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Solvingthe$290BillionCareCrisis
November2022
ByEmilyKos,SuchiSastri,NanDasGupta,RohanSajdeh,GabrielleNovacek,AliciaPittman,NeeruRavi,andAnisaVashi
BostonConsultingGrouppartnerswithleadersinbusinessandsocietytotackletheirmost
importantchallengesandcapturetheirgreatestopportunities.BCGwasthepioneerinbusinessstrategywhenitwasfoundedin1963.Today,
weworkcloselywithclientstoembracea
transformationalapproachaimedatbenefitingallstakeholders—empoweringorganizationstogrow,buildsustainablecompetitiveadvantage,and
drivepositivesocietalimpact.
Ourdiverse,globalteamsbringdeepindustryandfunctionalexpertiseandarangeofperspectives
thatquestionthestatusquoandsparkchange.
BCGdeliverssolutionsthroughleading-edge
managementconsulting,technologyanddesign,andcorporateanddigitalventures.Weworkinauniquelycollaborativemodelacrossthefirmandthroughoutalllevelsoftheclientorganization,
fueledbythegoalofhelpingourclientsthriveandenablingthemtomaketheworldabetterplace.
Solvingthe$290BillionCareCrisis
TheUScareeconomyisbroken.Gettingitrightisvitaltoeconomicprosperityandsocietalwell-being.
I
ttookCOVID-19,adeadlyglobalpandemic,fortheUSto
wakeuptothegapingfaultlinesinthe“careeconomy.”
Whatisthecareeconomy?Itisavastecosystemwhere
families,employers,andinstitutions—fromdaycaresand
nursinghomestoschoolsandhospitals—cometogethertosupporttheyoung,theold,andthesick.Thissupportis
necessaryforthefunctioningofahealthysociety,andthisworkunderpinseverypartoftheeconomy.Wecanignoreitnolonger.
TheDisorganizedCareEconomy
Thestoriesareeverywhere.TakeJoanne,anenvironmentalconsultantwithamaster’sdegreeandfull-timejobinthe
Denveroil-and-gasindustry,whoparedbackherworktotenhoursaweekbecauseshecouldn’tfindchildcareforher
babyson,Miles.Herfirstnannysleptonthejob,shesays,andasecondchosetoworkinaschoolformorepayandbenefits.Milescouldn’tlandaspotindaycare.Joanneismarriedandherhusbandhasastablejob,butwhenshereducedherworkhourstocareforMiles,thefamily’sin-comewashalved.
OrconsiderNaila,aregisterednursesince2013inSan
Francisco,whoworked12-hourshiftsthreetimesaweek.
Shequitfivemonthsafterherfirstbabywasborn,nudged
bythelocaldaycare’shoursofjust8a.m.to3p.m.Althoughherfamilycanliveonherhusband’sincome,sheregrets
leavingnursing,aprofessionshelovesandonethatdesper-atelyneedsexperiencedstaff.Still,Nailadoesn’tplanto
returntonursinguntilherchildisatleastfive.Thenshe’llprobablylookforamedicalclinicwithshortershifts.
Sandraengagedhermothertohelpwithhertwokidswhileshecontinuedhercareerasatalentrecruiter.Thenher
77-year-oldmomgotsick,andSandrahadtoquitherjobtolookafterallthree,movingintotheincreasinglycom-monunpaidroleofcaringforbothchildrenandparents.
Thesestresses—atthenexusoffamilyandwork—playoutmillionsoftimesadayintheUS,affectingusall.They
exposeafundamentalmismatchinsupplyanddemand
forcareservicesintheworld’sbiggesteconomy.Andthe
consequencesaresignificantandgrowing.Already,theUSbirthratehasdippedbelowreplacementrateaspotentialfamilybuildersholdoffhavingchildren,oftencitingthe
costandavailabilityofchildcareandthequalityofpublicschools.Atthesametime,thedemographicbulgeofagingbabyboomersandtherealitythatmorepeoplearelivingintotheir80sand90sputsenormouspressureonse-
nior-caresystems.Ineverycase,technology,efficiency,or
newfacilitiescanonlygosofar;thecareeconomyrequirespresent,skilled,compassionatehumanlabor.
