{"id":3626,"date":"2026-11-13T01:46:40","date_gmt":"2026-11-13T01:46:40","guid":{"rendered":"https:\/\/tobelikethis.org\/?p=3626"},"modified":"2026-11-13T01:46:40","modified_gmt":"2026-11-13T01:46:40","slug":"book-care-the-politics-and-economics-of-caring-premilla-nadasen-2023","status":"publish","type":"post","link":"https:\/\/tobelikethis.org\/?p=3626","title":{"rendered":"Book: Care: The Politics and Economics of Caring (Premilla Nadasen, 2023)"},"content":{"rendered":"
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Care is often seen as one of the most basic forms of human concern. It involves looking after children, supporting older people, helping those who are ill and meeting the needs of others. Yet care is also work, and the way societies organise that work reveals much about their values, their economic systems and their treatment of people.<\/div>\n
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In Care: The Highest Stage of Capitalism (2023), the American historian Premilla Nadasen argues that care has become an important source of profit within modern capitalism. Her central concern is not simply that care workers receive low wages or poor treatment. It is that the economic system increasingly turns human needs, including illness, poverty and dependence, into opportunities for financial gain.<\/p>\n

Nadasen draws on feminist history, labour studies and Marxist thought to challenge the belief that care is primarily a personal or moral responsibility. She argues that care must also be understood as a political and economic activity.<\/p>\n

Care as work<\/h2>\n

One of Nadasen’s central arguments concerns the way societies define care. Domestic work, childcare, nursing and support for older people have long been associated with women. Much of this labour takes place within families, where people often regard it as an expression of love rather than a form of work.<\/p>\n

This distinction has important consequences. When society treats care as a natural duty, it becomes easier to overlook the time, skill and effort involved. Care workers may receive low pay precisely because employers expect them to find personal satisfaction in helping others.<\/p>\n

Nadasen argues that the language of care can conceal exploitation. Describing a domestic worker as ‘part of the family’, for example, may suggest warmth and belonging while obscuring the unequal relationship between employer and employee.<\/p>\n

Her argument also challenges the assumption that recognising care as valuable will, in itself, improve the lives of those who provide it. Public praise for care workers means little unless it leads to fair wages, secure work and greater control over working conditions.<\/p>\n

Social reproduction and capitalism<\/h2>\n

Nadasen places care within the wider concept of social reproduction. This refers to the work required to sustain human life and maintain society across generations. It includes raising children, preparing food, cleaning homes, supporting those who cannot work and helping people recover from illness.<\/p>\n

These activities make paid employment possible. Workers need food, housing, rest and support if they are to take part in economic life. Yet conventional economic accounts often give far more attention to the production of goods and services than to the work that sustains the people who produce them.<\/p>\n

Nadasen develops this argument by examining the history of slavery, colonialism and racial inequality in the United States. She shows how capitalism has depended on forms of care and domestic labour that exploit women, enslaved people, migrants and racial minorities.<\/p>\n

Her analysis challenges the view that the care crisis is a recent problem caused mainly by changing family roles or an ageing population. Instead, she traces its roots to long-standing systems of economic and racial power.<\/p>\n

<\/div>\n

The commercialisation of human need<\/h2>\n

A distinctive feature of Nadasen’s argument is her claim that capitalism has found new ways to profit from the need for care.<\/p>\n

Private companies now provide or manage many services that governments once delivered more directly. These include healthcare, social care, welfare administration and support for vulnerable families.<\/p>\n

This creates a tension between two different aims. Care seeks to meet human needs, while commercial organisations seek to earn revenue and generate profit. These aims are not always incompatible, but Nadasen argues that the pursuit of profit can lead organisations to reduce costs, limit services and exploit workers.<\/p>\n

She also examines the role of the state. Rather than treating government and business as opposing forces, she shows how public contracts can transfer substantial resources to private companies. In some cases, firms profit from administering the very poverty and hardship that public policy claims to address.<\/p>\n

For Nadasen, this raises a fundamental question: who benefits from the care system? The answer may not be the people who need care or those who provide it.<\/p>\n

The unequal distribution of care<\/h2>\n

Nadasen also questions whose needs receive public attention.<\/p>\n

Political debate often centres on the pressures faced by middle-class families who must balance employment with childcare or support for older relatives. These concerns matter, but they can obscure the experiences of poorer households and the workers who provide paid care.<\/p>\n

