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I can tell you from firsthand experience that we’re not in a “sudden” caregiving crisis. It’s a catastrophe 50 years in the making.
If you want to understand how deeply broken America’s caregiving system is, consider this: The New York Times just published a sprawling 4,000-word essay America’s Caregivers are in Crisis about one family’s elder care crisis – a daughter juggling two increasingly fragile parents, a shattered leg, a ruptured tube, a father disoriented from chemo and dementia – and somehow still came away blaming the collapse mostly on the latest round of Medicaid cuts and immigration restrictions. Convenient targets, for sure. But focusing there is like pointing at the last flake of snow on an avalanche and calling it the cause.
To be clear, I think the Times story is heartfelt, beautifully written, and painfully familiar to millions of families. My own caregiving experiences have been challenging, leading me to leave behind my career to become a full-time caregiver due to the guilt, strain, and lack of care support.
But the framing in the Times essay? It’s exactly the kind of superficial diagnosis corporate America loves, because it distracts from decades of bipartisan neglect, profiteering, demographic denial, and policy choices that handed the future of eldercare to private equity chains, insurance middlemen, and unpaid women.
I can tell you from firsthand experience that we’re not in a “sudden” caregiving crisis. It’s a catastrophe 50 years in the making. And it didn’t happen by accident. It happened because political leaders, both Democrats and Republicans, were too busy pleasing donors and protecting corporate interests to address the unavoidable math of an aging nation.
It didn’t happen by accident. It happened because political leaders, both Democrats and Republicans, were too busy pleasing donors and protecting corporate interests to address the unavoidable math of an aging nation.
The truth is that America is aging into a care desert, and the institutions that should have warned us spent decades looking the other way—or cashing in.
Michelle Cottle’s piece captures the emotional chaos of caregiving: the 2:00 am hospital sprints, the disorientation and fear, the immigrant home-care aide who becomes the anchor of a failing system. Anyone who has ever cared for an aging parent read that and said: Yes, this is my life too.
But the Times presentation turns a structural collapse into a tear-jerker about one unlucky family. It gestures briefly toward Medicaid cuts and immigration policy, both real issues, but never asks the deeper question: Why is eldercare so fragile in the wealthiest nation on Earth? Why are millions of families just one fall, one bad diagnosis, one staffing shortage away from ruin?
Here’s what the Times doesn’t say:
I think it’s clear that caregiving is not a “family problem” but a deep national design failure—engineered through privatization, austerity, and the magical thinking that daughters and sons would always pick up the slack.
Here’s the part you won’t see above the fold in the Times: America handed long-term care to “the market,” and the market did what it always does: cut corners, extract profits, and leave families to hold the bag.
For decades:
The current administration’s Medicaid cuts? Bad. The immigration crackdown harming the frontline care workforce? Also bad.
But this crisis didn’t begin in 2025. It began when America decided that caring for our parents should be a private burden while corporate profits remained a public priority.
We are now living with the consequences.
And they are not overwhelmed families, or immigrant caregivers, or some abstract “strain on the system.” I think it’s clear that the real enemies are:
1. Corporate chains that treat eldercare as an asset class. Private equity now controls huge swaths of nursing homes, assisted living, and home-care agencies. Their business model is simple: raise prices, cut staff, extract profit, and pray no one looks too closely until the quarterly numbers hit.
2. Politicians who refuse to fund actual care infrastructure. We have social insurance for retirement (Social Security) and for medical care (Medicare). But long-term care? Nothing. Just vibes, wishful thinking, and a 700,000-person waitlist.
3. A culture that pretends family caregiving is an infinite resource. Women lose $320,000 in lifetime income caring for aging parents, per the MetLife caregiver study. But politicians treat this unpaid labor as if it costs nothing.
4. A workforce treated as disposable. Nearly 30% of direct-care workers are immigrants. We rely on them to keep our parents alive, then subject them to the threat of deportation. Instead of calling this “policy”, let’s call it for what it is: hypocrisy.
And the Times, for all its emotional clarity, still can’t bring itself to fully name these forces. It focuses on the pain, but not the power. On the collapse, but not the architects.
