Vice President Kamala Harris' recently announced "Medicare at Home" plan represents a crucial acknowledgment of America's caregiving crisis. However, it's a band-aid on a gaping wound—a wound that exposes the deep-seated inequities and systemic failures in our approach to elder care and support for family caregivers. I believe with some thoughtful adjustments, the proposal can lead to a more equitable elder care system in America.

The numbers are staggering: 53 million Americans provide unpaid care for aging or disabled loved ones, sacrificing their own financial security and well-being. By 2030, all Baby Boomers will be over 65, comprising 21% of our population. This demographic shift demands not just incremental change, but a radical reimagining of how we value and support care work in our society.

Harris' plan, while well-intentioned, risks perpetuating a broken care system that exploits caregivers—predominantly women and people of color—while failing to meet the diverse needs of families. By focusing on paying for "designated" Medicare aides, the current proposal supports only the high-cost portion of the market: the traditional for-profit home care agencies.

The current system is a microcosm of larger societal inequities.

That leaves behind many other care options that are vital to addressing our urgent care crisis. It ignores the reality that 78% of adults requiring long-term care solely rely on family and friends for support. And of those who can afford to pay for help, nearly a third rely on the “gray market” of informal caregivers. These groups—family caregivers and informal non-professional caregivers – should also be covered if Medicare were to pay for home-based care. Otherwise, the Harris proposal is favoring a for-profit home care agency system, at the expense of more affordable options, that the majority of people rely on.

Beyond affordability, many people actually prefer to not deal with the for-profit care market. One NIH-funded study on home care needs revealed a stark truth: patients value vouchers to pay for........

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