Just Care: Messy Entanglements of Disability, Dependency, and Desire by Akemi Nishida (review)

Reviewed by: Just Care: Messy Entanglements of Disability, Dependency, and Desire by Akemi Nishida Chris Gabbard Akemi Nishida. Just Care: Messy Entanglements of Disability, Dependency, and Desire. Temple UP, 2022. x + 248 pp. Just Care: Messy Entanglements of Disability, Dependency, and Desire is the first book someone who wishes to learn about care in the US should read. It is long overdue, a major and timely exploration taking up the neglected and pressing issues of care recipients and caregivers, the relations between them, and, in turn, their relations with the for-profit care industry and state institutions. Akemi Nishida, an assistant professor of disability studies and gender studies at the University of Illinois Chicago, combines research with storytelling to expose the injustices pervading the US healthcare system when it comes to the caregiver and care receiver populations. Nishida's book also captures life-affirming moments of care justice, ones often buried beneath the layers of care injustices inflicted by the US healthcare assemblage. Nishida's approach is groundbreaking because it both investigates and accounts for the perspectival differences between caregivers and care recipients. Feminist studies has theorized care labor as women's work and as a "burden" (11) imposed on women; moreover, it takes for granted that female care workers are the ones whose lives are worn down and consumed in order for care receivers to thrive. Conversely, disability studies often constructs care work as ableist violence, characterized by theft, neglect, and abuse. Unsurprisingly, a clash of standpoints occurs in view of the two movements' emancipatory goals, with the outcome being that each group seeking justice has conducted its struggle separately. A scholar of feminist disability studies, Nishida is well situated to see a bigger picture and embrace a more "holistic" (44) approach, one that breaks down the care recipient-provider binary. Care studies has perceived either care workers or care receivers as bearing the injustice and violent treatment perpetrated by the other, with the latter supposedly prospering at the former's expense. Nishida contends that care studies has failed to grapple with "the overlap or mutual construction of care worker and care receiver populations" (45). In her telling, both groups are exploited, set up for debility and death by what she calls the "care industrial complex" (43). The book's strength and brilliant insight can be summarized in this statement: the "public healthcare assemblage is prioritized to the detriment of care workers and Medicaid enrollees" (100). Both are exploited by Medicaid and the home-care-service sector, the latter of which has become almost entirely for profit. Only by "recognizing that the circumstances and well-being of care workers and disabled End Page 174 enrollees are contingent on one another and deeply intertwined, can solidarity be forged between these populations, rather than situating care workers or enrollees as sacrificing themselves for the other or antagonistically contrasting their experiences and perspectives" (102). Nishida contends that both groups are "left uncared for, debilitated, and further marginalized, while the . . . care industrial complex—flourishes" (78). According to the author, since the 1980s and 1990s the neoliberal political economy has intensified the home-care-services' profit drive while state and federal governments have sought ways to cut expenditures. State legislators wish to provide care services to sick, disabled, and elderly citizens at the lowest cost to taxpayers, and the for-profit care agencies who contract with state Medicaid programs have been looking for ways to strip down their services to pad their bottom lines. Unsurprisingly, the results have been disastrous for workers and enrollees alike. Home care thus has become industrialized and commodified, and its participants— workers and enrollees—have been transformed into tokens "to be exchanged and circulated" (91), meaning that both are treated negligently as expendable populations. Nishida employs the concept of necropolitics, one she draws from Achille Mbembe. He describes it as "the power and the capacity to dictate who may live and who must die. Hence, to kill or to allow to live constitutes the limits of sovereignty, its fundamental attributes" (qtd. in Nishida 99). Nishida applies this concept to care as it is structured in the US, stating that "to call care necropolitical is to argue that both care...