Elder Care Reformation (ChanyoungJeongFirstEssay)

-- By ChanyoungJeong - 21 May 2025

Elder care policies in the United States are structurally broken, rooted in Western society’s rigid and deeply ingrained emphasis on individualism. The nation’s near-religious devotion to personal independence and liberty, while foundational and often admirable, has distorted into something harmful. This obsession with self-sufficiency has shaped a system that sees dependence not as natural, but as weakness. Yet aging is not failure; it is a biological inevitability. The crisis we face is not just financial, but cultural and political. And our refusal to confront it with the seriousness it deserves is a moral failure and a national disgrace.

The Limits of American Individualism in an Aging Society

The prevailing American model of family life rests on independence. Parents raise children until they turn 18 or 21, then those children are expected to build their own lives. Over time, parents become visitors in their children’s homes, and eventually, they are placed in nursing facilities. This trajectory may once have worked in a different economic reality, but it now collapses under the pressure of high costs of living, lower birth rates, and the rising median age.

We no longer live in multigenerational homes. We move apart, both geographically and emotionally, and there is little infrastructure to support the reconstitution of those ties when dependency returns. The result is abandonment, not out of malice, but out of exhaustion.

Increasing Median Age

In 1980, the median age in the U.S. was 30. Today, it is nearly 39 and still rising. Americans are living longer due to medical advancements, but those extra years often involve debilitating conditions like dementia, fractures, and chronic disease, especially in the final decade of life. These years require care, not just medicine. And yet, our health system offers little to no structured support.

Medicare begins at age 65 but excludes most long-term daily care. Medicaid is the only public program that covers it, and only for the very poor. One must have less than $2,000 in assets to qualify, and even then, they face years on a waitlist. In between, the majority of middle-class families—too rich for Medicaid, too poor for private options—are left stranded. A home health aide averages $60,000 a year. A private nursing home room costs $110,000.

Current Government Offerings Result In Financial Difficulties for Middle Class Citizens

The financial strain is devastating. Thirty percent of older adults have stopped saving. One in four are accruing more debt. The system does not fail silently; it ruins lives. And still, the conversation remains muted, stifled by a cultural aversion to discussing death and dependency, and by the political grip of the private insurance and long-term care industries, which benefit from the current chaos.

We have done better before. Social Security nearly eliminated old-age poverty in the 1930s. Medicare brought universal health coverage to the elderly in the 1960s. But for long-term care like feeding, bathing, and basic life-sustaining services, we have left a gaping hole. A new layer of universal social insurance is not just desirable, it is necessary.

Solution #1: Increasing Pay and Benefits of Elder Care Workers

The elder care workforce is underpaid, overworked, and largely made up of women and immigrants—many of whom are being actively driven out of the workforce by the current presidential administration. It is crumbling under pressure. High turnover undermines continuity and quality of care. Government-backed wage standards, benefits, and training programs would stabilize this sector and improve conditions for both caregivers and patients.

Solution #2: Mandate Elder Care Benefits In Employment

Employers should be required to offer elder care support, including paid leave, flexible hours, or subsidies, just as many now do for child care. Companies like Johnson & Johnson have shown this can boost employee retention and well-being. Scaling this nationally would ease pressure on millions of working caregivers.

Solution #3: Establish a National Eldercare Benefit

A robust, tax-funded program, modeled on Social Security and Medicare, could provide long-term care for middle-income Americans. It would reimburse families, subsidize professional care, and incentivize innovation. Countries like Sweden and Japan have succeeded with similar models. We can too, but this requires moving away from our low-tax, low-service model toward a more social democratic vision.

Political Reality and Human Urgency

Of course, such reforms face political resistance. But they are not impossible. Demographic reality—the aging of the baby boomers and the shrinking workforce—will soon make inaction unsustainable. We will also need to expand immigration to meet the rising demand for caregivers. A humane elder care policy is not just a moral necessity, it is an economic one.

Conclusion

The question is no longer whether elder care should be improved. The question is whether we will admit that aging, like childhood, is a stage of life that demands collective care. The United States once led the world in recognizing that the elderly should not live in poverty or die without medical care. It is time to finish the work. A national elder care system is not a handout. It is an investment in our shared future.

https://moglen.law.columbia.edu/twiki/bin/view/Main/ChanyoungJeong

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