she has employment opportunity that pays much more than mine, so I do nearly all of the “homework.”

    Third, it was a valuable asset for my wife to have stayed home during the very early childhood of our four youngest children. The decision was made, however, by evaluating whose current work brought more income,and whose current work offered the more flexible schedule (such that even the employed parent could be available if needed), not some idea that “it’s her job.”

    Fourth, after having triplet daughters (now 8) and a younger son (now 6), I have a very keen appreciation for every aspect of childcare. Only difference is, I didnt’ (and still don’t) have time to watch the damn soaps.

    Now that we’ve established where I’m coming from, I’ll address the fact that the thread was originally regarding the undervaluation of caregiving. Remember that? You, obviously, are content to belittle one of the most noble endeavors of humankind in the name of making a political point. I can’t help it if you hate yourself for being a stay-at-home mom for ten years. I can’t help it if those feelings came from radical feminists as well as from the evil patriarchy. You’re being dishonest, however, in claiming that my original comment came from the viewpoint that caregiving is “woman’s work” when my issue was with the undervaluation of that work by most of society, male and female. Of course that was convenient for you, as you are quite content to demean that work yourself, so long as you’re attacking an imagined misogynist.

  20. It’s a real shame that we don’t take adequate care of our elderly. I see it more as a societal problem rather than a sexism problem. There is no reason a society as rich as ourselves can’t take care of our elderly.

    My grandma is in one of those apartments, what do they call them now? I don’t even know. It’s like a dormortory for older people. It actually seems kind of fun. Almost feels like college, except everyone goes to bed at 9:30 and watches Wheel of Fortune after supper.

    Anyway, my uncle does quite a bit to help. He’s a retired school teacher and he is the one that drives her places and stops by to keep her company.

    But the people that take care of the elderly that can’t function on their own, they are the ones with the real hard jobs. I can’t imagine taking care of someone that can’t bathe themselves or go to the bathroom on their own. I once was a “night security” guy at an old-folks home when I was in college. It was depressing. The first night I was excited and showed up with board games to play with the old folks. I got there at 8 at night and all of them were in bed already.

    I’m never getting old.

  21. Mandos: “I understood it as “sons take care of parents by marrying someone else’s daughter and daughter-in-law takes care of parents.” Is this an uncharitable stereotype?”

    I think it’s pretty accurate. I’ve seen families where the man’s parents moved in to his home, and his wife took care of them. Some web sites about the “Sandwich Generation” also brought up that point.

  22. the flip side is that it gives women the option of quitting their jobs or taking time off without too many people second-guessing them. I don’t think the same can be said for men. Imagine a 50-year-old man announcing in the boardroom that he’s quitting in order to care full-time for his elderly parents.

    Sorry Jill, but I have to go with mythago here—men have this choice also, and all they have to do to exercise it is jump right on in. Really! Men are not more at risk of losing their careers than women. Are they more at risk of being “made fun of” in the boardroom? Perhaps. But as a woman who ran the gauntlet of broken barriers by entering the trades, color me unsympathetic. So what if people call you names—-really! Should have gotten over that in grade school, y’know?

    But the use of the word “boardroom” here is very telling to me. This isn’t really an issue, in most cases, for the folks in the boardroom, regardless of gender. The folks in the boardroom tend to have the money to hire in-home help, or put their parents in an adult day-care, or quality old folks home. They tens to have the types of jobs that come with paid leave, in case they do need to take time off. Chalk it up to the NYT to keep up the tripe that “working woman” invariably means “corporate woman”. Arrgh!

    How does the working class do it? With great difficulty, the same way we do every other damn thing. I’m the only child in my family, and my mother is terminal. She’s starting to feel a lot of pain now, and the hard part of this journey is just beginning. My folks don’t live within a daily driving distance, and I know that when my mom needs at-home medical intervention, my father will be unable to do it. He wasn’t even able to give their dog insulin shots—I know he won’t be able to handle injections or feeding tubes. Since my daughter was a preemie, that’s old hat to me…but mom’s insurance won’t pay for her over here where I live—they have no HMO outlet here. She would have to pay her medical expenses out-of-pocket, which she can’t afford to do since slightly over half her pension is already going for insurance costs.

    Which brings up this little comment: I find it interesting that both the article and Jill were blind to the presumption that it is correct and proper for aging parents to place the burden of care on their children, rather than their own resources.

    What resources? My eighty-five year old grandmothers aren’t physically able to work any more—-they’ve worked their whole damn lives. My mother is terminal and can’t work anymore; she’s really starting to feel the impact of her cancer. This comment strikes me as a hearty “fuck you” to all working class people, who busted their asses their entire lives, scrimping and saving the precious little that was left over so they’d be able to live long enough to enjoy time with their grandchildren…..bah! WHAT resources? Look, I make a decent living, and save 15% of my before tax paycheck by leading a very frugal life and living in the “bad” part of town—even so, I still won’t be able to save enough to live off my savings in case of infirmity or old age. There’s just not that much there.

    And shall we get into what really separates the struggling from the non-struggling—inheritance? Keeping struggling elderly people from being able to pass on their house (often the only “resource”) to their children insures that another generation repeats the same pattern.

    David, has anyone in your family ever been sick? I mean, really sick? Six-digit bill sick? Then you can some talk to me about “resources” and who’s supposed to supply them. Till then, go sit in the truck.

  23. I think my point is getting a little lost here, and I probably won’t clear enough. I agree with everything Mythago is saying, and everything you’re saying. I realize men have the choice also, just like they have the choice to be stay-at-home dads. What I’m saying is that because care-giving has traditionally been such gendered work, and such under-valued work, it’s more socially acceptable for women to leave their jobs to take care of elderly parents than it is for men. Doesn’t mean that men can’t or don’t do it, just that the social norm is that it’s a “woman’s job.” Which is sexist and shitty. I didn’t mean to imply otherwise when I talked about what I personally want to do; just because it’s a choice I’d make doesn’t mean that it’s one freely made, or that it’s one everyone should make or has the option of making, or that it’s not a sexist, shitty choice.

    As for the resources thing, I hear ya loud and clear on that.

  24. David, has anyone in your family ever been sick? I mean, really sick? Six-digit bill sick?

    Someday I’ll have to tell you about my Grandma getting mesothelioma from working in the Navy yard, or my Grandpa spending his last days moored to a dialysis machine thanks to kidney failure. Today is not that day.

  25. Jill, I hear you that it’s more socially acceptable for women to take time off—-but why? Because for the most part, men aren’t doing it. Men, as a group, haven’t decided to break that barrier, even though they are working within the same parameters that women are.

    That’s what gets me. In my lifetime, women, as a group, have broken all sorts of barriers. There has literally been a sea change in what is considered “socially acceptable” for women, and that has been due to our breaking those barriers. We took our opportunities; we formed that critical mass.

    And when men form that critical mass of folks who say “enough!”, who join us in recreating a work schedule and lifetime career track that is more amenable to a human scale, that’s when we’ll have a solution.

