Skip to content Skip to footer

Care Must Be a Collective Practice of Survival, Not a Site of Profit Extraction

“I think it is imperative upon all of us to push back on the system of profit from care,” says Premilla Nadasen.

Part of the Series

“In this moment of crisis, we have to understand how the care economy functions.… I think we have to ask ourselves, do we want someone to profit from our pain? Do we want our loved ones to be for sale? I think it is imperative upon all of us to push back on the system of profit from care and to find alternative ways of thinking and doing care,” says author Premilla Nadasen. In this episode of “Movement Memos,” Nadasen and host Kelly Hayes discuss the role of care work in the U.S. economy, the exploitation of care workers and why the profit-driven dynamics of the care industry must be upended.

Music by Son Monarcas & Heath Cantu


Note: This a rush transcript and has been lightly edited for clarity. Copy may not be in its final form.

Kelly Hayes: Welcome to “Movement Memos,” a Truthout podcast about organizing, solidarity, and the work of making change. I’m your host, writer and organizer Kelly Hayes. Today, we are talking about the politics of care work, and what we mean when we use the word “care.” We will be hearing from Premilla Nadasen, author of Care: The Highest Stage of Capitalism. In her latest book, Premilla acknowledges the power of radical care work, but also troubles the use of the word “care” as a catch-all concept that can sanitize harmful capitalist dynamics and obscure our own culpability in the exploitation of others. We live in a time when gig work, orchestrated by apps and algorithms, has left workers who provide home health care assistance, deliver food, or clean or repair people’s homes, at the mercy of alternating employers. As consumers, many of us engage with services that cast us as employers, even if the power and control we wield over individual workers is fleeting. This crowd-sourced oppression is taking place in a society that has clarified that, when it comes to labor, “essential” is code for “disposable.” So, over the next hour, we are going to talk about what care work is, who does it, what it means to us, and how we might live differently. This is a complicated subject. As Premilla writes in Care:

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” — a slogan first used in the early 2000s by the New York City–based advocacy group Domestic Workers United and later adopted by the National Domestic Workers Alliance. Although it is historically unpaid or underpaid and un- accounted for in gross domestic product (GDP) and other economic measures, without care work, things would simply shut down. Yet, while care is essential to our survival, care as a politics, as discourse, as policy, and as labor is complicated, nuanced, and contradictory.

So we’re going to dig into those contradictions today. If you appreciate this episode, and you would like to support “Movement Memos,” you can subscribe to Truthout’s newsletter or make a donation at You can also support the show by subscribing to the podcast on Apple or Spotify, or wherever you get your podcasts, or by leaving a positive review on those platforms. Sharing episodes on social media is also a huge help. As a union shop with the best family and sick leave policies in the industry, we could not do this work without the support of readers and listeners like you, so thanks for believing in us and for all that you do. And with that, I hope you enjoy the show.

[musical interlude]

Premilla Nadasen: My name is Premilla Nadasen, I’m a historian at Barnard College, and a longtime activist and community organizer, and have been engaged in movement building for almost four decades. And my pronouns are she/her and I live in New York City.

I recently published a book called Care: The Highest Stage of Capitalism. This book in a lot of ways builds on the work I have done, the academic and the political work I have done over many years. My first book was on the welfare rights movement in the 1960s. It was about Black women in particular who were on welfare assistance, who were fighting for state assistance to be able to stay home and care for their children. My next book was about domestic worker organizing and the demands that domestic workers, mostly Black domestic workers, made in the 1960s for the same rights and protections as other workers. So in many ways, this book builds upon a body of scholarship that I’ve done and organizing. I’ve worked closely with local domestic worker rights groups, with the National Domestic Workers Alliance. I worked with welfare rights organizations to really try to think critically about care, the meaning of care, the language of care, what care looks like in practice, and the intersection between care and state support systems, and the kind of organizing that’s happening in local communities.

During the pandemic, we saw growing concern about care and care work. There was a discourse, what I call the care discourse about universal investment in care, about mutual dependency. But one of the things I saw during the pandemic is how some people’s care is privileged over other people’s care. So there was a kind of very visible public recognition of essential workers and care workers here in New York City. People would open their windows at 7:00 p.m. when the nurses and the doctors were getting off their shift and would bang their pots and pans in appreciation. So we talked a lot about the value of this work, but we also know that these workers didn’t always get the pay and the benefits and the protections that they needed and deserved.

