Joan Tronto on Care, Democracy and Economics

I loved how Joan Tronto’s short book, Who Cares? How to Reshape a Democratic Politics, so simply and succinctly argues for a way to radically rethink politics, economics and democracy. She writes:

We hear often that we are in a care crisis. That is, we face a shortage of formal caregivers to cope with the increased care needs of ever-more elders who will need ever-more care. But this crisis involves more than demographic and labor market projections. We all experience a version of it daily: “I wish I had more time: to care for my loved ones, to contribute to causes I care about, to be there for my friends.” We spend so much time on undesirable tasks and so little time on ones we really value. How can everything be so upside down? This pressure seems to each of us a personal failing. But it isn’t. It’s a political problem. (2)

And a economic problem. And a collective problem. I love the way she is cracking open what is ‘political’ and economic, returning them where they belong in our everyday lives. She continues:

I will argue that what ails our democracy is not (or not only) that there is too much money in politics, or that elections aren’t meaningful or deliberative enough, or that there are myriad other concerns about how we conduct our democratic politics. Instead, I want to argue that what we currently call “politics” is wrong, and that our obsession with market-foremost democracy distorts what should be the most fundamental concern: care. The market can’t make ethical decisions about who receives what care, yet we’ve organized our democracy to leave large segments of the polity priced out of the markets that would make us better when we are ill, educate us when we are ready to learn, let us spend time with our children if we have them, and ensure the safety of our loved ones. The result is disastrous for the kind of equality that is essential to a functioning democracy. Fixing it requires a new understanding of care and a better definition of democracy. (2)

I love also the expansion of what ‘care’ means here, why it belongs at the centre of our thinking as a concept not just big enough to encompass our survival as individuals and as a species, but to transform how we live on, care, and ensure the survival of, this planet.

When I say “care,” I don’t mean only healthcare, child care, and caring for the elderly. I don’t mean only finding a babysitter on a website called I mean, as Berenice Fisher and I defined it some time ago, “in the most general sense, care is a species activity that includes every thing we do to maintain, continue, and repair our world so that we may live in it as well as possible. That world includes our bodies, ourselves, and our environment, all of which we seek to interweave in a complex, life-sustaining web.” (3)

And this:

Care is about meeting needs, and it is always relational… (4)

Again we come back to relationality, interconnectivity, interdependence.

She summarises her earlier work, a formulation of care I really love developed with Berenice Fisher. They provide four phases, but again they should be seen as interconnected, and strongest when encountered together.

1. Caring about. First, care proceeds from meeting needs. While some needs seem obvious, discerning a need is actually a complicated task. Even simple examples belie this complexity. The baby is crying: Does it need a bottle? Simply to be held? Most examples are much more complex. The people “on the other side of the tracks” are poor: Why? Such questions invite complex thinking about “the politics of needs interpretation.”2 In the first place, then, care requires caring about: identifying caring needs. (5)

2. Caring for. Second, just because a need exists does not mean that anyone in particular has to address it. In cities, people often walk by the homeless as if they weren’t there, perhaps thinking, “Somebody should do something about thatโ€ฆ” Accepting responsibility and realizing that some thing has to be done is the second phase of care. (5-6)

3. Caregiving. Once a need is identified and someone has taken responsibility for addressing it, meeting it requires work. The third phase of care is the actual task of care giving. The epidemiologists need to study how the virus spreads, the floodwaters need to be dammed, someone needs to teach the new students English, and so on. Most caregiving raises questions about good care practices. Do vouchers for food work better than giving people surplus cheese? Does being a stern teacher help students or push them too hard? Is the faucet leak fixed? And here is another complication: The people who recognize the need are not necessarily the same ones who take responsibility for fixing it, and those responsible are not necessarily those who do the actual caregiving. A son might be responsible for arranging his parents’ doctor visits from another city, so he calls his father’s social worker. But if those who are responsible allocate resources based on a too-limited scope of caring, then they may allocate too little. It’s a frequent problem-hospitals often have insufficient supplies; for example, of telemetry units. Caregivers learn to cope with caring in less-than-ideal circumstances. (6)

4. Care-receiving. After the work of caring is done, another phase remains. How do we know the care was successful? Care-receiving prompts a response. Given how pervasive care is, some of it is routine: washing the dishes after dinner, filling potholes in the spring, etc. But even if care receivers do not say “Thank you, that helped”–for neither the baby nor the patient still in a coma will necessarily do so–care is not complete until the need is met. That requires looking again at the situation and the resources assigned to improve it. And, often, looking again will lead to recognizing new needs, and the process repeats. Endlessly. Needs never end until we die. Care is always present, rarely visible, always requiring something from us. (6-7)

Repeat that… Endlessly. Needs never end until we die. Care is always present, rarely visible, always requiring something from us.

I really love that repetition. Please understand. Care is always present. Always needed. Please can we value that, support that, centre that, share that. Because this also is what being a good, decent human being means, and in turn not just a good friend or neighbour, but also a good political citizen.

Care makes us good citizens, facilitates skills in making us attentive, responsible, competent, responsive. (7-8)

I love also this way of understanding the political, with a small p and a large P, and why the care of everyday is so central to politics even though care has been stripped from them in the Western context for centuries.