    I’ve just heard one-too-many-times from my brethren, “oh….but you can take time off, and it’s ok, ‘cuz you’re a woman…” No, it’s not ok. My employers don’t give me a break when my daughter gets sick and I have to leave work to care for her. They don’t say, “oh, poor kid. go home and do the right thing.” No. But if the men on the jobs started taking that time off—and I mean, not just the handful of single fathers that are doing so now, but the married men too (instead of leaving that duty for their wives), then the stage would be set for real change. Right now, women are ghettoized into doing it, and men are being led to believe that they can’t, because of fear of career damage. Well, the fear of career damage is real—but the men won’t suffer more career damage than the women.

    See, what it comes down to, is that my brothers know that by taking time off of work to caretake for family members, they will be taking chances. And giving up privilege. And that’s not easy. But dammit, it’s necessary. Because the current situation isn’t serving men, either. Critical mass is the key.

  26. What I’m pointing out is that they
    (feminists)
    didn’t invent disdain for homemaking. They rejected the idea that women were inferior to men, and suited only for lesser, unpaid, supportive work. They didn’t take the next step and question the notion that men’s standards were the right one, that the “rat race” was a more noble and appropriate calling than raising a family, and so on.

    but many feminists did just that. If though women argue that in a patriarchy, they (we) run the risk of getting pushed right back into Kinder Kuche Kirche with a pat on the head for doing such noble work — a problem that’s existed since the suffrage debates and probably before that.

    As for the NYT piece. It was fairly interesting. Of course it failed to capture the lived reality of most female carers, but that’s I suppose to be expected: “woman struggles with poorly-paid assembly-line job plus caring for parents” is not news. At least it made some gesture towards care’s being a feminist issue.

  27. You wouldn’t like to see me mad.

    This is the part where I’m supposed to be all a-tremble out of fear of your scary temper, right?

    You, obviously, are content to belittle one of the most noble endeavors of humankind in the name of making a political point

    In other words, I made a point, and you didn’t like it, so you’ll throw a verbal tantrum. Again: “radical feminists” didn’t dream up the idea that housework and childcare suck. They merely rejected the idea that women, being inferior, were naturally fit for such work (which men oughtn’t to lower themselves to do). It wasn’t until much later that they questioned the notion that such work was inferior to, say, selling stock all day.

    If it makes you feel better to pretend that I am self-hating or that homemaking was truly honored by everyone until the damn feminists ruined everything, I guess I can’t stop you. But I’m not going to see Betty Friedan or Erma Bombeck as THE ENEMY! because they pointed out how little anyone really valued what they did all day.

    This comment strikes me as a hearty “fuck you” to all working class people

    It’s also a good example of the “fuck you” that our sexist society gives to women who are at-home parents and homemakers. Oh, did you stay home and keep house all your life, and you don’t have money because your husband didn’t save enough, or your investments failed, or his pension vanished in a bankruptcy? Too bad, you lazy bitch, you should have had a real job and paid your own way.

    I suppose Bo will blame radical feminism for that one, too.

  28. David, how then could you even come up with the comment that grandma and grandpa should have these resources on their own? If your grandparents didn’t have their own resources to handle their own medical bills, what makes you think the rest of us do?

    Yes, I take it as a given that family members are going to need to care for their elderly; I take it as a given that the elderly are not going to have the resources to care for themselves. The average U.S. paycheck, combined with the cost of living, combined with the astronomical medical expenses and health insurance, pretty much guarantees that the lion’s share of us are going to be faced with having to rely on relatives in our last days.

    Where I come from, “resources” aren’t financial. It is a given that no one has spare cash. “Resources” come in the form of other human beings, human beings that can pitch in—in non-monetary ways. Having someone nearby that can hook up a feeding tube means not having to pay a home-care nurse to do it, which costs a helluva lot of money at the end of the month, and eats up precious “maximum lifetime benefit” on insurance. The maximum lifetime benefit on my insurance is one million. Three months after my daughter was born, I received a bill in the mail for $750,000, payable within thirty days. I laughed. What the fuck else could I do? There was no way I could come up with that much. Ever. In my life. And I work goddamn hard. And I’m tired of hearing from conservatives that I’m not working hard enough, because if I was, then magically I would have these resources. My daughter had expenses after that, too. She spent the first six months in two different hospitals. She has just about exhausted her “maximum lifetime benefit”. She just turned six.

    Shit, you know, I don’t want much. I’m not asking for the moon, sun and stars here. I just want my mother to be able to stay at my house, when her cancer gets so bad she can’t walk. I’d like for her insurance company to recognize the human aspect of my mother’s illness. Financially, it would cost significantly less for mom to stay in my house, in a rented hospital bed in my dining room, and be cared for by me, than for her to be admitted to a nursing home. But they’ll pay for the nursing home, but won’t pay for the minimal medical necessities to do the same thing here. She’s a human being. She’d rather spend her end days here, amongst family, being cared for by family, and having those increasingly-rare “good days” amongst family, than be in a nursing home. If she ends up going to a nursing home, the only time we—-my daughter and I—will get to see her is on the weekends. I don’t have the option of leaving work without losing my job. I’m not covered under FMLA yet, and won’t be for practically another year.

    That’s it, basically. I don’t want to miss the “good days”. I don’t want my daughter to miss the “good days”. I’m tired of a medical system that says, “what…..you’re not dead yet? Hurry the fuck up!”

  29. It’s also a good example of the “fuck you” that our sexist society gives to women who are at-home parents and homemakers. Oh, did you stay home and keep house all your life, and you don’t have money because your husband didn’t save enough, or your investments failed, or his pension vanished in a bankruptcy? Too bad, you lazy bitch, you should have had a real job and paid your own way.

    Bingo. For all the lip service given to homemakers; for all the anti-feminist ranting-and-raving by noted conservatives—-where are they on the position of granting Social Security credit for homemakers? Nowhere, that’s where. “Social Security is for people in the workforce.” ‘Nother words, get off the couch and throw those bon-bons away, sister, and quit being a sponge.

    Damned if you do, damned if you don’t.

  30. La Lubu I had no idea there was a lifetime limit to payouts under health insurance (I live in New Zealand, we still have a national health service), that’s completely insane, I’m so sorry.

    I think this debate shows how important it is to link the campaign for equality in a formal sense, with changing what is valued. The two issues are intertwined, not in conflict. I triend to write about this on my blog, because I think it’s really important that ending sexism in the sense of creating equality isn’t seen as in any conflicting with ending sexism in the sense of valuing women’s work.

    Oh and Bo I don’t think radical feminism argued “that a woman choosing to be a full-time parent, homemaker, or caregiver is “wasting” her life.” Many of the people you quoted weren’t radical feminists, and most of those quotes don’t devalue caring work but marriage, which is a different thing.

    In New Zealand feminists were the only groups who were campaigning for housework to be more valued in the 1970s.

  31. mythagos

    In other words, I made a point, and you didn’t like it, so you’ll throw a verbal tantrum.

    No, you didn’t make any point at all, and no, I didn’t throw a verbal tantrum. Hard to type a verbal tantrum, even if I had wished to throw one.

    I realize, though, that I did the unthinkable–attributed less-than-admirable qualities to a handful of feminists (those that I carefully classified as “radical feminists”). Perhaps the goddess shall one day forgive me.

