A rationale for care

The COVID-19 pandemic highlights the failure of governments in Canada to adequately deal not only with the care emergencies of a pandemic, but also with the long-standing gaps and deficiencies in care that precede this crisis. COVID-19 exposes the inequities that pervade our country: inequities in access to health and to care, especially in relation to areas such as sick leave, medications, housing, and decent, safe working conditions. It also highlights the persistent and growing inequalities in income and wealth.

The ‘care sector’ is extensive and includes direct personal care in the public and private spheres, government funded social services and protective policies, and the related government programs that support care work. It includes the people who provide the paid and unpaid care labour and those needing support and care.

The chronic failure to adequately deal with care issues reflects several assumptions that must be challenged.

First is the assumption that care issues are not like the crucial sectors that require government support because they drive the economy, sectors such as resources, finance, and manufacturing. This assumption ignores the real contributions of the care sector as an economic driver. Health care and education alone, at 12.3% of GDP, contribute more to the economy than other major sectors, such as manufacturing, oil and gas, and mining. The care sector is also labour intensive and accounts for at least 21% of all paid labour. These numbers do not include another crucial contribution to the economy, unpaid labour in care work.

The care economy also has a crucial role in maintaining economic stability through its role as an automatic stabilizer that can serve to inhibit the dramatic economic fluctuations that occur with economic downturns. Care work does not decrease when there is a business downturn and the continued expenditures/incomes in this sector can help maintain stability without having to invent extensive new temporary programs each time there is a crisis.

The care sector is critical ‘social infrastructure’ that needs public capital expenditure and other public support, much in the way that utilities and transportation do. Public child care centres, long term care facilities, public pharmacare, and extensive community-appropriate care supports and services for all Indigenous communities are some of the most obvious examples of deficits in public infrastructure. These are all areas that have significant potential for providing economic stability while meeting care needs and improving future outcomes and potential. Moreover, they are central to maintaining a healthy labour force.

Second is the assumption that governments cannot afford to provide for care needs, especially given an aging population. Since 1995 Canadian governments have consistently spent less than the average of OECD (world’s wealthy) countries on social services. While Canada used to be one of the leaders in public expenditures on people, it is now a laggard. Social spending in Canada is now 2% less than the average of all wealthy countries. This is a large difference, amounting to $46 billion a year more that could be spent on social services if Canada even reached the average OECD expenditure rate.

Clearly there can be enough money when it is considered necessary, as the spending in response to COVID-19 and earlier economic crises demonstrates. How much we spend is a matter of values. Not spending on care issues is both morally wrong and damaging to the economy.

Third is the assumption that care work can be undertaken either by unpaid work in the home, mostly done by women, or by paid workers, also mostly women who are largely an underpaid labour force that relies disproportionately on recent immigrants, migrant workers, and racialized women. Traditionally associated with women, much of care work is also assumed to require little skill and thus little formal education, which in turns justifies poor financial compensation and poor working conditions.

While care workers, both paid and unpaid, have been heroic during the pandemic, and lauded for their work, several issues need to be understood. A significant one is that the conditions of work simply do not attract enough workers. Among other things, this underlines the need for access to status for migrants who perform much of care workand are more exposed to exploitation. Another is that unpaid work simply cannot take up the slack, even if there are relatives and friends willing to do so. The crisis in care has reached such dramatic proportions that governments need to provide more than temporary fixes. They need to immediately increase both the quantity and quality of paid work,and ensure that these workers are appropriately trained and compensated. Altogether people and governments need to act on the pandemic-revealed recognition that the conditions of work are the conditions of care.

Planning for a post-pandemic recovery needs to build resilience in the economy so that insights gained from the pandemic are not lost when vaccines are widespread and the present crisis diminishes. In care homes, for example, declining death rates in the wake of vaccines do not mean the sector is safe for those who live, work and visit in them. Radically improved care is crucial for families supporting those needing special care, and for people who need distinct services. This is the critically urgent case for Indigenous communities, migrants, people with disabilities, and those with addictions. Governments must act to act to support young people whose care and education have suffered during COVID-19, and to support parents struggling to find affordable, quality care for their children. The future requires access to high quality educational and training opportunities, from early learning and childcare to post-secondary education and skills upgrading.

For the past year, our governments emphasized that we are all in this together. We would add that to get out of this together we must care for each other. We need federal leadership to carry these hard-earned pandemic lessons into a recovery by investing in a Care Economy that supports both those who need and those who provide care.