• About the Book
• Table of Contents
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1

Introduction

Douglas Wolf

In this overview of the volume, Wolf outlines recent developments in long-term care policy and how research can help lead to a truly universal long-term care system in America.

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2

Long-Term Care and Long-Term Family Caregivers: Outdated Assumptions, Future Opportunities

Carol Levine

Blending insights from her personal life and policy analysis, Carol Levine asks: How can public policy best support long-term family care?

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3

The Rise and Fall of the Class Act: What Lessons Can We Learn?

Howard Gleckman

In an engaging history of the CLASS Act, Howard Gleckman examines why the landmark legislation failed and if it can be improved.

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4

The CLASS Promise in the Context of American Long-Term Care Policy

Robert Hudson

Robert Hudson looks at the history of long-term care policy in America and why the issue has remained only marginally acknowledged or addressed.

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5

Free Personal Care in Scotland, (Almost) 10 Years On

David Bell and Alison Bowes

After reviewing recent policy shifts in the United Kingdom, David Bell and Alison Bowes describe the costs and benefits of the provision of free personal care in Scotland.

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6

Population Aging and Long-Term Care: The Scandinavian Case

Svein Olav Daatland

Svein Olav Daatland analyzes the Scandinavian approach to long-term care, with a particular emphasis on the Norwegian model.

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7

Lessons on Long-Term Care from Germany and Japan

Mary Jo Gibson

Germany and Japan have both implemented mandatory social insurance programs to help provide long-term care. Mary Jo Gibson provides an in-depth analysis, along with possible lessons for American policymakers.

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8

The Long-Term Care Workforce: From Accidental to Valued Profession

Robyn Stone

In her overview of the formal, paid long-term care workforce, Robyn I. Stone discusses current challenges and potential solutions to increase supply and quality.

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9

The Perverse Public and Private Finances of Long-Term Care

Leonard Burman

How do Americans pay for long-term care? Leonard Burman explains the long-term care financing system, which he calls "dysfunctional."

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10

It Takes Two to Tango: A Perspective on Public and Private Coverage for Long-Term Care

David Stevenson, Marc A. Cohen, Brian Burwell, and Eileen J. Tell

David Stevenson, Marc A. Cohen, Brian Burwell and Eileen J. Tell look at the private long-term care insurance market and ask: Why don’t more Americans purchase such insurance?

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11

Long-Term Care Coverage for All: Getting There from Here

Nancy Folbre and Douglas Wolf

Editors Nancy Folbre and Douglas Wolf conclude the volume by discussing potential pathways to more comprehensive long-term care insurance.

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In 1999, one in four British children lived in poverty—the third highest child poverty rate among industrialized countries. Five years later, the child poverty rate in Britain had fallen by more than half in absolute terms. How did the British government accomplish this and what can the United States learn from the British experience? Jane Waldfogel offers a sharp analysis of the New Labour government’s anti-poverty agenda, its dramatic early success and eventual stalled progress. Comparing Britain’s anti-poverty initiative to U.S. welfare reform, the book shows how the policies of both countries have affected child poverty, living standards, and well-being in low-income families and suggests next steps for future reforms.

Britain’s War on Poverty evaluates the three-pronged anti-poverty strategy employed by the British government and what these efforts accomplished. British reforms sought to promote work and make work pay, to increase financial support for families with children, and to invest in the health, early-life development, and education of children. The latter two features set the British reforms apart from the work-oriented U.S. welfare reforms, which did not specifically target income or program supports for children. Plagued by premature initiatives and what some experts called an overly ambitious agenda, the British reforms fell short of their intended goal but nevertheless significantly increased single-parent employment, raised incomes for low-income families, and improved child outcomes. Poverty has fallen, and the pattern of low-income family expenditures on child enrichment and healthy food has begun to converge with higher-income families.

As Waldfogel sees it, further success in reducing child poverty in Britain will rely on understanding who is poor and who is at highest risk. More than half of poor children live in families where at least one parent is working, followed by unemployed single- and two-parent homes, respectively. Poverty rates are also notably higher for children with disabled parents, large families, and for Pakistani and Bangladeshi children. Based on these demographics, Waldfogel argues that future reforms must, among other goals, raise working-family incomes, provide more work for single parents, and better engage high-risk racial and ethnic minority groups.