  32. For all the lip service given to homemakers; for all the anti-feminist ranting-and-raving by noted conservatives—-where are they on the position of granting Social Security credit for homemakers?

    Generally we’re for stopping the theft of their spouse’s paychecks by the Ponzi scheme ripoff that has been foisted upon them by liberals.

  33. LaLubu–
    Kudos for taking on that statement by David. I initially intended to address it, but since several commenters had passed over without jumping on it, I was afraid bringing it up would simply call more attention to it than he deserved. I do think, though, that the only thing worse than a capitalistic healthcare system would be a socialistic healthcare system.

    I think the biggest problem began when health insurance became an expected benefit from employment. Suddenly, insurance companies didn’t have to price-compete for business from individuals. Insurance then became something that was supposed to pay for everything, from routine visits to major medical procedures, so the price skyrocketed without the end-consumer realizing how much it was increasing. By the time the cover-everything insurance became too expensive for employers to provide and they started rolling back on coverage, it was far out of reach to most of their employees.

    The second factor, of course, is the skyrocketing costs of malpractice insurance, due to the litigious nature of modern culture.

    Slather this all with a heavy glaze of profit for everyone who’s involved at nearly every level of healthcare and medical management, and the whole system is a quite unwieldy beast.

    Problem is, there’s no easy answer. Government manages to muck up nearly everything it touches, by adding about sixteen layers of bureaucracy and putting thirty more people on the payroll than necessary for any given task.A capitalistic system will continute to grow until it collapses upon itself. I think there are even harder times ahead, but that things will eventually get better. I’m just not at all convinced that there are any reasonable proactive options to bring about the necessary changes.

    Ideally, routine checkups would be very affordable (about $20-$30 per annual visit), pharmaceuticals would be affordable again (a good start would be to ban advertising in anything but trade publications), and insurance to catch that one-in-a-hundred chance of someone having a major medical event in a given year would be affordable to the average worker. Doctors would be sheltered from frivilous lawsuits and proven cases of malpractice would result in reasonable monetary compensation (not $40M for a lost finger, in other words), and a permanent revocation of the doctor’s licensure.

    I’m afraid I won’t see much of the above in my lifetime, though.

  34. Robert, you know as well as I do that most people simply don’t earn enough money to save enough for retirement on their own. Social Security is an anti-poverty scheme, not a “ponzi scheme”. Pensions are becoming a thing of the past, and that’s not a good thing. I know the Cult of Hyperindividualism that you worship with advocates a strict Do-It-Yourself method, but the fact is that’s not workable for the majority of folks. There isn’t enough money left at the end of the month, and even if there is, all it takes is one medical emergency or one car breakdown to evaporate month, even years, of diligent saving. You’ll see…..when people start outliving what meager pittance is in their 401k’s.

    Feminists were the first people to bring up Social Security credit for homemakers, independent of their spouse. Why independent of the spouse? Because if a couple divorces, the ex-spouse is not entitled to benefits unless the marriage lasted at least ten years. That means that homemakers get thoroughly screwed in the event of divorce. They’ll never get those years back. Feminists were also the first to count up the dollar value that homemakers contribute to a household.

    I say, “pony up!” If homemakers were truly valued, they’d be getting SS credits for their years of work-in-the-home, instead of platitudes about how “important” their job is…..”important” enough to not cough up the funds they may need later…..bah.

  35. Robert, you know as well as I do that most people simply don’t earn enough money to save enough for retirement on their own.

    Nonsense.

  36. The radical feminists were critical of the limitations of wife and mother, but it was the liberals who glorified life in the boardroom. The marxists and radicals I remember from those days were just as disdainful of the alienated labor of the average wage slave.

  37. Weel, perhaps you can do the math for me then, Robert. I’ll give you a typical scenario in my neighborhood—divorced woman with two kids, high school education or maybe a year of community college. Works as a secretary, retail clerk, or waitress. Takes home $1500 a month after taxes.

    She pays $500 in rent (two bedroom apartment).
    She pays an average of $150 for natural gas (it’s cold in the Midwest).
    She pays an average of $75 for electricity, water, and sewer.
    She spends $500 on food and household sundries like toilet paper.
    She spends $40 on a cell phone, eschewing a land line (hope she’ll never need 911).
    She spends a frugal $100 on gasoline for her old beater car, a necessity for employment.

    Now, that leaves her with a whopping $135 left. She’s lucky, in that her kids are old enough to watch themselves after school, as long as no one from DCFS shows up (they’re both under thirteen), so no child care expenses. She’s thirty-four, and never saved for retirement before, because her husband didn’t think it was necessary….he had a pension. Well, he had a pension until the factory closed down, and after two years of un- or under-employment, meth and alcohol looked like the better way out to him, hence the divorce. They were renters, so she came away with about $2000 in savings. He had already drank up the rest.

    So, she started saving for retirement, ‘cuz she didn’t want to end up like the homeless elderly ladies in the neighborhood, pushing grocery carts down to the soup kitchen at lunch and dinner. According to this site, if she puts $45 of that $135 a month into a 401k, and she earns 5% interest, she’ll have a whopping $62591.60 to retire on, if she’s able to work another 35 years.

    Sure hope her car doesn’t break down, or any medical emergencies crop up. That’ll kill the 401k contribution for the month, for sure. (and remember Robert, she doesn’t have cable….even the cheapo poor-folks version!)

    Granted, she could go back to school, and get a better job. She probably will, too. Even so, it’s unlikely that she’ll have much more than $100,000 at retirement. Even with Social Security (which she can get at 67), she’ll still be skating on the edge of poverty. And that’s if she remains healthy enough to work continually until retirement—sure hope she doesn’t find a lump in her breast.

    Robert, I’m really not trying to be pissy here. This is the typical scenario in my neighborhood. Single mothers of two divorced from alcoholic husbands (who for the most part, don’t work, and seldom cough up a child support payment). They don’t have college degrees and have a hard time finding a job that pays more than nine bucks an hour. Meanwhile, this is what the poverty line is where I live for one parent with two children. My “typical example” mom is making half that….but like I said, she’s lucky, ‘cuz her kids (let’s say, ages eight and ten) are old enough to be “latchkey” kids, if DCFS doesn’t find out.

    The best case scenario for this woman? That she applies, and gets into, an apprenticeship in the trades. As bad off as the trades have been over the past couple of years, we’ve done better than most of the white-collar world, which has been decimated by layoffs. Welcome to the Rust Belt.

  38. Robert, you know as well as I do that most people simply don’t earn enough money to save enough for retirement on their own.

    Nonsense.

    Being… crushed… by weight… of evidence! Cannot resist.. being persuaded…

  39. Hmmm.

    She pays $500 in rent (two bedroom apartment).
    Seems a bit high, but let’s assume it’s reasonably roomy and/or in a desirable location.

    She pays an average of $150 for natural gas (it’s cold in the Midwest).
    Okay, but that money’s not spent in warmer months (and the electric bill for a/c isn’t going to be nearly that much).

    She pays an average of $75 for electricity, water, and sewer.
    Okay.

