Blog

December 18, 2018

Crisis in Elder Care

by Abigail Gutmann-Gonzalez

Originally appeared in the Winter 2018 issue of Democratic Left.

Women who work outside the home are facing a generational crisis as they find themselves searching for home care for elderly relatives. The U.S. elderly population, defined as those age 65 or older, accounted for 13% of the population in 2010, a figure expected to grow to 20% by 2030.

The elderly population has greater need for in-home care and few means to attain it. For this reason, caregiving often falls to the family—particularly wives, daughters, and daughters-in-law. Daughters are 28% more likely to care for an elderly parent than are sons, and women provide almost two-thirds of unpaid elder care overall. Time magazine highlighted the case of Ruby Lawrence, who had to shoulder the burden of caring for her elderly mother with dementia because her family could not pay for extended long-term care but was not poor enough to qualify for Medicaid. Caregivers like Lawrence may also experience negative psychological consequences, such as anxiety, depression, and stress, as a result of providing care.

Because women on average make 80 cents for every dollar that men make, women are often pressured to take on a caregiver role in order to ensure that the one wage shared in a family is the higher one. The sacrifices women make to provide elder care include decreased work hours, passing up job promotions, or quitting their jobs. The value of the informal care that women provide is estimated to be around $148 billion to $188 billion annually. At the same time, cuts to Medicare and Medicaid as well as rising costs of healthcare have led many insurers to push toward homecare and away from nursing homes. And, of course, most of the people employed in the homecare industry are women, who receive very little for demanding and demeaned work. In addition, because women outlive men on average, after caring for a spouse or elderly relative, they are often left alone, with nobody to care for them, and fewer economic resources to obtain care.

The for-profit health insurance industry makes high-quality elder care accessible to the wealthy and inaccessible to the working class. As Marxist feminists, we understand that removing the material cause of this inequality is our primary task. To relieve the burden of elder care that falls disproportionately on women, we need a publicly funded, universal, single-payer healthcare program that includes long-term elder and hospice care in its comprehensive coverage.

DSA’s National Medicare for All program advocates for just such a system. Prioritizing the health of working-class Americans, including the elderly, over the profits of insurance company executives is a crucial demand for Marxist feminists. Daughters and wives freed from the responsibility of elder care can enjoy greater equality within society. A reduced burden on their time, energy, and material resources will give women more independence to pursue their own ambitions—and more freedom to enjoy the company of their aging family members, without performing tasks that should fall to fairly compensated professionals.

Single-payer can only be won when workers stand up to health insurance companies—in the streets, in their workplaces, and at the ballot box—and demand that their interests be prioritized over corporate profits or tax cuts for the wealthy.

Abigail Gutmann-Gonzalez is a public health researcher and program evaluator. She is co-chair of East Bay Democratic Socialists of America and co-chair of the local Medicare for All Committee.