What can the United States learn from the British example? Britain’s War on Poverty is a primer in the triumphs and pitfalls of protracted policy. Notable differences distinguish the British and U.S. models, but Waldfogel asserts that a future U.S. poverty agenda must specifically address child poverty and the income inequality that helps create it. By any measurement and despite obstacles, Britain has significantly reduced child poverty. The book’s key lesson is that it can be done.

JANE WALDFOGEL is professor of social work and public affairs at the Columbia University School of Social Work and visiting professor at the Centre for Analysis of Social Exclusion at the London School of Economics and Political Science.

The way Americans live and work has changed significantly since the creation of the Social Security Administration in 1935, but U.S. social welfare policy has failed to keep up with these changes. The model of the male breadwinner-led nuclear family has given way to diverse and often complex family structures, more women in the workplace, and nontraditional job arrangements. Old Assumptions, New Realities identifies the tensions between twentieth-century social policy and twenty-first-century realities for working Americans and offers promising new reforms for ensuring social and economic security.

Old Assumptions, New Realities focuses on policy solutions for today’s workers—particularly low-skilled workers and low-income families. Contributor Jacob Hacker makes strong and timely arguments for universal health insurance and universal 401(k) retirement accounts. Michael Stoll argues that job training and workforce development programs can mitigate the effects of declining wages caused by deindustrialization, technological changes, racial discrimination, and other forms of job displacement. Michael Sherraden maintains that wealth-building accounts for children—similar to state college savings plans—and universal and progressive savings accounts for workers can be invaluable strategies for all workers, including the poorest. Jody Heymann and Alison Earle underscore the potential for more extensive work-family policies to help the United States remain competitive in a globalized economy. Finally, Jodi Sandfort suggests that the United States can restructure the existing safety net via state-level reforms but only with a host of coordinated efforts, including better information to service providers, budget analyses, new funding sources, and oversight by intermediary service professionals.

Old Assumptions, New Realities picks up where current policies leave off by examining what’s not working, why, and how the safety net can be redesigned to work better. The book brings much-needed clarity to the process of creating viable policy solutions that benefit all working Americans.

ROBERT D. PLOTNICK is professor of public affairs and adjunct professor of economics at the University of Washington.

MARCIA K. MEYERS is associate professor of social work and public affairs at the University of Washington.

JENNIFER ROMICH is associate professor of social work at the University of Washington.

STEVEN RATHGEB SMITH is Nancy Bell Evans Professor of Public Affairs at the Daniel J. Evans School of Public Affairs, University of Washington.

A West Coast Poverty Center Volume

A Volume in the American Sociological Association’s Rose Series in Sociology

Winner of the 2012 Academy of Management's George R. Terry Book Award

Winner of the 2013 Inequality, Poverty, and Mobility Outstanding Book Award Presented by the American Sociological Association's Section on Inequality, Poverty, and Mobility

The economic boom of the 1990s veiled a grim reality: in addition to the growing gap between rich and poor, the gap between good and bad quality jobs was also expanding. The postwar prosperity of the mid-twentieth century had enabled millions of American workers to join the middle class, but as author Arne L. Kalleberg shows, by the 1970s this upward movement had slowed, in part due to the steady disappearance of secure, well-paying industrial jobs. Ever since, precarious employment has been on the rise—paying low wages, offering few benefits, and with virtually no long-term security. Today, the polarization between workers with higher skill levels and those with low skills and low wages is more entrenched than ever. Good Jobs, Bad Jobs traces this trend to large-scale transformations in the American labor market and the changing demographics of low-wage workers. Kalleberg draws on nearly four decades of survey data, as well as his own research, to evaluate trends in U.S. job quality and suggest ways to improve American labor market practices and social policies.