So very often that care discourse was framed in terms of the service that these workers provided. That is people were considered important to the degree that they took care of other more privileged people. Their own wellbeing was either not mentioned or it was dependent upon the work they did. So the logic is if we need them, if they care for us, then we should ensure that they are taken care of. But of course, we should be concerned about all people, whether they provide a service or not. And the language we use matters because it shapes how we see and treat these workers. But at the same time, even as it was a celebration of care and care workers, during the pandemic, we also saw increasing financial interest in care. There was a growing market for care for corporations, nonprofits, the state,, which is a digital platform company sold for $500 million in 2020. connects people in need of care with people who are doing care work.

And so the motto of these companies is doing well by doing good and they are doing well, yes, but because they’re benefiting from people’s hardship. But they’re actually not doing good for the world or for any of us.

KH: The provocative title, Care: The Highest Stage of Capitalism, is a reference to Vladimir Lenin’s Imperialism: The Highest Stage of Capitalism, in which the Russian revolutionary discussed finance capital, monopolies and the exploitation of colonized people. While Lenin broke down the realities of a monopolistic stage in the evolution of capitalism, Premilla’s book explores the rise of a financial era defined by corporate cash grabs, the splintering of worker power and a politics of disposability that have defined the COVID era.

PN: Capitalism is premised on profit as a goal, but in the care economy, some people’s pain translates into other people’s profit. So the title of my book Care: The Highest Stage of Capitalism, really speaks to the shift both in terms of how I see care operating in the marketplace. Care, at one point in U.S. history might have been understood as connected to the welfare state as a system of support for people. Care increasingly today is a site of profit and a site of extraction, although of course there was always a level of extraction in care, but a sizable chunk of the U.S. economy today makes money from the hardship, illness and disability and family crisis that many people are experiencing. And so the title also speaks to how I see the U.S. economy shifting away from manufacturing and toward the care and service economy more broadly.

Care today is crucial to the US economy. So if we look historically from about 1980 to 2020, so in 1980, the percentage of American workers employed in manufacturing was about a quarter, and that dropped to about 8% in 2020. The percentage of people in healthcare and education during that same 40 year period doubled from about 8% to 15%. Of the top 10 Fortune 500 companies defined by revenue today, 4 are part of the care economy. In contrast, in 1980, the top 10 included 6 oil and gas companies, 2 tech firms, and 2 auto manufacturers. So what does that mean and why is care the highest stage of capitalism? Well, I think it means that care is really fundamental to the US economy today. And it means if we are all healthy, if we had support systems of care, if we’re non-impoverished and unhoused, the American economy would collapse because even though the pandemic was devastating on so many levels, some people, some CEOs, some stockholders, some investors actually did very well because of the pandemic.

KH: One aspect of Premilla’s book that I really appreciated was her intervention around the term “care work.” As someone who believes that community care is deeply important, and that care work is essential to our movements, I really valued Premilla’s discussion of the way discourse around “care work” has sometimes been weaponized in the service of neoliberalism. Concepts that are important to us are often twisted and abused by the ruling class, and the concept of care is no exception. As Premilla writes:

By masking unequal racial and economic access to care and the drive for profit underpinning the care economy, the care discourse transforms the paid and unpaid labor necessary to maintain and reproduce life—what Marxist feminists have called social reproduction—into a category disconnected from its larger economic and political significance.

PN: I talked a little bit about the problems with the language of care and the care discourse, and feminists have been writing and talking about care as a framework for social policy and for governance for more than 30 years. Yet as we know, that care discourse is most often focused on the needs of middle-class families. There’s no discussion of cash assistance programs, and there was a dismantling of welfare in the same period. So care as a discourse is often centered on the needs of middle-class families and what care workers can do for those families.

Socialist feminists and Marxist feminists have really pushed us to broaden how we think about care. In fact, they don’t use the term “care.” They use the term “social reproduction,” and that’s a more expansive term. It is not only about paid care work, it is not only about unpaid household labor. It looks at both paid work and unpaid work and understands that the care work, if we want to call it that, or the labor of social reproduction, is necessary for the maintenance of human life and the reproduction of human life. And that includes the reproduction of human life. And that includes education, healthcare, food service. It is the work that is essential for society to function, but it is also essential whether paid or unpaid for capitalist profit because it produces the workers who produce the products. So the labor of social reproduction, according to Marxist feminists, creates labor power for capital.