InaMay2022report,weestimatedthesizeofthecareecon-omy,includingbothunpaidandpaidcaregiving,atupto$6trillion,approachingaquarteroftotalUSGDP.(SeeExhibit1.)
Thissegmentoftheeconomyisexpandingveryfastbut
remainsprecarious,withlittlecoordinatedactionsofartoaddressgapsandorganizecomprehensivesolutions.Now,we’vequantifiedwhatthesegapsinthecareeconomycosttheUSinGDPeveryyear.
?
?
J
BOSTONCONSULTINGGROUP1
Exhibit1-TheUSCareEconomyIsWorthUpto$6Trillion
Valueofunpaid-carelabor1
Formaleconomy2
Grayeconomy3
u$400B
$2.5T–$3.5T
$2.2T
pto
UnpaidcaregivingPaidcaregiving
Sources:USBureauofLaborStatistics;InstituteofEconomicAffairs;BCG/DynataCaregiverSurvey2022(N=3,673);BCGanalysis.
1Calculatedasthevalueofunpaid-carelaborifitwerepaid:numberofindividualsprovidingunpaidcaremultipliedbytheaveragetimespentpro-vidingunpaidcareinanequivalentfull-timepositionmultipliedbytheaveragepaid-caregiverwage.
2CalculatedinrealGDPterms,basedonthenumberofpaidcaregiversmultipliedbytheaveragepaid-caregiverwageforeducationalservices,ambu-latoryhealthcareservices,hospitals,nursingandresidentialcarefacilities,individualandfamilyservices,andchild-daycareservices.
3CalculatedusingInstituteofEconomicAffairsestimatesonUSshadoweconomy.
WeforecastthattheUSwillloseabout$290billiona
yearinGDPin2030andbeyondifwefailtofixtwocriti-calcare-economydynamics:(1)thelackofavailableworkerstofilladramaticallyincreasingnumberofthesehands-on
jobs,and(2)thedepartureofproductiveemployeesfrom
thepaidlaborforcetotakeonunpaid-careduties,whethertheywanttoornot.Thateconomiclossisequivalentto
losinghalfoftheannualGDPgrowthprojectedfrom2022–2023.1Or,putanotherway,itismorethantheannualreve-nueofAlphabet,thesecond-biggestUStechnologycompa-ny.
Thecarecrisisistiedtothemarketforhourlylabor—sig-nificantly,low-wagelabor—and,therefore,intersectswiththepostpandemic“greatre-enrollment”andaUSunem-ploymentratehoveringbelow4%.About1.8millioncriti-cal-carejobs,includingnursingassistants,homehealth
aidesandchildcareworkers,areopen,accordingtothe
USBureauofLaborStatistics.Andthedemandforthese
jobsispoisedtogrowinthenexttenyears,wellbeyond
thesevacancies.However,theserolesgenerallypayless
than$18anhourandofferpoorbenefits.Workersare
requiredtobeonsite,withinflexiblehoursandunexpectedovertime.Trainingisinadequate;turnoverishigh.It’sno
wonderthesepositionsarestarvedforapplicants.
1.SomeGrowthProjectedfortheU.S.Economy,2020-30,CareerOutlook,September2021,USBureauofLaborStatistics,
/
careeroutlook/2021/data-on-display/economic-growth.htm.
2SOLVINGTHE$290BILLIONCARECRISIS
Ampleopeningsinindustriesthatcompeteforthesame
workers,suchasretailandhospitality,exacerbatethe
problem,andarealreadydrawingawaycurrentcare-econo-myemployeeswithbetterpay,perks,andeasierduties.
