Episode 170 - Care with Premilla Nadasen Transcript

[00:00:00] David: Hello and welcome to Overthink.

[00:00:20] Ellie: The podcast where two professors bring philosophy into dialogue with everyday life.

[00:00:24] David: I'm Dr. David Peña Guzmán.

[00:00:26] Ellie: And I'm Dr. Ellie Anderson. David, the past couple of years of my life have been dominated by care obligations while I've been trying to balance my job and my hobbies and my relationships. I've also been finding myself spending so many hours and a lot of emotional and mental energy on elder care.

My parents are a bit old relative to my age, and both of them have really needed a lot in the past couple of years. Without getting into too much detail, I ended up moving back into my childhood home to help out and also having to ensure that my dad, who has Alzheimer's disease, has gotten the care that he needed first by trying to find in-home care.

And second, by ensuring that he moved into a home that would give him the care that frankly, like we couldn't give him in the house. And top of mind throughout all of this has been money. It has been such a stressful experience here in the US, I mean, it's not gonna be a surprise to any of our listeners to know just how bad the financial situation around care is and just the costs are absolutely astronomical.

And I say this as somebody who comes from a position of relative economic privilege with a nice childhood home that my parents own with them having retirement funds like it has been almost completely unmanageable for our family, and it continues to be a source of stress.

[00:01:59] David: Well, and I know, from conversations that you and I have had also as friends outside of this podcast, just how emotionally difficult that has been for you and your siblings to have to negotiate this, to have to make decisions, to have to then bring some of those decisions to your parents, sometimes to make them together, sometimes to make them for them.

And so aside from the economic pressure, there is this emotional impact that the fact that we live in a culture where care now suddenly falls on the shoulders of individuals because it has been largely privatized and personalized by the failure of the welfare state, tells us something about how deformed caring relationships and caring practices are nowadays, right? Where like it, they get mediated by capital, they get mediated by private companies, they get mediated by insurance and, it can feel extremely dehumanizing.

[00:02:59] Ellie: Yeah, and I think just the way that the finances have been front of mind, even as like the emotional toll and the time that I've devoted to these care obligations has been immense, I think speaks to like how messed up this system is. And at the same time, even though this has been so difficult for my sister and me, as well as for our parents and our, you know, broader family system, the kind of thing that I'm dealing with is the kind of situation that tends to get centered in the care conversation.

A lot of times the care conversation revolves around working moms who definitely are struggling, like even far more than I am, but at the same time. You know, even though my case is a little bit different in terms of elder care, middle class, working, white women often get centered in these conversations around care.

And the author of the book we're gonna be talking about today, Premilla Nadasen, she writes about how there is undoubtedly a crisis of care with respect to the kind of thing that I'm talking about. But actually the care crisis is so much more than that. And the voices that don't get centered are suffering all the more so and so she talks, for instance, about a woman named Sandra Killit, who's been a community organizer for close to 30 years, and she came into this role because of her hardships as a single parent. Sandra separated from her husband in the mid nineties, and she moved with her two small boys out of the home that they had previously lived in, and she found her herself bumping up against the increasingly tattered welfare system she got on Temporary assistance to needy families or the TANF program. This program required periodic and seemingly random requests for further documentation, frequent meetings with caseworkers and 30 hours of employment per week, which basically meant that Sandra wasn't able to do the work that she needed to do, and which was her reason for going on welfare to begin with, which was take care of her two sons, which is a full-time job.

And so Nadasen writes about how Sandra's situation illustrates the hypocrisy of the care discourse, which has failed to address the care needs of the poor. In requiring her to have all of these extra meetings and to work while also somehow taking care of her kids. The situation puts her in an absolute impossible bind, which is what led to her organizing in the decades since.

[00:05:15] David: Yeah, and you know, the, the thing especially about the TANF is that it was a reform under the Clinton administration, so it was a democratic change that made it actually worse than it was before. So it's not even a clear left versus Right problem. It's just part of a larger pattern of the state deresponsibilizing itself of its obligation to care for citizens.

And often what this has translated into in practice are programs that impose a lot of requirements, often punish individuals, especially those who are the neediest among us for not meeting those requirements, often funnel those individuals to the prison industrial complex, and in many cases are designed precisely to ensure that the people who need care don't actually receive it while the government can claim that it's offering benefits.

