5 Big Ideas

Care at Scale

In partnership with

The size of the problems we face in care are daunting–hard to access and afford childcare, a home health care industry that is still a bit of a wild west with massive supply issues, and inadequate, and sometimes even dangerous privatized facilities in which our elders age. This means the size of our solutions must be equally grand – visionary, accessible, and humane. Here are five ideas for care solutions at scale that make us hopeful about the future…


331 million served - if you interface with people, you interface with care.

Caregivers wield control of $6 trillion! We need to start seeing them as citizens and consumers who deserve better services and products to make their lives easier and more joyful. Corporations have a huge role to play in recognizing the scale of this demand–particularly when it comes to men, who are more willing to pay for care support, and families from a wide range of economic backgrounds, who we found are also hungry for more market-based solutions. How do corporations and other kinds of organizations that Americans interact with on a weekly, and sometimes even a daily, basis think more creatively about serving families and caregivers where they’re already showing up? There is so much untapped potential here. For some, it will begin with just naming, explicitly, that they are seeking to serve caregivers with products and services, such as Home Depot’s aging-in-place vertical and CostCo’s unprecedented attention to assistive devices for the aging population. 


Passing and implementing care policy is essential for all of us.

Care needs a robust lobby tantamount to the one that other urgent intersectional issues of our time have, like climate change. We need bipartisan federal leaders who understand that care is consistently a majority issue—an infrastructural issue, in fact—and something that can transcend partisan stalemates. As such, we celebrated President Biden’s unprecedented Executive Order on care earlier this year alongside our collaborators and colleagues, and yet we are very sober about the open questions on impact. We are at the beginning of a long journey. And it’s not just the federal level that is poised to deliver care at scale; innovation and advocacy at the state, city, and county levels are proving to have game-changing potential.


More widespread and vivid stories of care are fundamental to a caring future.

If we are going to demonstrate that care is a majority issue, we have to start telling stories–through film, television, radio/podcasts, on social media and in books–that transcend those who already identify with the caregiver identity and/or feel like they are a part of this movement. We are inspired by films like Crip Camp and Duty Free, made by past Care Guild honorees, as well as the cultural work of Caring Across Generations, which includes collaborations with Hollywood insiders like Alfonso Cuaron, director of Roma, and the writing room at This Is Us.


Scale is most promising where the frontier of technology meets our fundamental humanity.

Of course the scaling of care solutions can be realized through technology. There are so many exciting advancements entering mainstream America today–whether it’s new forms of monitoring to ensure safety of infants or elders, powerful dynamism in the connected home, or modernized tools for mobility, like the electrified walker. AI, of course, is the most promising in many ways–unleashing new capacity in the care concierge category, for starters. But we must make sure that as we take these giant leaps forward in scale, we keep humans at the center. What feels like witness and not surveillance? What makes one’s life easier, but not at the expense of connection? What can artificial intelligence do and what requires a human touch? These are questions that we should be designing around in the coming years to make sure that scale feels dignifying, not dehumanizing.


Sometimes scale grows from the tiniest of seeds.

Just imagine Ruth Beckford-Smith serving the first free breakfast to the first little cutie in Oakland as part of the Black Panthers program in 1969. That led directly to every Title I public school student in the country having something to eat every single morning. Or imagine Ed Roberts in the middle of the night with a motley crew of activist friends, hacking into the concrete and making the first curb cut in the 1960s. That, along with lots of daylight advocacy, led to massive infrastructure shifts that support, not just disabled folks, but everyone and anyone who lives and moves through cities. While scale is grand, sometimes it starts with a small group of citizens demanding more dignifying experiences for their own communities. In the process, they set a new bar for people in power to rise to, fast-tracking the scale of impact.

Alva J. Fisher
James P. Steyer
Mark Edwards
Kathleen Taylor
Michael Dembrow
Rachel Schumacher
Tim Knopp
Sarah Vanover
Bob Wieckowski
Tony Thurmond
Richard Bloom
John Cotton Dana
Yoky Matsuoka
William L. Gee
Tawni L. Nazario-Cranz
Marie-Louise Ansak
Scott Bomar
Harvey Karp
Nina Montée-Karp
Chiquita Brooks-LaSure
Sree Chaguturu
Ed Roberts
Craig Jelinek
John Marick