That’sevidentinthenumbers:asofJuly,pandemic-relatedjoblossesacrossthebroadereconomyhadlargelyrecov-
ered,butjobtotalsinchild-careserviceswerestill8%shortofprepandemiclevels,accordingtotheCenterforAmeri-canProgress.2AboutathirdofUSdaycarecentersclosedorreducedcapacitybymorethan50%inthelasttwoyearsbecauseofalackofworkers.3
ForCEOsandotherleaders,understandingthemagnitudeofthecareeconomyanditscurrentdysfunctioniscriticaltograpplingwithlaborshortagesandbroadertalentcon-cerns.Careworkersrequirecompetitive,livablewages.
Peoplewhohirecareservicesinordertodotheirjobsinotherindustriesrequiresupport.FailingtorecognizethechildcareandeldercareresponsibilitiesofmillionsofUSworkerssapsproductivityandjobsatisfaction.
FixingthecareproblemintheUSnowisn’tjustgoodbusiness,it’snecessarybusiness.
QuantifyingtheCareCrisis
CareactivitiesarecriticaltoGDPgrowthbecausethey
supportworkersineveryotherindustry.Still,economists,
investors,andcorporateexecutiveshavelongoverlooked
thislabor,bothbecauseitstraddlestheinformaleconomyandbecauseithasbeenderidedas“women’swork.”But
careistooimportanttoahealthyUSeconomyandstablesocietytoneglect.Mostothercountrieshaveaddressed
workers’careneedsmoredeliberately.Onedramaticexam-pleistheissueofpaidleave:theUSistheonlydevelopedcountrythatdoesn’tmandatepaidtimeofftosupport
employedwomeninthedaysaftertheygivebirth.Bonding
withanewbornandrecoveringfrompregnancyarefunda-mentaltothematernalexperience,yetwestilldon’t
guaranteeincomeinthisperiodofaworkingwoman’slife.
About56%ofUSworkers—roughly90million
people—havecareresponsibilitiesoutsideoftheirfull-timejobs,accordingtoaproprietarysurveyofmorethan3,600employedcaregiversconductedbyBCGandDynata,our
codingandsamplingpartner.(Seethemethodology.)
Approximately40millionofthesecaregiversrelyon
paidcare—suchasnannies,daycares,ornursinghomes—togotowork,meaningthatwhenpaidcarefallsthrough,theyareatriskofmissingworkorleavingtheirpaidjobs
altogether.Theremainderrelyonunpaidcare,includingfamily,friends,neighbors,andothers,ordoitallthem-selves.(Seethesidebar.)
2.TheChildCareSectorWillContinueToStruggleHiringStaffUnlessItCreatesGoodJobs,CenterforAmericanProgress,September2,2022,
https://www.
/article/the-child-care-sector-will-continue-to-struggle-hiring-staff-unless-it-creates-good-jobs/
.
3.EmmaKLeeandZacharyParolin,“TheCareBurdenDuringCOVID-19:ANationalDatabaseofChildCareClosuresintheUnitedStates,”Socius,7,July21,2021,
/doi/full/10.1177/23780231211032028
.
BOSTONCONSULTINGGROUP3
OverviewoftheCareEconomy
Thecareeconomyiscomposedofbothunpaidandpaidcaregivinginoursociety.Therearethreemaintypesofcaregiversinthiseconomy:
•UnpaidCaregivers.Anyonewithunpaid-carerespon-sibilitiesforchildren,adultfamilymembers,orboth,
whethertheythemselvesareemployed.
•EmployedCaregivers.Asubsetofthefirstgroup—work-ersinthebroadereconomywhoalsohaveunpaid-carere-sponsibilities,forchildren,adultfamilymembers,orboth.
•Paid-CareWorkers.Individualswhoprovidecareastheiroccupation.Manycareworkersarealsoemployedcaregiv-erswithunpaid-careresponsibilities.Manyofthemalso
relyonpaid-careworkersfortheirownfamilymembers.