And I find this term very useful because it allows us to think not about individual households or even individual workers, but to think about a system of sustaining and reproducing human beings and what the purpose of that system is.

So Marxist feminists, I think, have done important intellectual work, and it helps us think about how the labor of social reproduction creates the conditions of possibility for capitalist profit.

But I also think that we have to move beyond that or build upon that. If we shift our gaze to Black and brown people, we actually get a slightly different perspective about the role of the labor of social reproduction. And what we see from the lives of Black and brown people is that capital has derived profit not only from labor power, but from life itself.

And the most obvious example of this was during the era of slavery when enslaved people were valued both as labor power because they worked in the fields or in the household, but also as commodities, as a source of wealth for slaveholders. So the labor of care or the labor of social reproduction was an important site of resistance. Of course, we know that for enslaved people. But it also increased the wealth of the slaveholding class.

And this is important because I think that history of racialized social reproduction is reflective of what’s happening today, where life making, where social reproduction, where the labor of care, where our need to care for our loved ones, whether infants or elderly, our desire to care for ourselves, our access to medications has become a source of profit extraction and in many ways is the engine of the economy. So it’s a very different logic of capitalism.

KH: This point about how our basic needs and our desire to see our loved ones cared for creates sites of extraction for capitalism is so important. If we think about imprisoned people, for example, we see how the basic needs of people in jails and prisons create tentacles of the prison-industrial complex, with businesses extracting wealth from the always inadequate, or even absent services that carceral institutions partner with businesses to provide. Oftentimes, the provision of services for incarcerated people extracts funds from loved ones who live outside prison walls, because the system manufactures scarcity within the prison system. Imprisoned people often do not have warm enough clothes, the ability to communicate with the outside world, or enough food to eat without financial investments from loved ones who must engage with high-priced, predatory services.

Those of us outside the prison setting also engage with a variety of services to survive and reproduce our lifestyles. While our situations typically aren’t as grave as those of imprisoned people, we are also living in a system that does not provide for our needs, and thus creates endless opportunities for predation. You may often hear friends talk about the impossibility of keeping up with house cleaning, child care, and their own physical and emotional needs, while also holding down a full time job. For many people, finding this balance is simply impossible. Social reproduction is work, and when our jobs demand the majority of our time and energy, we often have little left for the labor that is often referred to as “care.” As a result, overextended people may feel overwhelmed or inadequate. As we attempt to troubleshoot these issues, and meet our own needs, we might wind up contributing to the exploitation of others, which we will discuss more a bit later.

But first, it’s important to further flesh out what we mean when we talk about care. Because while the generalization of “care” in matters of labor can mask the profundity of social reproduction, it can also flatten distinctions between different types of labor. This flattening can lead us to over-identify some industries with particular workers, such as doctors and nurses, while invisibilizing others.

PN: The term care work is complicated, and it has been used to refer to entire sectors of work such as health care, education, in part because those are fields where women are disproportionately represented. There are many people in the field of health care and education who do not interact with people. So it would be hard-pressed to understand how they are care workers. This includes people who are working as janitors or in laundry rooms of hospitals, business managers, research nurses or domestic workers who only clean.

So those are people who are very often lumped into the industries, who are lumped into that category but don’t actually do care work. At the same time, there are categories of workers who do interact with people, who perhaps have an investment in the wellbeing of the people who they’re working for, but are excluded from the category of care work. So I ask, would a financial advisor, for example, who is invested in the wellbeing of their client, is a financial advisor a care worker? Is a male athletic coach who is working with middle school boys and is deeply concerned about their wellbeing and their future, are they care workers?

So I think the term care work and the language of care has really been a little confusing in terms of who we’re talking about and who does care work. The definition of care work, I think, has been too closely bound with the normative assumptions of gender. That is, it is assumed to be nurturing work done primarily by women. And we know of course that is a white normative definition of gender. And I think that’s obscured the definition and really muddled the conversation about care. And it also erases the many men of color who are employed as home health care aides and nurses who are actually doing what we might call care work.

KH: When considering the language that we use to discuss care, another aspect of Premilla’s book that I really appreciated was her discussion of the emotional expectations that are placed upon people who do the work of social reproduction. Even people who are advocating for healthcare workers, domestic workers or educators will sometimes do so by valorizing their emotional regard for the people they serve. Premilla argues that “conflating the emotion of care with the practice of care” can actually play into what she calls the “coercion of compassion.”

