NEW YORK – Though they care for the sick, injured and elderly, thousands of home health aides here don’t have any health insurance themselves. They are among the almost 2 million New Yorkers who are uninsured. If they get sick, they have few choices: Ignore it, go to the emergency room, or fork out their own hard-earned money.

That last choice is a rough one for people who earn between $5.50 and $7 an hour (most closer to the lower figure), and who receive no sick pay.

A small example of just how miserly the industry is: one agency, Partners in Care, gave annual wage increases of a whopping 8 cents an hour over a 10-year period.

It is not uncommon to find salary caps at $7.50 an hour – which takes years on the job to reach. A few agencies do provide some health benefits, but there are minimum monthly hour requirements, and workers are rarely given enough cases to reach the minimum.

How can such a situation exist? Not surprisingly, it relates to the fundamental problem of health care in the U.S. It’s a money-making, profit-driven industry.

The way the home health aide system works is that Medicare funds are distributed to hospitals, nursing homes and companies like VNS Homecare. These companies, in turn, contract with local agencies. It is to their advantage to use as little of that money as possible on wages and benefits – because whatever is left they keep as profit.

Who are these home health workers? The vast majority are women, immigrants for the most part, from every corner of the globe, especially Latin America and the Caribbean, and with growing numbers of Asians and Eastern Europeans.

They leave their own families every day to care for others in their homes, a practice which, according to union officials, has been shown to be both better for the patient as well as less expensive than hospital or nursing home care.

Home health aides do everything from taking vital signs, giving medication, performing finger sticks, testing blood pressure, and bathing their “clients,” to cooking and cleaning for them – our parents and grandparents, neighbors, the city’s ill and elderly.

What can be done?

“We want to put pressure on the agencies to pay their fair share. We want to educate the public, and force some changes, including that there must be regulations and standards,” said 1199 SEIU Home Care Division Vice President Keith Joseph. “We are demanding a $10 an hour minimum by 2006, and we are demanding medical benefits. We want seven paid holidays, at time-and-a-half.”

In addition, the union is demanding bereavement days, sick time, and vacation time. And they want the agencies to pay into the jointly administered education fund so that members who want to go to school, improve their skills, or learn English, for example, can do so.

“The campaign is to bring every home health aide under one umbrella, and eliminate the employers’ ability to pit the workers against one another,” said Joseph. “We won’t accept the conditions these workers are working under any longer.”

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