How much is $470 billion? It is $120 billion more than the government spends on Medicaid in a year. It is nearly 90 percent of the federal Medicare budget, and it is over half of our annual Social Security obligation. $470 billion is a big number, but it is also a quiet number that represents the value of care that an informal workforce of 40 million family caregivers collectively provides to their loved ones every year.
Former First Lady Rosalynn Carter quintessentially captured just how meaningful $470 billion can be when she said, “There are only four kinds of people in this world—those who have been caregivers, those who currently are caregivers, those who will be caregivers and those who need caregivers.”
{mosads}In the U.S. today, the aging of the baby boomers means that the population of older adults is growing at an unprecedented rate. In just the next three years, nearly 15 million people will turn age 65. By 2030, one in five of us—or 73 million people— will be 65 or older, and most of us will either need care or need to care for someone. As evidenced by the numbers alone, the vast majority of that care will be unpaid.
But how are we taking care of our caregivers? How are we taking care of ourselves as caregivers? The magnitude of these questions—the magnitude of caregivers’ contributions—is only now sinking in with policymakers and the public.
As we make policy shifts and public investments to respond to the aging of America, we cannot lose sight of the fact that we depend on the contributions and investments of caregivers to make the policy pieces fit. Without these spouses, adult children, other relatives and close friends providing essential emotional, physical, financial, medical and social supports, our country would have a $470 billion piece missing in our aging and healthcare policy puzzle. Communities, states and the federal government depend on the work of unpaid caregivers to meet the home and community-based services needs of an aging population.
But caring for those we love also carries a personal cost. Crisis situations often precede many caregivers’ entry into an unfamiliar and sometimes scary role. Complex medical and social systems often complicate the experience of caregiving. We know this job takes a toll. Studies have shown that being a caregiver can be detrimental to one’s health, and that those negative effects worsen with time and age. So what happens to the care recipient if their caregiver can no longer provide support? What does it mean for the caregiver’s own aging experience? What does this all mean for taxpayers if our informal workforce of 40 million caregivers providing $470 billion worth of care to friends and family gives up? And what are we doing to ensure that this doesn’t happen?
That’s why the aging of our nation must also drive real investment and improvement in solutions to supporting caregivers. The good news is we are not starting from scratch. For 17 years, the National Family Caregiver Support Program (NFCSP; Title III E of the Older Americans Act) has supported caregivers of older adults through locally developed and delivered services, including training, support groups, respite care and access to other services that can make caregiving just a little easier, such as adult day programs or home-delivered meals for their loved ones.
But with a growing population of older adults and a dependency on informal caregivers, we must consider meaningfully expanding existing successful supports for NFCSP and other federal programs that cannot currently even begin to meet the need. n4a’s membership—the nation’s 622 Area Agencies on Aging and more than 250 Title VI Native American aging programs—administer local aging and caregiving programs and understand the tremendous value of caregiving services to both caregivers and older adult care recipients.
Unfortunately, NFCSP and all the Older Americans Act programs and services are vastly underfunded despite ever-escalating demand. NFCSP provides roughly $150 million to support caregivers across the entire nation—which is, despite a growing need and costs, several million less than it was seven years ago thanks to budget cuts and sequestration. Congress must, at a minimum, increase NFCSP appropriations in FY 2018 so that local programs can reach and support more caregivers. Next, Congress should explore policy solutions to expand existing successful models of caregiver support and coordinate federal leadership, policies and resources to develop policy solutions to preserve and strengthen the country’s informal, yet essential, workforce of family caregivers. Taking this responsibility seriously will honor those who have been, and currently are, caregivers. We owe this effort to those who one day will be caregivers. We owe it to ourselves—for one day, we will likely need a caregiver.
Sandy Markwood is the CEO of the National Association of Area Agencies on Aging.
The views expressed by this author are their own and are not the views of The Hill.