    She spends $500 on food and household sundries like toilet paper.
    A month? For one adult and two kids? Jesus H. $350 would be reasonable.

    She spends $40 on a cell phone, eschewing a land line (hope she’ll never need 911).
    Land line would be $25 or so.

    She spends a frugal $100 on gasoline for her old beater car, a necessity for employment.
    Unless the old beater gets better than 30mpg, “frugal” has no business being in that sentence.

  40. One sentence: move to a larger apartment and get a roommate.

    Assuming that the 3-bedroom model moves the rent from $500 to $700, that frees up $150 from rent and $112.50 on utilities. Swallow her pride and hit the soup kitchen once a week, and cut that grocery bill down to $400 – eminently reasonable, as I’m paying less than that now for two adults and a toddler. That’s a total of $362.50 carved out of her budget, on top of the $45 you found for her, she’s got $407.50 a month. She and the roommate can split the basic cable, and now she can squirrel $400 a month away while improving her standard of living.

    Comes out to $465K at retirement, even with your dreadful five percent return. Not the French Riviera, but it’ll give her an annuity income of 30 or 40 grand, even after Social Security goes into default.

  41. pharmaceuticals would be affordable again (a good start would be to ban advertising in anything but trade publications),

    I am definitely in your amen corner here; medicine isn’t to be taken lightly, and choices on which or if to take medication shouldn’t be based on slick ads.

    I’m not as optimistic as you are about the field though; I’m inclined to believe that private bureaucracy is at least as effed up as government bureaucracy. My mother was a federal employee (VA nurse), so I grew up hearing about the horrors of government medical decisions; by the same token, my own experience, and the experience of many union brothers and sisters in our own self-funded plan are just as bad.

    I’m also not convinced that the high cost of malpractice insurance is actually related to actual malpractice cases. Here in Illinois, insurance rates for physicians skyrocketed even as claims, and even cases filed, went down! I think there’s plenty of good-old-fashioned crookedness to go around. Meanwhile, when my daughter had her first surgery, it was by a physician who had already lost privileges at one of the hospitals in the city, due to his drug problem. I did not know this at the time my daughter needed surgery; he came highly recommended from her neonatologist. He seemed like a nice guy.

    A couple months later, after she came home from the hospital, he made the front page of the paper for killing two infants and almost killing a third. I wondered if the reason my daughter wasn’t gaining weight was related to his surgery (one of the infants he killed, it was because he removed the entire bowel). I wondered if he didn’t lie about how much intestine she had removed.

    Well, he did lie. I was told “two centimeters”, the reality according to the records was around a foot. Yet I didn’t sue. Why? Well, because with all my daughter’s complications it would have been hard to prove that that was the reason she wasn’t gaining weight. That, and I had enough on my plate—I wanted all my focus to go towards getting her healthy, and it was damn hard enough to do that. I didn’t want precious time with my daughter spent in lawyer’s offices. I needed that time to take her to therapy (which she had four times a week).

    But see, it never would have been an issue at all, if I had had access to his records. If I had known that he had hospital privileges revoked, if I had known that he had had a drug intervention done while he was still a medical school resident, I never would have allowed him near my daughter, let alone with a scalpel. But here in Illinois, we (the patients) don’t have access to those types of records. I have to pass a urine test to go to work, but surgeons don’t. Criminy, don’t get me started….

    See, most people don’t sue. There’s a handful of sue-happy folks with multiple lawsuits under their belts, and then there’s the worst-case scenarios, like the mother who got to hold her infant daughter while she dies in her arms, unable to live without her bowel. I met that mother later on, and yes, she sued. For an undisclosed sum, with a gag-order attached.

    There’s a lot that needs to be changed here Bo, but I don’t have much faith in the private sector to solve these problems. The AMA is the private sector, and they protect their own. There’s definitely a “white wall of silence” in the medical world. There needs to be more transparency to the public.

    It’s late, and I’m tired. I’m angry, and I’m frustrated. And my stoic mother isn’t trying to show how much pain she’s in; she’s just drinking more often. And she’s never done that before. The cancer in her bones is going deeper than just the “bad arthritis” pain she talked of before. I can tell by how quickly bottles get emptied around here. And I’m going to have to get loaded for bear again, and argue with another insurance company. And it shouldn’t have to be like this. I’m going to be running on this daughter track, and losing my breath again.

  42. Your scenario, Robert, makes no allowences for any sort of emergencies or unforseeable expenses. Did you fail to take this into account, or are we just going to hope our hypothetical person is very, very lucky? (That probably looks sarcastic, but it’s not.)

  43. I worked under the premises established by La Lubu, Joe.

    Sure, there will undoubtedly be emergencies.

    I also assume that this person will improve their economic status over the 35 year run of our simulation. For one thing, her kids will move out and her expenses can drop by 2/3.

  44. I also assume that this person will improve their economic status over the 35 year run of our simulation.

    This can also be a problem. The market can shiv you in the back. As a Michigander, seeing people being thrust down the socioeconomic ladder is a sight I’m very familiar with.

  45. The market “shivs” people who didn’t prepare for life. That can be infuriating or tragic, but it isn’t, or oughtn’t be, normative.

  46. David, follow the link.

    In my city, $500 is what apartments cost in the “iffy” neighborhoods like mine—the neighborhoods where there’s a relatively low incidence of gang violence, but a high incidence of home burglaries.

    The $150 is the monthly average of natural gas. Higher in the winter, lower in the summer. Her apartment is in an older building.

    The $500 is not just food, but other household necessities like dish soap, hand soap, shampoo, toothpaste, aspirin, Pepto-Bismol, toilet paper, school notebooks/supplies, socks and underwear (all the other clothing, including coats and shoes, comes from charity), tampons and pads, laundry detergent, aluminum foil, coffee filters, sponges, furniture polish. etc. It’s a reasonable amount.

    Beggars can’t be choosers. Poor people don’t get to choose which car to drive. Regardless of the mileage, she needs a car, as there is no evening or Sunday bus service in town. Carless=jobless around here. And a one-way cab fare from my neighborhood to the retail jobs on the West side is $20. The $100 means she only uses the car for work; no road trips.

    Having a cell phone means the school can reach her when she is at work; you are required to pick your children up immediately if they get sick. Having a cell phone means if her beater breaks down on the road she can call a friend to pick her up…..her kids might worry if she had to walk five miles to get home (the time factor). Having a cell phone means you can call the police if the ex breaks in; if a land line was your only access, the ex would have already cut the line. A cell is her better bet, even though here, it’s ten dollars cheaper to have a land line (my land line is a little over thirty, and I don’t use it for long distance).

    Robert, it’s pretty impossible for a person with children to find a childless roommate. Even so, a roommate brings tremendous risk. Unless you’ve known and trusted your roommate your entire life, you’d be better off not risking having a roommate around kids. Number one, if your roommate gets busted with drugs, so do you. Which means your kids get put in foster care, while you fight a jail term—-and lose your job, even if found innocent. Not a risk worth taking. Straight-and-narrow types don’t want to “roommie” with kids. Unless they have kids, which kills the savings factor (although it could help in other ways). Also, what if “roommie” doens’t cough up his/her share of the rent and utilities? Added expense, not added savings. Ixnay on the oommieray.

