Caring for ethics and the politics of health care reform in the United States

It is increasingly recognized that the work of (unpaid) informal caregivers constitutes an important contribution to care delivery in the United States and in many other societies. Accounting for the range of social, economic and political circumstances in which this care is produced has become the focus of a number of academics and others theorizing the ‘third sector’, or the ‘social economy’. However, some scholars are concerned that the increasing attention paid to the role of informal economic activity will either legitimate neoliberal state withdrawal from social reproduction or facilitate continued invasive commodification of relationships that were formerly part of social life. While these are possible dangers, J.K. Gibson-Graham's diverse economy framework and theory of community economy allow us to understand the social and economic conditions that support, rather than undermine, a caregiver's fidelity to the process of caring. Given the size of the informal caregiving sector, it would remain an important aspect of the care economy even if the United States developed a national health care system. It is important to understand informal caregivers as economic subjects, with their desires, motivations, hopes and anxieties. What emerges from my qualitative research is an understanding of informal caregivers as ethical subjects who operate best in a network of collective recognition and support. Informal caregivers are neither self-interested economic actors nor (necessarily) victims of failed social support. Rather, they are, potentially, agents of change in a new politics of health care reform.