The one-sentence summary

Care is the foundation of organic life and in our hearts is honoured as an irreducible good, but in the economy it is treated as a second-class citizen, barely recognized in the relentless rush for productivity and wealth.

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WHAT THE BOOK SAYS

  • This is a manifesto for a healthier and more humane society. Because prosperity is primarily about health, the economy should always and everywhere be about care. The care economy is economy as care. The two central ideas in the book are intertwined: human prosperity is about health rather than wealth, so the economy should concern itself with care in all its forms rather than growth.
  • Health is defined as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. Care is an activity that includes everything we do to maintain, continue and repair our world so that we can live in it as well as possible. That means care for the young, the elderly, the sick, our community, our home and the material conditions for life itself, including the planet, climate, soil and oceans.
  • The careless economy is characterized by an absence of care, the undermining of health, and the monetization of disease. In it, cure dominates care.
  • The book starts by exploring our conceptions and misconceptions about what health is, looks at it as a process of adaptation and a restorative force, its relationship with post-growth economics, the pressures placed on healthcare by the changing global burden of disease, and the forces which have given rise to those changes. Frustratingly, what was known about medicine and care centuries ago has been expunged from the record in favour of commercial interests.
  • Our culture is pathogenic – it causes disease itself because the pursuit of prosperity conceived as wealth is profoundly at odds with the goal of prosperity construed as health. Health is all about balance. Wealth is all about more.
  • There has been a large shift away from infectious diseases to chronic diseases that are now responsible for three-quarters of all deaths worldwide. By 2030 this will cost the global economy over $47 trillion.
  • How can personal wealth be called prosperity if it comes through death, disease and deprivation for others? If wealth is dependent on child labour and industrial homicide, can we even call it prosperity?
  • More GDP doesn’t mean more prosperity. Degrowth proponents aren’t asking for less prosperity – just to redefine it to make it equitable and sustainable. Those who always want growth deliberately label this disagreement as the difference between expansion or extinction, as though relentless forward motion is the only way. This never-ending obsession with novelty is misguidedly seen as the foundation of economic growth, while durability is seen as a distraction and antithetical to it.
  • Postgrowth thinking doesn’t deny technological solutions to the challenges we face, it starts by asking what kind of economy we need to allow people to live as well as possible within the limits of a finite planet, by offering avenues for change such as structural, social and system change.

WHAT’S GOOD ABOUT IT

  • The untrammeled pursuit of symbolic immortality through material expansion and economic power is not care. It has no legitimacy as an act of care because it fails as a restorative force.
  • Knowing that we are going to die frames our existence. We need what sociologist Peter Berger calls a sacred canopy – a framework of cultural meaning within which to make sense of our lives. Religion has failed us, as has capitalism, the patriarchy, technology, and our own ingenuity, so the sacred canopy is in desperate need of renewal.
  • The original meaning of Euphoria is being well or healthy.
  • The origin of the word value is the Latin valere, meaning to be well, strong and healthy.
  • Pain is an opinion on an organism’s state of health. It is a protector not a detector. In mixing up health with pleasure, we have profoundly confused health with the absence of pain, allowing unscrupulous companies to make vast amounts of money through phenomena such as the opioid crisis.
  • Allostasis refers to stability through change. Homeostasis allows humans to adjust, within reason, to changing circumstances.
  • For germ theory, curing disease is all about identifying, isolating and eliminating germs. For terrain theory, it’s all about changing those aspects of the environment such as diet, lifestyle and toxins, which undermine the body’s own ability to cure itself. Germ theory won that contest and so created the bedrock for the modern pharmaceutical healthcare industry.
  • There is an interesting gender bias in which most male economists are concerned with efficiency and productivity, while female economists have developed an entirely different strand premised on the importance of care to human life.
  • This is in stark contrast to the toxic masculinity that has taken hold of many of our leaders, who perpetuate it through a male propensity for violence whose ultimate expression is always war.
  • In The Wisdom of Insecurity, Alan Watts points out that the question “What shall we do about it?” is only ever asked when we don’t understand the problem. To understand it and know what to do about it are therefore the same thing.
  • Care is about legacy, a wishlist, a principle, prevention, a postgrowth guide, an investment, an unpaid debt, climate action, freedom, and taking the red pill to leave The Matrix.

WHAT YOU HAVE TO WATCH

  • This book covers a huge amount of ground, so don’t expect a simple checklist of action to take because it’s way more complicated than that.