    I’m not assuming that she puts every single possible dime away for savings, because that’s not workable. Unexpected expenses come up. Like needing new shoes and not finding your size in the St. Martin de Porres Center. Kid with an ear infection. Or expected occasional expenses, like oil changes for the beater (she does them herself), or birthday cakes for the kids.

    I’m saying, that even if she goes back to school and gets a better job (which she in all likelihood will), there is still going to be a significant lag time in her ability to save a significant amount towards retirement. Like, when she earns more money, the first thing she’ll want to do is buy a house to lower her living expenses (my three-bedroom Craftsman is $318 monthly) and build equity. Equity she can send her kids to college with, because she doesn’t want them sharing her fate.

    She’ll buy a reliable car. More importantly, she’ll have insurance on the car again for the first time in years! She’ll buy her own clothes, and her kids own clothes. She’ll get health insurance in her new job (even though she has to pay for it); something she didn’t have in the old one. She’ll buy birthday presents for her kids, and maybe send them to karate class, or guitar lessons—they’ve been begging for years. She’ll buy furniture for her house. She’ll pay down her student loans that got her the education to get the better-paying job.

    And then she’ll start saving significantly. But by then, she’ll be about forty. She’ll have twenty years to build up her savings—provided she doesn’t get ill or disabled. Not long enough to build up a retirement healthy enough to carry her through. See, I’m assuming a certain amount of health problems as she ages, even though she eats right and doesn’t smoke. The odds are not with you as you age. Medicine is expensive. She is also going to send her kids to college, which is an added expense for her.

    Point being? She needs a safety net. Pensions and Social Security were to be two legs of that safety net, along with savings. Back in the day, people recognized that the lion’s share of us simply don’t earn enough on our own to fund our own retirement. Pensions and Social Security were there to take up the slack and spread the risk.

  47. Tanooki Joe, I’m assuming the rosiest possible scenario for “typical mom”, in that:

    1. Neither she nor her kids have any major medical difficulties; no hospital visits, no chronic conditions, no broken bones, no stitches. No dental problems, no orthodontic needs, and perfect vision (no glasses).

    2. Typical mom resists advice to “find a man”, and puts forth effort to get an education instead. In her current socioeconomic condition, the men she is likely to meet will place obstacles in her way when it comes to education; I and every woman I know who’s been poor has had vicious, knock-down, drag-out fights over our studies, and we’ve all had to dig our textbooks out of garbage cans. No kidding.

    3. She is able to double her income over the course of six years, by getting a degree and a raise. This will put her over the poverty line. Some of that “extra” money she will invest; some of it she will use to take her children on their first-ever vacation, among other things.

    4. Housing costs stay low in this area; a combination of the market continuing to drag ass and the relatively low wages (in comparison with more fashionable areas of the country).

    I’m also assuming that she is frugal but not ascetic; her asceticism in the early years is purely one of lack of choice. When she has choice, she will remain frugal but occasionally splurge on luxuries, like a magazine or book. People need to have their rewards for working, otherwise why bother?

  48. Back in the day, people recognized that the lion’s share of us simply don’t earn enough on our own to fund our own retirement.

    But if you gang up on somebody who has more money, then you can make them give you some! Good plan.

  49. Well, we can’t all be robber barons.

    I’m also not convinced that the high cost of malpractice insurance is actually related to actual malpractice cases.

    It’s not. I won’t even pretend that these links are from a neutral source:

    http://www.atla.org/pressroom/FACTS/medmal/inslobyadmit.aspx

    http://www.atla.org/pressroom/FACTS/health/Research/healthaffairs2005.aspx

    but they refer to an actual, non-lawyer-affiliated study, the abstract of which is here:

    http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.240

    People insist that anything they don’t like (litigation, teen pregnancy, drug use, rudeness) is “skyrocketing” without checking the numbers.

  50. LaLubu,

    It’s not the grand total of malpractice awards that cause the malpractice insurance rates to climb, it’s the threat of huge rewards that allow the malpractice insurance underwriters to keep escalating prices. Every time the government refuses to look at realistic reforms in tort law, they’re given another excuse to rase rates–in reality reacting to the “what if” scenario.

    Your story illustrates exactly why I’m all for license revocation for incompetent doctors. Huge malpractice awards gain a lot of money for the lawyers involved, a little money for the plantiffs, and one more excuse for the insurance industry to crank up those rates.

    The crux of the malpractice issue: if a doctor, through negligence or incompetence, causes the death or disability of me or a loved one, he needs to not ever have the opportunity to do such again. There is room for some monetary damages, but nobody deserves to get rich off of the death or disability of a loved one.

    myathago, the studies to which you link illustrate just what I’m saying: that the insurance companies are insuring against potential judgements, not the actual judgements that are handed out. As it stands, regardless of how slim the statistical possibility is that doctor “A” will be sued, he’s forced to carry insurance that essentially has no top limit on payout, in order to protect his private assets. Otherwise, he may be holding a malpractice policy that covers $5M when a judgement is handed down for $30M. I live in the poorest state in the Union, and I can take anyone interested on a 2-hour tour of my immediate area and point out well over a dozen homes built off of various lawsuit money, most from medical settlements. These are homes in the $200K range, in an area where most homes are built for less than $75K. Guess who ultimately foots the bill on this extravagance?

  51. But if you gang up on somebody who has more money, then you can make them give you some! Good plan.

    Ahh, but Robert, why do they have more money? Read Shapiro’s “The Hidden Cost of Being African-American”. Don’t worry, it’s fully applicable to white folks too. It basically draws out the reasons for why “the rich get richer, the poor get poorer”.

    Hint: it damn sure has nothing to do about how hard a person works, or how much they sacrifice to attain their goals.

  52. If the rich are getting richer while the poor are getting poorer, La Lubu, then logic would dictate (among other things) that the bottom quintile of today would live worse than the bottom quintile of the previous generation, and so on backwards for the duration of the validity of the aphorism.

    Is this the case? Is the poor man of 2005 living worse than the poor woman of 1980, is living worse than the poor of 1955, is worse off than the poor of 1930?

  53. Every time the government refuses to look at realistic reforms in tort law, they’re given another excuse to rase rates

    Insurance companies raise rates even when the goverment imposes malpractice caps. (Which are not ‘reasonable reform’, anyway. Reform is requiring good science in the courtroom.)

    I live in the poorest state in the Union, and I can take anyone interested on a 2-hour tour of my immediate area and point out well over a dozen homes built off of various lawsuit money, most from medical settlements

    And what led to those medical settlements? As you say, incompetent doctors don’t get their licences yanked. The people living in those homes did not win them in a lottery. Would you trade your eyesight, or your wife’s ability to ever have children, or your child’s being in a wheelchair for life, for a new house?

    Malpractice lawyers work on contingency fees, which are essentially comissions. They don’t get money unless they win, which means they get a percentage (not “most”) if they win and zip if they lose. Just FYI, as long as you’re going around and looking at houses, check the real estate of lawyers who do malpractice defense. I assure you they’re not living in shacks.

