The elderly – who cares?
I had driven past the old mill owner’s mansion a number of times. I hadn’t really paid any heed to it other than as the marker of an obscured lane I drove down to deliver my granddaughter to her destination. This time, though, an approaching vehicle had me pulling into the sweep of its gateway. I had a moment to look up. What had once been the domicile of a very obvious capitalist had become a care home. A plaque on the gate post gave its original name below a larger, more prominent, name board. I read, therefore, ‘Saint Mary’s Residential Home’ and only then ‘The Ashes’. There’s a statement of reality, I thought.
One of the undoubted benefits of capitalism has been a general prolongation of life, at least in its heartlands. It is undeniable that more people live to a greater age than ever they did even in fairly recent history. This is an unintentional consequence of the way society has developed due to the scientific and technological advances capitalism has made, had to make, to protect and advance profitability. A growing elderly population is itself a source of profit. Age brings with it a multitude of longer-term conditions and ailments that is an expanding market for the pharmaceutical industry. And when the point is reached that medicine itself cannot sustain those with failing health, then there is another market, social care.
Capitalism is an exemplary system in providing commodities to meet people’s needs. However, there is a caveat. All commodities are available to all, just as long as they are paid for. This is not callousness, but the very essence of capitalism.
Care as a commodity
There are basically two types of social care; external, carers coming to the person’s own home, and internal, with the person accommodated in a care home. On average, external care costs between £20 and £25 an hour. Internal home care averages at £1,000 plus per week.
Care as a commodity must realise both the monetary value of those actually giving the care, care workers, and surplus value for the providers. The providers own the means for care-giving, the actual buildings and all the paraphernalia required to adequately cater for their residents’ needs. Once these expenditures have been met by the care providers – who may be individual business owners or, increasingly, care providing companies – whatever monies remain constitute the profits. This model is classical capitalism. Therefore there is always the tension between the cost of labour and the requirements for material expenditure and financial returns for owners/shareholders. Careworkers are skilled labour and yet their salaries hardly reflect this, often being on or close to the minimum wage.
The minimum wage has become the determining factor for these salaries. When that rises to accommodate cost of living increases, so do the salaries. This is, therefore, an increased cost to the providers. Also, a cost of living increase will affect other elements vital for the care of residents, food, energy and such like. These costs could be taken away from financial returns, but an increasingly less profitable business loses viability, perhaps even ends in bankruptcy.
The alternative is to increase fees, so the plus part of the aforementioned £1,000 per week gets ever larger, moving towards £2,000 per week. This becomes a growing drain on individual means to pay, more rapidly diminishing whatever assets were accumulated throughout a working life. This may lead to families contributing to elderly relatives’ care, which then becomes a strain on those families’ financial resources at a time when living costs are rising. A need to increase those family resources becomes pressing, so higher remuneration is sought. In this way some of the care costs are shifted, indirectly, to other sectors of the capitalist economy.
State funding
Perhaps the state, either directly or through local authorities, takes up the shortfall. This may be done directly through funding in part or whole, an individual’s care needs, following assessment via means testing. Further expenditure will then be incurred through the requirement to employ administrators to carry out the assessments. As the state and local authorities do not have any income other than what is raised through direct or indirect taxation, taking on a significant extra financial responsibility requires extra funding. Any subsequent tax increase, direct or indirect, initially reduces the incomes of workers who pay it.
This has a political consequence for the party imposing the tax increase. Vitriolic elements of the media will make great play of the avaricious state picking the pockets of hard-working families. Come an election, local or national, and the ‘low-tax’ party wins the vote. However, once in power, that administration is immediately faced with the same financial dilemma. The closure of underfunded care homes, with residents put out into the streets, is not a vote winner. Demanding greater contributions from individual assets would also be unpopular as prospective inheritances are reduced.
If the administrating party manages to survive the tax rises, workers whose salaries have been reduced actively seek salary increases, or perhaps reduce spending, or both. The result is the tax increase is ultimately transferred, yet again, to other sectors of the capitalist economy.
Not a drain
When a person retires from employment they do not retire from capitalism. Those, the majority, not requiring care, though receiving pensions, do not constitute a drain on the economy because they are not economically idle. They are providers of unpaid childcare. All the financial factors set out above for social care of the elderly, apply to the care of children to enable their parent(s) to work. Capitalism depends on a constant supply of labour power, so provision of childcare is crucial.
Then there is volunteering. The argument often levelled against socialists that people would not work unpaid is given the lie by the ‘retired’. An often-voiced trope amongst those no longer in paid employment is they don’t know now how they ever had time enough to go to work.
Those who take advantage of out-of-season holidays are redirecting some of their assets to businesses whose commodity is leisure. Pensions being deferred parts of wages/salaries are being spent in much the same way as parts of wages previously saved in bank accounts and such like.
Capitalism has evolved to become a highly complex organism in which each part affects other parts. The elderly requiring care, the retired, like the very young, are as much a part of that organism as any other. However, the avaricious nature of capitalism, ever trying to reduce its costs, can lead to a perception of some members of society being almost parasitic. Only a society not obsessed with money and costs can truly fully value all its citizens and willingly strive to meet their needs, whatever they are. In a word, socialism.
D. A.