A 'Care' Agenda Is Essential Policy 

R.N Natalie O'Connor greets her first patient of the day Rita Fuller, 83, at her home and goes over a COVID-19 pre-vaccine checklist before administering it in Manchester, Connecticut on February 12, 2021. (Photo by Joseph Prezioso/AFP via Getty Images)

A search of presidential speeches through the Miller Center at the University of Virginia shows that not one president before Joe Biden ever used the word “caregiving” in a public speech. Not one.

The ascendance of a new administration in the midst of a catastrophic public health crisis represents a unique galvanizing moment for care policy. The COVID-19 virus is like the dyes doctors use to see pathways in MRIs and X-rays, lighting up in fluorescent color the gaping cracks in our systems of care that have been historically kept invisible.

This month, a group of more than 200 scholars and other experts signed a letter to the Biden-Harris administration calling on them to begin implementing initiatives to build a comprehensive care policy structure in the United States for the very first time. As co-chairs of the Carework Network, organizers of this effort, we urge action in this critical moment.

For the first time in mainstream public discourse we are talking about a care agenda that includes caring for children, older adults, and those who are ill or disabled as essential infrastructure.

The pandemic has elevated the visibility of the critical role caregiving plays in all of our lives, as well as in supporting paid work and economic growth. Vice President Kamala Harris has written about the importance of fixing our care system to enable women’s full participation in the economy and to advance gender equity. And in the midst of a national reckoning on race, addressing the inadequacies and inequities in our current social organization of care is also a critical element of dismantling systemic racism.

Care has become part of the public and policy dialogue in a way that is unprecedented in the United States.

Early in the crisis, health care workers, some child care providers, and those caring for older or disabled adults were among those deemed “essential” by most states. Yet despite applause and signs of appreciation, pay and protection for these critical workers was largely lacking.

Widespread closures of schools and child care centers made clear how much we depend on an infrastructure of paid care to support our families, our communities, and our economic activity. In long-term care facilities, staffing shortages and systemic inadequacies were linked to overwhelming rates of illness and death.

And story after story detailed the crushing burden of unpaid care faced by families left to tend to children, older family members and relatives with disabilities, while trying to balance paid work with almost non-existent supports.

In this historical moment, care has become part of the public and policy dialogue in a way that is unprecedented in the United States. The COVID relief bill, the American Rescue plan, includes a set of emergency provisions related to paid and unpaid care. But even more important are plans detailed during Biden’s 2020 campaign and in the recently proposed American Jobs Plan to create a permanent infrastructure to support caregiving throughout the entire life cycle.

[No] president before Joe Biden ever used the word “caregiving” in a public speech. Not one.

In addition to public investment in K-12 schools, we need public support for care of younger children, and of all children in non-school hours to support working parents. We need to create and fund a system that provides genuine choices to older adults to be cared for at home or in well-regulated and fully staffed long-term care facilities. Investing in more flexible supports is also key to allowing individuals with disabilities of any age to live in communities. Finally, low-wage workers in health care, child care, education, home care and long-term care deserve living wages and full access to worker protections of all kinds.

Paid care infrastructure is only one piece of the puzzle. A comprehensive care policy must also include support for unpaid caregivers, including parents, those caring for older adults, individuals with disabilities and others who need short- or long-term care. One key element is a system of paid medical and care leave for all workers that allows all to take time to care for themselves or others without losing wages or losing their jobs. Reforms that provide tax credits and Social Security buy-in for those performing unpaid care are also crucial.

The good news is that many of these provisions are on the table in a way that was unimaginable only one year ago. The prominence of care in the relief package and early appointments to key roles are promising signs that this care agenda is indeed a priority.

Mignon Duffy is associate professor and chair of the department of sociology at the University of Massachusetts Lowell and co-chair of the Carework Network.

Kim Price-Glynn is associate professor of sociology at the University of Connecticut and co-chair of the Carework Network.

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