I think a real caregiving solution for America would look like this:
These things are possible and within reach, but they require political courage, not billion-dollar corporate lobbyists whispering in the ears of Congress.
It’s why I built CareYaya: a social enterprise that brings tens of thousands of healthcare students into care, at fair wages, offering families support that Washington refuses to provide. It’s not a replacement for real policy, but it is real-world evidence that America could rebuild caregiving if it actually wanted to.
What didn’t make it into the pages of the Times is that we aren’t witnessing a tragic accident, but rather, the result of decades of political decisions that protected profits over people.
America is aging. Families are breaking under the weight. And unless we name the real villains – the corporations, the profiteers, the policymakers who looked away – we will keep reading stories like Cottle’s for the next 50 years.
The care collapse is here. And until we stop letting the wrong people take the blame, we’ll never build the system every aging American deserves.
"Donald Trump and Republicans have left children and their families poorer and worse off in ways that will be felt for generations."
A report released Tuesday by Democrats on the Senate Finance Committee details how US President Donald Trump and Republicans in Congress are waging a multifront war on children by targeting healthcare programs, education, and nutrition assistance as part of their scorched-earth assault on the nation's safety net and redistribution of wealth to the very top.
"In just months, the Trump administration has gutted access to healthcare for millions of children, slashed funding for school meals and nutrition assistance, fired thousands of workers dedicated to advancing child welfare and protecting children, and unleashed policies that traumatize and harm immigrant families and LGBTQ+ youth," reads the report. "These actions are not isolated—they reflect a coordinated agenda that will leave a generation of children sicker, hungrier, and less safe."
As part of the sprawling budget reconciliation package that Trump signed into law over the summer, Republicans enacted the largest-ever cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP), slashing more than $1 trillion combined from the two programs.
Roughly half of all kids in the US are covered by either Medicaid or the Children's Health Insurance Program, and around 40% of SNAP beneficiaries are children, meaning cuts to those programs will have far-reaching impacts on the nation's youth in the coming years.
"By making the largest cuts to healthcare and food assistance in the nation’s history, Donald Trump and Republicans have left children and their families poorer and worse off in ways that will be felt for generations," Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, said in a statement on Tuesday.
"By dismantling the very systems that safeguard children’s health and future, Trump and Republicans are condemning a generation to poorer health, deeper poverty, and diminished opportunity."
In addition to denouncing cuts to Medicaid and SNAP, the new report outlines how the Trump administration is imperiling mental health programs by canceling grants and other funding, harming children's education by throttling Head Start funds, and inflicting deadly cuts to programs that aid kids overseas—all while delivering massive tax cuts to the richest Americans and largest corporations.
"Trump’s cuts to healthcare access, food assistance, and education have stripped millions of kids of the care, nutrition, and protection they need to thrive," the report states. "By dismantling the very systems that safeguard children’s health and future, Trump and Republicans are condemning a generation to poorer health, deeper poverty, and diminished opportunity."
"Unless stopped," the report concludes, "Trump’s war on kids will leave lasting scars on millions of children and weaken the nation for decades to come."
"Republicans have a million ideas regarding healthcare. Except one," said Sen. Bernie Sanders. "They will never acknowledge that healthcare is a human right—to be guaranteed to ALL."
As President Donald Trump postpones unveiling his supposed plan to tackle soaring US healthcare costs—reportedly after pushback from congressional Republicans—Medicare for All advocates have renewed calls for shifting to a single-payer system.
"Republicans have a million ideas regarding healthcare. Except one," Sen. Bernie Sanders (I-Vt.), who caucuses with Democrats, said on social media Monday afternoon. "They will never acknowledge that healthcare is a human right—to be guaranteed to ALL."
The union National Nurses United also called for Medicare for All on Monday, pointing to a recent West Health/Gallup poll that found 47% of US adults are worried they won't be able to afford healthcare next year, the highest level since they began tracking in 2021.
"The urgency around this is real," West Health president Timothy Lash told NBC News. "When you look at the economic strain that is on families right now, even if healthcare prices didn't rise, the costs are rising elsewhere, which only exacerbates the problem."
