The difficulty in conceptualizing health and social care resides in its complex and dialectical character: its constitutive social relations are not reducible to a single logic or type of actor; it is both a descriptive and a normative idea, a tool of classification and evaluation, a means of analysis and a weapon of critique. It is both theoretical and practical, a scientific construct and an ethical stance, rooted both in academic disciplines and the manifold practices of health and social care. This article draws out the radical core of the concept of care as a dialogical form of labor that transcends mere instrumental or strategic action; it then explores the contradictions of this praxis in the context of the social division of care in late capitalism.
The concept of careHealth and social care have become a massive set of service, financial, and manufacturing industries shared between the public, private, not-for-profit, and informal sectors. The manufacturing side of health and social care (construction, pharmaceutical products, surgical, diagnostic, and other equipment) is dominated by flourishing capitalist firms selling to the huge, welcoming markets constituted, regulated, or subsidized by states. The financial landscape of health and social care is peopled by a mix of public bodies, private, cooperative, and mutual assurers, as well as individuals paying out of pocket. Health and social care "services" are parceled out in various ways, depending on the country, between public agencies, private firms, cooperatives, charitable and non-profit associations, families, neighbors, and friends.