The people who can compete and succeed in this culture are an ever-narrower slice of American society: largely young people who are healthy, and wealthy enough not to have to care for family members. An individual company can of course favor these individuals, as health insurers once did, and then pass them off to other businesses when they become parents or need to tend to their own parents. But this model of winning at all costs reinforces a distinctive American pathology of not making room for caregiving. The result: We hemorrhage talent and hollow out our society.