In the private sector, some farsighted entrepreneurs are already stepping into the breach of the care economy. Sheila Lirio Marcelo, a Harvard MBA/JD who found herself caring for two small children and aging parents at the same time, founded Care.com because she was having trouble finding quality caregivers. Care.com is a marketplace for caregivers of children and the elderly; it matches a caregiver and an employer every two minutes. And it’s not just helpful to families and caretakers alike, it’s big business. The company raised $91 million in an initial public stock offering, and when it went public in January 2014, Care.com had a market value of over $550 million.
Bright Horizons is another company that successfully monetizes care. They provide a variety of services from high-quality early-education centers to emergency childcare to coordinating on-site daycare at various companies, hospitals, and universities. Bright Horizons is also publicly traded, and when it returned to the market in 2013, it was valued at $1.4 billion.
Real estate developers are also starting to respond to the caregiving needs of American families. In California, for example, developers are creating townhouses geared toward multigenerational families. These townhouses include bathrooms and bedrooms on the ground floor so seniors don’t have to use the stairs and then traditional nuclear family layouts on the upper floors. That way, the “sandwich generation” can take care of their parents, and the grandparents can help watch their grandchildren.
Seniors are also banding together so that they can grow old with their friends, Golden Girls style. It’s called “co-housing,” and a housing consultant told The New York Times that it will be especially appealing to boomers. The “social consciousness of the 1960’s can get re-expressed” through communal living, she predicted. I can personally testify to the pleasure of these arrangements; I share an apartment in Washington two days a week with a dear friend whom I have known since college. She moved from her home base in New York to serve in government; her husband comes down regularly. It’s just like having a college roommate again, complete with visits from the boyfriend!
Outside large-scale caregiving companies and real estate developers is a growing army of individual caregivers. Ai-jen Poo’s National Domestic Workers Alliance joined with twenty other organizations to create the Caring Across Generations movement. By focusing on changing U.S. demographics, particularly around aging, and pioneering innovations in home- and community-based caregiving, the movement seeks “to transform the way we care in this country.”
Caregivers for adults with dementia—Alzheimer’s disease and other forms—face special challenges. But as with children, education and specialized training can make a substantial difference both to the individuals being cared for and the caregivers. More broadly, the Family Caregiver Alliance is a community-based nonprofit organization that addresses the needs of the families and friends providing unpaid, long-term care for their loved ones at home.
Look also for an explosion of jobs based on providing different types of specialized care. We have always had doctors and nurses; now we have physician’s assistants of many different kinds and nurse-practitioners with multiple specializations. And therapists of every description for body and mind are proliferating: for balance, posture, gait, stress, and recovery from challenges ranging from joint replacements to stroke. These are not jobs that people take when they cannot get into “real careers.” They are jobs that require medical knowledge and skills as well as the ability to build a meaningful set of relationships with clients; they are essential to allowing all of us—from youngest to oldest—to lead better lives.
Beyond the market for high-quality paid care is a broader approach to thinking about our entire economy in a way that takes account of the value of care. How should we measure the social capital in our relationships and the human capital that we build through nurture and care? The Caring Economy Campaign is developing economic indicators that track social wealth alongside traditional measures of money and property. At the very least, we should be able to measure the economic value of care for children and adults. After all, the entire idea of the gross domestic product is a human construct; we can measure anything we think is important and seek to increase.
AN EXCEPTIONAL AMERICA
IN THE FOREIGN POLICY WORLD, and the political world generally, entire libraries have been written about American exceptionalism. As a nation, we have thought ourselves to be different from other nations from our very earliest days. In 1630, John Winthrop, who would become governor of Massachusetts Bay Colony, wrote, “We must consider that we shall be as a City upon a hill. The eyes of all people are upon us.” We were to be the shining example of people who could govern themselves, who could establish freedom of worship and expression, who could explore and develop what was, to us and to our fellow Europeans, “the new world.”
In the realm of care, the United States is largely exceptional for what it is not doing. We are alone among all advanced industrial countries (and indeed virtually among all countries) in not mandating paid maternity leave; many of our peer countries in Western Europe, by contrast, provide quite generous maternity and paternity leave. Britain, for example, even under austerity, provides up to a year of leave with at least some pay.
Beyond the early weeks and months of life, other industrialized countries offer an astonishing array of facilities and services to support parents and caregivers more generally, from daycare for children to adult care for the disabled, the senescent, and the dying. Former Norwegian minister of children and family Valgard Haugland sums up his country’s philosophy: “We have decided that raising a child is real work, and that this work provides value for the whole society.” It is only fair, then, “that the society as a whole should pay for this valuable service.”
