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The Road to Hell

'The road to hell is paved with good intentions.'

Anon

My task was simple. Or so I thought. I sat down to write this book just as the world was emerging from the coronavirus pandemic, confident it wouldn't take long. I had a strong narrative and a clear backstory. The characters were already familiar to me. And, to be honest, the concept of the book is pretty simple to convey.

There are two central ideas. They are connected to each other in fairly obvious ways. The first is that human prosperity, properly considered, is primarily about health rather than wealth. The second is that, in consequence, the economy should concern itself first and foremost with care, in all its forms, rather than with relentless growth, as it does at the moment.

That's pretty much it.

My journey towards these two ideas began a long time ago. Possibly even in childhood. More recently, it came from thinking about the nature of human prosperity. And in particular from thinking about what prosperity can possibly mean when we're living on a lonely rock in the middle of nowhere, hurtling through the universe at a million miles per hour.

What can it mean for us to live well on a small blue (finite) planet?

Deceptively simple. It doesn't take long to see that it's actually a complex question. To answer it you probably need some psychology. Some sociology perhaps. And a little history wouldn't go amiss. You also need some economics, of course. As my title suggests. The Care Economy is in part at least a book about the economy.

That's not to say it's full of statistics or equations. For me, that's not what economics is. Sometimes, of course, you have to get your hands dirty with data. And every now and then a little conceptual analysis is definitely in order. But first and foremost, I see economics as a lens through which to understand how we organize society in pursuit of our common wellbeing. It's the study of answers to my 'deceptively simple' question.

That question also demands some attention to philosophy. In the old days that used to be taken for granted. Economics was part philosophy from the outset. Later, economists created a sophisticated discipline that not many people could understand. Quite often not even economists. And that, to my mind, is a recipe for disaster. Not knowing how to organize society or, worse still, appointing a small number of people to tell you (in a language you don't speak) how best to do it for you - that's a catastrophe waiting to happen. Something to be avoided. At all costs.

So The Care Economy is a book about the economy for people who aren't necessarily economists. It's for people who don't even like economics as much as for those who do. It's for people who hated economics at school, like I did, as well as those who loved it. It's a book for people who feel that economics has nothing to do with them as well as those who realize that it probably does and feel it might be a good idea to know a bit more about it.

In short you need no qualifications to read this book. Because you need no qualifications to care about the care economy. You just need to care. Which, of course, doesn't apply to everyone. But in all probability those people who don't didn't bother picking up this book in the first place. And if they did, I guess they can always change their mind.

It's also worth saying that you don't need to be an expert in care either. If we take prosperity as health seriously, I'm going to argue, our job is not just to delve into specific sectors of the economy which we happen to label with the word 'care'. The care economy isn't a standalone sector. It isn't some desirable cherry on the top of the economic cake. I'm saying something different here. I'm saying this. Because prosperity is primarily about health, the economy should always and everywhere be about care. In talking about the care economy, I'm talking about economy as care. That's my case.

The state of wellbeing

It stands to reason I'll need to define some terms. First up, I'll need to be clear what I mean by health and what I mean by care. But it's relatively easy to come up with some working definitions for both those concepts.

Fortunately, the World Health Organization (WHO) has done a pretty good job already. Back in 1948 when it was founded, it defined health as 'a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity'. Maybe today we'd want to include planetary wellbeing in that list. It's difficult to imagine how we could achieve the rest of those things on a sick planet. But aside from that, it's a definition that's definitely stood the test of time. As a starting point, that's good enough for me.

When it comes to care, it's a little trickier. But I've always been drawn to a framing of care by the US writers Berenice Fisher and Joan Tronto. They define care as 'an activity that includes everything we do to maintain, continue and repair our "world" so that we can live in it as well as possible'. That seems broad enough to me to include all - or at least many - of the things we mean when we talk about care.

Care for the young. Care for the elderly. Care for the sick and the faint of heart. Care for our family. Care for our community. Care for our home. Care for the material conditions of life itself. And, of course, it would definitely include care for the planet that sustains us. Care for the climate. Care for the soil. Care for the oceans. Care for our 'world'.

When we get down to details, these initial definitions may need some adjustment. Particularly if we want to do justice to the specific dynamics of health or to the singular qualities of care. Dimensions that I'll have to unfold further if I want to bring you along with me. But for now they work. They're definitely good enough for me to give you a sense of what I'm aiming at.

In one sense they make my thesis self-evident. Perhaps even tautological. If care is about maintaining and continuing a state of wellbeing, then of course the economy should be all about care. What else would it be doing? On the other hand, it's clearly a long way from what the economy actually is doing. Most of the time at least. So there's definitely some scope for inquiry.

Aside from that my case is simple. Let's say straightforward. Nothing is ever entirely simple. It all seemed very manageable. The book was already in sight. I agreed a deadline with my editor. I negotiated a short retreat from my day job. And at the end of 2021 my partner Linda and I decided to rent a small cottage in rural Wales where I would catch up on reading and make a start on writing. Three things happened more or less simultaneously.

The invisible heart

The first and perhaps most predictable thing, obvious if I'd thought about it for a moment or two, was that I found myself marooned in a foreign country without a valid passport. I'm not talking about Wales. That's still a part of the British Isles. For the moment at least. This particular stranding was metaphorical.

The Care Economy was a good title. Short, simple and to the point. It seemed like a suitably inclusive label under which to pursue my project. But my reading immediately reinforced something blindingly obvious. It wasn't my label. It wasn't my country. The terrain had already been charted extensively by pioneers who came before me. And almost exclusively those pioneers were women.

It was women who'd highlighted the essential nature of care. Women who'd pointed out the poor treatment of carers. Women who'd developed an entire discipline of feminist economics premised on the importance of care to human life.

That's not remotely surprising. To this day most of what we refer to as care work is carried out by women. So inevitably it was women who'd largely concerned themselves with understanding care, with exploring its challenges and with exposing its fundamentally gendered nature.

I'm not saying we should take that division of labour for granted. I don't believe we should. But amongst economists I'd say the gender bias is even more pronounced. Male economists have concerned themselves endlessly with economic efficiency. With productivity. With technology. With investment. And in particular with economic growth. Reams and reams have been written about economic growth.

These male economists have also spent a lot of time praising Adam Smith's 'invisible hand'. That's the mythical force which claims to translate narrow selfish interest into the common good through the magic of market-based mechanisms. But they've left woefully unexplored what the US feminist economist Nancy Folbre has called the 'invisible heart' of society. Even today that heart is kept beating largely through the underpaid or unpaid labour of women. It would be totally meaningless to write anything about the care economy without recognizing this fundamental truth.

I'd known that all along. At an intellectual level. But I hadn't really understood what it might mean until I immersed myself in the...