Cover image for Making Care Work: Why Our Economy Should Put People First by Nancy Folbre (UC Press, 2026)
We all like to see where we are going but sometimes need to step into the dark. Consider a slightly revised version of the Parable of the Streetlight: An economist is searching for lost keys under a streetlight. Another economist comes along and offers to help, and after a fruitless search asks, “Are you sure this is where you lost them?” The first economist says, “No, I lost them in the park.” The second economist asks, “So why are we searching here?” and the first says, “Because this is where the light is.” Usually the story ends here, but in this case the second economist asks, “Why on earth is there no streetlight in the park?,” then pulls a small flashlight out of her backpack and says, “Let’s head over there, anyway.”
We need to look beyond the market economy captured by GDP to better understand the institutional arrangements that have evolved to help us take care of ourselves over time. Households, communities, firms, and states are sites of productive activities that can’t be understood merely in terms of decisions to buy or sell. They are stamped by complex forms of individual and collective conflict that can lead to unfair, inefficient, and unsustainable outcomes for society as a whole. As the history of accounting for care illustrates, economic power can sway perceptions of economic reality, sometimes in self-defeating ways.
Effective cooperation often depends on clearly demonstrating the gains from cooperation, which, in turn, depends on how we define gains. The crucial task of accounting for both paid and unpaid care provision requires efforts to tally costs and benefits that include dollars but can’t always be reduced to them.
The Paradox
How can we depend so heavily on the production, development, and maintenance of human capabilities yet not regard this as an economic achievement? While care is often a source of intrinsic satisfaction, it is difficult for care providers to measure, much less capture, the value they create for care recipients, for the economy as a whole, and for the human future itself. Care provision is a public good that relies heavily on moral values, social norms, and pro-social preferences, but it does not rely on these alone.
Like most public goods, it requires institutional governance and is vulnerable to exploitation that can take the form of free-riding (enjoying the same benefits as others without paying the costs) or top-riding (seizing an unfair share of the benefits). Patriarchal hierarchies traditionally provided an authoritarian structure for care provision that has been weakened by capitalist development promising that the drive to maximize profits would increase the scope for individual choice and improve economic well-being. This promise was never completely fulfilled, and it is no longer sustainable.
The undervaluation of care provision is symptomatic of tensions between the market and the larger economy. This book began with the observation that, between 1977 and 2022, most Americans began to disagree that “it is better for everyone if the man is the achiever outside the home and the woman takes care of home and family.” This change reflected a longer process of renegotiation that could be traced back to the emergence of organized feminism, punctuated by a specific letter that the Association for the Advancement of Women sent to the US Congress in 1878.
Over the next 150 years, three successive debates gradually modified the meaning of individual achievement. The first debate concerned the definition of work. Even today, the meaning of this word defaults to paid work; the terms “labor force” and “labor supply” refer only to the paid labor force. Yet the feminist slogan, “Every mother is a working mother,” has gained traction. As the number of births has dwindled, the cost of failing to recognize, much less support, the work of caring for others has begun to receive the attention it deserves.
The second debate, focused on the measurement of work, led to the development of official national surveys showing that the time we spend taking care of ourselves and others equals that which we spend working for pay and profit. About half of the work performed in the US, one of the most affluent capitalist economies of the world, takes place outside of the labor market. Many women work an especially long double day producing, developing, and maintaining human capabilities, but men also devote considerable time and effort to this end. They too are caught between the demands of earning income and other, less easily measured needs.
The third debate, revolving around the valuation of unpaid work, led to the development of satellite national accounts revealing what GDP would amount to if unpaid work were valued at the cost of hiring a paid housekeeper to perform it. Such lower-bound estimates boost the conventional measure of GDP by a considerable amount but represent only a first step toward the development of better national accounts. Unpaid and paid services are not perfect substitutes because emotional attachments, moral commitments, and person-specific skills matter. People need time as well as money. Social investments yield both monetary and non-monetary benefits.
Household market income is a poor measure of household living standards (and inequality in living standards), because it ignores both the value of time devoted to unpaid work and the time and money required for the care of dependents. The dangers of relying entirely on a market metric are exemplified by the practice of assigning dollar values to human lives based on projections of individual earnings or spurious measures of “willingness to pay.” Efforts to strip moral values out of such calculations ignore one of our most important social achievements—democratic ideals.
Like emerging models of environmental accounting, social accounting can provide direct assessments of non-monetary outcomes like health and happiness, offering a more complete picture of the “output” of care provision than one based only on the imputed dollar value of its “inputs.” None of the four institutional sites of the Care Diamond offers a perfectly satisfactory means of organizing care services. Many adults lack the resources they need to provide adequate self-care, much less care for dependents. That women pay a disproportionate share of the costs of dependent care both limits their earnings and discourages their family commitments.
An increasing number of Americans live alone, many at a distance from family and friends. Communities and the non-profit organizations that serve them provide vital services, but segregation by race and class leads to moral travesties and wasted human resources. Affordable housing, protection against crime and drug abuse, and assistance in the face of natural disasters remain in short supply. Segregation based on race, ethnicity, and class tends to reproduce, even amplify patterns that limit people’s ability to find, much less sustain their neighborhoods of choice.
Capitalist firms pay their employees on the basis of their contribution to profits, with only weak incentives to reward contributions to public goods. Paid care services often generate social benefits that are not easily captured by market revenues. Efforts to cut costs often lower the quality of the services provided to consumers, especially those without the economic bargaining power to pay a premium price. Many large employers face competitive pressure to replace employees with robots and artificial intelligence. Their reliance on the capabilities of the resident U.S. population has diminished over time and is likely to dwindle further. Many highly-paid managers and professionals have successfully bargained for access to benefits such as paid family leaves, flexible schedules, and the right to engage in paid employment from home. Most other employees are left to fend for themselves, vulnerable to unpredictable schedules as well as the ups and downs of the business cycle.
Increased income inequality has prompted more firms to target their sales to affluent consumers who are less sensitive to prices than ordinary Americans. There are few shortages of high-end luxury homes, top-quality child care services, condos in assisted living communities, or boutique medical services for those able to pay. By contrast, those employees who have seen little or no improvement in inflation-adjusted earnings that were low to begin with are largely priced out of the market for child care and elder care services.
Direct public investments in care provision could provide enormous social benefits.
In March 2025, the US Secretary of Commerce announced his intention to completely remove government spending from the official measure of GDP, presumably to emphasize what he considers its unproductive nature. Recent purges by the Department of Government Efficiency (DOGE) have removed taxpayer-funded data on health, crime, gender, natural hazards, and climate. In the long run, however, it will be difficult to hide the effects of drastic cuts to social investment—reduced services and greater unmet needs.
Excerpted from Making Care Work: Why Our Economy Should Put People First by Nancy Folbre (University of California Press, 2026). Used with permission.
Click here to read Nancy Folbre’s conversation with Emma Robertson on the importance of care provision and a vision for more care-focused public policy.