Over objections from progressives, including Sanders, a small group of Senate Democrats earlier this month agreed to help GOP lawmakers end the longest federal government shutdown in US history in exchange for just the promise of a mid-December vote on extending Affordable Care Act (ACA) subsidies to help over 20 million Americans who face skyrocketing premiums.
Citing unnamed White House officials, MS NOW reported Sunday that Trump was set to introduce the Healthcare Price Cuts Act to combat what the sources called "surprise premium hikes" as soon as Monday.
"The plan would also eliminate 'zero-premium' subsidies currently offered under the ACA, intending to stop 'ghost beneficiaries,' a frequent Republican concern about alleged fraudulent policy recipients, by requiring a small minimum payment as a means to verify eligibility to receive benefits," according to the outlet.
"The nascent plan also features a deposit program that would incentivize lower-premium options on the ACA exchange," MS NOW continued. "For individuals who downgrade coverage, the difference in coverage costs would be distributed to a 'Health Savings Account' provided with taxpayer dollars."
However, as Politico detailed Monday, also citing unnamed sources, "Trump's healthcare plan is in limbo after pushback from Republicans who were caught off guard by the president's forthcoming proposal—questioning, in particular, whether it would include additional abortion restrictions."
As parts of Trump's proposal continued to leak in the absence of its formal introduction, the American Prospect's Ryan Cooper and David Dayen wrote Tuesday that "all told, there's a good chance that Democrats will accept this offer, or something like it, as the best they're likely to get for the time being."
"If they are ever in power again, they can fix the ACA permanently, and avoid the danger of subsidies expiring (as the Prospect advocated back in 2021). But it's quite revealing as to the total bankruptcy of the Republican Party when it comes to healthcare policy," the duo added. "The GOP will flinch from more than doubling health insurance premiums—at least if middle-class people and up are the most affected—but only if they can also make the insurance worse, and make poor people pay more."
Last week, in a pair of op-eds and a letter to Democratic lawmakers, Sanders argued that "at a time when the Republicans have been forced to finally talk about the healthcare crisis facing our country, it is essential that the Democratic Caucus unify behind a set of commonsense policies that will make healthcare more affordable and accessible."
He called for not only extending the ACA tax credits, but also repealing Trump and congressional Republicans' $1 trillion in cuts to the ACA and Medicaid; expanding Medicare to cover dental, vision, and hearing; cutting prescription drug costs by requiring pharmaceutical companies to charge no more for medications in the United States than they do in Europe or Canada; investing in expanding primary healthcare; and banning stock buybacks and dividends, and restricting CEO compensation.
Although Medicare for All lacks majority support in the Democratic Caucus, Sanders—the ranking member of the Senate Committee on Health, Education, Labor, and Pensions—also emphasized his belief that it remains the ideal long-term solution. He reintroduced the Medicare for All Act in April with Democratic Reps. Pramila Jayapal (Wash.) and Debbie Dingell (Mich.).
Other single-payer advocates have also seized on current concerns and debates about the ACA. In a column for Truthdig last Thursday, Conor Lynch wrote that "with Republicans spotlighting the greed, corruption, and inefficiency of US healthcare, progressive Democrats have an opening to take Medicare for All off the back burner and renew the push for a comprehensive overhaul."
"The fact that Republicans are calling out insurance companies for their profiteering shows how much the national mood has changed since the passage of the ACA," he continued. "With Republicans unable to offer anything but a return to an intolerable status quo ante, Democrats should make the case for moving beyond the broken status quo."
The previous week, CJ Mikkelsen, a retired firefighter and paramedic now leading a small nonprofit in Michigan, made the case in the Midland Daily News that "we need a system like every other country in the developed world has."
Mikkelsen shared some of his and his wife's health struggles and stressed the society-wide benefits: "Medicare for All would mean that everyone is covered for everything at all times. No more losing coverage because you’ve lost your job, want to go back to school, or are starting your own business. The last thing I want you to know about Medicare for All, and pay attention here—IT’S CHEAPER THAN WHAT WE'RE DOING NOW."