Saying that care is deeply political requires us to think of politics with both a small “p” and a capital “P.” Small-p politics occurs in everyday life. We don’t usually think of our many daily interactions as political, but I argue that we should. Everyday life is political because all caring, every response to a need, involves power relationships. Especially when we are thinking about the care that we can’t provide for ourselves, caregivers are in a position of relative power. Infants are at the mercy of their caregivers for protection and food, and sometimes caregivers wield that power in tragic ways. Doctors have power over their patients, and hospitals have worked out protocols (such as informed con sent) to try to protect us from abuses of such power. (9)

But let’s pull back a bit further and we’ll see that capital-P Politics is also at work here. Every caring act occurs in a larger political context that reflects a given society’s values, laws, customs, and institutions. Let’s return to the screaming nursing home resident. Why is that elderly man there in the first place? Decisions have been made: individually by the resident and his family, socially through a set of values about where and how old people should live, and legally and politically by provision of Medicare, Medicaid, and regulations to control how nursing homes get paid. On the broadest level, all societies organize care activities. (10)

Many societies have arguably done a really terrible job of this, where care has been undertaken by slaves, people with low caste, workers with low-pay… But what if? What if we made care work equal, done by those who are equal? What if we prioritised the idea of caring with, rather than for? Of acknowledging care as absolutely necessary and as something universally both given and received? What if we give care when we can and then we receive it when we need? What utopia. And what if we then go one step further and imagne this is how we redefine democracy.

Hence, we arrive at a new definition of democracy: Democracy is the allocation of caring responsibilities and assuring that everyone can participate in those allocations of care as completely as possible. (15)

It’s intriguing. I’m not sure where my resistance is, it’s something I need to think about. Maybe because it feels as simple as a hat trick. But there is no resistance to this way of conceptualising the achieving of equality.

Equality is not a starting point for democratic citizens. It is something that all citizens achieve, not through an “identity” as citizen, but through concerted action over a lifetime. If democratic citizenship is to be truly inclusive, then we have to recognize that caring is what will get us there together.

And so I suppose it follows:

We, as citizens, need to decide in general terms how caring will be organized. Not everyone needs to do all of the caring work, nor do all the details about caring need to be organized by government. But the general handing-out of care responsibilities is a political question, and one we should address through politics. (16)

And not just any kind of politics, but an inclusive politics:

Furthermore, because exclusion has often been the way in which some are stuck with disproportionate caring responsibilities, it is important that everyone be included in this process. Otherwise, historically, those who are excluded will remain stuck with such duties. (16)

Care, Inc.

It is in the next chapter that Tronto provides a trenchant critique of the current capitalist care system, with a focus on the US. It’s great, though I won’t repeat it here. But what I do love is again, the cracking open of politics and economics to question it: what is t really all about? What matters? As she phrases it:

Increasingly, however, democratic politics has come to be about managing the economy, which resurrects the question: To what end?

The most common answer provided in the United States today is that the purpose of managing the economy is to allow the market to have the freest reign. This presumes that a free market yields free democratic citizens. From the standpoint of care, however, this way of thinking is deeply flawed. There’s a deep connection between Politics as national policy and the politics of everyday life. Institutions shape who we are and how we think of ourselves as citizens. If we wish to create the conditions for citizens to be equally free to care as they wish for themselves and others, then we need to rethink this market-foremost orientation. (17-18)

In reality, she writes, we can see that this way of thought ‘creates deep inequalities and diminishes the sense of “caring with.”‘ (21) on the Political level, while also transforming people at the small-p political level: more hours at work and the need for two salaries; growth in winner-takes-all mentalities and competition to see to your own family’s advantage; the reduction of everything to personal responsibility. All results in an ‘uncaring, un-democratic hierarchy’ (25) with growing divides between us and them, the acid that dissolves the body politic.

Making the Caring-With Revolution Happen

This could come through ensuring everyone has an equal voice in deciding how care duties are allocated. Imagine that. Imagine the difficulty of that but don’t say no way. Start thinking wow, how might we do that?

Where to start? Start caring about care. Make it something we all do because we all value it and because this is what makes life worth living.

I rather love that here, Tronto says we’ll probably hear a bunch of people with privilege talk about why they should be exempt from care. Lol. She’s totally right. She demolishes them excuse by excuse:

  • ‘I’m not good at caring’ (or women are just better at it). Answer: because it’s expected of us and we have to do it all the time, now we expect it of you too, so start practicing, only that way can we all get better.
  • ‘I’m busy working’ (and my work is too important to take time for caring). Answer: we need to rethink work patterns, prioritise time for care for everyone (also I kind of think get over yourself).
  • ‘I”m taking care of my own family’. Answer: slow down, stop competing, care for others doesn’t need to take away from care for your own
  • ‘Bootstraps worked for me–and will work for you’. Whatever dude, people helped you. Besides, caring is part of what brings meaning to life, not just making a pile of money and holding on to it.

And so on to transformation in the way we live, in our institutions, in our economy and in our p/Politics. Another list distilled of what this requires:

  1. Pluralism: needs and ways of giving and receiving care are many
  2. We need to switch perspectives, not just think about what we want
  3. We need to recognise both the diversity and ubiquity of caring needs through caring with in a way that facilitates respect and full citizenship. Makes me think about some of the incredible crip theory that I need to read more of.
  4. We need to understand care as complex and that we are NOT the heroic caregiver. Let’s break down that story/power relation.

Imagine all of these, imagine living and implementing these… and a democracy that is not just more caring but better at providing care. ‘Caring with’ builds trust and solidarity not hierarchy, it centres inclusion not exclusion, and these are what make democracy function.

How do we get there? Not just a care movement (note to self to read Deborah Stone), but also rejection of the idea that the market will provide and a recentring of care to align with the values of equality, justice and freedom.

Tronto, Joan (2015) Who Cares? How to Reshape a Democratic Politics. Ithaca: Cornell University Press.

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