A CAPITALIST SOCIETY measures value by what it’s prepared to pay for people’s time. So, what to make of the fact that when it comes to the hard work of care, Americans pay the most—$14.80 an hour—to the people who walk their dogs? Those who tend to children and the elderly make considerably less, according to PayScale, a compensation data and software company.

But don’t blame free-market forces, says Sudarshan Sampath, PayScale’s director of research. Dog walking is a competitive business, while roughly 70% of home health workers are paid by Medicare and Medicaid. The government caps reimbursement for the service at a rate that—given operating costs and margins—makes for paltry wages, says Jeounghee Kim, an associate professor at Rutgers who studies the care economy. Parents, meanwhile, tend to pay for childcare and often rely on family members or unlicensed providers; for regulated services to compete, they have to keep wages low.

With a senior population that is expected to double in the coming decades—not to mention a shortage of professional caregivers already— Sampath sees the artificially low wages as a real issue: “The economic case doesn’t make sense anymore.” Kim calls it a crisis that has so far proved “too expensive to fix.”