So I'm here thinking about the fact that, for instance, with the TANF, even if you do everything right and you go to all those meetings and meet all of those requirements and successfully satisfy all the conditions. At best, it will only offer you benefits for a few years after which you are just left in the dust, and so there is no long-term solution for people who need care and support and aid.

[00:06:37] Ellie: Yeah. In fact since 1997, the TANF budget that goes directly to the poor has decreased dramatically. People in need, Nadasen points out are given job training rather than jobs and offered services rather than money.

[00:06:51] David: Yeah, like the last thing you need when you're hungry is training for some hypothetical job that's not even put in front of you, right? And so there is some deep incoherence in the way the money is allocated. Either way, I think we can differentiate here in this discourse around the problem of care in our society between two very broad communities, or rather between one specific community and then a broad community that includes a lot of different populations.

There is the community of largely white women, mostly middle class, who are at the center of discourse, right? How do we ensure that women in middle class positions have the childcare, have the elderly care that you need? And you mentioned that in some ways this kind of fits with your experience and in some ways it maybe also doesn't.

[00:07:40] Ellie: No, I think it fits pretty squarely within it. Honestly.

[00:07:43] David: Yeah, just in so far as like, for instance, you don't have to deal with childcare. And so like there are some, some minor differences, but in general, yes, it would be people like you who are centered in this discourse, which does not make the emotional tax that you suffer for having those responsibilities on you any less.

And then there is this very broad set of communities like the poor, the formerly incarcerated people of color, immigrants who are almost completely excluded from the way in which we think about care in our culture. And Nadasen points out that these communities suffer from what she calls a policy of organized abandonment, which is a term that she takes from the scholar Ruth Wilson Gilmore, to suggest that in fact it's not that we don't have policies for these vulnerable communities, but that our official policy is one of systematic organized abandonment.

And, Ellie, you mentioned your experience with care. After reading this book, I started thinking about my own relationship to care and my family's relationship to care.

To be clear, I've never really thought about care as something that has structured my or my family's experience. But after reading this book, I'm realizing just how wrong that is. So, for example, growing up I had a number of odd jobs that according to Nadasen's account of care fall under the care economy.

So for several years during grad school, I was a tutor. Tutoring is a form of caring for pupils. Of course, today I am a teacher, which is also a version of that. But even before that, my first few jobs when I was a teenager, I was first and foremost a waiter And later I also worked as a barista and worked at bars and restaurants. Also, my mom is a janitor, and of course I know that, but now I'm thinking about how her and I are differently positioned within the same care economy.

[00:09:45] Ellie: Yet, and in fact, janitorial work is one of the forms of work that Nadasen mentions often gets excluded and is typically performed by people of color. You know, the preschool teachers are recognized as care workers, but the janitors who clean up at the end of the day are often not.

[00:10:00] David: And my mom in particular does a kind of janitorial work that sometimes includes very direct interaction with families and sometimes doesn't, like sometimes she cleans private homes, but sometimes she cleans like banks and factories where she doesn't have to interact with anybody, but it still falls under the category of this kind of household management labor that is typically feminized, that is typically racialized. And that has been her career for the past several years.

And so, as I think about my family, I'm now realizing just like how deeply care in the politics of care, shape our family dynamics, even when thinking about some of those identities that Nadasen talks about, right, we are a brown family. We're also an immigrant family, so we've had to deal with some obstacles tied to immigration status. There are members of my family who were formerly incarcerated and who have to jump through a lot of legal hoops and lost rights as a result of that. It was interesting for me to read this book because I saw a reflection of my family that I haven't really thought about before, and that was very helpful and comforting in a way .

[00:11:11] Ellie: Yeah, and Nadasen points out just how the care economy has exploded. And so you know, more and more people are finding themselves within it, whether or not they recognize themselves in it. And so while it's easy for me to recognize myself as doing care work, as you mentioned, like it might be a little bit more challenging for your mom to be recognized as doing care work, and this is why Nadasen thinks an intersectional analysis is so important, and I should say we're gonna be focusing in this episode on that dimension and on specifically the care economy today, and how the care discourse is often at odds with how care actually works.