These countries are already reaping the benefits, in terms of both competitiveness and social mobility. A decade ago, Andy, who has long studied European politics, told me that it was easier to move up from humble origins into the middle class in Europe than in the United States. I just couldn’t believe it. It seemed preposterous; our history is replete with examples of immigrants fleeing hidebound class structures and religious prejudice to make it in America.
Today, though, it’s impossible to deny. Multiple economic studies from a range of universities, think tanks, and international organizations have concluded that an immigrant to Denmark, Australia, Norway, Finland, Canada, Sweden, or Germany has a better chance of improving his or her lot than in the United States. Poor children in these countries have almost double the chance of climbing out of poverty as they do in the United States. To be sure, some of these countries are smaller and more homogeneous than America. But Canada, for instance, has a higher percentage of foreign-born citizens than the United States does, yet Canadians are twice as likely to move up the social and economic ladder as Americans are. And though multiple factors are correlated with social mobility—segregation, income inequality, schools, and family structure—the ability of families, supported by communities, to maintain a stable and caring environment for children plays a very big part.
We don’t have to do exactly what other countries do. In fact, some evidence suggests that the ultra-generous maternity leaves in Europe can actually hurt ambitious women. Claire Cain Miller points out in The New York Times that women in Europe are half as likely as men to be managers, while women in the United States are equally likely to be managers. This disparity is due to a combination of unintended consequences of long maternity leaves: women may put the brakes on their ambitions, and employers may be reluctant to put women of childbearing age in key positions because they fear they will be absent too much.
But here is what we can do. We can take our founding credo—“All men are created equal”—and understand it to mean that men and women are equal and that the work that was once divided between men and women—earning income and providing care—is equally necessary and equally valuable. We can also come to appreciate the many ways in which a caring society is a more
equal society.
Psychologist Carol Gilligan points out that we hear children yelling “You don’t care!” just as much as “That’s not fair!” “You don’t care” reflects the fear of abandonment that all vulnerable and dependent people fear—young, old, sick, or disabled. “That’s not fair” reflects the fear that those who have power will abuse it, will make or break the rules in favor of themselves.
Think about the implication of this point. It means that not being cared for is just as much a marker of inequality as being discriminated against. Both conditions are ways that those with power can take advantage of those without power—the young, the old, the sick, the disabled, the different, the structurally disadvantaged. “That’s not fair” can mean “You don’t see me or hear me; you don’t give me equal rights or regard.” “You don’t care” can mean “You have abandoned me in my time of need and vulnerability, when I could not assert my equality with my fellow citizens.”
As Americans, we should take pride in defining ourselves as citizens who care. Who care about our country and care about one another. Who remember that our past was not just a saga of rugged individuals setting out to conquer the land of opportunity, but also of barn raisings, quilting bees, grazing commons, and one-room schoolhouses. Who understand that we can only compete as a nation if we remember to care.
We can break through our current political logjams. We can reinvent ourselves once again, as we have many times before. We can be exceptional once again, not only for the speed of our computers and the power of our armies, but for the strength of our communities and the quality of our care.
CODA
In many ways this book is a love letter to my own family. They’ve always been the foundation of everything that I’ve done and all that I am; it’s no surprise that you’ve met various Slaughters and Moravcsiks within these pages. Still, over the past few years, as I’ve learned to look at the world through the dual lenses of competition and care, I’ve come to see many of my own family members differently, with newfound respect.
All my life, I’ve been keenly aware of how fortunate I am to have been born in the late 1950s instead of the early 1930s, as my mother was, or the 1900s, as my grandmothers were. Until recently, I saw these women in terms of what they could have been if they had only had the opportunities I have had. I’m still grateful that I came of age when those opportunities were expanding dramatically, but I now see these women—my foremothers—as having contributed just as much to society as their husbands did. They invested in their families; they educated and inspired their children, sons and daughters alike, to be what we have become; they cared for those in need, both immediate relatives and beyond. In the dry language of sociology and economics, they were the custodians of human capital. In a richer and more sensitive rhetoric, they were the nurturers of humanity itself.
My Belgian grandmother, Henriette Madeleine De Bluts Limbosch, married my grandfather, a medical student, in 1932, and had my mother and my uncle in quick succession. When the Germans occupied Brussels in May 1940, my grandfather refused to surrender with the Belgian army and instead managed to join the Allied Forces at Dunkirk and be evacuated to England, where he later joined the Special Air Service. After living under occupation for two years, my grandmother decided she would join him. Thus began a six-month saga worthy of Hollywood. She was an attractive young woman of thirty-four who would not take no for an answer.