A family that employs a cleaner, nanny or care worker may gain the freedom to pursue paid employment. Yet the person providing that service may struggle to obtain adequate care for their own family.<\/p>\n

This exposes a contradiction. Those who sustain the lives of others may have the least access to the resources needed to sustain their own.<\/p>\n

Nadasen therefore argues that debates about care must address social class, gender, race and migration together. Improving care for one group should not depend on the exploitation of another.<\/p>\n

Radical care as an alternative<\/h2>\n

Although much of the book examines exploitation, Nadasen also explores how people have organised care outside conventional market relationships.<\/p>\n

She draws on the history of civil rights movements, women’s organisations and community activism. The Black Panther Party’s free breakfast programmes provide one example of communities meeting urgent needs while challenging the social conditions that created those needs.<\/p>\n

Nadasen describes her alternative as radical care. This involves more than kindness or personal concern. It seeks to change the social and economic structures that determine who receives care, who provides it and who controls the resources.<\/p>\n

Radical care emphasises collective responsibility, mutual support and democratic forms of organisation. Rather than treating people as passive recipients of help, it recognises their capacity to shape the services and communities on which they depend.<\/p>\n

This is an important distinction. Nadasen does not simply call for more compassionate behaviour within existing systems. She argues for changing those systems themselves.<\/p>\n

Care, ethics and social change<\/h2>\n

Nadasen’s work raises questions that extend beyond the care sector. Many professions, including education, counselling and psychotherapy, claim to place human welfare at the centre of their practice. Yet their institutions operate within economic systems that shape access, funding, working conditions and professional priorities.<\/p>\n

An individual practitioner may offer thoughtful and ethical support while working within an institution whose policies restrict the help available. Personal compassion cannot always overcome structural inequality.<\/p>\n

This is one of the book’s most significant insights. Care is not simply a quality of relationships between individuals. It also depends on the social conditions in which those relationships develop.<\/p>\n

There are, however, questions about how far Nadasen’s proposals can extend. Community-led care may offer more democratic and responsive forms of support, but complex healthcare systems also require specialist knowledge, large-scale funding and stable public institutions. The relationship between radical community action and universal public provision remains an important practical issue.<\/p>\n

<\/div>\n

The book also concentrates on the United States, where healthcare funding and welfare provision differ from those in Britain. Its account cannot be transferred to the British context without examining these differences. Nevertheless, its central questions remain relevant wherever governments contract out public services or care workers face insecure employment.<\/p>\n

Nadasen’s contribution lies in changing how we understand the meaning of care. Rather than asking only whether people care enough about one another, she invites us to examine the institutions, policies and economic interests that shape our capacity to care.<\/p>\n

The resulting question is both ethical and political: what would society look like if meeting human needs, rather than generating profit from them, became the main purpose of its care systems?<\/p>\n

Reference<\/h2>\n

Nadasen, P. (2023). Care: The highest stage of capitalism. Haymarket Books. ISBN 9781642599664.<\/p>\n

Further reading: Publisher’s description and book details<\/a>.<\/p>\n<\/div>\n<\/div>\n

<\/div>\n","protected":false},"excerpt":{"rendered":"

Care is often seen as one of the most basic forms of human concern. It involves looking after children, supporting older people, helping those who are ill and meeting the needs of others. Yet care is also work, and the way societies organise that work reveals much about their values, their economic systems and their […]<\/p>\n","protected":false},"author":1,"featured_media":3627,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[32,24],"tags":[],"class_list":["post-3626","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-pure-blog","category-sophistication"],"_links":{"self":[{"href":"https:\/\/tobelikethis.org\/index.php?rest_route=\/wp\/v2\/posts\/3626","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tobelikethis.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tobelikethis.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tobelikethis.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/tobelikethis.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3626"}],"version-history":[{"count":1,"href":"https:\/\/tobelikethis.org\/index.php?rest_route=\/wp\/v2\/posts\/3626\/revisions"}],"predecessor-version":[{"id":3628,"href":"https:\/\/tobelikethis.org\/index.php?rest_route=\/wp\/v2\/posts\/3626\/revisions\/3628"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tobelikethis.org\/index.php?rest_route=\/wp\/v2\/media\/3627"}],"wp:attachment":[{"href":"https:\/\/tobelikethis.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3626"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tobelikethis.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3626"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tobelikethis.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3626"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}