Good Jobs, Bad Jobs provides an insightful analysis of how and why precarious employment is gaining ground in the labor market and the role these developments have played in the decline of the middle class. Kalleberg shows that by the 1970s, government deregulation, global competition, and the rise of the service sector gained traction, while institutional protections for workers—such as unions and minimum-wage legislation—weakened. Together, these forces marked the end of postwar security for American workers. The composition of the labor force also changed significantly; the number of dual-earner families increased, as did the share of the workforce comprised of women, non-white, and immigrant workers. Of these groups, blacks, Latinos, and immigrants remain concentrated in the most precarious and low-quality jobs, with educational attainment being the leading indicator of who will earn the highest wages and experience the most job security and highest levels of autonomy and control over their jobs and schedules. Kalleberg demonstrates, however, that building a better safety net—increasing government responsibility for worker health care and retirement, as well as strengthening unions—can go a long way toward redressing the effects of today’s volatile labor market.

There is every reason to expect that the growth of precarious jobs—which already make up a significant share of the American job market—will continue. Good Jobs, Bad Jobs deftly shows that the decline in U.S. job quality is not the result of fluctuations in the business cycle, but rather the result of economic restructuring and the disappearance of institutional protections for workers. Only government, employers and labor working together on long-term strategies—including an expanded safety net, strengthened legal protections, and better training opportunities—can help reverse this trend.

ARNE L. KALLEBERG is Kenan Distinguished Professor of Sociology at the University of North Carolina at Chapel Hill.

During the middle third of the twentieth century, workers in most industrialized countries secured a substantial measure of job security, whether through legislation, contract or social practice. This “standard employment contract,” as it was known, became the foundation of an impressive array of rights and entitlements, including social insurance and pensions, protection against unsociable working conditions, and the right to bargain collectively. Recent changes in technology and the global economy, however, have dramatically eroded this traditional form of employment. Employers now value flexibility over stability, and increasingly hire employees for short-term or temporary work. Many countries have also repealed labor laws, relaxed employee protections, and reduced state-provided benefits. As the old system of worker protection declines, how can labor regulation be improved to protect workers? In Rethinking Workplace Regulation, nineteen leading scholars from ten countries and half a dozen disciplines present a sweeping tour of the latest policy experiments across the world that attempt to balance worker security and the new flexible employment paradigm.

Edited by noted socio-legal scholars Katherine V.W. Stone and Harry Arthurs, Rethinking Workplace Regulation presents case studies on new forms of dispute resolution, job training programs, social insurance and collective representation that could serve as policy models in the contemporary industrialized world. The volume leads with an intriguing set of essays on legal attempts to update the employment contract. For example, Bruno Caruso reports on efforts in the European Union to “constitutionalize” employment and other contracts to better preserve protective principles for workers and to extend their legal impact. The volume then turns to the field of labor relations, where promising regulatory strategies have emerged. Sociologist Jelle Visser offers a fresh assessment of the Dutch version of the ‘flexicurity’ model, which attempts to balance the rise in nonstandard employment with improved social protection by indexing the minimum wage and strengthening rights of access to health insurance, pensions, and training. Sociologist Ida Regalia provides an engaging account of experimental local and regional “pacts” in Italy and France that allow several employers to share temporary workers, thereby providing workers job security within the group rather than with an individual firm. The volume also illustrates the power of governments to influence labor market institutions. Legal scholars John Howe and Michael Rawling discuss Australia's innovative legislation on supply chains that holds companies at the top of the supply chain responsible for employment law violations of their subcontractors. Contributors also analyze ways in which more general social policy is being renegotiated in light of the changing nature of work. Kendra Strauss, a geographer, offers a wide-ranging comparative analysis of pension systems and calls for a new model that offers “flexible pensions for flexible workers.”

With its ambitious scope and broad inquiry, Rethinking Workplace Regulation illustrates the diverse innovations countries have developed to confront the policy challenges created by the changing nature of work. The experiments evaluated in this volume will provide inspiration and instruction for policymakers and advocates seeking to improve worker’s lives in this latest era of global capitalism.

KATHERINE V.W. STONE is Arjay and Frances Fearing Miller Professor of Law at University of California, Los Angeles.

HARRY ARTHURS is former Dean of Osgoode Hall Law School and University Professor Emeritus and President Emeritus of York University.

CONTRIBUTORS: Takashi Araki, Thomas Bredgaard, Cesar G. Canton,  Bruno Caruso,  Consuelo Chacartegui, Alexander J.S. Colvin,  Mark Freedland,  Morley Gunderson,  Thomas Haipeter, John Howe,  Robert Kuttner,  Julia Lopez,  Keisuke Nakamura,  Michio Nitta,  Anthony O'Donnell, Michael Rawling,  Ida Regalia, Kendra Strauss,  Julie C. Suk,  Jelle Visser. 