Tosizethetotalcareeconomy,werefertotheUSBureauofLaborStatistics,whichincludeseducation,healthcare,andsocialassistanceinits“educationandhealthcare
servicessupersector.”Weprimarilyfocusonthesegmentsthatinvolvesupportforchildrenandelderlyadults.Thesesegmentsincludechildcareworkers,teachers,nursing
assistants,homehealthaides,orderlies,andsoon.
SOLVINGTHE$290BILLIONCARECRISIS
In2030andbeyond,theUSisexpectedtolosearound
$290billioninGDPayearasaresultofthecarecrisis.Ourestimatecomprisestwoparts:First,itincludesthelost
wagesbecausesomanycarejobsareunfilled.Second,itincludestheeffectofreducedlaborforceparticipation
becauseofcareshortages—thatis,peoplelikeJoanneinouropeningexample,whocutbackonherpaidworkintheColoradooil-and-gasindustrytotakeonunpaid-carework.
Thisfigureisamid-caseestimatebasedonaveragesofthelasttenyears.InthreedifferentscenariosinExhibit2,weseearangeofGDP-lossoutcomesbasedontherelative
“attractiveness”ofcaresectorjobs.Ononeend,improvingthequality-of-carejobswouldfilterthroughthesystembyattractingandretainingmoreworkers,andthereforemakebettercareservicesavailabletoall.Ontheotherend,morepeopleleavingcarejobsandfeweroptionsforpeople
lookingtohirecareworkershasdireconsequences.
Themid-casescenario—the$290billionloss—restson
thefollowingassumptions:Carejobsfillattheaverageratesince2012,resultinginacare-workershortfallofabout
14%by2030.About20%ofworkerswhocan’tfindade-
quatecareleavetheworkforcetofillthecaregapathome.
Inamoreoptimisticscenario—withaprojectedlossofabout$190billionayearin2030andbeyond—carejobsfillatthehighestratetheyhaveinthelasttenyears,andthe
care-workershortfallisabout13%.Roughly10%ofemployedcaregiversleavetheworkforceiftheirpaidcarefallsthrough.
Ontheotherend—withaprojectedlossofabout$500
billionayear—wemodeledtherelativeattractivenessof
paid-carejobsatthelowestlevelseenoverthelastdecade.Inthiscase,a15%vacancyinpaidcareensues.And40%
ofemployedcaregiversleavetheworkforceiftheirpaidcarefallsthrough,eventhoseworriedaboutthelossoftheirownincome.
ThesescenariosareusefulforexaminingthemagnitudeoftheUScareprobleminthecomingdecade.Buteventheselargedollaramountsdon’ttellthewholestory.Societal
hardships—includingstressandstrainonthosejugglingdemandingjobsandmanagingbothchildcareandelder-care—arecommon.Nearly60%ofemployedcaregiversinoursurveysaidtheystrugglewiththeirmentalandphysi-calhealthandwithproductivityandburnout.
Exhibit2-EconomicLossesfromtheUSCareCrisis:ThreeProjectionsfor
2030andBeyond1
LowCase
Paid-carejobsmore
attractive,feweremployed
caregiversleavethe
workforce
$190B
$110B$80B
MidCase
Paid-carejobsless
attractive,someemployed
caregiversleavethe
workforce
$290B
$110B
$180B
HighCase
Paid-carejobsunattractive,
moreemployedcaregivers
leavetheworkforce
$500B
$120B
$380B
Lostwagesfromunfilledpaid-carejobsLaborforceparticipationGDPloss
Sources:USBureauofLaborStatistics;BCG/DynataCaregiverSurvey(N=3,673);BCGanalysis.
Notes:Economiclossconsideredintermsofreducedincomeorwagesrelativetoforecast.Figureshavebeenrounded.1MeasuredinGDP.