    Bluntly, doctors and lawyers get along like cats and dogs, so it’s very easy for med-mal insurers to tell their doctor clients “We don’t really want to take all your money, but the bad lawyers made us do it”–and the doctors happily swallow it.

  54. And what led to those medical settlements?

    Insurance companies who don’t want the trouble, risk, or expense of a full trial. Even with a relatively weak case, a $20M lawsuit settled for $200K is hard for an insurance company to pass up, again responding to the potential, rather than the actual.

    The people living in those homes did not win them in a lottery.

    They’re living (and bragging) like they did.

    Would you trade your eyesight, or your wife’s ability to ever have children, or your child’s being in a wheelchair for life, for a new house?

    No, but I don’t think I’m entitled to a new house for any of those reasons. The money doesn’t fix anything, and I didn’t do anything to deserve it. I would much rather know the doctor responsible will never again practice medicine, have my court costs covered, such that it didn’t cost me more to hold him legally accountable.

    Agreed that good science in the courtroom is necessary, but many cases don’t make it there. Why? The risk of a monumental loss is greater than an insurance company is willing to take, given a better offer in settlement (I know I’m repeating myself). If you take the mega-judgement threat off the table, malpractice suits are more likely to go to trial, and the facts of the case brought out, whether exonerating or condemning the physician in question. That seems better for both sides, IMHO.

    Now to the point of attorneys collecting “most” of the award money: Monies awarded to a plantiff for punitive damages or compensation for lost wages or lost profits are all subject to federal income taxes as ordinary income. This drives most people in a sizeable award to a tax bracket of 33% to 35% (for an award upwards of $100K ). This amount must be paid on the entire settlement amount, as personal legal fees are not deductible. The attorney typically takes about 33%-40% of the awarded amount as his compensation, so strictly speaking, the attorney may only take a third of the total, but that’s typically more than half of the amount left after the federal income taxes are paid. Bottom line, between the plantiff and the attorney, the attorney gets more, and likely has a better way to shelter his income than the plantiff who went to a consignment-based personal injury attorney.

    For instance:
    $300,000 settlement/award
    $105,000 federal income tax (if more than $20K other income)
    $120,000 attorney fees (40%)
    $ 75,000 left to plantiff, before deduction of state income taxes

    The two entities deriving the most benefit from the current tort system are the government and attorneys. Might explain the number of attorneys in political office, but it certainly explains why it’s not likely to be meaningfully changed.

  55. Robert, the poor of 2005 are unquestionably worse off than the poor of 1950. Why? Well, cost of living compared to wages, for one thing. Please don’t try and tell me that the poor of today are better off because iPods exist, like you claimed over at Amp’s place.

    When the minimum wage was instituted, it was designed to pay for the basics a family needed. Now, the minimum wage pays for about a fourth of what a family of three needs to get by. Yes, I’d say a poor person of 1950 that could pay the rent for their basement tenement apartment and still be able to buy food is far better off than that same person is today, who cannot pay for both food and housing, simultaneously.

    In the Fifties, and even the Sixties, it was possible to find an employer willing to hire you even if you didn’t have a phone. It was possible to find an employer willing to hire you even if you didn’t have a car—outside of Chicago, New York, and a few other metro areas, just try getting hired, even to clean toilets, if you don’t have a car.

    Our times are more materialistic. So the poor of today have cheap tv’s…..big deal. TV’s can be picked up for $5 at a garage sale. There used to be a saying, back in the day….”poor but honest”. Now, the general consensus is that if you’re poor, you’re a schmuck. If you’re honest, you’re a schmuck. And if you don’t have a certain level of material possession, just try getting hired—in order to lift yourself up. Catch 22.

    Oh, and the cost of education relative to wages has been going up too. There’s fewer ways out. The lousy economy of, well, most of my life, means that most people live far away from relatives or old friends who could trade babysitting, or share gas money,or other money saving strategies common to my grandmother’s era. It takes a long time to re-create those kinds of relationships (and after you do, it’s common for one or the other party to move yet again, in order to find work). We weren’t as nomadic in the Fifties. We don’t have a choice about it.

    “Poor but honest”. Think about it, Robert. Go talk to some elders. Poor people are more hated now, and that makes a difference in one’s ability to overcome poverty. Poor people are less likely to be given a chance than back in my grandmother’s day. Poor people don’t eat as well, because their wages don’t go as far. Public transportation is rare in most areas of the U.S. today, while it was incredibly common in my grandmother’s day, when even small cities had streetcars and the railroad carried passengers from small towns to nearby small cities. That was a big money saver.

    Our grandparents have pensions, even if small. Our children will not. Our grandparents had steady jobs. We don’t.

    Fuck iPods. Fuck TV. Books are more expensive now (relative to wages). I think that sucks. I watch very little TV, but read like a fiend. I want cheaper books, and more expensive TV!

    The poor are worse off. CEOs are not.

  56. Yes, I’d say a poor person of 1950 that could pay the rent for their basement tenement apartment and still be able to buy food is far better off than that same person is today, who cannot pay for both food and housing, simultaneously.

    Which is why you see so many starving homeless people with jobs.

    You’re comparing situations, rather than individuals. Yeah, someone who can pay rent and buy food is better off than someone who can’t, regardless of time period. The question is whether that’s the same guy. The person earning the minimum wage in 1960 does not have the same level of education, job skills, and other social capital as the person at minimum wage in 2005.

    Comparing bottom-quintile households from 1950 to 2005, it is very clear that the trend is one of steady improvement. You are welcome to believe that access to cheaper and better transportation, information, music, etc. have no value, but that is counterfactual.

    Oh, and the cost of education relative to wages has been going up too

    And yet the proportion of people who get an education continues to climb – because the absolute cost of something, and its availability, are not the same thing. Yeah, it costs more to go to State than it did in 1950. And twenty million people get subsidies to do it, versus zero back then.

    Fuck iPods. Fuck TV. Books are more expensive now (relative to wages).

    Yeah, and that’s too bad. It’s also one of the few areas of consumer goods that have not become cheaper or held around the same – mainly because books have become the purview of a minority, as TV has exploded. Boutique goods cost more than mass market goods.

    The poor are worse off. CEOs are not.

    It is telling that you have to mention what’s happening at the other end of the spectrum. We’re talking about whether Joe is better off now than he was yesterday; what’s happened to Frank is immaterial to that discussion.

  57. And yet the proportion of people who get an education continues to climb – because the absolute cost of something, and its availability, are not the same thing. Yeah, it costs more to go to State than it did in 1950. And twenty million people get subsidies to do it, versus zero back then.

    I’d be curious to see a graphic on that relationship. If the subsidies are grants (i.e. free money) its a different story than if they are subsidized loans, which leave the student in a comparable position to the earlier generation. Meaning, does the person with eighty grand in debt and a poli sci degree today have the same economic power as a high school grad a generation ago.

  58. Yeah, it costs more to go to State than it did in 1950. And twenty million people get subsidies to do it, versus zero back then.

    You’re forgetting about the G.I. Bill, Robert. And when you’re discussing the history of educational subsidies in the U.S., that’s a pretty massive thing to forget.