And so with our apologies to the care ethicists, because care ethics has been a really important part of feminist philosophy in recent decades, that's not gonna be something that we have a chance to focus on today just for, you know, purposes of scope.

[00:12:03] David: Premilla Nadasen is a professor of history at Barnard College, Columbia University, where she is co-director of the Barnard Center for Research on Women. She's the author of Welfare Warriors and Household Workers Unite, as well as the book, which will be the subject of today's episode. Care: The Highest Stage of Capitalism.

Hello  Premilla and welcome to Overthink. I have to say, Ellie and I are super thrilled to have you on the podcast with us. We both loved your book. We read it over Spring break. We were texting each other back and forth about how much we were enjoying it. So we are very much looking forward to this discussion.

[00:12:42] 170: Well, thanks so much for having me. It's a pleasure to be in conversation with both of you.

[00:12:46] Ellie: No, thank you so much. I think one thing that immediately stuck out to me about your book is that we often hear about a crisis of care, and yet you have a pretty different interpretation of this than I think the standard discourse. The standard discourse often focuses on how childcare is extremely challenging for working mothers, how healthcare costs have skyrocketed, and elderly people are often left with very few options for affordable care in the us whether it's at home or in care facilities like the, the costs are just astronomical.

And you note that, you know, it's not that these issues are not a thing, but rather that the whole framing of this crisis of care and the issues on which we tend to focus tends to center the experiences of well off white women and leaves out the most vulnerable from the conversation entirely. So I'd love to start off our conversation by asking you to tell our listeners about this. How does the framing of the care crisis lead to this exclusion and how should we better understand the so-called crisis?

[00:13:53] 170: Yeah, so you know, when we talk about the care crisis, people often understand it in terms of the work family balance, right? We have to go to work, we have care responsibilities at home, whether those are children or disabled relatives or elderly family members. And so the question that is framed the care crisis has been how do people obtain work, go to work, but also at the same time, take care of their care responsibilities. And this is a particular problem that emerged when we saw large numbers of middle class white women enter the workforce in the 1970s and the 1980s. And I think this has been really foundational to understanding the care crisis.

The care crisis is real, as you say. You know, this was most visible during the pandemic, right? When we saw childcare programs shut down, there were 3.2 million children without care during the pandemic, and millions of women left the workforce in order to take care of their children. So I don't wanna downplay the importance of the care crisis and the ways in which middle class families struggle with both doing care and working in the for paid employment.

But I think this has erased many other ways we actually have to think about the care crisis. For me, the care crisis is not only about how do we afford childcare and elder care? But it's in fact about things like food insecurity, housing insecurity, family separation, incarceration, the climate crisis.

All of these larger structural issues has also deeply impacted the ways in which people are able to care for themselves and care for their families.

[00:15:40] David: Yeah, and one of the things that I really appreciate about your book. Is that you add a lot of nuance to our understanding of care because you point out that often when we talk about care and the crisis of care and solutions to the crisis of care, we bring some assumptions to what care is. You know, you talk about how we assume that it's always work done by women, but you point out that in fact it's a really complicated space and we have to be careful not to confuse different threads or strands of the kind of work that goes into this space.

So for instance, you talk about the difference between paid versus unpaid care work. You talk about the difference between care work that requires direct engagement with individuals who need care. So for example, a nurse that is dealing with patients versus care work that is a little bit more removed from that personal relationship like a research nurse, for example. You also talk about the fact that a lot of men, especially men of color, have gone into professions, especially in the second half of the 20th century that are traditionally feminized. So can you say a little bit more about the complexities of the care industry that has ballooned in recent decades?

[00:16:51] Premilla: Yeah. and I'll just start by saying that we often associate care and care work with women and with gender. There are assumptions about this work being nurturing, work, being centered on a really a white, middle class normative framing and ideas we associate with middle class women, right? Ideas of care, ideas of nurture, ideas of emotional investment, and I think what that does, as you're pointing out, is it simplifies and reduces what is in fact a very complex category of employment. And you mentioned the research nurses. We can also look at people who work in the billing department of the hospital, right? I mean, these are people who I guess in some ways might be considered care workers because they're in the hospital industry.