BOSTONCONSULTINGGROUP5
“Careworkersandcarejobsaretrulyessential.Theyenableouremployeestoproductivelyshowupatwork,knowingthattheir
children,parents,lovedonesarewelltakencareof.Withoutthem,wewilllosevaluable,trained,andpassionateworkersandwon’t
beabletofillandkeepfilledthejobsweneedtothrivebothasindividualcompaniesandasacountry.Fillingpaid-carejobs
isn’tjustanissueforgovernments,itneedstobetopofmindforCEOsandexecutivestoo—wecanhelpsolvethis.”
–RichLesser,GlobalChairandformerCEO,BostonConsultingGroup
InterlockingSolutions
Thecareeconomytranscendstraditionalbusinessbound-aries,andsmoothingthepathforworkers,companies,andtheeconomyoverallrequiresinterlockingprivate,public,
cultural,andindividualaction.OurstudyshowsthatasmallchangeintherelativeattractivenessofcarejobsmakesabigdifferenceintheeffectonlostGDP.So,
thoughtful,targetedchangesmayhaveanoutsizedeffectontheproblem.Thatis:thereishope.
Oursuggestedsolutionsstartby(1)addressingthesupplyofpaid-careworkersand(2)
helpingrelievethecareburdensthatpreventablepersonsfromfullyengaginginpaid
workor,inmanycases,forcesthemto
quittheirjobs.(SeeExhibit3.)
Exhibit3-FiveKeyLeversforAddressingtheEconomicBurdenofCareActivities
Interventions
Solutionarea
Improvepaid-caresupply
Reduceunpaid-careburdensonemployedcaregivers
Levers
WagesTrainingandrecruitment
UniversalchildcarePaid-careleave
Workplaceflexibility
Public
sectoractions
•Wagesubsidies
•Increased
reimbursementrates
•Improvedtrainingprograms
•Recruitmentcampaigns
•Caresubsidies
•Subsidized
universalchildcare
•National
paid-caregiverleavepolicies
Privatesectoractions:
corporations
•Advocacyformoreattractiveworkingconditions
•Advocacyfor
care-workerpipelinegeneration
•Caresubsidies
•Onsitechildcare
•Advocacyfor
universalchildcare
programs
•Paid-leave
provisionforchildandadultcare
•Advocacyfor
nationalpaidleave
•Flexibleworkprograms
Privatesector
•Technologyandtoolsthatincreaseefficiency
•Carecoordinationtoolsandtechnology
actions:
innovation
andreducedifficultyofpaid-carework
thatreduceunpaid-careburdens
Enablers
Individualculturechange
toshiftcaregivingbalancesathome,removing“traditional”expectationsofwomenandmothers
Corporateculturechange
tosupportcaregiversandensureworkandfamilylifecancoexist
Societalculturechange
toplacehighereconomicvalueoncaregiversandcarework
Source:BCGanalysis.
BOSTONCONSULTINGGROUP7
BoostCareSupply
Wehaveenoughworking-ageindividualsintheUSto
fillthe1.8million(andgrowing)vacanciesincarejobs.AccordingtotheUSBureauofLaborStatistics,about
9millionindividualscouldbeactivatedtofillroles,
includinghomehealthaides,nursingpractitioners,andpersonalcareworkers,whichareprojectedtobeamongthefastest-growingoccupationsofthenexttenyears.
(SeeExhibit4.)
Thesearepeoplecurrentlyonthesidelines,including
thosewhoreportthattheyaren’tworkingbecausethey
havefamilyresponsibilities,arediscouragedbytheirjob
prospects,orarerecentlyoutofajobandinthemarketforanewone.Ofcourse,carejobshavetobecomeattractiveenoughtoenticepeopletocomeintotheworkforce.And,inmanycases,thesepeoplealsoneedtofindthesupporttomeettheirowncareresponsibilities.
Wemustalsoadjustexpectationsofwhoparticipatesin
thisworkbydestigmatizingcarejobsas“women’swork.”About80%ofpaidcaregiverstodayarewomen,butmen
areequallycapableintheseroles.Additionally,somecom-munity-carejobs—suchasafterschoolprograms—may
suitretireeswhodon’twantfull-timepositions.Adjustingwhatweconsider“workingage”isworthwhile,especiallyasthepopulationagesandhealthyolderAmericansthrivewithsuchsocialengagement.
