Robert Espinoza on The CareWorks Project & the Caregiving Economy

Harry interviews Robert Espinoza, founder of the CareWorks Project, about improving long-term care quality and delivery. Espinoza describes his 16-year career in the sector and argues the U.S. long-term care system was designed as an extension of hospitals, despite most care now occurring at home and people wanting person-centered, dignified support. They discuss affordability, citing annual median costs ranging from about $75,000 for home personal care to $170,000 for a private nursing home room, and an estimated $563 billion spent on long-term services and supports in 2023, alongside major unpaid and opportunity costs, including over $1 trillion in unpaid family caregiving. Espinoza warns of worsening workforce shortages, with high turnover and over nine million openings needed, and advocates for a federal social insurance program, stronger state experimentation, and more proactive immigration policy. He outlines CareWorks services in advising, program design, narrative change, and leadership support.   Topics 00:35 Robert’s Care Journey 03:09 Why Care Feels Institutional 04:54 Affordability and Hidden Costs 08:51 Unpaid Caregiving Economy 10:53 Crisis Becoming Catastrophe 12:43 Workforce Shortage Reality 14:04 Social Insurance Solutions 16:52 States vs Federal Action 18:42 Vesting and Social Contract 23:07 What CareWorks Project Does 25:34 Policy Ask Immigration Reform 27:56 Advice for Families 30:06 Closing Thanks