However, their work is not caring work. And so I think there's an association of care work with emotional investment and with nurture that actually obscures the kind of work that people are doing. I think the other part of it is that there is both the paid work and the unpaid work. So we often do this work for our own family members because we care about them, because we love them, because there's no other option to do it.

We might feel it extremely burdensome, but we still do it. We might not wanna do it, but we do it because they are our family members or they are people in our community or our neighborhood who we love to some degree and wanna take care of. For most people who are doing this work for pay, it's a job, right?

They are getting paid. Hopefully they're getting paid well. And there's been a very long history of organizing and struggle by domestic workers and by care workers in order to achieve the labor rights to which they feel they've been entitled and excluded for much of the history of the 20th century. So I think part of the problem with framing this work as care is an expectation that the people who are doing the labor are going to be emotionally invested in the work. That they are going to go above and beyond the call of duty. They are gonna be there whether they get paid or not. If the person needs to be cared for, they will be there.

And that's dangerous territory, because what that does is it moves them away from being a worker towards essentially being a family member towards the expectation that they are there out of love, and not necessarily because this is a job. And so there's been a very long struggle by domestic workers, by other care workers to insist on labor rights, to demand labor rights to be treated as all other workers are being treated.

And I think we have to understand how in fact, the demands for emotional investment are extractive. The sociologist Arlie Hochschild wrote a very important book in the 1980s called The Managed Heart. She coined the term emotional labor there, and unlike the way emotional labor is sometimes valorized today, what Hochschild was talking about is emotional labor as extractive, right?

As demands on the worker that are in fact unfair and are exploitative. And I think for many domestic workers, for many care workers, the demands to be caring, the demands to invest emotionally are in fact extractive.

[00:20:21] Ellie: Yeah. One of the many examples in your book that really brought this home for me was that of Christine Lewis, who came to New York from Trinidad in 1989, ended up working as a nanny and found that in addition to the explicit obligations that she agreed to, you know, do as part of her work, there were all of these implicit obligations that she was expected to perform for the family, and how that often gets treated as something that's just expected because, oh, you are a part of the family.

And so like the, that kind of need to put up explicit boundaries for Christine ended up eventually connecting her to other workers, and she became one of the leaders of the domestic workers union. So I think that struck me as an example of the kind of organizing that you're talking about here.

[00:21:05] Premilla: Yeah, absolutely. And I think this framing of one of the family is extremely important because for generations, domestic workers were understood or called by their employer as one of the family, right? And so what did that mean on a day-to-day basis? It meant that they were essentially servants, right?

They were there. They were there full-time. They were expected to do their employer's bidding, and the job was defined not in terms of a specific set of tasks or responsibilities. 'cause we all know as family members, we just do what we have to do, right? We might not expect the kid to get sick. We might not expect, you know, a pipe to burst, but we just do what we do and we resolve the problems and the issues that we have.

For workers, it's different, right? It's an, it's a job and they should have a clear set of delineated tasks that sort of fall under the category of what their job is. A servant on the other hand, or one of the family is someone who is supposed to be available 24/7. And so I think Christine's example is powerful because it does in fact show us how a framing of one of the family is in fact a demand that somebody work above and beyond what's expected of them.

I think the language is very important here. There was a domestic worker rights movement in the 1970s. Those were household workers who organized for rights and protections. They actually rejected the term care workers. They rejected the term, even household workers or maids or servants, and they were frequently called servants in the 1970s and they wanted to be called household technicians, and they claimed that language because they believed that the work they did as domestic workers was in fact skilled work.

It was professional work, and they wanted to be seen as skilled professional workers. And so I think that as we grapple with thinking about how to move forward, we have to think about the ways in which our language around care work imposes a certain set of expectations upon people who work for us.

[00:23:06] David: I think this is a great place to talk about a distinction that I found very helpful from your work, and that is the distinction between care, which is a kind of emotional attachment, an investment that binds to people affectively and the practice of care, which is a behavior. It's something that you do independently of how you feel and you point out that we have to be able to differentiate between these.

Because what we should expect of care workers is the practice of care. A nurse should do their job appropriately with respect and dignity, but that additional expectation that they must love their job, that they must go above and beyond is extractive. It's exploitative and it is unjust. And it reminds me also of an observation that you make at some point in your book, which is that the expectation that care workers genuinely care for the people who employ them or who are receiving their services also translates into a misjudgment of their skills. So, for example, it's very common for nurses to be evaluated by patients, not based on whether or not they are nursing well, like doing the practice of care well.

