>(1) Yes, families do have the option to look after older members to a certain degree, and it's sad that parents in some societies are encouraged to separate themselves from their children and vice versa;
(2) But not everyone has children. Recall also that children are a huge unearnt burden to the state, while older people have already paid their national insurance / social security / whatever contributions and are just getting the care they paid for. We are all better off because we do not breed out of concern about our frailties; >
My preteen children year old are on firm warning... they can move out of state, but we parents are coming after them and moving into their attics/basements/spare rooms. There is no escape. And we live what we talk, taking care of our mother/mother-in-law next door.
Are we better off if people do not breed for the purposes of old age insurance? I doubt it. We are better off if people do not breed excessively out of fear that disease will utterly deprive them of offspring for old age, but it is probably more sustainable to "entrain" children in the care of parents out of a sense of duty, than it is to free them to maximize their income and then tax that income to pay "someone else" to provide elder care.
We might ask "would it not be more efficient for a lawyer or engineer to earn $200 K and pay someone else $50 K to watch an elder?" but that is probably a rare case. The cost of quality care is the cost of middle class income anyway, roughly, so why should this family service be exogenized into the market as opposed to remaining endogenous to the family?
Well there is ONE very good reason and that is that women are the vastly predominant providers of elder care services. Marketizing those services enables women to have public careers as opposed to be locked into the family care giver role... mother to children, nurse to elders... for their entire life. Families are only "free" if you ignore the lost opportunities they tend to cause for women.