“I Don’t Do It for the Money”

This chapter highlights the need for public policy to change how we value the work of home health aides (HHAs). Communities continue to relegate the work that HHAs do to the category of menial labor, when in fact it is something much more important and difficult to do well, more a profession than unskilled labor. In 2019, the number of HHAs for elderly Americans fell far short of those needed in many locales. Mean-spirited, xenophobic immigration policies may soon further reduce the numbers of people who are available to care for the elderly. Without enough people to do this work, the United States will move deeper into a second-rate nationhood. If there are not enough aides to go around, private-pay care will grow more expensive, and public long-term care at home will be reduced or eliminated for many, while wait times to receive what care is left will increase. Ultimately, people's lives will be of less quality than they might have been, and they may die sooner than necessary. The chapter then outlines a number of specific plans which have been elaborated to show how a better system of home health care might be funded in the United States.