But on their personality, you know, whether they're friendly, whether the patient feels like this nurse will do anything in their power to satisfy their desires. And so, can you talk about this distinction between care and practice of care and how it should inform care discourse moving forward?

[00:24:45] Premilla: The ways in which our expectations around care and emotional investment play out is very gendered and racialized, right? So we don't tend to evaluate doctors in the same way. We don't tend to evaluate investment brokers in the same way. Even though I would suggest investment brokers and financial advisors are also care workers, they care about our future wellbeing.

You know, we don't think about, you know, middle school boys coaches. You know, in that way, but yes, you're right. Nurses, domestic workers, teachers who tend to be women as well, we evaluate them based on their personality, based on how kind they are, how they made us feel about ourselves. And what this does is it erases the skill, it erases their expertise. And it instills in them this expectation around emotional investment, which I think has, you know, again, really distorted the actual job itself.

So I think when we think about the practice of care, we have to understand that every one of these jobs has a certain set of tasks that people need to do, a certain expertise that people need to put into practice.

And so to say that we shouldn't expect people to be emotionally invested in the labor doesn't mean that we don't expect them to do their jobs, right? If you have a nanny, for example, who is taking care of a child and that child scrapes their knee, you know, it might be appropriate to, to put a bandaid on that knee.

It might be appropriate to pick up the child and give them a hug, and that doesn't mean that one is emotionally invested. It means that you understand that a child needs to be hugged, right? And you're doing a very specific task around that child that's hurt. So I think we have to have a clear set of expectations around the practice of care, and that does not necessarily mean that someone is emotionally invested.

[00:26:46] Ellie: Yeah. And apropos of this, you have a passage in the book where you say that care is not commodified, rather the practice of care is commodified. And I guess I'm wondering how to draw that distinction in cases where the line between the emotion of care and the practice of care might not be so different.

And so like in the case of the giving a child a hug, I guess I'm wondering whether there might be sometimes a kind of blurring of lines. And I say this as somebody who, like I spent, you know, my entire time in grad school I babysat and did other forms of childcare work on the side. And I feel like in my experiences it wasn't always the case that I like really liked or cared or let alone loved the children that I was working with and, and whose parents I was working for. But I definitely found that there was like a kind of instant sort of emotional labor that was being done there. And so I guess I'm wondering like whether you think it might also sometimes be the case that care is commodified, even if, as you say, the practice of care is your emphasis or whether No, you really wanna hold to that distinction, even if it's not always evident, like on a first person level when people are performing this work.

[00:28:01] Premilla: That's a great question, and I think there is an attempt to commodify care as an emotion, but I don't think it is commodified, and that does not mean that people who do this work don't care. Some do, some actually do love the people who they're caring for. Some care for them, some like them, some don't like them.

I think for me, the issue is that, that is a choice that the worker themselves will make it is not something that can be imposed upon the employment relationship.

And so, and I think we all feel that I'm a teacher, right? And I treat all my students the same. Maybe I like some more than others, you know, that might the case. But I will meet all of their needs and I will respond to them all the same way. But I don't think that my employer should tell me how I should feel about my students, right? No one should impose on me, so it's really a question of power. The occupation of care work is one that is completely intersected with unequal power relations.

And so I think the problem is when an employer says, I expect you to love my child, the same way I love my child, which actually happens a lot. That's what middle class employers are looking for: somebody who loves their child the same way they do. I think that is an expectation that is indicative of the extractive emotional labor that Arley Schild was talking about.

[00:29:32] David: So one of the main takeaways I take it from your book, is that this crisis of care that we're dealing with makes care eneven. You know, there are people who receive care. There are people who provided, and that tends to be gendered and racialized in specific ways. But you also note that this crisis of care is not actually as new as our current care crisis discourse makes it seem.

We often talk about how it's something that happened in the second half of the 20th century. Having to do with changes in political economy, changes in the structure of the family and gender relations and work and so on and so forth. But you point out that racial capitalism has always produced a crisis of care because it has always made care available to some at the expense of others, and that's been happening for centuries.

