Great American achievements come in many varieties. There are those that demonstrate our ability to work on a grand scale, like great cities or massive public works. Others reflect exploration and creativity, like scientific breakthroughs or major works of art and culture. Others celebrate our strength, like the preeminence of our industries or victory in war.
Then there are those that are quiet, working on an individual scale but nonetheless making a profound difference to millions. Social Security is one of those, a lifeline that has lifted generations out of poverty, as are programs like Medicare and veterans’ benefits. These achievements don't get monuments on the National Mall or Nobel Prizes, but they nonetheless stand tall amongst American accomplishments.
In the last century, we thought of these programs as “safety nets,” as though life were a high-wire act. In this century, we can go further. We can do more than catch people when they fall; we can make life less precarious in the first place.
In the fall of 2019, my mother-in-law came to live with us, to be close to her grandchildren. A few months later, when COVID arrived and we went into lockdown, my wife and I carved out spaces for home offices and the kids left daycare to spend their days with grandma. I knew we were lucky to have this setup, but I didn’t fully appreciate it until other parents started opening up about their experiences. Trying to take care of kids and somehow manage remote school while continuing to work their jobs (if they were able to keep them), wondering what would have to give. Were their children losing years of their education? How could the parents possibly supervise at-home learning and still do their jobs? Would one parent have to stop working? How would they get by without the income? What they felt was something deeper than the practical difficulty of getting through each day. It was a sense that the world was indifferent, and that things might fall apart.
COVID made this dread a shared experience we could talk about, but even in normal times most Americans live with it, whether their worries are about physical and mental health, financial and career insecurity, care for children, care for aging relatives, care for family with special needs, substance abuse, or any of many, many other challenges. Even in a wealthy nation, even after centuries of growth and progress, few of us can escape these concerns. For many of us, they are a persistent, thrumming source of anxiety. For others, they are a daily crisis.
I’m a newcomer to thinking about a care economy, or care as a political value, and others have been speaking about it powerfully for years. As I’ve tried to understand it, I’ve started to see it as whatever work alleviates these stresses. It's easy to see that in a doctor or a daycare, but it is in so many kinds of work, both paid and unpaid. The care my mother-in-law gave our children during the pandemic was direct - love and attention each day - but she was also caring for us, the adults, by making it possible for us to continue our lives. I wish everyone could have had that. I wish all of us could have all the care we need, of every kind.
Why can’t we? Alongside everything else we want to accomplish in this century, why not set a goal of expanding the care Americans have–healthcare, mental healthcare, childcare, elder care, and beyond. The scope of that goal is daunting and may seem impossible today, when making any advance is expensive and prohibitively difficult—think of the decades-long, all-consuming struggle to pass and then defend healthcare expansion—and when one party is intent on cruelly rolling back the progress we’ve already made. But we cannot get to a better future, and we cannot even defend what we have now, without expansive ambition. In past posts, I've argued for the need for thinking bigger on economic growth and innovation, and we should be no less ambitious when thinking about care; indeed, a major reason to care about growth and innovation is because they will make it possible for more people to get the care they need. If, in the coming decades, we achieve a transition to clean energy, develop new forms of intelligence, and complete a mission to Mars (all of which I'd like to see), but ordinary people still struggle daily and live with the risk of ruin, we will have missed the point.
Sometimes the best answer is a government program, but there are other things we can do: policies like family leave that allow people to care for their loved ones, or investments in expanding the availability of professionals like nurses, social workers, and home health aides. The greatest thing we can do is create shared growth and opportunity so people can arrange their lives the way they want and afford the care they need.
Care is not a recipe for sapping the vitality of the economy, as opponents of these policies often claim. I want an economy that recognizes the value of work and that rewards effort and ambition, but I don't believe we need to accept insecurity and pain as its price. It seems too obvious to say, but an individual will add more to the economy when she has her needs met, has the attention and energy for her work, and is free to find a better job, get more education, or take an entrepreneurial risk because she isn't afraid of losing basic benefits. And, care will be a major engine of innovation, growth, and opportunity in this century, in part because care professions are unlikely to be automated away.
We have the ability–the obligation–to build a country where care is not an afterthought but a defining measure of our success. Where families are not one illness, accident, or layoff away from collapse. Where the work of caring, whether done by a parent, a nurse, a neighbor, or a social worker, is valued as essential to our prosperity, and where the scope of what we count as care is as broad as the human need for it. We can make life in America not just richer but more humane.