In the wake of the September 11 attacks, the U.S. government adopted a series of counterterrorism policies that radically altered the prevailing balance between civil liberties and security. These changes allowed for warrantless domestic surveillance, military commissions at Guantanamo Bay and even extralegal assassinations. Now, more than a decade after 9/11, these sharply contested measures appear poised to become lasting features of American government. What do Americans think about these policies? Where do they draw the line on what the government is allowed to do in the name of fighting terrorism? Drawing from a wealth of survey and experimental data, Whose Rights? explores the underlying sources of public attitudes toward the war on terror in a more detailed and comprehensive manner than has ever been attempted.

In an analysis that deftly deploys the tools of political science and psychology, Whose Rights? addresses a vexing puzzle: Why does the counterterrorism agenda persist even as 9/11 recedes in time and the threat from Al Qaeda wanes? Authors Clem Brooks and Jeff Manza provocatively argue that American opinion, despite traditionally showing strong support for civil liberties, exhibits a “dark side” that tolerates illiberal policies in the face of a threat. Surveillance of American citizens, heightened airport security, the Patriot Act and targeted assassinations enjoy broad support among Americans, and these preferences have remained largely stable over the past decade. There are, however, important variations: Waterboarding and torture receive notably low levels of support, and counterterrorism activities sanctioned by formal legislation, as opposed to covert operations, tend to draw more favor. To better evaluate these trends, Whose Rights? examines the concept of “threat-priming” and finds that getting people to think about the specter of terrorism bolsters anew their willingness to support coercive measures. A series of experimental surveys also yields fascinating insight into the impact of national identity cues. When respondents are primed to think that American citizens would be targeted by harsh counterterrorism policies, support declines significantly. On the other hand, groups such as Muslims, foreigners, and people of Middle Eastern background elicit particularly negative attitudes and increase support for counterterrorism measures. Under the right conditions, Brooks and Manza show, American support for counterterrorism activities can be propelled upward by simple reminders of past terrorism plots and communication about disliked external groups.

Whose Rights? convincingly argues that mass opinion plays a central role in the politics of contemporary counterterrorism policy. With their clarity and compelling evidence, Brooks and Manza offer much-needed insight into the policy responses to the defining conflict of our age and the psychological impact of terrorism.

CLEM BROOKS is professor of sociology at Indiana University, Bloomington.

JEFF MANZA is professor of sociology at New York University.

Due to continuing immigration and increasing racial and ethnic inclusiveness, higher education institutions in the United States are likely to grow ever more diverse in the 21st century. This shift holds both promise and peril: Increased inter-ethnic contact could lead to a more fruitful learning environment that encourages collaboration. On the other hand, social identity and on-campus diversity remain hotly contested issues that often raise intergroup tensions and inhibit discussion. How can we help diverse students learn from each other and gain the competencies they will need in an increasingly multicultural America? Dialogue Across Difference synthesizes three years’ worth of research from an innovative field experiment focused on improving intergroup understanding, relationships and collaboration. The result is a fascinating study of the potential of intergroup dialogue to improve relations across race and gender.

First developed in the late 1980s, intergroup dialogues bring together an equal number of students from two different groups – such as people of color and white people, or women and men – to share their perspectives and learn from each other. To test the possible impact of such courses and to develop a standard of best practice, the authors of Dialogue Across Difference incorporated various theories of social psychology, higher education, communication studies and social work to design and implement a uniform curriculum in nine universities across the country. Unlike most studies on intergroup dialogue, this project employed random assignment to enroll more than 1,450 students in experimental and control groups, including in 26 dialogue courses and control groups on race and gender each. Students admitted to the dialogue courses learned about racial and gender inequalities through readings, role-play activities and personal reflections. The authors tracked students’ progress using a mixed-method approach, including longitudinal surveys, content analyses of student papers, interviews of students, and videotapes of sessions. The results are heartening: Over the course of a term, students who participated in intergroup dialogues developed more insight into how members of other groups perceive the world. They also became more thoughtful about the structural underpinnings of inequality, increased their motivation to bridge differences and intergroup empathy, and placed a greater value on diversity and collaborative action. The authors also note that the effects of such courses were evident on nearly all measures. While students did report an initial increase in negative emotions – a possible indication of the difficulty of openly addressing race and gender – that effect was no longer present a year after the course. Overall, the results are remarkably consistent and point to an optimistic conclusion: intergroup dialogue is more than mere talk. It fosters productive communication about and across differences in the service of greater collaboration for equity and justice.

