Health Care Policy - Hiring Caregivers - An Example

Republican's are convinced that Government should have no role in in health-care - at least that is what they profess on the campaign trail.  My experience has been that it is private business that is not good at balancing making a profit with good care.

Some years ago I was handling care for a loved one who had a debilitating disease that eventually required almost constant care.  At a point, as her needs got more acute, I had to start hiring caregivers to take care of her during periods I could not cover.

There are many private sector companies offerring to provide caregivers for a fee.  I turned to a private company first, since that is the easiest and quickest solution.  It didn't take long for me to learn you don't get much for your money with private company caregivers.  The problem is built into the market.  The companies don't want you to get to chummy with a particular caregiver, since you could hire them directly at probably 60% of what you were paying the company, so they moved the caregivers around constantly to keep them from forming relationships with the patients.  This not only disrupted the ability of the patient to bond with the caregiver, it also meant every couple days a new caregiver would arrive who knew nothing about the patient, or the patients needs, or the routines of the household.  Because the caregivers were being moved around so much they lost interest in forming relationships with the patients and saw no reward in doing good work.  They were just punching a clock, doing as little as they could, getting out of the house as soon as they could.

So although it took a lot of my time, I ended up interviewing and hiring caregivers directly.  I found the County maintained a list of caregivers.  The county did background checks, and provided for bonding as a requirement for a caregiver to be on the list, and set a specific amount as the minimum the caregiver could be paid.  Over the next year or so I found a number of really hardworking, caring caregivers on the county list.  

At one point I got really busy and didn't feel like I had time to interview people, so I hired another company.  I had the same experience as with the first company.  So I went back to interviewing.

Now other folks I know around my age are confronting the problem of caring for an aging parent.  They often live a long way from the parent, or work all day, so they hire companies to provide assistance.  They have the same problems.  No continuity in care.   Caregivers pushed by the companies to get in and get out quickly so the company can send them to a bunch of different people in a day.  So the caregivers do little beyond show up for awhile.  

Unfortunately the option I used is generally no longer available because those county offices that maintained caregiver lists have been decimated by budget cuts, impelled by the financial collapse of that other "free" market on Wall Street.