Debate on The Contested Provisioning of Care and Housing
Analysing Senior Care in its Change – The Twofold Hybridity in the Societal Embedding of Marketised and Communitised Care
10th of May, 2023
Valentin Fröhlich
Due to societal transformation, the field of senior care is in flux. Responding to growing demands and arising care gaps or even crises in European countries, the interaction of the state, market, communities, third sector and families or individuals has shifted. On the one hand intensified outsourcing of senior care to the private sector, the responsibilisation of individuals as well as the family and the growing presence of profit-oriented companies, selling care on transnational markets was observed (cf. Aulenbacher 2020; Vaittinen et al. 2018; Lutz 2017). Accordingly, in-kind services are replaced and supplemented by financial subsidies, leading to commodification. As a result, the creation of markets is politically motivated, supported, or accelerated, leading to marketisation, and corporative practices are increasingly introduced, leading to corporatisation (Farris & Marchetti 2017). On the other hand, cuts in or outsourcing of public services entail not only market-oriented care services but also ambivalent civic society engagement and protective responses by the community. In this context, through the rise of a configuration that has been called “community capitalism” (van Dyk & Haubner 2021), not only individuals, the market, and companies, but also volunteers, unpaid work, and civic engagement are taken into service, creating a distinct instrumentalization of the “resource” community. Yet in contrast, community building also deals with the struggle to organise social environment collectively, involving attempts to create an adequate political and regulatory framework for providing care, making care visible, promoting participation (Wegleitner & Schuchter 2021; Klie 2019), and the “search for future images of successful care” (Schuchter et al. 2022: 230; own translation).
Shifted responsibilities were thereby not only accompanied by the further evolvement of market-based (agency-brokered) care and the progression of caring communities into an important pillar of senior care provisioning in affluent societies but also by movements in the practice, requirements, orientation, and societal framing of these care arrangements. While the established model of transnationally operating agencies consists in the placement of largely migrant female care workers in the household of the cared for, changing patterns and cross-sectoral activities have become apparent and although a caring community is already defined by its openness (cf. Sempach et al. 2023) these changes and new activities at the interface of communities, the state, the family, and the market are also increasingly taking place. This not only suggests that the field of care and, in this respect, the marketisation and communitisation of care are contested, but moreover opens the question of whether changes in the provision of care and the organisation of care work are potentially due to precisely this contested nature. It is thus this very question that prompts us to consider the tendencies of marketisation and communitisation not as mechanical or deterministic, but rather as inherently heterogeneous and hybrid, and this at least in a twofold way. In this blog-entry, we take this thought of a “twofold hybridity” further by combining Polanyi’s substantivist understanding of the economy with the institutional logics perspective.
Principles of ‘Caring’ Behaviour …
According to Polanyi, man “survives by virtue of an institutionalized interaction between himself and his natural surroundings. That process is the economy, which supplies him with the means of satisfying his material wants” (Polanyi 1977: 20). This substantivist economy is thereby not to be confused with a formalist definition, i.e. the equation of “the human economy with its market form” (ibid.), as economic processes or the organization of livelihood are not solely characterized by (market-)exchange but also by redistribution, reciprocity and householding[1] (ibid. 2001). These principles manifest in “heterogeneous combinations; and even where one is clearly dominant, that dominance may be codependent on other forms” (Peck 2013: 1555). With this understanding, Polanyi thus provides tools to examine variegated forms of market-based and community-based care provision and allows to reveal the formative hybrid interplay of different principles. If we look at the movement towards marketised agency-brokered live-in care through this lens, it becomes apparent that the commodification, marketisation and corporatization of care is decisively shaped by the principle of (market-)exchange, but that the tendency of disembedding results in redistributive or reciprocal reactions, without which it could not persist as an even more establishing arrangement (cf. Aulenbacher et al. 2018a, b). While the state occupies an ambivalent stance in the provision of care – pushing markets for centuries –, redistributive policies or regulations bear the potential to counteract the effects of marketisation. Reciprocity is not only fundamental to any (care) relationship – although sometimes asymmetrically and thus not in a strictly Polanyian sense –, it also is the basis for creating bonds between different actors who, as a community, build a place for advocacy or protest. As care in the household of the person to be cared for, live-in care furthermore encompasses or even appropriates the principle of householding by integrating the caregiver as a (quasi-)member into this self-sufficient unit.
… and the Institutional Differentiation of Society
In addition to Polanyi’s theory, we draw on the institutional logics perspective to examine how (market-)exchange, redistribution, householding, and reciprocity interact with the institutional order of society and corresponding logics. Logics as defined by Thornton et al. (2012: 2) are “assumptions, values, and beliefs by which individuals and organisations provide meaning to their daily activity, organise time and space, and reproduce their lives and experiences”; that emerge from and are linked to “institutional orders” of the family, community, religion, state, market, profession, and corporation (ibid.: 104). As stated by Brigitte Aulenbacher et al. (2014: 213) for the field of care and care work, institutional logics express themselves as guiding action individually, organizationally, and institutionally (cf. Aulenbacher et al. 2018a, b), thus enabling us to examine how – and according to which implicit rules – actors orient their practices. At the same time, actors may refer to different logics that are potentially conflictive, but also mutually benefiting each other (Dammayr 2019: 67f.). This means that market logics and the principle of market exchange respectively logics of the community and community principles can coexist with each other and with logics of the state, corporation, profession, religion, and family. In the provision of live-in care cash-for-care policies, competing agencies on an ever-growing care market, and the family’s demand for “loving”, intimate but also professional care work provided at home intertwine. In contrast, caring communities rearrange logics and are oriented towards reciprocity, which may conflict with market or corporate logics.