    I’m not sure that it matters whether things have got better or worse since 1950, since it was pretty miserable to be poor and elderly in 1950. What’s changed in a big way, I think, is that people are living longer and probably spending more of their lives needing a lot of care. As a society, we’re going to have to figure out some way to deal with that, because most families don’t have someone who can quit their job and provide unpaid care for all the elderly relatives.

  59. I’m not forgetting about the GI Bill, Sally; it existed then, it exists now, so it’s a wash. However, you’re right that I shouldn’t have listed its impact as zero back then.

    Binky, those are good questions, and outside the scope of proving them in a brief comment.

  60. I’ve been looking for some simple measures, and here’s one that is indicative of what I am talking about. This is a Census bureau graph indicating the trends in total impoverished population, and the poverty rate, from 1959 to 2004.

    In 1959, there were about 40 million people considered poor. In 2004, 37 million, a slight decrease – as the population of the country has doubled.

    In 1959, the rate of families in poverty was around 23%. Today, about half that, at 12.7%.

    What that means for our discussion is this: in 1959, the bottom quintile of American households were almost entirely poor – only a couple percentage points had their heads above water. In 2004, only half of the bottom quintile are in poverty.

  61. a $20M lawsuit settled for $200K is hard for an insurance company to pass up

    A plaintiff’s lawyer who really thinks the lawsuit is worth $20 million is not going to settle for $200K, no matter how much the insurance company wants to. And really, there just aren’t that many $20 million lawsuits. They make great headlines. (Those headlines also convince people that perfectly reasonable settlements are a rip-off. Heck, they read in the paper that people make tons of money, so how can you be telling them that Dr. Moneybags’s offer of $100,000 is fair?)

    The attorney typically takes about 33%-40% of the awarded amount as his compensation, so strictly speaking, the attorney may only take a third of the total, but that’s typically more than half of the amount left after the federal income taxes are paid

    Which is gross income, subject to taxation, and spread over the entire time the case was pending. ($100K sounds great until you spread it out over three years or so.) You’re really arguing that attorneys take less of a tax hit than plaintiffs do. It’s misleading to paint that as the attorney getting “most of the money”. I assume you know that a standard tactic of defense attorneys is to delay and to file frivolous paperwork, because it bleeds the plaintiff’s side and they bill by the hour.

    The only yardstick and recompense is money. You don’t settle for a plaintiff to get his eyes back, or for Grandpa to be able to live two more years; you settle for money. I don’t understand why you’re chastising people for spending money on a house. Getting an award for pain and suffering, or for loss of companionship, is not something you can use to go into the Wayback Machine and make the pain never have happened. If people spend it on a house, who cares?

    The tort system is the worst system for remedying malpractice, except for all the others.

  62. Jill, radical feminists have said that, on several occasions, and in several ways, that being a housewife/mom is not something to be valued. (hope a long blockquote works)

    Oh, for fuck’s sake.

    Dude. Read the source material, not some cherry-picking horror-file, or don’t comment.

  63. She pays $500 in rent (two bedroom apartment).
    Seems a bit high, but let’s assume it’s reasonably roomy and/or in a desirable location.

    Is this a joke? Two-bedroom apartments in my area cost three to four times as much. That’s the price in a “desirable location.” Five hundred a month would be reasonable, if not suspiciously low, virtually anywhere in this country.

  64. She pays $500 in rent (two bedroom apartment).
    Seems a bit high, but let’s assume it’s reasonably roomy and/or in a desirable location.

    You’re kidding me, right? In my neck of the woods, $500 won’t even get you a studio apartment. A two-bedroom place will cost $1,000, and that’s if it’s out in the boondocks, away from any decent public transportation and/or access to main highways. In a suburb or a dodgy section of the city, the rent for a two bedroom will go up to $1200 a month, easily. And that can go up to $1,600-$2,200 per month depending on where the place is and how tricked out it is. $1,000 will get you–at the very best–an old place with some code violations in a remote location.

    $500? Please. Even fifteen years ago, you coulnd’t get a two bedroom in this area for $500.

  65. No folks, in my neighborhood (central Illinois–rust belt), you can get a two-bedroom for $500. I know that’s hard for folks on the coast to believe—but you see, here, that $500 is more than what many homeowners are paying on their mortgage.

    I have a two-story, three-bedroom Craftsman-style home, with hardwood floors throughout, a full (unfinished) basement, brick fireplace, back deck, two car garage (unattached), and I’m paying $318 a month for it.

    Here, that $500 is a big chuck of change. The average yearly income in my neighborhood is less than $25,000. Our housing costs are lower, but so is our pay.

  66. You are welcome to believe that access to cheaper and better transportation, information, music, etc. have no value, but that is counterfactual.

    Robert, I specifically said that access to cheaper, more reliable transportation was more prevalent in the Fifties, since streetcars and Interurban rail between small cities and neighboring small towns was ubiquitous. Now, a car is your only alternative, and it is far more expensive to own a car than to hop an Interurban rail carvfrom a small town of 1500 to the neighboring larger one where you work. Interurbans were once the lifeblood of small towns—cheap too, since they operated on already-existing rail lines.

    And there are plenty of working homeless. Been to a food pantry lately? Food pantries around here hand out tight rations because the need is so great. There’s not much to go around. There’s a lot of really struggling people out here; unemployment is high and underemployment is even higher.

    Get out of the house sometime, for crying out loud.

  67. No folks, in my neighborhood (central Illinois–rust belt), you can get a two-bedroom for $500. I know that’s hard for folks on the coast to believe—but you see, here, that $500 is more than what many homeowners are paying on their mortgage.

    I have a two-story, three-bedroom Craftsman-style home, with hardwood floors throughout, a full (unfinished) basement, brick fireplace, back deck, two car garage (unattached), and I’m paying $318 a month for it.

    Here, that $500 is a big chuck of change. The average yearly income in my neighborhood is less than $25,000. Our housing costs are lower, but so is our pay.

    Oh, I’ll believe that it’s a going rate in some parts of the country, and that it might be possible to get a 2br for less in some parts. I know that $1500/studio isn’t at all representative. But too high an estimate, when in many places it’d be a godsend? Especially given that, the lower the housing costs, the fewer economic opportunities there tend to be? Um, no.

  68. Agreed. That’s the problem here—few economic opportunities. If you earn $15 an hour or more, most people here will consider you as making “big bucks”. As a tradeswoman, I’m considered wealthy by my neighbors, because in comparison, I am. Yet most middle class people consider me to be skating above the edge of poverty.

    That’s what I tried to present in the example—the perspective. When you can’t afford what you need, you’re poor, no matter the dollar value. In my example, the woman has a car. Yet, she doesn’t have car insurance (or health insurance). Robert thinks she ought to be saving every little bit toward her retirement—no “frills” like birthday presents for the kids or new shoes. Yet, even if she did that, just one car accident without insurance would take away all her savings—the court would make her liquidate.