Ambitious and timely, Dialogue Across Difference presents a persuasive practical, theoretical and empirical account of the benefits of intergroup dialogue. The data and research presented in this volume offer a useful model for improving relations among different groups not just in the college setting but in the United States as well.

PATRICIA GURIN is Nancy Cantor Distinguished University Professor Emerita of Psychology and Women’s Studies at the University of Michigan.

BIREN (RATNESH) A. NAGDA is associate professor of social work and Director of the Intergroup Dialogue, Education & Action (IDEA) Center at University of Washington.

XIMENA ZUNIGA is associate professor of social justice education at University of Massachusetts, Amherst.

As one of the fastest-growing segments of the American population, the children of immigrants are poised to reshape the country’s political future. The massive rallies for immigration rights in 2006 and the recent push for the DREAM Act, both heavily supported by immigrant youth, signal the growing political potential of this crucial group. While many studies have explored the political participation of immigrant adults, we know comparatively little about what influences civic participation among the children of immigrants. Coming of Political Age persuasively argues that schools play a central role in integrating immigrant youth into the political system. The volume shows that the choices we make now in our educational system will have major consequences for the country’s civic health as the children of immigrants grow and mature as citizens.

Coming of Political Age draws from an impressive range of data, including two large surveys of adolescents in high schools and interviews with teachers and students, to provide an insightful analysis of trends in youth participation in politics. Although the children of both immigrant and native-born parents register and vote at similar rates, the factors associated with this likelihood are very different. While parental educational levels largely explain voting behavior among children of native-born parents, this volume demonstrates that immigrant children’s own education, in particular their exposure to social studies, strongly predicts their future political participation. Learning more about civic society and putting effort into these classes may encourage an interest in politics, suggesting that the high school civics curriculum remains highly relevant in an increasingly disconnected society. Interestingly, although their schooling predicts whether children of immigrants will vote, how they identify politically depends more on family and community influences. As budget cuts force school administrators to realign academic priorities, this volume argues that any cutback to social science programs may effectively curtail the political and civic engagement of the next generation of voters.

While much of the literature on immigrant assimilation focuses on family and community, Coming of Political Age argues that schools—and social science courses in particular—may be central to preparing the leaders of tomorrow. The insights and conclusions presented in this volume are essential to understand how we can encourage more participation in civic action and improve the functioning of our political system.

REBECCA M. CALLAHAN is assistant professor of education at the University of Texas at Austin.

CHANDRA MULLER is professor of sociology at the University of Texas at Austin.

Beginning in the 1990s, the geography of Latino migration to and within the United States started to shift. Immigrants from Central and South America increasingly bypassed the traditional gateway cities to settle in small cities, towns, and rural areas throughout the nation, particularly in the South. One popular new destination—Nashville, Tennessee—saw its Hispanic population increase by over 400 percent between 1990 and 2000. Nashville, like many other such new immigrant destinations, had little to no history of incorporating immigrants into local life. How did Nashville, as a city and society, respond to immigrant settlement? How did Latino immigrants come to understand their place in Nashville in the midst of this remarkable demographic change? In Nashville in the New Millennium, geographer Jamie Winders offers one of the first extended studies of the cultural, racial, and institutional politics of immigrant incorporation in a new urban destination.

