Worker-to-Owner Pathways in Community Health Care
We are embarking on a listening campaign to learn from workers, families, community leaders, and policymakers who understand the realities of today’s care economy. Our aim is to design solutions that help workers become owners, improve health outcomes, and reduce costs by shifting resources toward prevention and back into local communities.
The Challenge
The U.S. care economy is in crisis. Families face soaring costs for childcare, eldercare, and basic health services, while workers providing these essential services earn poverty wages and have no pathway to stability. In California, even credentialed graduates in community health, home care, and behavioral support struggle to secure jobs that pay a living wage. Meanwhile, healthcare systems continue to pour billions into high-cost emergency and institutional care, spending $400,000 a year to keep someone in a locked psychiatric bed, compared to $27,000 for community-based support. This mismatch drains public budgets and leaves communities underserved. The paradox is stark: rising costs and worsening outcomes, with dollars flowing into systems that treat crises but fail to build long-term health or wealth. Without new models, the care economy will remain a cycle of underpaid labor, overburdened families, and unsustainable public spending.
The Opportunity
With Futuro Health, we have a chance to transform the care economy from a cycle of low wages and high costs into an engine of health and shared prosperity. The pathway is simple but powerful: move workers from jobs into ownership. Instead of entering into unstable, low-paid positions, healthcare workers can become co-owners of enterprises that deliver care closer to home—community health hubs, neighborhood care homes, childcare and eldercare cooperatives. Ownership changes incentives: workers stay longer, provide better care, and reinvest earnings locally. Families gain affordable, culturally competent services in their own neighborhoods. Governments and insurers save money as dollars shift from expensive hospitalizations and crisis care into preventive, community-based solutions. Each new enterprise becomes not just a workplace but a local economic engine anchoring wealth, creating jobs, and strengthening the social fabric. This is the worker-to-owner pathway in action: healthier communities, stronger local economies, and a care system that delivers more for less.