Cross-generationalcareforoneanother—teensinteractingwithseptuagenarians,forinstance—isavirtuouscircle.
It’shappeningelsewhere.IntheNetherlands,forexample,universitystudentscanlivefreeinnursinghomesin
exchangefor30hoursamonthofprovidingcompanytoelderlyresidentsorteachingskillssuchashowtouse
socialmedia.4
Exhibit4-ActivatingDifferentLaborPoolstoSolveUSPaid-CareShortages
M=Million
Availabletowork
0.8M
(marginallyattached)
butnotlookingdueto
illnessordisability
pool
Activation
0.5M
Availabletowork
(marginallyattached)
butnotlookingbecause
discouragedordueto
familyresponsibilities
Wantajob
nowbutdidnot
seekemploymentinlastmonth
Donotwantajobnow
94M
+
Didnotsearchinlastyear
DTiopuorayejbolorsers
familyresponsibilities
DidnJotbsleavrrshin
Discoternotsr
familyresponsibilities
Didtwseenrtsin
6M
3.6M
Notinlaborforce
99M
+
Currently
unavailable
towork
0.6M
1.4M
Permanentjoblosers
+
Laborforce
165M
1.4M
0.9M
Employed
159M
+
6M
1.8M
16+
Non-institutionalizedcivilianpopulation
264M
Unemployedand
seekingemploymentinlastmonth
+
0.4M
Individualsavailabletofillcurrentjobvacancies
~9M
Sources:USBureauofLaborStatistics,August2022;2020Census.
4.“SeniorCareAroundtheWorld:InnovationandBrightIdeasfromCountriesAcrosstheGlobe,”Arosa,
/senior-care-around-
the-world/
.
8SOLVINGTHE$290BILLIONCARECRISIS
SelectiveimmigrationprogramsforqualifiedhealthcareworkerscanalsobridgegapsinpaidcarebeyondthecurrentUSlaborsupply.Suchprogramsareunderwayinother
countriesbuthaven’tbeentriedintheUS.Forexample,
Canadalaunchedthefive-yearHomeChildCareProvider
PilotandtheHomeSupportWorkerPilotimmigration
programsin2019,lettingindividualsworkinginchildcareorhome-supportprofessionsapplyforpermanentresidence.5
Fillingallthosecarejobs,ofcourse,wouldalsoprovidethecompoundingadvantageofunlockingtalenttofillthe
laborshortageinothersectorsacrosstheeconomy.
IncreaseWages
Toboostsupply,carejobsneedtobemoreappealingandvalued,startingwithhigherwages.TheaveragehourlypayofaUScaregiverislessthan$14.Thatcompareswith$19anhour,onaverage,forentry-levelworkatAmazon.
Onebarriertoboostingcaregiverwagesiswhoisfooting
thebill.Inthemajorityofchildcarecases,familiespay
individualsorcenters,andtheafter-taxexpensecanbe
overwhelming.Parentsofinfantsandtoddlersspendabout10%oftheirincomeonchildcaretoday,despitetheUS
DepartmentofHealthandHumanServicesrecommendedspendingcapof7%.6Withoutfamilies’abilitytopaymore,privateorpublicsubsidiesareaprimarysolution.More
companiescouldincludechild-caresubsidiesinemploy-
mentpackages,althoughpublicdirect-wagesubsidieshaveamoreimmediateeffectonraisingpayforchildcarework-ers—aquickerboostintheappealofthesejobs.TheEarlyChildhoodEducatorPayEquityFund,forinstance,provides$7,000to$14,000peryearinpaymentstoqualifiedfull-
andpart-timeworkersinWashington,DC.7
Ineldercare,raisingpayisrelatedtoreimbursementrates
fromgovernmententities,especiallyMedicaid,theprimarysourceoffundsoflong-termservicesandsupportforolderadults.Thesereimbursementratesanchorthesalariesfor
home-careandnursing-homeworkers—lowreimbursementratesresultinlowwages.Somegovernmentshavealreadyconsideredthis.In2021,Oregonintroducedanenhanced
wageadd-onprogram,increasingMedicaidreimbursementratestohome-andcommunity-servicesprovidersandnurs-ingfacilitiesby10%and4%respectively.Withthisprogram,thestatewasabletomandateminimumwagesforhome-careandnursing-homeworkersbetween$15and$17perhour,withincreasesoverfollowingyears.
