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Melinda Gates: How rethinking caregiving could play a crucial role in restarting the economy

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Gates, Melinda
Publication Date: 
7 May 2020


As workday interruptions go, it was a cute one. Midway through a video call with our foundation’s covid-19 response team, a naked toddler appeared in the corner of the screen.

Comic relief is in short supply these days, and we all welcomed the laugh. Later, it occurred to me that the moment had a certain symbolic significance. It is — and should be — impossible to have a meaningful conversation about recovering from this pandemic without addressing an aspect of Americans’ lives that is too often invisible: caregiving.

To safely reopen the country, healthy people need to be able to go to work and sick people need to be able to stay home. We know that will require scaling up testing and contact tracing. We overlook that it will require scaling up caregiving solutions, too. It’s hard to stay home sick in a country where 1 in 4 workers lacks even a single paid sick day. It’s also hard to get back to work when you’re responsible for children or older adults but have nowhere to turn for safe, affordable care.

Even before the pandemic, caregiving options were inadequate and expensive. Now, everything that already made life hard for working families is about to get worse. Forty-seven states have closed schools for the academic year. Thousands of day-care centers may never reopen. The threat of covid-19 has made otherwise self-sufficient seniors reliant on their families in new ways.

It’s no mystery who will bear most of the burden. It’s women. It’s always women. Even though most women now work full-time outside the home, they still spend two hours more each day on household tasks and caregiving, are 10 times more likely to stay home with their sick children and are nearly three times as likely as fathers to quit their jobs to take care of a family member. The data tell us that the unpaid caregiving work done by women in their households is, in fact, one of the biggest barriers they face to equal opportunity in the workforce. Post-pandemic, they risk falling even further behind.

If there were ever an excuse for inaction, there isn’t one anymore. To ensure a fast and inclusive recovery, governments, business leaders and investors need to make caregiving a priority.

Lawmakers can start by expanding access to paid sick and family leave for the duration of this crisis. The emergency provisions recently passed by Congress are an important first step, but they provide too few sick days and cover too few workers. Future stimulus packages should also offer additional assistance to child-care facilities, so they can stay open to serve essential workers now and return to full capacity when needed.

Congress should also enact a national paid family and medical leave policy that will guarantee men and women the ability to take time away from their jobs to care for a loved one or recover from an illness without threatening their financial stability. Paid leave has been shown to improve the health of women and children, boost men’s participation in caregiving and keep women in the workforce. It should be a cornerstone of our social contract.

But even with these new federal policies in place, workers with caregiving responsibilities would need increased flexibility from their employers. Some companies have rapidly scaled up remote-working capabilities, which, if kept in place, could actually improve recruitment and retention of female employees in the long run.

We also need solutions for essential workers, who, studies show, are more likely to be women — and, more specifically, women of color. To keep the country running — and keep these nurses, transportation workers and grocery-store cashiers in the workforce — employers should explore offering options such as modified schedules, on-site child care, and subsidies for child care and eldercare.

New market-based solutions can help, too. Parents looking for alternative child-care arrangements may look, for example, to a company called Winnie, which connects parents and child-care providers. Seniors and their caregivers may look to Papa, which offers older adults rides, assistance and companionship. My company, Pivotal Ventures, has invested directly and through partners in these companies and others as part of our broader strategy to drive caregiving innovation. Entrepreneurs with bold ideas to modernize care should have the opportunity to realize them.

It shouldn’t have taken a national emergency to put caregiving on the agenda, but it isn’t the first time this has happened. During World War II, governments and businesses partnered to open “war nurseries” across the country. While Rosie the Riveter was on the assembly line, she needed child care.

But when the war ended, the soldiers returned, Rosie was sent home and the nurseries closed. Instead of using the lessons from that emergency to better prepare for the next one, America shifted the responsibility onto someone else.

As it turns out, that someone was us. We may not have created the broken caregiving system, but our only chance of recovering and rebuilding is to be the ones who fix it.