So I wanna hear you say a little bit more about how racial capitalism has produced the situation that we're in today, in which, as you put it in the book, the politics of social reproduction has led to new forms of profit making, such as the explosion of the care economy, which you mentioned is even larger today than the defense industry, which was a wild claim to me.

There were a lot of wild statistics in your book that really made me think about this in a different way, and this was one of them.

[00:30:58] Premilla: Yeah, so I'll say there's a couple of ways that I think racial capitalism is really foundational to how we should understand care, especially in this moment. One is there is inequity in the care system, right? We know that some people are cared for and some people are not cared for. We do have some services and some support for, especially for middle class families, some for working class families, although those are being slashed, you know, yearly.

The very poorest in our country actually have very, very few services and support. Those tend to be people of color and especially women of color. These are people who are unhoused, people who are unemployed, people who are formerly incarcerated, single mothers, in fact, is the largest category of impoverished people. And so there is racial hierarchy in terms of how we understand poverty and who has access to care support systems and who does not.

And we can think about, for example, how people get care benefits. One way that they get care benefits is through the private sector. You have a job, you have an employer that provides health insurance for you. Google, for example, provides a lot of support for some of its employees. Some are subcontracted, but the full-time Google employees actually get a lot of childcare benefits, get paid, family leave, things like that.

But the care economy is one, the way I define it, the way I understand it, is profit extraction from life. Okay, and that is companies that are making money off of our need, our desire to care for ourselves, and care for our families. This includes the healthcare system. We live in a for-profit healthcare system, right?

Increasingly it includes education, it includes housing. We need housing in order to live right? And so we can go down the line of the ways in which companies are making money off of our need to just survive and live day to day. This, as you mentioned, I have talked about in the book as a growing part of the US economy, that is more and more important.

In fact, if you look at the top 10 Fortune 500 companies defined by revenue today, four are part of the care economy, whereas in contrast in 1980, the top 10 included six oil and gas companies, two tech firms, and two auto manufacturers. So even though this is growing, it's a more significant part of the US economy, it's not altogether new because black and brown people have been experiencing profit extraction from life for a very long time.

And the best example of this is actually the example of slavery, right? If you think about the transatlantic slave system. There were insurance companies, there were slave holders, there were shipping companies that made money off of the movement of people from the African continent to North and South America.

There were slaveholders who made money off of the sale of human beings. There were slave holders who made money off of the children that enslaved women birthed. That is profit extraction from life, right? On a very basic level, not only labor exploitation. And so I think thinking about profit extraction from life and the care economy in this longer historical framework really helps us understand the racial divide that has shaped care and what we can learn from history.

For me, this is fundamentally about how history can teach us about the ways in which capitalism and racial capitalism and care have functioned, partly as a way to think about re-imagining care in new ways.

[00:34:49] Ellie: Yeah, and maybe also I imagine some of our listeners may be familiar with the term racial capitalism, but others may not. So maybe we could just say a little bit about what that term means to, you know, kind of help situate what we're talking about here.

[00:35:02] Premilla: The concept of racial capitalism suggests that we actually cannot think about capitalism without racism. That since its inception in Europe, during the industrial and pre-industrial period, there has always been some form of racial distinctions and the concept of race there is a broad one. It doesn't only mean black and white, and I rely a lot on the work of Cedric Robinson, who looks at this early period in European history and the ways in which racial divisions shaped people even within Europe.

So racial capitalism suggests that there is no capitalism without racism, and that in order to understand how capitalism functions, we have to think about the ways in which race and racism has shaped it, and undergirded capitalism and capitalist extraction.

[00:35:54] Ellie: These insights are essential and to my mind, like pretty indisputable at this point. And they really give the lie to the capitalist idea that it's all about the free market. It's like, no, how is the free market, so-called free market able to develop on the backs of enslaved people? And so this idea that the kind of profit that capitalism was able to generate and really, yeah, the cumulative nature of capital is really undergirded and made possible through chattel slavery, I think is such an important background to have on the current crisis of care or what's called the crisis of care.

