Squeezed with Yvette Nicole Brown

Episode Title: Bonus: Xavier Becerra Talks Caregiving in America
Date: October 2, 2024
Host: Yvette Nicole Brown
Guest: Xavier Becerra, U.S. Secretary of Health and Human Services

Episode Overview

In this bonus episode, Yvette Nicole Brown sits down with Xavier Becerra, the United States Secretary of Health and Human Services, to discuss the profound and complex realities of caregiving in America. Drawing on both his policy expertise and personal experience as a caregiver, Becerra responds to the real challenges faced by listeners—ranging from the cost of elder and child care to navigating benefit systems, mental health, and the emotional journey of caring for loved ones. The conversation is empathetic, honest, and aims to connect government action with the everyday lives of caregivers.

Key Discussion Points & Insights

1. Personal Caregiving Journeys and the Emotional Weight ([00:02]–[05:47])

• Becerra shares about caring for his father:

  • "He is one of my heroes. He is the guy who taught me how to do work in the garden, to build things inside the house... he showed me how to never give up."
    — Javier Becerra ([01:29])
  • Moving his parents in with him in 2017 due to his father's congestive heart failure.
  • The last year of his father's life required hospice and more intimate care, culminating with family surrounding his father when he passed.

• Yvette’s parallel caregiving story:

  • She’s cared for her father, who has Alzheimer's, for 10 years, acting as "the caretaker of his memories" ([03:43]).

• Becerra reflects on acceptance and the end-of-life transition:

  • Shares a heartfelt doctor’s advice about letting his father enjoy his favorite foods:
    "You let him have whatever he wants... you get to that point where you do everything you can, especially for someone you love... at some point, you let them make the decision."
    — Javier Becerra ([04:31])
  • Light-hearted banter about favorite treats (Drumsticks ice cream) brings levity and warmth.

2. Addressing Real Caregiver Challenges from Listeners ([06:37]–[15:00])

a. Paid Leave and the Sandwich Generation

• Need for affordable care for both young children and elders.
• Federal policy focus: Making care (child, elder, disabled) more affordable and home-based.
  • "The care economy counts on us to be there for them ... The closer people are to the place that they know and love and where people love them, the better the care will be."
    — Javier Becerra ([07:12])

b. Long-Term Insurance and Costs

• A listener’s long-term insurance is running out; future care could bring large out-of-pocket costs.
• Policy update: The administration is aiming to make home care more affordable and improve standards for nursing homes, including requiring a nurse in every facility ([08:17]).

c. Mental Health Parity for Youth

• Mental health coverage is often denied under commercial insurance.
• Becerra: There's a legal requirement for mental vs. physical health coverage parity—families should know their rights and appeal wrongful denials.
  • "People are duped into buying insurance policies which... are really just junk... you don't really get the coverage you need." ([09:13])
  • Encourages complaints to the Office of Civil Rights if insurance companies deny rightful coverage.

d. Exploding Costs of Childcare

• A single dad spent $70,000 on NYC childcare for triplets in one year.
• Becerra: "America, while it's the richest country in the world, is not affordable for families... Our economy will be depending on these kids... If we can't even provide them with the care they need... it's not a very smart investment."
  ([11:21])

e. Dementia Models and Support for Caregivers

• The new "GUIDE" program is a Medicare-supported, voluntary model for improving dementia care.
• Emphasis: Caregivers should understand their entitlements and persistently demand the support loved ones deserve, as lack of information often leads to unnecessary heartache ([12:19]).

f. Support for Immigrant & Non-English Speaking Families

• Recognizes need for translation, legal help, and home-based care information.
• "We have to make sure people know their rights. We have to make sure people understand what services are available."
  — Javier Becerra ([13:49])

g. Supporting Stay-at-Home Parents

• Jessica, a listener and former daycare worker, became a stay-at-home mom due to safety and education concerns.
• Becerra: Changing the status quo is difficult, but efforts focus on supporting home-based models of care ([14:47]).

3. Reflections and Takeaways from Becerra ([15:00]–[16:35])

• Lessons learned as a caregiver:

  • "You just have to be patient and you become like the parent for your parent, and you learn to give to them what they gave to you when you were a baby and as you were growing up."
    — Javier Becerra ([15:08])
  • Emphasizes emotional, spiritual caregiving, not just financial/logistical.
  • Acknowledges his own privilege and intent to honor parents' dignity.

• Yvette’s closing gratitude:

  • "It is literally my pleasure to explain to him... how things move in the world now, because he's forgotten. It is the greatest privilege of my life to be his caregiver. I pray I get to do it for another 20 years."
    — Yvette Nicole Brown ([16:35])

Notable Quotes & Memorable Moments

• "His last year, probably his last six months... at that point where we let him have what he wanted when he wanted it, it felt pretty good because he was happier."
  — Javier Becerra ([04:31])
• "You let him have whatever he wants... at some point, you let them make the decision."
  — Javier Becerra ([04:41])
• "You tell him we support him in his effort to have that drumstick."
  — Javier Becerra, joking about ice cream ([05:47])
• "[Caregivers] should let us know if insurance companies deny mental health service claims... you may be entitled to get payment... It's a matter of knowing your rights and using all of us as your soldiers on your side."
  — Javier Becerra ([09:49])
• "How do you help him still feel the dignity and respect of what was a man who was dying?"
  — Javier Becerra ([15:56])
• "It is the greatest privilege of my life to be his caregiver."
  — Yvette Nicole Brown ([16:35])

Important Timestamps

• [01:29] Becerra shares his father's legacy and early days caregiving
• [03:43] Yvette relates her caregiving journey with her father
• [04:31] Story about letting his father enjoy life near the end
• [07:12] Discussion on paid leave for the sandwich generation
• [08:17] Policy on long-term care costs and insurance
• [09:13] Mental health parity and insurance pitfalls
• [11:21] The unsustainable cost of childcare in America
• [12:19] New Medicare “GUIDE” program on dementia
• [13:49] Support for immigrant/LEP caregivers
• [14:47] Stay-at-home parents’ unique challenges
• [15:08] Becerra’s biggest lessons as a caregiver
• [16:35] Yvette expresses the privilege of caregiving

Closing Encouragement

• Resources: Listeners can contact the Department of Health and Human Services at hhsieahs.gov or file complaints with the Office of Civil Rights if denied mental health coverage ([17:15]).

This episode is an honest, deeply relatable conversation connecting national caregiving policy with individual experiences. It underscores the blend of empathy and advocacy needed—whether in family homes or in the highest offices of government—to make care not just a private struggle but a shared priority for the nation.