EYE ON THE PIE: Will people pay more for better care?

It was dark and I was feeling anxious about getting this column out on time. Then there was a tap at the sliding door to the deck. It was an apparition, a ghost, a figure all in white out of a 19th-century novel. But the tap was real.

I opened the door and recognized her. “Nellie,” I said, “what are you doing out here at this hour?” Yes, it was Nellie, the Nervous Nurse, who lives close by. “My frog is loose and I thought she might be in trouble over this way.” I don’t know Nellie’s frog or any such beast. But, instead of laughing, I said, “Nope, haven’t seen her in quite a while.” “Are you writing your column? Did I disturb you?” Nellie said with her usual vocal tremor. “No problem,” I said. “I wouldn’t want to interfere, but if you’re searching for a topic, have you considered the shortage of care givers?” Nellie said. Shortage, I thought, that’s when a price is too low and buyers can’t get all they want at that going price. “What shortage are you talking about? Nurses?” I asked. “Oh, no,” she said. “Oh, yes, but no. There is a shortage of nurses, but I was thinking of care givers. Nurses have very short-term interactions with people, but care givers necessarily establish longterm relationships. Our society needs more professionally trained care givers. With all the changes going on in the economy and population, I’d think that care giving would be better understood as a business opportunity.”

“Care givers,” I pondered without the benefit of facial hair to stroke for an intellectual effect. “Nellie, that’s perfect. I’ll do a column about the shortage of care givers, but you know my conclusion.”

“Yes,” she said, “economists have to say that if the price (or wage in this case) would rise, more people would come forth to take those jobs. But it’s not that simple.”

“It never is,” I agreed. “Professional care givers require training and protection from exploitation. It’s not a job amateurs should just walk into. Yet training and appropriate supervision will involve more compensation than many buyers would be willing to pay.”

“Only,” Nellie continued my thought, “if the buyers don’t understand the difference between the professional and the amateur care giver.”

“This is a good one, Nellie,” I chuckled. “There’s a huge and growing market for care givers. We have 20 million children under age 5 in this country. That’s an enormous market to aid working parents and those who would prefer to go to work than to be full-time care givers.

“Then there are nearly 11 million Americans 65 and older who live alone. If even half of them can use professional care givers, we have another market segment of 5 million. Plus, think about people with disabilities.”

Nellie now stood close, breathing heavily.

“Yes, yes,” she panted. “Indiana alone has 805,000 people age 5 and older who suffer a self-care disability. And those with a self-care disability have about the lowest employment rate of any group of people with disabilities.

“That’s just one of many disabilities people have to contend with. Care givers are so important for the quality of life of the young, the old, and those in between with disabilities. They not only help their clients,” she said choking with emotion, “but they free others in the family to live less constrained lives.”

I didn’t like where this was going. There I was, well over 65, clearly scruffy, with burn holes in my clothes from cigars. Any moment now she could declare me a candidate for care-receiving.

“Didn’t I hear a frog just now?” I said, cupping my hand to my ear. Nellie virtually flew off the deck and into the forest in search of her pet frog. Relieved, I went inside to write.