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The XX Files

When you talk do they listen?


The woman on the line sounded liked she was in her late 50s. She seemed nice, maybe a little tired. I'd later learn why. She said she was conducting a poll about health care for New York State.

            I know people are chosen at random for polls. But it doesn't feel random. Especially since in the past four months, for the first time in our lives, my husband and I have been included in two polls --- this one and one for Nielsen Media, the TV-ratings company --- and I've been asked to register for jury duty. Why is my family suddenly all the rage in the opinion business? When the pollster asked the first question, my suspicion turned to anger.

            "What concerns you the most?" she said, ticking off a dozen or so options. "Employment, saving for a child's education, health care costs, availability of insurance, crime, the state budget..."

            What concerns me the most? Now they ask me? Where were the pollsters when we were broke, living in a rundown place with a screaming whelp, no insurance, and our very own stalker living in the apartment below? Where were the pollsters when we couldn't move away from the stalker because the landlords we called --- unwilling to comply with strict lead-abatement laws --- hung up when they learned we had a child?

            I know where the pollsters were. They were calling the suburbs. They were calling the people with health insurance and two cars and homes they owned or, at least, were paying off. So, you can say we were chosen at random if you want, but I can't help feeling that my family has recently arrived on some sort of map of Acceptable America --- Bush's America --- where immunized, pampered children play on broad green lawns.

            If pollsters don't contact Real America --- where uninsured Americans can't afford basic care, unemployment stats don't tell the whole story, and the number of affordable housing units is at an all-time low --- Acceptable America won't ever have to face any disturbing facts.

If the poll had anything to do with Pataki's announcement last week to reduce benefits and jack up health care costs for recipients of government medical aid, my answers didn't do a lick of good. In Acceptable America, it's easy to cut aid to Real America; the poor have no powerful lobby to stand up and voice opposition.

            Luckily for Rochester, some still care. A study commissioned by the Women's Foundation of Genesee Valley focused on what a single woman needs to be economically independent in this region. Instead of using the outdated federal poverty levels, the foundation used a more nuanced measurement called the Self-Sufficiency Standard.

            "Federal poverty levels were devised in the 1960s when food was 30 percent of expenses," says Dr. Kathleen King, professor of nursing at the UR and a lead investigator of the study. "They don't represent the actual costs of things now."

            The SSS accounts for the basics, as well as childcare, family size, and regional price differences. In the 1960s and 70s, a minimum-wage worker could support a family of three at or above the poverty-level minimum. Now, minimum wage ($6/hr in New York as of January 1) earns significantly less than the poverty line for a family of three.

            In the chart, you can see the federal poverty line for a household with one adult, one school-aged child, and one infant is $15,264, compared to the full-time minimum wage of $12,480. This is not enough money to live. Using the Self-Sufficiency Standard, that same family, located in Monroe County, would need to earn $36,936 just to achieve economic independence.

            Now, compare this to the median income of female heads of households with families (FHH). The difference between what single mothers actually earn (median FHH income) and what they need to make (SSS) is roughly $11,700 a year. How to close this gap?

            Rosemary Mitchell, director of the Women's Foundation, has a plan. She wants to work with government and service agencies to identify good jobs that pay well and have opportunities for advancement through training.

            Many agencies provide excellent services, she says, but the key to success will be collaboration. She points to an effective partnership between the Visiting Nurse Service, BOCES, and a few other agencies which helps home health aides train to become licensed nurses.

            "It costs a lot of money," to put together these kinds of work-advancement opportunities, Mitchell concedes, "but it will cost a lot less in the long run."

The pollster was waiting for my answer. What was I most concerned about? "Health care," I said. "Not mine, but the 45 million Americans with no health care. Especially the people who have, in the past four years, lost their insurance along with their jobs." (I know. I sound like a wanker. But I actually did say this.)

            "You're talking to one of them," the pollster said into the phone. She cleared her throat. "I lost my job one-and-a-half years ago and I haven't had health insurance since." I was stunned; I hadn't expected a personal revelation. She moved along briskly, mixing poll questions with details of her life.

            "After each of the following choices," she said, "state whether you think it's a crisis, not a crisis but a problem, a minor problem, or not a problem: federal cuts to Medicaid. Now I work two jobs. All week and weekends and still no insurance."

            "Um," I said. "Crisis."

            "OK, state whether this is a crisis, not a crisis, et cetera: private hospitals' preferential treatment of patients with insurance."

            Was this on the script or was she editorializing? "What?" I said.

            "Don't you know?" she said. "Private hospitals charge uninsured patients three times what they charge the insured."

            "Crisis?" I answered tentatively. "Yes!" she said as if I'd answered a game-show question correctly.

            The poll had entered the Twilight Zone, and yet I didn't hang up. I wanted to answer all the questions I wished someone had asked me when the jobs disappeared and I was nuts with fear. Maybe she was a little nuts with fear, too. The least I could do was listen.

Help is on the way, but it could take a while. In order to improve the wage situation, Women's Foundation researcher Dr. King says, the data has to get out there. She's been presenting the study to corporate leaders, politicians, and heads of other foundations. "I'm not sure many people recognize the extent of the problem," she says.

            One woman, living in Real America and quoted in the study, sees that the problem goes beyond numbers. "They are rude," she says of some service providers and others. "They treat you like a ball of dirt. They don't return your calls. They get frustrated. They take it out on us. They have a lot of people they are dealing with; they get mixed up. We have to consider this."