My brothers and I grew up on the stories of her flight. She eventually dictated her memories of the entire six-month journey—from France to Switzerland, through Spain to Portugal, and finally by boat to London. Whenever her friends in the Belgian Resistance tried to arrange a way for her to slip across the border from occupied into free France, the response that came back was “Yes, but without the children.” On that subject my grandmother was adamant. She had no idea what the war would bring, and she simply would not leave her children behind. As she explained to my mother decades later,
Looking back now, with some life experience and age, I fully realize that it was total repression of the possible looming dangers. It also was, I guess, because I have a very optimistic personality. Often I have tried to imagine myself in a difficult situation, asking myself how on earth I was going to get out of it, and never would I think that I could not resolve the problem or get out of the plight I would be in. No, I never considered that I would not be successful in this particular endeavor and that it could really be disastrous for myself and my children.
I have to smile when I read that passage. It is so much Grandmère, a woman of such iron determination that when her doctors told her much later in life that she would only hobble due to a loss of cartilage in her ankle, she simply gritted her teeth, endured the pain, and continued to stride the streets of Brussels at a ferocious pace. She managed her household, her husband’s surgical practice, and the family’s investments, bringing a detailed perfectionism to everything she did. She was often strict and demanding—she used to correct the thank-you letters I sent her in French and send them back to me—but she was also willing to put in an unlimited amount of time with her grandchildren on schoolwork or any other projects to help them succeed.
I have always looked at my grandmother’s life and thought that her combination of determination, optimism, management ability, and ingenuity would have made her an amazing CEO—Belgian business might never have been the same! I still wish that she had had a much wider range of choices about how to live her life. But I now see a woman who made it possible for my grandfather to tend countless grateful patients, raised two successful children who have each contributed to the world in their own way, provided a critical safety net for several of her grandchildren, and brightened and improved the lives of many people.
Grandmère understood that the web of care requires work. She was a creature of duty. Her mother had insisted that her spine never touch the back of a chair when she sat (a posture lesson she tried but failed to pass on to her daughter and granddaughters). That same upright acceptance of the roles society assigned her gave shape and purpose to her life, caring not only for her husband and children, but also for her parents, my grandfather’s parents, friends, neighbors, and even Marie, her longtime housekeeper. It is society as a whole that assigns value and prestige to what people do; as I see it now, she added every bit as much social value caring for her family and community as her husband did caring for his patients.
My American grandmother, whom I knew as Ma, was cut from quite different cloth. Born Mary McBee Hoke in 1902, she grew up as an only child in Lincolnton, North Carolina, a small town where her family had lived for generations. When her father was named to the supreme court of North Carolina, the family moved to Raleigh. Her mother died suddenly when my grandmother was only eighteen, leaving her to be her father’s companion for a few short years until he died as well.
She was a young woman of means with a large circle of friends in the mid-1920s; her house quickly became the center of her set’s social life. She had graduated from what was then Saint Mary’s College—a school that then ran from elementary school through the first two years of college—and read law briefly with a local attorney. She traveled on her own, to Boston and even to Europe. The picture I have of her is of an independent, energetic, daring young woman ready to shape her own life.
Then she met Edward “Butch” Slaughter, an assistant football coach at North Carolina State University. She fell in love; they married in 1930. Shortly thereafter my grandfather took a job as the line coach at the University of Virginia and eventually moved his young family to Charlottesville, where they lived for the rest of their lives. Charlottesville was just several hours to the north, but in Ma’s eyes it was a completely different world: stiffer, more formal, and more socially conscious. She became the coach’s wife rather than the judge’s daughter; she devoted herself to her family but never recovered her former self-reliant and social self.
At her funeral I talked about her love of words, how her children a
nd grandchildren could recite the poems that she had memorized in her own childhood. I always thought she would have been a wonderful English professor. Or a lawyer, using her phenomenal memory for detail to build her case. She could sit down next to anyone from anywhere in the South, ask a few questions, and figure out how our family and theirs intertwined at some point over the past two centuries. The failure to harness that talent for a more productive use than identifying “kissing cousins” is a classic example of how societies lose out when they do not allow their women to achieve their full potential.
I have thus always thought of Ma’s life as a prime example of unfulfilled potential. And yet, to me, her first grandchild and only granddaughter, she was everything a grandmother should be. I wear her Saint Mary’s school ring, with the initials MMH, on my little finger; rare is the day that I do not look down at it and remember her. When I think of how her unconditional love and unflagging support for my every move have been part of the bedrock on which my own achievements have been built, I value what she did as much as I regret what she could not do.
I’ve changed my lenses on some of my current family members as well. After my article came out, a close childhood friend wrote and observed how different my father had always been from hers and from the other fathers we both knew growing up. I wrote Dad an email thanking him and wondering, for the first time, how it was that he came to be so progressive for a man in Virginia in the 1960s. He told me that as a trial lawyer he had handled a certain number of divorce cases in which men left their wives, who then had no means of supporting themselves. He vowed at that point that his daughter would never find herself in that position.
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