Moving from schools to neighborhoods to Nashville’s wider civic institutions, Nashville in the New Millennium details how Nashville’s long-term residents and its new immigrants experienced daily life as it transformed into a multicultural city with a new cosmopolitanism. Using an impressive array of methods, including archival work, interviews, and participant observation, Winders offers a fine-grained analysis of the importance of historical context, collective memories and shared social spaces in the process of immigrant incorporation. Lacking a shared memory of immigrant settlement, Nashville’s long-term residents turned to local history to explain and interpret a new Latino presence. A site where Latino day laborers gathered, for example, became a flashpoint in Nashville’s politics of immigration in part because the area had once been a popular gathering place for area teenagers in the 1960s and 1970s. Teachers also drew from local historical memories, particularly the busing era, to make sense of their newly multicultural student body. They struggled, however, to help immigrant students relate to the region’s complicated racial past, especially during history lessons on the Jim Crow era and the Civil Rights movement. When Winders turns to life in Nashville’s neighborhoods, she finds that many Latino immigrants opted to be quiet in public, partly in response to negative stereotypes of Hispanics across Nashville. Long-term residents, however, viewed this silence as evidence of a failure to adapt to local norms of being neighborly.

Filled with voices from both long-term residents and Latino immigrants, Nashville in the New Millennium offers an intimate portrait of the changing geography of immigrant settlement in America. It provides a comprehensive picture of Latino migration’s impact on race relations in the country and is an especially valuable contribution to the study of race and ethnicity in the South.

JAMIE WINDERS is associate professor of geography at Syracuse University.

Some economic events are so major and unsettling that they “change everything.” Such is the case with the financial crisis that started in the summer of 2007 and is still a drag on the world economy. Yet enough time has now elapsed for economists to consider questions that run deeper than the usual focus on the immediate causes and consequences of the crisis. How have these stunning events changed our thinking about the role of the financial system in the economy, about the costs and benefits of financial innovation, about the efficiency of financial markets, and about the role the government should play in regulating finance? In Rethinking the Financial Crisis, some of the nation’s most renowned economists share their assessments of particular aspects of the crisis and reconsider the way we think about the financial system and its role in the economy.

In its wide-ranging inquiry into the financial crash, Rethinking the Financial Crisis marshals an impressive collection of rigorous and yet empirically-relevant research that, in some respects, upsets the conventional wisdom about the crisis and also opens up new areas for exploration. Two separate chapters–by Burton G. Malkiel and by Hersh Shefrin and Meir Statman – debate whether the facts of the financial crisis upend the efficient market hypothesis and require a more behavioral account of financial market performance. To build a better bridge between the study of finance and the “real” economy of production and employment, Simon Gilchrist and Egan Zakrasjek take an innovative measure of financial stress and embed it in a model of the U.S. economy to assess how disruptions in financial markets affect economic activity—and how the Federal Reserve might do monetary policy better. The volume also examines the crucial role of financial innovation in the evolution of the pre-crash financial system. Thomas Philippon documents the huge increase in the size of the financial services industry relative to real GDP, and also the increasing cost per financial transaction. He suggests that the finance industry of 1900 was just as able to produce loans, bonds, and stocks as its modern counterpart—and it did so more cheaply. Robert Jarrow looks in detail at some of the major types of exotic securities developed by financial engineers, such as collateralized debt obligations and credit-default swaps, reaching judgments on which make the real economy more efficient and which do not. The volume’s final section turns explicitly to regulatory matters. Robert Litan discusses the political economy of financial regulation before and after the crisis. He reviews the provisions of the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010, which he considers an imperfect but useful response to a major breakdown in market and regulatory discipline.

At a time when the financial sector continues to be a source of considerable controversy, Rethinking the Financial Crisis addresses important questions about the complex workings of American finance and shows how the study of economics needs to change to deepen our understanding of the indispensable but risky role that the financial system plays in modern economies.

ALAN S. BLINDER is the Gordon S. Rentschler Memorial Professor of Economics and Public Affairs at Princeton University.

ANDREW W. LO is Charles E. and Susan T. Harris Professor at M.I.T.

ROBERT M. SOLOW is Institute Professor, Emeritus, at M.I.T.

CONTRIBUTORS:  Ben S. Bernanke,  Patrick Bolton,  J. Bradford DeLong,  Christopher L. Foote,  Kristopher S. Gerardi, Simon G. Gilchrist,  John Hull,  Robert A. Jarrow,  Robert E. Litan,  Burton G. Malkiel,  Kevin J. Murphy,  Thomas Philippon,  Tano Santon,  Jose A. Scheinkman, Hersh Shefrin,  Meir Statman,  Alan White,  Paul S. Willen,  Egon Zakrajsek.