PN: Care work is often celebrated by feminists and celebrated in the mainstream media. And by care work, I mean paid care work, home healthcare aids, people doing elder care or childcare. And it’s celebrated and these workers are uplifted, presumably because they care for and love the people who they are caring for.

But I would suggest that we think more carefully about the language. Most importantly, when people do this work, they may or may not have an emotional investment. They may be able to do their jobs, which could include making food for someone who’s unable to do so for themselves. They might hold a child who needs soothing. So these are specific tasks that may not reflect how they feel. Care is an emotion, and the emotional burden of their work is something that domestic workers have lamented for generations.

So they’ve never wanted to be, or they’ve never wanted to have the expectation of care placed upon them. The sociologist Arlie Hochschild calls this emotional labor. So I think we have to distinguish between feelings and tasks. That is, rather than focusing on emotion, does somebody care? Are they invested? Is this something they really want to do? We should examine the particular task of a job. Are they actually doing their job?

My daughter is a home health care aide and she loves her work very much, and she does an excellent job at her job, but it’s not clear that she loves the people who she’s taking care of. She might like them or she might not like them, but she still has a responsibility and I feel, I think feels the responsibility to do the day-to-day work of taking care of them regardless of how she feels.

KH: The day to day work of social reproduction has not only been devalued in our society, but in some cases, it has actually been demonized. I grew up in the 80’s and 90’s, and as I came of age, I witnessed what Ruth Wilson Gilmore calls “organized abandonment” play out in my own life. Organized abandonment is the intentional disinvestment in services that sustain our communities, and the ramping up of policing and carcerality to maintain order amid the ensuing collapse. When I was a small child, my father worked in a steel mill. In the 70’s and 80’s, capitalists were moving that kind of production work overseas, where labor was cheaper and environmental standards were lower. Consequently, my father, and hundreds of thousands of other steel workers were thrown out of work during that time. When my dad lost his job, the welfare system, while troubled, was still intact, but my father went to great lengths to avoid accepting benefits – including picking up dangerous, exploitative day labor work that would sometimes leave him physically injured without health care or any meaningful legal recourse.

Why was my father hesitant to seek government assistance for my family? Because accessing welfare benefits was highly stigmatized in the United States. What my father regarded as a prideful work ethic was actually the product of a society that demonized Black women and women of color who received welfare benefits. That demonization and the “welfare queen” stereotype popularized by Ronald Reagan not only tainted the welfare system in many people’s minds, but also tainted perceptions of social reproduction. Rather than viewing the work of maintaining a household as labor, which ought to be paid for, the caretaking work of Black people, women of color, and other poor people in need of welfare benefits, was papered over with notions of laziness and greed. Welfare recipients were characterized as wanting something for nothing, as though the work of social reproduction itself was nothing, and therefore worthy of scorn, unless it was accompanied by wage labor.

We are now so removed from experiencing anything like a functioning welfare state that the idea of public benefits is rarely part of the conversation when we discuss how overburdened we are, and how unable we are to provide or access the care that we and our loved ones need. Discussion of any universal provision is often ridiculed as hopeless idealism, but to have meaningful conversations about work, care, and social reproduction, we have to talk about the destruction of the welfare state, and the possibilities and understandings of labor that were eclipsed under President Bill Clinton.

PN: The welfare state is often not a part of the conversation about care, but in fact, I think it has to be. It has been a source of support for poor women, however inadequate historically, and I think a robust welfare state can help counter the class inequality that cuts through who can and cannot care for their loved ones. So if you have economic privilege, you can make that choice.

But in addition to that, I would say that the welfare system has also served as a platform for organizing and activism for poor Black women. There was a vibrant welfare rights movement in the 1960s that brought together 30,000 women who demanded the right to stay home and care for their children. Black women historically were denied that right. In fact, the state has historically devalued the mothering work of Black and brown women.

The history of welfare has been deeply intertwined with the politics of race. It was founded in 1935, primarily for white women in order to reinforce the gender division of labor and their domestic responsibilities. So the assumption was that white men would go out to work and white women should stay home and take care of their children. And when there was no white man to take care of the woman in the picture, then the state would have to step in and take care of that mother and her children.

