When women reach critical mass in any institution, or industry, it’s a tipping point. Critical mass can be between 20-30%, depending on the ratio of leaders and rank-and-file women. There’s a huge body of research that shows, whether it’s a legislature, a corporate board, a Navy ship, or an appellate court, when women reach this tipping point they begin to change how things are done - for the better. Jay’s best-selling book looks at everything from Hollywood and the end of the casting couch culture to the historic numbers of women running for office.

These days in Washington people like to remark: We live in interesting times, in the best sense of the ancient Chinese curse. We are in the midst of a once-in-a-500-year information revolution. Not since the invention of the printed press has the world been so disrupted. Smart phones are changing the way Americans hail cabs, book hotels and, of course, consume news. And they want to see their government equally disrupted. The problem is our bureaucracy was built by founding fathers who viewed rapid change as akin to tyranny: they imposed checks and balances to ensure deliberation. Add to that the disruption of media as outlets struggle to find footing in the digital age, fake news and twitter-sized attention spans. The collision of reality tv and cable news that led to Donald Trump’s presidency is just at the beginning of this war between two immutable forces, disruption and government, which will redefine our democracy for centuries to come.

America is short more than one million family caregivers and we will be short more than 4 million by 2030, the year that the last of the Baby Boomers turn 70. So just as the need for care will be the highest, the quality and supply of it will be the scarcest. Despite the anticipated bankruptcy of Medicare’s main hospital fund in 2026, and cascading failures in the states’ Medicaid systems, and spiraling costs that will bankrupt much of the American middle class, few people are paying attention to the crisis. The federal government passed a bill in 2018 to study the situation, but a reopening of health care policy is unlikely until after the next election at the earliest. Enter the states, unions, startups and non-profits. In recent years Hawaii, Washington, New York and Maine— and cities like San Francisco—have sought to pass laws and programs to address caregiving issues have been tackling wage issues for the senior care workforce. Startups like Honor, Care Academy and Jay’s MemoryWell have also begun to tackle the issue. And non-profits have pushed to pair schools and senior communities on hyper-local levels. But these efforts will do little to stem the catastrophe that will pull millions of mostly women out of the workforce just as they are reaching critical mass and finally making as difference.