And I think it also raises questions for us about the care economy because as you mentioned. This care discourse, the kind of neoliberal idea that like what we need is just better maternal leave policies and stuff like that, you know, which, okay, yes, and also, it's about a lot more than that as you talk about the care discourse in centering largely around the care economy and the people who offer care services and those who pay for those services. The people whose kind of work family balance, as you mentioned earlier, is particularly challenging under current economic conditions.

What we're missing is all the people who are outside this economy, such as the poor single mothers that you mentioned, or people with disabilities, people in conditions of unemployment who simply can't afford to pay for the care services they desperately need. And whose care services have been continually whittled away by the federal government and some of the changes that you talk about in recent decades around, you know, like changes in welfare law requiring employment status and that type of thing.

And so we're talking about a massive group of people here who are neither providers nor consumers of services, of the care market, and therefore are abandoned by the care discourse. And so even these progressive policies aren't gonna really tackle the issue. And so how is it that we deny these most basic care productions for those who need it most?

And how might we better tackle this issue?

[00:38:00] Premilla: I would say we have, you know, broadly a two tier care system, both of which are profit making in different ways. So on the one hand we have the very privileged or the middle class who, some of whom are experiencing a care crisis, who turn to the private sector. As a way to resolve that crisis. So we can think about nursing homes, we can think about for-profit childcare centers that are run by companies like Bright Horizons, where people pay a lot of money to have their children cared for.

We can think about the hospitalization and hospital care that people pay for. Those are people who turn to the private sector. Private sector who have no choice but to turn to the private sector because of the paucity of federal support and federal programs or state programs. And so there's a lot of profit being made around this middle class crisis of care.

In fact, there has been new initiatives to get companies to invest in care to meet the needs of middle class families. Right. That is pretty clear to us. I think the other side of it that I really tried to uplift in the book is also how poor people who don't have access to care have become a site of profit extraction around care.

And we can look for example, at people who are formally incarcerated, who have been released from prison, who now, for example, are entering job training programs, right, or who are turning to low income services or who are expected to wear monitors. They often have to pay for these services, or there is a nonprofit company, or there is a government agency that is subcontracting out to a private company that is paying for those services.

So again, you have a private corporation that is benefiting off of the needs of these low income, formerly incarcerated people. One of the things I talk about in my book is what has happened in Mississippi, in the welfare program.

And in Mississippi, a lot of, and this is true throughout the country, that our public welfare systems, our public healthcare systems for the poor and for the middle class are actually being contracted out to private for-profit companies. These are dollars that were supposed to be spent to care for our most needy people. But in fact, what's happening is there are companies that are making money off of this.

The foster care system is another really important one where companies have come in and are taking a very big cut from childcare, from child welfare dollars, and we can also look at the detention of people at the border of immigrants in particular, and companies like Core Civics. A private company that is being contracted out by the federal government.

Core Civic talks about the people under their care, right? So they have identified themselves as a space of care caring for immigrants who are being detained. And so I think there's profit extraction on all sides of people who are not getting the care they need, who are being detained, who are being surveilled.

And then we also have the profit extraction from people who actually do have resources and are just trying to care for themselves and their families.

[00:41:22] David: Yeah, no, this is really good because we might think that the solution to the care economy and to the privatization of care services is further investment in public services at the federal and at the state level. And you say, look, even the ones that are already in place are being used to siphon money, taxpayer money from the government to these private companies, and so there is a lot of fraud in this space as companies are rushing into the space.

And so, in particular, I liked when you talked about the case of Mississippi where you know there is this stereotype of fraud of the black welfare queen, where fraud is committed by poor black women who are taking advantage of state services. And you point out there is a lot of fraud, but it's not there. That's not the source of the problem. The problem is these large corporations who are swooping in, in order to extract capital from this new care economy.

And this brings me to a broader question about care. Earlier I pointed out that you make a distinction between care, the feeling, the sentiment, the relationship, the investment, the practice of care, the performance of certain actions and behaviors that provide comfort and care for others.

What I didn't mention is that there is a third layer to this distinction. There is care, the practice of care, and then finally what you call radical care. And radical care is essentially your proposal for how to navigate this really tricky space of the care economy and the care non economy as well. So what is radical care and how can it transform our understanding of care practices these days?