So care and mothering work has historically been associated with white women. Black, brown and Indigenous women were seen as workers and their mothering work was devalued. In fact, in the 19th century, Indigenous girls were forcibly removed from their homes and communities and taken to boarding schools and placed as domestic workers in the homes of white families, presumably to teach them domestic and maternal skills. But we know of course, that that was fundamentally about labor exploitation because they were discouraged from becoming wives and mothers. And if they did, the Bureau of Indian Affairs forced them to give up those children.

Black and Puerto Rican women who began to join the welfare roles in the 1950s in greater numbers, in fact, were increasingly pushed off the welfare roles. At that moment when more Black and brown women were applying for welfare assistance, the program became more punitive and it moved away from supporting women as mothers towards the first work requirements being instituted, suggesting that if in fact there was a job, or if a woman was employable, then she ought to be out in the workforce rather than home taking care of her children.

So there was a lot of public opposition to Black and brown women receiving welfare assistance. They were by and large considered undeserving. There was a tremendous amount of vitriol that was directed at Black women and Puerto Rican women in particular. There was a stereotype of a welfare queen, which was this caricature and myth of a woman who could work but chose not to, who cheats the system, has multiple children with multiple men, and does very little to care for them.

So it was that kind of demonization that began in the 1960s when the welfare roles became more racially diverse. That led to the dismantling of the welfare system in 1996 with bipartisan support. And today, there is nothing of a welfare system that exists or in any kind of systematic way for poor mothers. Black and Brown women have never been supported in their mothering work, and I think it’s an indication of how little care for their own families has been [valued by] the state or for the economy. Black and Brown women have served as care workers, but the care for their own families has actually meant very little.

KH: As public services have been shredded, politicians have often touted nonprofits as the solution. In Chicago, when former Mayor Rahm Emanuel sought to close half of our city’s publicly funded mental healthcare clinics, Emanuel argued that patients would actually receive better, more efficiently managed care within the nonprofit system. However, we know that the “non-profitization” of the care economy, as Premilla calls it, has not led to better outcomes for people in need.

PN: With the shredding of the safety net, there has been a simultaneous growth of the non-profit sector that is filling the gap in care and support because of the hollowing out of the welfare state. Nonprofits are getting public money to care for the unhoused and the food insecure. But most of these public dollars don’t go to the people in need. It goes to the bureaucracy and the staff of the nonprofit. That’s true of our welfare system as well. Something like 25% of welfare dollars end up in the hands of the needy, of the people who need assistance, and that is true of the money that’s going into the non-profit sector as well.

Many years ago, I worked with a woman named Theresa Funiciello, who was a former welfare recipient. She wrote a wonderful book called Tyranny of Kindness. In that book, she explains the system of food rescue that is designed to feed the hungry. She considers things like the overhead cost of transportation to move food from one place to another, the refrigeration, the storage, the staff salaries, office space, computers and other equipment. She argues that this raises the price of what she calls “table scraps” far beyond what they were initially worth. And so, she writes that a formerly free product now has added value at every level as it takes its journey. I’m quoting her here. She writes that, “You can give a mother 50 cents to go and buy a head of lettuce on sale, or you can send a head of lettuce through this crazy system and keep increasing the original price as it moves through both literally and figuratively through layer after layer of do-gooders. The real beneficiary in this system are the tens of thousands of people who have become employed through its secondary market.” And so I think that it’s one example of how there is this dire need for people who need food and then this non-profit system that emerges, presumably to try to feed those people. But in fact, it is a system that is feeding itself, that is benefiting itself and using a lot of public dollars to do so.

So we’ve seen an enormous growth of non-profit organizations in the past 30 to 40 years. They are funded by corporations, by donations from the wealthy, from state grants, and they’ve become a massive part of the economy. So in 2016, over 12 million people were employed in the nonprofit sector, and that represented more than 10% of private sector employment. In 2020, there were about 12.5 million workers in the nonprofit sector. It was the third-largest employment sector behind retail and only slightly below manufacturing. So the nonprofit sector is huge. It’s growing. They are getting more and more tax dollars either through direct grants from the government or through tax breaks because of their nonprofit status. And it’s questionable whether they are actually invested in alleviating the problems that they were designed to create.

