No, There’s No Such Thing As ‘Investing’ In Eldercare

Retirement

Back last month, I observed that supporters of greater federal government funding of child and eldercare, in the form of the American Jobs Plan spending, had taken to calling this “infrastructure spending” by redefining infrastructure away from referring to basic physical systems such as roads, electric or water systems, to a new meaning of “job-enabling jobs.” I had objected for multiple reasons: it’s acceptable to borrow for long-lasting improvements to the built environment but not day-to-day-spending, for one, but also because — yes, call be old-fashioned — I’m still not on board with advocates trying to persuade me by engaging in deceit, that is, by redefining words to suit their purposes.

Turns out, that’s not the only word being redefined.

What, after all, is an investment?

Here’s a serviceable definition: “An investment is an asset or item acquired with the goal of generating income or appreciation.” That’s from Investopedia. It seems common-sense enough, doesn’t it? For most of us, our investments take the form of our 401(k) or other retirement accounts.

We’ve also gotten used to other uses of the term, for example, hearing people speak of making in “investment” in a relationship by putting forth efforts to spend time with a person, even if we might cringe at the idea that we expect relationships to pay us back over time.

And advocates of increased government spending like to use that term to refer to infrastructure spending, to claim not merely that, say, a new highway would provide long-lasting usefulness, but that taxpayers will get their money’s worth, that increases in employment or the economy in general will more than make up for the initial cost.

That being said, here are some new ways that term is showing up in reporting and policy advocacy, with respect to the proposal to spend $400 billion over 8 years on increasing wages for home care workers for the elderly, and reducing the Medicaid home care waiting lists:

Washington Post, April 2, 2021,

“President Biden’s jobs plan proposes a massive investment in home care for the elderly and people with disabilities, as America’s caretaking system faces strain from the nation’s looming demographic challenges. . . .

“Biden’s plan says it would use $400 billion to ‘expand access’ to home care in a way that would also support ‘well-paying caregiving jobs.’ It does not specify exactly how to do either, although a substantial investment could both expand the supply of caretaking services and, potentially, drive down costs overall.”

The 19th, April 15, 2021,

“President Joe Biden’s administration has vowed to change that, proposing the first multi-billion investment in home care in the nation’s history: $400 billion to expand Medicaid payments to home and community health, nearly doubling the current annual allotment. . . .

“Meanwhile, demand for home care is only ballooning. Researchers say that while $400 billion represents an unprecedented, potentially transformative investment, the issue will require continued attention, especially as more Baby Boomers age into needing care and increased desire to age at home — rather than nursing homes — means more Americans in general are opting for home-based services.”

USA Today, April 12, 2021,

“You might say to yourself, “Why is the commerce secretary talking about investments in the care economy?” Biden’s Commerce Secretary Gina Raimondo said in a White House news briefing last week.”

To be clear, there is no element in the proposal which contains the construction of anything long-lasting. It’s not about building new residential or day facilities, nor does the proposal contain new research funding regarding dementia, or to create new devices to help the elderly live independently or reduce their need for caregiving. There is nothing about the proposal that could create anything new or sustainable; it’s merely for eight years of spending, at which point, well, it ends.

This is not investment. This is simply government spending. For a period of 8 years, it would help some number of elderly or disabled people, whose quality of life is reduced due to lack of care, and it would help some adult children or other family member-caregivers, who are unable to work themselves due to the time they spend caregiving, and it would help home care workers, whose pay is set a low rate due to tight Medicaid budgets.

But “investment” is simply not a synonym for “spending.” If I take the kids on a European vacation, I have not invested in anything, however much I might say that I am “making memories” or teaching the kids about other cultures. There’s nothing wrong with that, there’s no reason not to spend money, but it is not an investment.

And, likewise, when it comes to discussing federal spending, we have to acknowledge that there is necessary spending of all kinds, regardless of whether it “pays for itself.” Yes, I say this in part because I find it irritating when words are redefined for propaganda purposes, and all the more so when someone who wants to persuade me, attempts to do so through these word games rather than through a sound, reasoned argument.

But beyond that, to care for the disabled and the elderly does not in any sense, “pay for itself.” We do not provide this care because it will, over time, somehow or another, make us a more prosperous country. We do not even provide care for the disabled or elderly, nor should we increase the level of care that we do provide, because it is a job-creation program for potential caregivers.

Adopting the language of “investment,” as with adopting the rhetoric of “investment,” however much it is intended to make the spending program more appealing, is entirely missing the point, and risks doing more harm than good, if it leads toward metrics that assess the value of this spending by the future economic benefit, rather than the degree to which it meets basic human needs today.

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