As an analytical tool, our concept of a “twofold hybridity” hence encompasses the configuration of economic processes as entangled, mutually dependent principles and a further societal differentiation in the provisioning of care along the institutional orders of the family, the market, the corporation, the community, the state, the profession, and religion.
References
Aulenbacher, Brigitte / Dammayr, Maria / Décieux, Fabienne (2014): Herrschaft, Arbeitsteilung, Ungleichheit: Das Beispiel der Sorgearbeit und Sorgeregime im Gegenwartskapitalismus. In: Prokla 175, 44(2), 209-224.
Aulenbacher, Brigitte / Décieux, Fabienne / Riegraf, Birgitt (2018a): Capitalism goes care. Elder and child care between market, state, profession, and family and questions of justice and inequality. In: Equality, Diversity and Inclusion: An International Journal, 37(4), 347-360.
Aulenbacher, Brigitte / Décieux, Fabienne / Riegraf, Birgitt (2018b): The economic shift and beyond. Care as a contested terrain in contemporary capitalism. In: Current Sociology, 66(4), 517-530.
Aulenbacher, Brigitte (2020): Auf neuer Stufe vergesellschaftet: Care und soziale Reproduktion im Ge-genwartskapitalismus. In: Karina Becker / Kristina Binner / Fabienne Décieux (Hg.), Ge-spannte Arbeits- und Geschlechterverhältnisse im Marktkapitalismus. Wiesbaden: Springer Fachmedien Wiesbaden; Springer VS, 125–147.
Dammayr, Maria (2019): Legitime Leistungspolitiken? Leistung, Gerechtigkeit und Kritik in der Altenpflege. Arbeitsgesellschaft im Wandel. Weinheim: Beltz.
van Dyk, Silke / Haubner, Tine (2021): Community-Kapitalismus. Hamburg: Hamburger Edition.
Farris, Sara R. / Marchetti, Sabrina (2017): From the Commodification to the Corporatization of Care. European Perspectives and Debates. In: Social Politics: International Studies in Gender, State & Society 24/2, 109–131.
Klie, Thomas (2019): Wen kümmern die Alten? Auf dem Weg in eine sorgende Gesellschaft. Pattloch.
Lutz, Helma (2017): Care as a fictitious commodity. Reflections on the intersections of migration, gender and care regimes. In: Migration Studies 5/3, 356–368.
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Polanyi, Karl (1977): The livelihood of man. New York, N.Y. u.a.: Acad. Press.
Polanyi, Karl (2001): The Great Transformation. The Political and Economic Origins of Our Times. Boston: Beacon Press.
Schuchter, Patrick / Wegleitner, Klaus / Herpich, Andreas (2022): Die Dialektik der Sorge zwischen Regel und Ausnahme: Ethische Reflexionen zu „Care & Corona“ rund um das Hospiz Veronika Eningen. In: Limina 5/1, 223–249.
Sempach, Robert / Steinebach, Christoph / Zängl, Peter (Hg.) (2023): Care Schafft Community – Community Braucht Care. Wiesbaden: Springer Fachmedien Wiesbaden GmbH.
Thornton, Patricia H. / Ocasio, William / Lounsbury, Michael (2012): The Institutional Logics Perspective: A New Approach to Culture, Structure, and Process. Oxford University Press.
Vaittinen, Tiina / Hoppania, Hanna-Kaisa / Karsio, Olli (2018): Marketization, commodification and privatization of care services. In: Juanita Elias / Adrienne Roberts (Hg.), Handbook on the international political economy of gender. Cheltenham Northampton: Edward Elgar Publishing, 379–391.
Wegleitner, Klaus / Schuchter, Patrick (2021): Handbuch Caring Communities – Sorgenetze stärken – Solidarität leben. Eigenverlag Rotes Kreuz.
[1] We are deeply indepted to Anna Safuta’s seminal comment at the workshop “The Contested Provisioning of Care and Housing”, pointing out the essentiality of householding in analysing senior care that takes place in the (private) household of families or the realm of communities.
Valentin Fröhlich
Valentin Fröhlich, MSSc, BSc: Ph.D. student in Social
Sciences and Humanities. Fellow of the Austrian Academy of Sciences (ÖAW) at
the Institute of Sociology (Department for the Theory of Society and Social
Analyses) of the Johannes Kepler University Linz and Student Research Assistant
at the Institute of the History of Philosophy of the Catholic Private
University Linz. As part of the ÖAW
DOC-team 114 “The Contested Provisioning of Care and Housing” (https://www.contestedcareandhousing.com) he is currently
researching the societal organisation of care between marketisation and
communitisation in the care regimes of Austria, Hungary, and the Netherlands. The blog post is the result of close cooperation with
Brigitte Aulenbacher and Florian Pimminger within this project.
Read the other essays on the Contested Provisioning of Care and Housing here: