Care: The Highest Stage of Capitalism

by Premilla Nadasen

An eye-opening reckoning with the care economy, from its roots in racial capitalism to its exponential growth as a new site of profit and extraction.

Since the earliest days of the pandemic, care work has been thrust into the national spotlight. The notion of care seems simple enough. Care is about nurturing, feeding, nursing, assisting, and loving human beings. It is “the work that makes all other work possible.” But as historian Premilla Nadasen argues, we have only begun to understand the massive role it plays in our lives and our economy. 

Nadasen traces the rise of the care economy, from its roots in slavery, where there was no clear division between production and social reproduction, to the present care crisis, experienced acutely by more and more Americans. Today’s care economy, Nadasen shows, is an institutionalized, hierarchical system in which some people’s pain translates into other people’s profit.

Yet this is also a story of resistance. Low-wage workers, immigrants, and women of color in movements from Wages for Housework and Welfare Rights to the Movement for Black Lives have continued to fight for and practice collective care. These groups help us envision how, given the challenges before us, we can create a caring world as part of a radical future.

Genres: Nonfiction, Politics, History, Feminism, Sociology, Economics, Labor

299 pages, Kindle Edition

Published October 10, 2023

Reviews

[Sunny Lu · Rating 5 out of 5]

Thought provoking, provocative, straightforward & accessible. Forces you to sit with discomfort in a particular way that I really respect. Docking half of a star off my rating (so 4.5) because the text didn’t get into the family abolitionist ethic of understand the labor of care

[Durakov · Rating 3 out of 5]

I liked this and especially appreciated the glimpse into welfare, domestic labor, and care organization happening in the US. The chapters on domestic labor and labor trafficking were very insightful and informative. The polemical points around social reproduction were also thought provoking and helpful to think through. It's also eminently readable.

However, the author falls prey to two classic leftist tropes that are less insightful than comfortable and familiar. One is naming a new kind of capitalism or economy, in this case "Care Economy". The claim implicit in the title that we have entered into a new "phase", "stage," or type of capitalist economy seem dubious at best. I also can't grasp the stakes involved in doing this. Why does it matter? I think Nadasen would probably say it draws our attention to less obvious processes in the economy, which is fine, but I think framing it as a stage, phase, or type is somewhat confounding. Even if care takes up greater shares of spending in the US, capitalism is a social system and a series of evolving social relations. If one sector expands in one place, other sectors must correspondingly expand or contract. Trying to systematize one or another shift under a title will lead us down the wrong path in the long run.

When she finally does start talking about what she means by "accumulation" in the care economy, it's clear she's actually talking about extraction (from revenue earmarked for federal or state relief programs) or straight up fraud. This is all true and well put, but I think framing these as part of the capitalist accumulation cycle (M-C-M') is confusing, since it's consuming money that is more often than not spent and not reinvested. This is part of a theoretical move: Nadasen wants to blur the line between social reproduction and production in the cycle. Point taken, and I think she complicates the easy division well enough on more than one occasion, but whether this signals a new process is dubious, since this kind of extraction has always existed.

Second is having to end the book with a "radical dreaming" and "radical care" or some other optimistic but poorly defined future-oriented outlook. She starts the final section recalling the Black Panthers' and Young Lords' food and health programs, and then pivots to recent mutual aid and horizontal care networks. No problem there, except that the division between nonprofits doing normal versus "radical" work seems ambiguous to me. But then a number of the final projects and books discussed add little besides insisting that mutual aid is prefigurative, or radical dreaming is important. Why? Is it actually prefigurative? Of what? How could we know that? Do we really need dreams and maxims? After reading the book up to that point, my takeaway was not that we need to "rethink" care or dream better, but that we need real material structures capable of tending to needs at a mass level. I'm very skeptical of theories that look at tiny mutual aid societies in cities and imagining any kind of scaling up, since I can't think of any examples where they were able to maintain their style and ethos. Nadasen doesn't necessarily do that, but she does quote multiple authors who do for an account of "radical dreaming." I think a more grounded presentation of the organizations doing care work would still have left the reader with some optimism, but without drifting into the clouds.

All that sounds very critical, but the historical sections and basic analysis are good and the book is certainly worth reading!

[Brooke Gordon · Rating 4 out of 5]

The last chapter "But Some of Us Are Brave" is my new roman empire.

[Breann Hunt · Rating 2 out of 5]

My beef with the book started in the intro. You crack open the spine, ready for anything, and you're met with a deluge of jargon. For a book that purports to generate working class solidarity as its aim, it is incredibly inaccessible. For readers who may be sincere in their desire to learn about this issue but unfamiliar with specific terms, you will not get a compelling or satisfactory definition of anything. You will instead be confronted by the most archaic prose imaginable.

More substantively, my issues are as follows:
- The author wants to take down every ideology, proposal, movement etc without coming up with any solid, clearly articulated alternative. You just learn it's "bad" because of "neoliberalism". Like yeah, I already knew about that so what principles should we adhere to now? no answer for that.
- Quoting of sources favorable to her arguments, while just summing up arguments she wants to attack. Wants to wade into the weeds of minute details of how specific terms are used etc but doesn't give the other side a fair trial.
- Often read more like a case study of the one organization this author had a lot of first hand experience of. Which is fine for a book if you're upfront about it, but this book claims to be about more systematic, sweeping issues and just referring to the same case study gets old fast.
- Needlessly pedantic. Obviously sympathetic to underrepresented voices but spent too much time fighting about what care work does or does not entail. Is this a study of the way people use this term? I have a hard time believing that on the ground care workers care about the details of this protracted debate, and I feel that the author is biased by her advocacy for the more professionalized "organizer" class.
- The organization of the book lends itself to repetition, a lack of clear chronological history of the issue (relevant because she talks about care being really bad now, and also in the past, but sometimes it was better (like in the 70s), but also who knows because she never explains it very well)
- She keeps changing the definition of a "care worker". Always leaves you guessing. Is it teachers? Is it nurses? Is it babysitters? is it house cleaners? live in servants (do we have those any more?) and no clarity on how big any of these groups are. Like if there are 500 live in servants in America, we have bigger problems I hate to say it, and we need to focus on those low key. And it assumes that each of these groups of so called care workers has the same set and depth of concerns but in fact, I don't think that’s true and especially, it was not proven to be true in any argument the author makes.

[nkp · Rating 4 out of 5]

Well researched and well written. I picked this up because it follows a lot of my prev interest in family abolition and social reproduction. It also ended up being a nice companion to Foucault class, since one of the criticisms of his work comes from his lack of gender analysis. I learned a lot about the social reproduction bit + got more insight into how social welfare programs reroute funds to the rich- an idea I was vaguely aware of already but was never explicated to me. Makes me want to read more about the New Deal and how it failed to curb inequality, not because the programs were badly designed but because not enough was done to aim the programs towards people in need vs letting it leak to business interests.


I really need to stop reading other goodreads reviews, especially for theory books, because it just highlights how much capitalism flattens insight and imagination. How can someone read thru this whole book detailing the failures of capitalism in handling the care economy and chuck it aside once the text proposes NOT letting capitalism handle the care economy. Makes me sad.

[KT · Rating 5 out of 5]

An excellent book about care - nurturing, feeding, nursing, assisting and loving human beings, in other words "the work that makes all other work possible" as defined by the Domestic Workers United and National Domestic Workers Alliance

The care economy, as an institutionalised, hierarchical, profit-oriented system in which wealth is accumulated by the for-profit sector, the state, nonprofits, and individual families and household, has benefited ideologically as well as monetarily from the evisceration of the public sector as a result of capitalism remaking itself by turning to forms of accumulation that are rooted in the very crises it has created. Contemporary capitalists earn profit from producing and sustaining humans, sometimes for their labour power, but increasingly because they need care. The profits of care accrue from providing market-based services, managing state programs, or financing people's efforts to combat poverty and misery, so if the defense industry profits from death and destruction, the care industry profits from disability, dependence, and disease
The book envisages the abolition of the care economy in the long run, but only as part of a broader shift away from a profit-oriented system of racial capitalism

Reviewing the writing on care work that valorises the presumed connection between paid care and emotional investment, thus transferring employers' hopes and expectations onto the work, the book points out that the language of care and emotion erases the inequality and power dynamics inherent in the employer-employee relationship that caters to the needs of employers, while employees are valued only to the degree that they serve their employers
The book is keen to separate the emotion of care with the practice of care as one might engage in caring acts without an emotional attachment. By valorising paid care as emotional labour, employers' expectations for an emotional investment and "familial love" are transferred onto the worker and fail to recognise how those demands are exploitative and inhibit resistance.
Thus the book comes to the conclusion that an occupation should not be defined by emotion, in that workers should not be expected to invest emotionally, nor should the discourse on emotions eclipse the rights of the worker or determine what tasks they should do

Reviewing the debates about whether domestic work is productive (in a Marxian sense) given the profit now earned from social reproduction, the book concludes that there is no inherent contradiction between capital accumulation and social reproduction

The book does a good job of drawing on the history and fact that the paid labour of social reproduction is predicated on racialise and class power that is inextricably connected to the legacy of slavery, immigration, settler colonialism, and imperialism. Thus, the language of care-as-emotion has no more place in discussions of paid domestic work than the language of affection has in studies of slavery. This logic has been buttressed by the deployment of the term "care work" on behalf of neoliberalism to detach the paid labour of social reproduction from the history of racial capitalism and capitalist labour and profit

[Amelia Figler · Rating 1 out of 5]

I thought some of her point made a lot of sense but what she backed it up with didn’t make sense. Also didn’t feel like she really came up with tangible things to do besides abolish capitalism.

[Robyn · Rating 4 out of 5]

I appreciate this book’s intervention into what has become a sort of common-sense and abstracted term on the left, “care work”. I think the author demonstrates why it is important and useful to root our thinking back into the concrete and material. I can also imagine that this is a call to sections of the left who might under-appreciate and thus under-examine social reproduction, as well as issues of oppression, and their relationship to capitalist production. It’s helpful in sharpening analysis of social reproduction for the current moment. I liked her questions on how to relate to states’ involvement in providing care to people, within and beyond capitalism — resource intensive medical care, for instance. I also appreciate ways that the book grounds itself in accounts of people doing various kinds of social reproduction work — who they are, their working conditions, and how they became connected with movements (for domestic workers rights, migrant justice, and more). Goodreads user @Durakov articulates a critique of the author’s analysis that I found really helpful. I think maybe this book is trying to speak to “everyone” on the left, which can sometimes muddle the analysis and lead to examples in the last chapter that don’t line up with some of what seems to underpin the broader arguments she is making. Anyway, an impressive book that I would still certainly recommend!

[hannah peterson · Rating 2 out of 5]

I originally rated this book 3 stars because despite its shortcomings, I was appreciative for the minimal amount of sources it provided me for my QP research. After further reflection however, I do think this book is kind of a mess. The idea of “care workers” is an extremely important one, so why did the definition of what they are change with each chapter? By broadening the research subject it makes the argument not as powerful. My second qualm is that nothing is defined. So much of my research this summer has been about the concept of neoliberalism, but no one (including this author) seems to want to define it. It’s always assumed, but this is a case where it needs to be properly defined or else the reader is going to get confused. That and reiterating the same point over and over just makes this book repetitive and like you are using big words to impress the reader when you yourself don’t actually know what they mean.

Not to bring it back to my research, but when I think of people who are most in need of care workers in their home, I think of the disabled, the young, and the elderly. While those groups of people were brought up in each chapter, it seemed like the author skirted around them whenever they possibly could. How are you going to write a book about care workers and those who need care, when avoiding the people who need the care almost entirely? I am grateful for the minimal research this was able to provide me, but overall felt sloppy and rushed.

[Shubh Thakkar · Rating 5 out of 5]

I feel like this is truly one of the most life-changing books I’ve ever read. I’m super glad I read this right after reading Matthew Desmond’s Poverty in America, as the theory & examples presented in this book are further evidence that the suffering of poor people is completely preventable.

The way the author discusses the concepts of radical care is so eloquent and well-informed, and it encouraged me to continue viewing myself as part of an interdependent community that shows up for each other. Lots of revelations, especially in the last chapter!

This book ENRAGED me at times (such as the discussion of how the state quite literally PREYS ON CHILDREN — makes sense that this government has no regard for children that are victims of settler colonial forces abroad when it literally doesn’t care about kids within its borders). Such an informative and emotional read 100/10

[Marnina Hornstein · Rating 5 out of 5]

Made me question everything I thought I knew about the care field. I'm hoping to incorporate a lot of this book into how I practice social work in the future. I feel like the book provided a lot of history but I would be interested in reading more interventions to combat for-profit care.

[alex]

im pissed off at the state

[Anne · Rating 4 out of 5]

A really beautifully well-researched book that exposes the systems of racial capitalism that underpin the care system.

I read this book over such a long period of time that I honestly can’t remember what the beginning chapters were like. What I do remember is that an abolitionist feminist demand for care demands the end of capitalism and that the urge to care for others is not economic but rather redemptive and inherent in all beings and especially feminists.

I still find it appalling that in a recent lecture I attended on palliative care, when we were naming issues with the current hospice system, nowhere did anyone talk about the overworking and underpaying of care workers who are often immigrants who have no choice but to accept the conditions they are forced to work under. I really want to use this book as a framework to push institutions like hospitals to recognize the work of these caretakers.

[Ren Morton · Rating 5 out of 5]

Of all the nonfiction books that I may recommend, this one is a must read if you’re desperately trying to figure out what is going on and how we can do it differently. Written for a popular audience, this book nevertheless provides solid academic background and empirical date for her main argument: that social reproduction (activities that provide for the well-being of families, intergenerational needs, and communities) is not in conflict with capitalism (the “it’s not cost effective” argument), but that capitalism actually expands to extract profit from care needs. Even beyond that, capitalism causes the needs so that it can extract profit from providing the services to “address” the need. The crisis generates profit, so there is a vested interest in maintaining the state of crisis. (Thus “crisis capitalism” where everything feels like it’s in crisis or things have to be made into a crisis to garner attention). Using care services and the pandemic as the point of departure, Nadasen uses financial reports, corporate websites, government budgets, and labor statistics to “follow the money” - demonstrating that while expenditure on care now exceeds military spending, vary little of it actually benefits recipients. Instead, through public-private partnerships, the money is funneled into the salaries of CEOs. They don’t want to solve poverty or make people “self-sufficient,” they want all those problems into increase so they can get the lucrative government contracts. Thus our tax money is paying CEOs and leaving us in ever more precarious situations. But take a breath. The last chapter discusses alternatives that have been long imagined and implemented. There are alternatives, there are post-imaginaries. And this, above all, must be disseminated and stewarded.

[L]

A Marxist feminist analysis of care and the care economy that really gets at so many of the things I’ve been craving. The articulation of social reproduction is really compelling, especially as a way to link disparate forms of care. I’m especially appreciative of some of the questions raised around care and abolition, and the documentation of how the non profitization of care and poverty often re-allocates resources to middle-class professionals rather than directly giving people the funds they would need to survive and thrive. Continually thinking about what the role of reform should be in the care movement, and also what it would look like to continue to advance a “care not cops” abolitionist agenda — one that recognizes that in order to build our care we must reject both the carceral state and militarism. I’m also thinking a lot about care geographies and the role of sites of supposed care (eg, prisons), which is picked up in this book and is a definite opening for more inquiry.
I’m a little skeptical of the title itself … I would have loved to see more direct linkages between the care economy, especially its current for-profit privatized apparatus, and monopoly capital and empire (for example, migrant domestic workers in the US are not only immigrating due to the ravages of US imperialism on their home nations, but very much part of empire’s continued “extraction”—would be nice to link this to Rodney’s underdevelopment). It’s trying to do a lot, especially in the last chapter, which ultimately left me with more questions than answers.
Overall, just a very readable, comprehensive, rigorous book. Definitely could be assigned to somebody who had never dabbled in these topics before, which is always a beautiful and necessary thing.

[Megan · Rating 5 out of 5]

This book was a lot more serious that I expected and I really liked it. The book dissects the care profession in respects to race, gender and where they fell in the timeline of life. I get the feeling from reading this book that the author recommends dismantling entire systems but I honestly can't see how that is possible considering the people that were voted in recently which appear to be setting us back decades. Another thing that has come up for me recently is hearing about AI robots. I sound crazy writing this but I heard it on a podcast and I think that it could be true. Some companies are trying to make human-like robots to "wash laundry, wash dishes, take care of people in nursing homes, take care of older relatives who are living at your house." Sounds like they would like to replace or "help" us workers of the care industry. I am a carer and so I have some skin in the game, but if every job can eventually be replaced by bots, what will we do all day? Hmmm. And will relaxing all day need to be replaced too? Is this slavery of the bot? I'm not saying I am for or against robots, but I do have some concerns. When do we stop? Which jobs don't need replacing? Is the goal to replace every single job? So much to think about.

From the book:
“In fact, keeping people of color in a perpetual state of crisis made them more controllable as workers.”

[Albrecht Dürer · Rating 3 out of 5]

I was assigned this book for a graduate history course for analysis of race and gender. The first six chapters were well organized and supported with several valid sources. The final chapter is where her thesis falls apart. Once I read her solution to the care crisis was abolishing capitalism and creating socialist communities, I discounted the book as having any real solution and therefore was nothing more than an anti-capitalist rant directed at white people. She cites several examples of Democratic Presidents (specifically FDR and LBJ) as creating or exacerbating the struggles of mostly poor minorities, but refuses to blame them. Instead she blames Capitalism, Neoliberals and white people. She praises liberals for "valiantly" promoting change, but their ideas also fail which she also ignores. She refuses to acknowledge that liberals and rich people of color also benefit from the crisis of care.

Remove the final chapter and this book is a great history on the struggle and abuse of minorities, especially women. Something needs to be done because their struggle is still real, but abolishing capitalism is NOT the answer.

