The issue over care should be about how it is delivered, not how it is funded

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The UK’s new PM talked a lot last week about care, and there’s no doubt that identifying what care is needed and how it is to be provided are significant issues facing us, particularly as the population ages. Sadly, though, the debate rapidly turned into one about how care is to be paid for, which is a completely different issue – and in some ways, irrelevant. The need for care is based on the aggregation of the needs of millions of individuals – whilst the level of provision might vary according to how much money is available or what budget is set, the need doesn’t change in response to the funding.

If we start from first principles rather than ideological views about money and the size of the state, the nature of the problem changes. One of the problems with neoliberal economic thinking is that it values only two things: labour and capital. The economy is seen as belonging only to those who supply either their labour or their capital – with a huge bias in favour of the latter. Everything and everyone else is then seen as a ‘burden’ on the productive economic activity of those groups, often with the implicit assumption that the living standards / purchasing power of those non-productive groups should be limited to the basics. But if we instead see the economy as a social construct, with the objective of serving all members of the society in which it operates, the picture changes completely. A successful economy needs to be able to provide a decent standard of living (leaving aside, for the purposes of the current argument, who decides what that is, and on what basis) for all its members – young, old, sick, and disabled. And, however defined, that ‘decent standard’ includes things like education, health – and care.

If ‘the economy’ is to serve all of us rather than only those supplying labour or capital, the question ceases to be about how much we tax to pay for x, y, or z, and instead becomes one of how we ensure that the level of economic activity is high enough to provide that decent standard of living – and what mechanism we use to share the benefits of that economic activity. Economic growth is important, of course, but once we accept the obvious truth that growth cannot be infinite in a world where resources are finite, we cannot use that growth – however much the politicians try to do so – as an excuse to avoid discussing the issue of distribution. But avoiding that issue, ultimately, is why the supporters of the current neoliberal capitalism reduce everything to a question of ‘how will you pay for it?’. Better – from their perspective – to turn people against each other over a question of taxation than to get to grips with the question of how wealth and income are distributed. All the debate around how care is to be funded - like the debate about the welfare bill, or the pensions triple lock – is about diverting attention away from the key question, which is about the distribution of wealth and income within society. And whose interests are served by that?