[00:43:11] Premilla: Radical care for me is non-hierarchical, anti-capitalist, so not-profit driven collective care. And I saw this in motion in Mississippi. So Mississippi is the poorest state in the country. It has the lowest welfare benefits, and as you mentioned there has been a tremendous amount of profit extraction and fraud on the part of welfare officials and for-profit companies.

But despite the limited support in Mississippi, what I witnessed there were people who came together in their communities, often rural communities where there's very little support, and they had, they developed collective ways of taking care of one another. One woman in particular, Ellen Reddy, who runs a center for girls, young girls who are experiencing violence at school, at home, created the Nollie Jenkins Family Center.

So for me, this is an example of how in a context of state failure or state abandonment, people have to come together and find ways to take care of one another. We saw this during the pandemic as well, where there were multiple efforts for people to create mutual aid associations, the friendly fridge movement.

It was an amazing capacity of people helping other people, and they did so voluntarily. They did so without government support. They did so without corporate support. So I think that there is a long history of this. The Black Panther Party, for example, in the 1960s started a free Breakfast for children program. They had health clinics, mobile health clinics.

I would distinguish between just a kind of collective care. Where people help one another out, which I think is extremely important. I don't wanna diminish that or minimize that in any way whatsoever. But also then thinking about how do we take those models of collective care and move it towards transformative care.

Right. Because it is not enough for us to take care of one another. It's important for us to take care of one another, but we also have to think about how to transform, right? How to transform capitalism, how to transform the kind of exploitative and extractive care programs we're currently witnessing. So I think for me, part of radical care is social movement organizing, right?

And thinking about how those care practices are also models of education. How they are prefigurative, and by that I mean they are modeling something that we'd like to see develop on a larger scale in the future. I don't think any of us actually believe that there should be profit extraction from our basic desire to live and care for one another, that our love for other people should be a site of profit for anyone.

I don't think anybody would agree with that. And so if that's what we believe the question is, how can we move in a different direction?

[00:46:08] Ellie: I think the answer to that in your book is that we have to abolish capitalism, and I couldn't agree with you more on that. And I also think that is part of what's so radical about your book. You say, you know, oftentimes people trace the crisis of care to neoliberalism, which would mean that it's a much more recent historical development.

As you mentioned, we also trace it to gender. And not that that's like wrong, but that's only part of the story. And so it's at least partially wrong, but although not entirely, and so if you think that the care crisis is a product of neoliberalism, then it's like, oh, well we just have to make our capitalism a little bit better and move away from neoliberalism.

But if in fact it's racial capitalism, which has gone back hundreds of years, then it's a far more radical change that needs to occur.

[00:46:51] Premilla: Absolutely. So, you know, and we've seen a lot of proposals. I mean, during the Biden administration, there were a lot of proposals for expanded childcare, for support, for childcare centers, for assistance, for community clinics, things like that, all of which are good.

But I have a lot of questions about programs like that if in fact there aren't guardrails around who's gonna benefit and around who's gonna profit. Because I think the model we have seen is government grants that are going to either for-profit companies or nonprofit companies. That actually don't have an interest in abolishing the problem because their very existence depends on the problem.

There's a wonderful book by a woman named Theresa Funiciello, a woman who I met many years ago, back in the 1990s. She was a welfare recipient who ended up working in New York State government. She wrote a book called The Tyranny of Kindness, which is about how the nonprofit food rescue programs that were funded by the state were in fact interested in maintaining hunger as a problem because they needed hunger to continue to exist in order for their own existence.

[00:48:03] David: Well, Pramila, thank you very much for this very careful and nuanced analysis of care under capitalism and under neoliberalism. It was a pleasure to read your book and we highly recommended it to all of our listeners and viewers. The title is Care the Highest Stage of Capitalism.

[00:48:23] Ellie: Thank you so much.

[00:48:24] Premilla: Thank you. It was wonderful to be in conversation with you.

[00:48:29] Ellie: We hope you enjoyed today's episode. Please consider subscribing to our substack for extended ad free episodes, community chats, and additional overthink content.

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We'd like to thank co-producer and audio editor, Aaron Morgan, Production Assistants Bayarmaa Bat-Erdene, and Kristen Taylor. And Samuel PK Smith for the original music. And to our listeners, thanks so much for overthinking with us.