[Merricat Blackwood · Rating 3 out of 5]

Lots of very interesting reporting and marshalling of facts. Some of the structuring arguments seemed really weak to me. E.g., it seems like Nadasen is often writing against the claim that there's a looming crisis of care or social reproduction and that the untenably high cost of care (particularly for children, but also for the elderly and disabled etc.) is going to collide with the basic need to keep bringing up future generations of the workforce. Her argument seems to be that capitalism has already resolved this tension by finding ways to extract profit from care work; she's obviously right about the extraction but I just don't actually see how that resolves the tension. The last chapter of this book seems nearly interchangeable with like five other Verso books that I have read, highlighting the work of several tiny (although obviously very admirable) mutual aid organizations and inviting us to imagine, revolutionarily, that they could be seamlessly scaled up to serve 350 million people. This chapter also does the unbelievably frustrating thing of asserting that in the post-capitalist future we will have Community, and Community will be Nice for everyone in it, and that will be that. I.e., Nadasen's vision for care for disabled people in the future is "messy dependency," "where mutuality is not reciprocal but based on desire, ability, and agency." Okay, what if you are old and your family has moved away or you are alone in a foreign country and no one has the "desire" to care for you? Does this not just cash out to "no actual enforceable right or entitlement to care"?

[McKenna Heap-Garner · Rating 2 out of 5]

I was so intrigued when I started the book. The discussion at the beginning about how the valorization of care work justifies our exploitation of care workers hit deep. But then the author lost me in the jargon and her frustratingly broad and incoherent definition of care workers. Are they domestic workers, nurses, and teachers? But also doctors and surgeons? By taking such a broad approach, I felt like the impact of her argument was diluted and difficult to follow. And then there were no real actionable solutions, other than abolish everything and let communities naturally fill the void. Okay. I’m always on board for creating a more caring society, but getting rid of all established systems of care and expecting community members to provide for each others’ complex needs doesn’t seem super feasible, and it sounds like a recipe for even more exploitation. Who is actually going to do the care work, and how will that be enforced?

[Moizza · Rating 3 out of 5]

I wish I could rate this higher, since I agree with everything argued, but I found this pretty unfocused, repetitive, and overly polemical for what could be a point of consensus among those debating the changing roles and functions of labor in late capitalism: that teachers, nurses, and other care workers aren't fairly compensated because of how care is (de)valued in society. Nadasen is a historian, so her approach is heavy on description and light on data analysis. The Marxist concept of social reproduction is only one lens through which care work could be viewed, and while I understand and appreciate this view, I didn't learn anything about labor from this that I didn't already know going in.

[Michael Brown]

Daniel Denvir on this book:
"A reckoning with the care economy, it traces its logic in history, showing that it’s an institutionalized hierarchical system in which some peoples’ pain translates into other peoples’ profit.
As Sarah Jaffe put it, it takes apart the care industrial complex that has emerged like the military and prison industrial complexes before it, to wring the last drops of profit from the lives and deaths of working people."

[Amanda Cox · Rating 1 out of 5]

A book about the care industry, mainly composed of women and marginalized communities, and how they're not treated well by society.

I didn't finish this book. I read about a quarter and just didn't jive with it. I agree to the premise that care work is often overlooked in our society and how that's a problem. But the tone of the book was way to academic and preachy for me to enjoy the writing.

Read as an audiobook. Did not enjoy the tone of the narrator.

[Rhiannon Johnson · Rating 5 out of 5]

I received a copy of this book from the publisher

I took a class called The Commodification of Care in college. This text is pretty much that course crammed into a single book. Very impressive.

[E]

This should actually be required reading!!!

[gv · Rating 5 out of 5]

Absolutely brilliant. I want everyone I know to read this. I don’t think I will ever stop talking about this book!! So good to read right after “Household Workers Unite.”

[Carley · Rating 4 out of 5]

Learned a lot, felt seen, super readable which I loved.

[Lisa K · Rating 5 out of 5]

essential essential reading

[Rae Simpson · Rating 4 out of 5]

Minuteman. Rec by Harriet. Important concept, now swept aside by survival issues.

[Caitlin B · Rating 5 out of 5]

A must read. Extremely informative and illuminating read on the care system and who really benefits.

[Nadia · Rating 4 out of 5]

Було цікаво. Але це книжка лише про США і їх контекст.

Вражає, що авторка / активісти різних ініціатив називають потребу / вимогу державної/ комунальної/ спільної турботи про дітей / хворих / літніх і тд людей "антикапіталістичною" та "комуністичною". Зразу відчутно, що мова йде про дуже індивідуалістичну культуру, в якій всяка спільна турбота і догляд має назву аж "radical care".