KH: I want to circle back to the devaluation of social reproduction and those who provide it, which, in our current context, means that we have to talk about the gig economy. As I’ve mentioned, I appreciate the ways in which Premilla’s analysis of the care economy implicates those of us who access these services. I think phrases like, “There’s no ethical consumption under capitalism” are often deployed in ways that obscure the power dynamics that many of us engage with under the current system. By claiming that they are not employers, companies like Uber deem workers independent contractors, which makes their actual boss the revolving set of people who access the service. Many of us rightly condemn gig-based companies for refusing to take responsibility for the rights and well-being of workers by acknowledging them as employees and accommodating them accordingly. But in the absence of such an arrangement, these workers are available to us more cheaply and readily than they might otherwise be, and our rating of their performance may carry an out-sized weight, affecting their ability to continue earning a living. Such workers are, in a sense, perpetually at our mercy, but many people do not analyze or question their own role in this process – often because we are up against our own unfair challenges and obstacles. But to avoid analyzing our participation in these systems is a costly mistake.

PN: The care debate or the care discourse, the crisis of care as it is understood, often focuses on people who need care, on children, on elderly people, on disabled people. The focus is on care receivers, and the conversation is often about the quality of the care they receive, about whether there are enough caregivers to provide the care that they need. And, in fact, what happens I think in this conversation is that it obscures the labor relationship. We don’t tend to see the person who is providing the care as a worker. In fact, that language of caregiver, I think is indicative of the way that relationship has been constructed. But in fact, the people doing the work are workers. They ought to be seen as workers. They often have their own care needs. I think that divide between the caregiver and the care receiver also presumes that the person who’s giving care doesn’t need care themselves. It also speaks to the positioning of this occupation in the broader discussion about labor and labor relations.

When the New Deal was passed in the 1930s, there were two primary categories of workers who were excluded from New Deal protections, agricultural workers and domestic workers. Those were largely Black, brown and Indigenous groups who were engaged in that work. Care work or domestic work has always had a precarious relationship to the question of labor rights. Even today, home health care aides, for example, don’t have the same labor rights and protections even to this day as other workers do.

I think that as we see the care economy evolving and growing, what is in fact happening is more and more care workers are a part of what we would call the gig economy. They’ve in fact always been a part of the gig economy, but it’s a growing part of the gig economy. I think it’s imperative that we understand people who are providing care as workers and who perhaps need care themselves.

KH: I think people have become adept at exempting themselves or others from concerns about how the gig economy affects workers, and that can lead us to abdicate our collective responsibilities to each other. For example, anytime there’s an Uber or Lyft boycott, I see people talking about how disabled people need to be able to use those services, so it’s ableist to say they should boycott. I always ask, in these situations, “Why aren’t you working on a carpool plan or some way for disabled people to participate in the boycott?” Rather than simply saying, “We can’t support the workers because that is a hardship for some disabled people,” why aren’t we invested in overcoming the hardship collectively? The refusal to support workers is modeled as solidarity with disabled people, while nullifying solidarity with the workers — all without any actual effort. Because simply saying, “This is an unreasonable ask for some people” doesn’t demand much of us. Whereas, if we wanted to be in solidarity with disabled people who need rides, and striking workers, we would try to figure out how people who needed the boycotted services could be supported, so that they, too, could act in solidarity.

PN: It’s also this assumption that the category of disability is a bounded category and that people who are disabled are a distinct group. In fact, we know there’s a spectrum of disability. There are people who are partially disabled, people who might not fall into the category of full disability. And, in fact, I work very closely with a lot of domestic workers on the ground doing grassroots organizing, and many of them are what we would call disabled. They have various physical ailments and limitations, but they in a sense have been considered outside that category of disability because they need to continue to work and they do not have a full-time caregiver themselves. And so, I think there’s a way in which these categories of who is disabled and who is not disabled, who is a caregiver, and who is a care receiver, has actually artificially created boundaries between people who ought to be allies.

KH: Those artificial boundaries between people who ought to be allies are part of a larger crisis that we are all experiencing. Late capitalism is not simply overwhelming us, it is breaking us. In her book, Premilla wrote:

We are reaching a critical threshold. People have fallen deeper into debt, are self-medicating, and have dropped out of school or the workforce? There are record numbers of children in foster care, families without access to affordable or any childcare, elderly people without caretakers, people who are unhoused and food insecure, and people with disabilities who are incarcerated. The crisis of social reproduction has reached a breaking point.

Late capitalism has fostered these crises, while the market repackages our problems as personal failings that we can overcome with the right set of apps, products and services. But the crisis of social reproduction is not manufactured at an individual level.