    Yet, if she has no savings, she can get off with paying a fine and having her license suspended. The court won’t make her and her kids take their new shoes back to the store, or sell off all their furniture. Poor people tend to put money into the items that will make their lives easier right now. But it’s hard to explain that to a middle class person who has never had to make a choice between paying for insurance or buying winter coats for the family. The middle class person would say, “buy car insurance! what happens if you get into a wreck?!” But if you don’t have a winter coat, you will be cold every day—and you may never get into a wreck.

  69. Well here’s the thing–a lot of people where I live make $25K-$30K a year but still have skyrocketing housing costs to contend with. So they may make marginally more than than folks in the rust belt, but it’s not enough to cover the difference in housing costs. A 2 BR place where I live would cost twice that–likely three times that. Which fucks over the working class and working poor–and then you’ve got people who work but who are homeless.

    You already know all this, Lubu. I don’t have your patience. I get sick to the teeth of having to explain basic fucking economics to people who think poverty is a cakewalk and no big deal.

  70. Well here’s the thing–a lot of people where I live make $25K-$30K a year but still have skyrocketing housing costs to contend with. So they may make marginally more than than folks in the rust belt, but it’s not enough to cover the difference in housing costs.

    Yep. And one of the things I hear a lot is how much “easier” people in the South have it, because their cost of living is lower. It ain’t that low. There’s a few union brothers out of my Local working down in the areas Katrina hit, and they’re telling me their $19 an hour isn’t going very far, even without considering that this is just a temporary gig for them—they live on a little, and send a little back home. They have no intention of uprooting their families to move down there.

    That’s another thing the Roberts of this world don’t understand; why the advice to “move where the money is” is for the most part, unworkable. When you are poor, you are more reliant on friends and family than if you aren’t. Not so much to borrow money, because they likely don’t have any either! Naah, for the little things, like being able to get a ride to work when your car breaks down, or have someone pick your kids up at daycare if your boss says, “if you leave, don’t come back.” It is DAMN HARD to make non-family, non-childhood friend connections like that.

    I know. I’ve had to make them. My family moved a lot when I was a child, and when I was an adult (nineteen) I moved and stayed put—didn’t really intend to, it just worked out that way. And I learned something by doing that. I started paying attention to provincialism, and how it has an effect on job opportunities and job security. There are a few places in this country that aren’t very provincial, but even those places have their deep pockets of it, depending on one’s field of employment.

    This doesn’t just matter for you. This matters for your child, too. It bothered my father that he wasn’t able to help me get a job in high school, like his dad did for him. I went to school during the Reagan Depression, when there were no jobs—that was a factor. But some kids had ’em—the ones with connections. My father lived in the same small city his entire life, until he was eighteen. That made a difference. It made a difference for all of my parents brothers and sisters too—even though they all left, when economic times were tight and they had to “go back home again”—for a while—having that network of people who were willing to help them get a job, or let them know where the unadvertised child care was, made a crucial difference.

    That’s a large part of why I stay where I am. Culturally, I’d be better off where you are, Sheelzebub (Chi-town, right?). But I’ve managed to get to a point here Downstate, where I’m finally recognized as a long-termer (hey, fewer people are asking me “where are you from?”, a question that I don’t know how to answer, because I’m not “from” anywhere in the sense that they are). I’ve put down a certain amount of roots, and it’s hard to start over. And I’m a pretty sociable, outgoing type. It’s still hard. There’s a time factor to building a close relationship with folks you aren’t related to by blood (or by having grown up together).

    Why is it that middle-class people recognize the value of “networks” when it comes to getting ahead in the corporate world (at least, judging from the line of books about it in the “management” section of the bookstore), yet don’t think that networks make a critical difference in the lives of people who aren’t corporate players? No, we can’t all “move where the money is”, given that if we did, the money wouldn’t be there anymore. I’m saying that we can’t, because we’re giving up other advantages if we do—long-term advantages that are difficult or unlikely to be replaced.

  71. Now to the point of attorneys collecting “most” of the award money: Monies awarded to a plantiff for punitive damages or compensation for lost wages or lost profits are all subject to federal income taxes as ordinary income. This drives most people in a sizeable award to a tax bracket of 33% to 35% (for an award upwards of $100K ). This amount must be paid on the entire settlement amount, as personal legal fees are not deductible. The attorney typically takes about 33%-40% of the awarded amount as his compensation, so strictly speaking, the attorney may only take a third of the total, but that’s typically more than half of the amount left after the federal income taxes are paid. Bottom line, between the plantiff and the attorney, the attorney gets more, and likely has a better way to shelter his income than the plantiff who went to a consignment-based personal injury attorney.

    Oh, Bo. You’re being disingenuous.

    We’re talking med mal here. Pain and suffering and medical expense awards are not taxable. And that’s going to be the vast bulk of the damages in a med mal case, certainly if there’s a settlement and the plaintiff’s attorney is any good.

    If the award comes after a jury trial, and there are significant punitive damages, it’s pretty durned likely that money’s going to be a cold comfort.

  72. Lubu, on networking you are absolutely right. I have a friend that left her social network here to try and get into a school out in the Northwest at in-state tuition rates. Without her network of people that helped her with her daughter, she couldn’t last the year it took. Jobs weren’t scarce, but apparently you had to be “in the know” to get a decent one. She got an apartment just fine, but without a decently paying job couldn’t afford it, and that was with a roommate. Finally she moved back to Indiana and was forced to live with her parents until she could get back on her feet.

    The most difficult thing, she said, was her inability to find decent care for her daughter. In Indiana, she relied on friends (like me) and family to help her out with childcare, especially since the only job she could work that got her good enough money to live while she went to school (straight A student, I should add) was as a bartender. And try finding decent care for a child when your hours are from 6pm to 4 am. When did she sleep? Hell if I know.

  73. I know I’m coming in late on this and the conversation as drifted quite a bit in the last few days, but as a woman in a marriage with decidedly “non-traditional” gender roles, there was one portion of the original post.

    while I hate to see things like caring for family become socially mandated for a group of people by simple virtue of their vagina-possession, the flip side is that it gives women the option of quitting their jobs or taking time off without too many people second-guessing them. I don’t think the same can be said for men. Imagine a 50-year-old man announcing in the boardroom that he’s quitting in order to care full-time for his elderly parents.

    One the the most consistent experiences my husband and I have had is receiving a rather consistent level of surprise, bordering on shock, from people when they first learn of our plan to have him be an SAHD after I finish school. This, in my experience, is one of the areas where the patriarchy works against men.

    Heaven forbid a man should be nurturing; heaven forbid a man should find his calling in devoting his life to making a home for his spouse and children; heaven forbid a man should be vocal in his commitment to care for his parents and his in-laws full-time once they are old enough to need that care.

    All of these things are deemed proper, even expected from a woman, but when a man chooses that path, when a man expresses his truest self through the role traditionally considered house-wifely, his masculinity is challenged, or worse, people accuse him of all sorts of perversion. The assumption is that if you are male and a good homemaker, you can’t possibly be fully male. The assumption is that if you are male and good with children, you must be a pedophile.

    We, as a society, say that men need to be more active around the home, that they need to be willing to take on more responsibility for childrearing. But, at the same time, we punish men who devote their lives to these things.

    Quite a nice Catch-22 we’ve caught some gents in.

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