Theeconomicargumentforincreasingadult-carewagesisstrong.ACityUniversityofNewYorkstudyestimatesthatpayinghome-careworkersbetween$30,000and$40,000
annuallydependingonthecity(versusthecurrent$22,000median)couldgenerate$3.6billionineconomicsavings
acrossthestate.8Costswouldpayforthemselvesthroughpositiveeconomicspillover,taxrevenue,publicassistancesavings,andproductivitygains,thestudyfound.
ImproveTrainingandRecruitmentOfPaid-CareWorkers
Somestatesalreadyareshiftingthenarrativearound
caregivingcareers,brandingthembothessentialand
rewarding.They’verevampedtrainingprograms,employ-
mentportals,andrecruitingcampaigns.Arizona,forin-
stance,isofferingpersonalizedcareermapsandconnec-tionstotrainingandtestingcentersandissponsoring
sharedworkerstories.Mainebudgeted$20millionto
promotehealthcarejobsin2022,with$1.5milliondedi-
catedtorecruitingcampaigns.Generally,statesshouldopttobothactivelyrecruitcaregiverstotheirworkforceaswellasmaketrainingprogramsmoreeasilyaccessible.They
candosobyprovidingonlineoptionsinmultiplelanguag-esandofferingcareer-pathwaysitestohelpprospective
caregiversunderstandjobprogressionovertime.
“Inourresearch,afewsessionsonchild
developmentincreasedcaregivers’jobsatisfactionbecausetheytaughtthemhowtobetterdotheir
job;inparticular,howtohandledifficultsituationswithgroupsofchildren.”
–MyraStrober,ProfessorofEconomics,GraduateSchoolofBusiness,StanfordUniversity,onprofessionalizingcaremanagementroles
RelievingtheUnpaid-CareBurden
About43%ofemployedcaregivers,orabout40million
people,relyonpaid-caresupporttogotowork.Theseem-
ployedcaregiversspendanother20to40hoursaweekon
theircareresponsibilities,basedonoursurvey.Tackon
another30hoursonreportedchoresanderrands,and
caregivingismorethanasecondfull-timejob.(SeeExhibit5.)
Workershortagesandrisingcostsstrainthecaresystem,
forcingmanyfamiliestomaketradeoffsbetweenpaidworkandcaringforlovedones.Theyneedcost-andtime-savingsupport.
5.“HomeCareProviderPilots,”C,
/canada-immigration/pilot-programs/home-care-provider-pilots.
6.WorkingFamiliesAreSpendingBigMoneyonChildCare,CenterforAmericanProgress,June20,2019,
/article/
working-families-spending-big-money-child-care/
.
7.“Washington,D.C.,OffersFinancialRelieftoLocalChildCareWorkers,”The19th,September20,2022,
https://19/2022/09/child-care-
workers-washington-dc-payments/
.
8.IsaacJabola-Carolus,StephanieLuce,andRuthMilkman,TheCaseforPublicInvestmentinHigherPayforNewYorkStateHomeCareWorkers:
EstimatedCostsandSavings,CityUniversityofNewYork,March2021,
/wp-content/uploads/2021/03/The-Case-for-Public-
Investment-in-Higher-Pay-for-New-York-State-H.pdf.
BOSTONCONSULTINGGROUP
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