PN: We are at a critical threshold with the dismantling of social support systems, a growing and expansive carceral state. People have very few places to turn for assistance. 40 million Americans are living in poverty today. 1.5 million Americans live in what is known as extreme poverty, nearly twice as many as 20 years ago. That is a term that used to be associated with other countries, not the United States, not a supposedly industrialized country that is very wealthy. Philip Alston, who’s the UN Special Rapporteur on extreme poverty and human rights in 2017, did a study of extreme poverty in the United States and was shocked at the growing levels of extreme poverty and the kinds of conditions that people are living under.

There’s something like 3.7 million people who are experiencing housing insecurity. People have fallen deeper into debt, are self-medicating or have dropped out of school or the workforce, there are record numbers of children in foster care, families without access to affordable childcare or perhaps any childcare. There are elderly people without caretakers, people who are unhoused, people with disabilities who are incarcerated.

We really are at a critical threshold, and that threshold for me is this growing crisis of care, while at the same time, there are investors who have their eyes on this crisis and are salivating about how they can turn this misery into dollars. The Boston Consulting Group, which is a think tank in Boston, estimates that the worth of the care economy is $6 trillion. They’re talking both about paid and unpaid care work, and they estimate that to be about 60% of the GDP. There are companies that are eagerly seeking out new ways to profit from care.

Melinda French Gates founded a company called Pivotal Ventures. It has produced what they call an investor’s guide and an entrepreneur’s guide to the economy. I think in this moment of crisis as people with power and people with money are trying to figure out how to profit from it, we have to really be very clear and understand how the care economy is functioning, and functions, and we have to develop alternative strategies of resistance and care systems. I think we have to ask ourselves, do we want someone to profit from our pain? Do we want our loved ones to be for sale? I think it is imperative upon all of us to push back on the system of profit from care and to find alternative ways of thinking and doing care.

KH: As we consider alternative ways of providing care, there are, of course, many radical visions of caretaking and mutual aid that we can explore. In the last chapter of her book, Premilla discusses some of those efforts, including the defense committee work of organizers like Mariame Kaba. Premilla stresses the importance of radical care projects, while also noting their limitations.

PN: There’s a very long history of radical care, of mutual aid and collective care that people in movement spaces, people who have been abandoned by the state, have created to survive and cope and have constructed new models of being and living. And I’ve been really lucky to work with some of these organizations, the Damayan Migrant Workers Association here in New York City, which is a Filipino organization that helps people escape labor trafficking situations. And they are committed to social transformation, but also they engage in practices of radical care. So during the pandemic, they distributed care packages to their members. They were out in the streets. They assisted and worked with people who had lost their jobs. And that has been a central part of their practice since the organization was founded 20 years ago. At the same time, they are anti-capitalist, they are anti-imperialist and have worked to transform labor trafficking laws and systems.

I also work with a group in Mississippi. This is the poorest state in the country with the least state support and assistance. And in parts of rural Mississippi where I have traveled with my students, we have seen families and communities that have developed systems of care and support, places where there is no such thing as state assistance, there is no such thing as public transportation, there is no such thing as a community center or any kind of services for people in need, there is no public housing, yet people have come together, families have opened up their homes and created family daycare centers. There’s a woman in Holmes County, Mississippi, and her name is Ellen Reddy, who created a center called the Nollie Jenkins Family Center, named after her grandmother, to take in young women and girls who were in need.

And so that’s just one example. There are many, many other examples in Mississippi where people have come together to try to provide the systems of support that other people in their community need. And, Kelly, in your really inspiring book with Mariame Kaba, the two of you share countless examples as well of care that has emerged, the mutual aid care, in the context of the carceral state or protests and resistance movements. And so there are many examples of care, collective care, radical care, that have emerged in the recent past. But we also know that there’s a much longer history, the Black Panther Party, for example, and their work, their Free Breakfast for Children Program, the medical clinics that they started. So social movements have long understood the value of both meeting people’s needs now, providing the care that people need in this moment while also working to transform the structures that we live under. It’s an example of the prefigurative politics, which Harsha Walia defines as envisioning and actualizing egalitarian care relations.

