70 Cents An Hour

As the final phase from a bill passed back in 2007, today the federal minimum wage rises to $7.25 an hour from $6.55 for workers across the country. This brings the federal minimum wage, adjusted for inflation, back to where it was in the 1990s. It's hard to determine how many minimum-wage employees there are out there, but the best guess is that five million people get a raise today. Here's one of them.

While those workers include thousands of financially secure students still living with Mom and Dad, they also include thousands of the most impoverished and vulnerable members of the workforce – those who sink further into debt each month as ordinary expenses outweigh their meager paychecks.

April Greer, 36, is one of them.

Her troubles began in December, when her husband was sent to prison for a parole violation, leaving her the sole provider for her three teenage children who live with her.

In January, she was fired from her job at a cellular provider. She said she was late for work because her sister-in-law commandeered her car.

She spent early spring trawling East Dallas for a new job, but, like millions of Americans, she found none.

In early May, Greer's electricity provider finally turned out the lights. A few days later, her landlord changed the locks. She and her children crowded into the South Dallas bungalow of her husband's parents.

She finally caught a break two months ago, when a nonprofit agency helped her land a part-time, minimum-wage job at T.J. Maxx, taking home about $800 a month.

Two weeks ago, after she started having dizzy spells at work, she collapsed and spent two days in the hospital.

Doctors aren't sure what's wrong with her. Maybe diabetes. Maybe her heart. Maybe just stress.

Greer knows she can't afford $434 a month for the medication her doctor says she needs. She can barely afford the $100 a week she's been paying her in-laws to cover their ballooning utility bills.

She wants to find a second job, but doesn't know if her body can take it.

"Since I'm the only one right now for my kids, I have to take care of my health," she said.

Those with the lowest incomes are often those who have the most health issues. That comes from stress, overwork, the lack of a nutritious diet, living in low-income environments where more pollution exists, and a variety of other factors. In this most cruel of American landscapes, the poor and the sick often are the same person.

But what we'll hear today is how adding 70 cents an hour will bankrupt businesses. In actuality it will act as a mini-stimulus, giving the poor about $28 more a week for necessities that will almost certainly get spent and cycled into the economy.

What we certainly won't hear about is how the struggle of these minimum-wage workers fits into the health care debate. Many are probably already on Medicaid, but a provision in the bill would limit out-of-pocket costs for everyone, and expanding access would help make sure nobody who needs health coverage slips through the cracks. The air-blown press corps may have thought Obama's press conference was bor-ring, but the issues discussed directly affect the lives of people like April Greer. It would be nice if they could take up the debate with some inkling of concern for her, rather than acting like theater critics critiquing how folsky or animated the President was during his press conference.

Republicans and fiscal scolds say we just cannot afford to help someone like April. She ought to just get a job with the government. But Krugman says something important today - contrary to conservative belief, access and cost control are complementary.

Why does meaningful action on medical costs go along with compassion? One answer is that compassion means not closing your eyes to the human consequences of rising costs. When health insurance premiums doubled during the Bush years, our health care system “controlled costs” by dropping coverage for many workers — but as far as the Bush administration was concerned, that wasn’t a problem. If you believe in universal coverage, on the other hand, it is a problem, and demands a solution.

Beyond that, I’d suggest that would-be health reformers won’t have the moral authority to confront our system’s inefficiency unless they’re also prepared to end its cruelty. If President Bush had tried to rein in Medicare spending, he would have been accused, with considerable justice, of cutting benefits so that he could give the wealthy even more tax cuts. President Obama, by contrast, can link Medicare reform with the goal of protecting less fortunate Americans and making the middle class more secure.

As a practical, political matter, then, controlling health care costs and expanding health care access aren’t opposing alternatives — you have to do both, or neither.

April Greer probably just wants the peace of mind that she can get treatment when she needs it, without going deeply and overwhelmingly into debt in the process. Long-term budgetary constraints and bending cost curves matter less to her. But Krugman is right that the two are not in conflict, and must be packaged together.

I'm happy April is getting a small raise for her troubles today. I want her to get a health care system that honors her struggle and provides her security. But Senators need a three-week recess, so she'll have to wait.