Paid care services such as child care, elder care, teaching, and nursing are vulnerable to competitive pressures that often generate low-pay/low-quality outcomes. Both workers and consumers suffer as a result. This article develops an economic analysis of the “care sector” that emphasizes the potential to build political coalitions that could push for a high-pay/high-quality alternative.

This essay argues that concerns regarding the impact of work/family balance on gender inequality should be extended to broader analysis of all care work. Paid or unpaid care devoted to all dependents has distinctive characteristics that contribute to disempowerment and underpayment. Expenditures of money as well as time increase economic vulnerability. Public policies should provide greater support for caregiving outside the market, improve the supply and quality of purchased care services, and challenge conventional accounting systems that mismeasure economic welfare.