So radical care or collective care helps us imagine care differently and imagine our future differently. And as you and Mariame put it, it is world-building. It offers hope at a time when it seems there is very little hope. But at the same time, this kind of community care, I think for the long haul is unsustainable. It’s very difficult work and it’s unsustainable under this kind of capitalist regime. There’s a lot of care and perhaps not enough capacity. And most of us don’t have the skills for certain kinds of care work, certain kinds of medical treatments, for example, that are necessary and essential for the survival of some people.

So I think even as we provide care in this moment, and even as I understand and deeply value community care, we have to simultaneously think about transformation and creating a different kind of world because, ultimately, the care we’re creating now is in part about survival, but also about imagining and envisioning a different kind of world. So I am hopeful and feeling that we will at some point get to a place where our care will not be a form of resistance, but will solely be a form of living and creating new ways of being.

To me, creating a different kind of world is one where everyone’s care needs are taken care of, where care is a system of collective support that is anti-capitalist, that is anti-racist, that is gender inclusive, that understands the different care needs that people have, and understanding the different capacities that people have to give care. I don’t believe care can be egalitarian. Care is never egalitarian. It is not about equality, but rather it is about giving what we can and about getting what you need. And so for me, a real caring society would be universal in that sense, but it would be one in which we’re all equally invested.

[musical interlude]

KH: Well, I am so grateful for Premilla’s insights and for her book, Care: The Highest Stage of Capitalism. It’s a book full of necessary insights, and as someone who believes deeply in the potential of our radical care projects, I think it’s extremely important to interrogate how the language of care is being deployed in this society. We also have to be cognizant of the ways in which we may be participating in the exploitation of others, or how we might be justifying that exploitation. As life gets harder, under late capitalism, we are sold “solutions” that involve the heightened exploitation of others – workers who are both essential and disposable under capitalism. When I think about the ways in which people exempt themselves from being concerned about the struggles gig workers face, due to whatever difficulties we face that may lead us to employ gig workers, I think about the way in which this society has exempted us all from thinking about what happens to people in prisons, or to exploited workers in the Global South. There are social permissions for different forms of forgetting and disregard in this society. Those exemptions will only become more numerous and vast as the destruction of late capitalism continues. From people who are living in cages to unhoused people, to people on the wrong side of a border, to people who are delivering our food or caring for our parents, to disabled and immunocompromised people, we will be given logics that excuse us from caring what happens to people, or feeling responsible for our role in their suffering. We have to rage against those dynamics. We have to forge relationships and solidarity with those capitalism would divide us from, rather than simply taking up our part in their exploitation or destruction.

We have to understand these dynamics if we hope to upend and replace them, and that means understanding what those dynamics are doing to us, and how we may be culpable. If we want transformation, we have to, as Premilla suggests, recreate the society we inhabit. This system is not sustainable, and the fixes it offers will always come at the expense of other people. To truly be free means breaking that cycle, such that my comfort does not mean someone else’s suffering or exploitation. I believe we can build that world and I am grateful for projects that are prefiguring those possibilities.

As we wrap things up today, I want to share with you all that I will be taking some time off after this episode. As many of you know, I struggle with chronic health problems. Unfortunately, I am going through a really rough time right now, between new and old conditions, and require a lot of rest and healthcare. So, I will be stepping back from the show for about a month or so. During that time, I will also be taking a break from writing my newsletter, but I will be publishing some wonderful book excerpts, with the support of Haymarket Books and AK Press, so I will have lots to discuss with folks when I am back in action. If you want to receive those book excerpts, you can sign up for my newsletter at

I want to thank all of you for your understanding and your support. I hope you’ll use this time to get caught up on any episodes you might have missed, or to revisit older episodes that you may find helpful in these times. Making this show is really important to me, because political education is essential to the work of remaking the world. That is collective work, and I couldn’t do my small part of it without you all, so thank you for being on this journey with me.

I also want to thank our liste4ners for joining us today, and remember, our best defense against cynicism is to do good, and to remember that the good we do matters. Until next time, I’ll see you in the streets.

Show Notes

Countdown is on: We have 2 days to raise $28,000

Truthout has launched a necessary fundraising campaign to support our work. Can you support us right now?

Each day, our team is reporting deeply on complex political issues: revealing wrongdoing in our so-called justice system, tracking global attacks on human rights, unmasking the money behind right-wing movements, and more. Your tax-deductible donation at this time is critical, allowing us to do this core journalistic work.

As we face increasing political scrutiny and censorship for our reporting, Truthout relies heavily on individual donations at this time. Please give today if you can.