Care Doesn't Scale

Role of the State and Public Provision

• Many see care (child protection, elder care, disability support) as a public good that cannot fund itself and must be politically financed.
• Others argue government provision doesn’t change the underlying 1:1 or 1:few nature of care, so it cannot benefit much from economies of scale.
• Disagreement over whether the state is “ideally efficient” at public goods like defense/education; critics point to well-known bureaucratic inefficiencies.
• Several note that even low‑intensity or imperfect state care is better than no care, but such services are politically vulnerable and often underfunded.

Labor, Migration, and Exploitation in Care Work

• Aging societies face a looming shortage of caregivers; some suggest large-scale immigration as the de facto solution.
• Others highlight abusive recruitment systems, debt bondage, and de facto coercion of foreign care workers, likening parts of the sector to “near‑slavery.”
• There is skepticism that migrants will continue doing the “shit jobs” once they gain options, which limits how far this can scale.

What “Care” Means and Why It Resists Scale

• Central claim echoed repeatedly: you can love many people, but at any given moment deep, individualized attention is essentially 1:1.
• Institutional settings with high child‑ or patient‑to‑staff ratios are described as only able to prevent disasters, not provide real emotional care; kids “grow up cared for by nobody.”
• Some push back, arguing you can care for multiple people (e.g., several children) over time; contention is really about intensity and simultaneity, not total number over a lifetime.
• Empathy is seen as especially non‑scalable; institutions often assume “someone else is checking” and no one asks if the recipient is actually okay.

Technology, Automation, and What Can Scale

• Many agree around‑care activities (paperwork, logistics, basic medical tasks) can be streamlined so humans spend more time on relational work.
• Debates on robots/LLMs in elder care: some see them as vital support to relieve family burden; others see automating intimate tasks as dehumanizing and fear it will be used to cut human staff.
• Broader view: technology historically makes non‑scalable things (production, communication, information) scalable; some expect future tech to do more of this around care, but not replace human connection itself.

Economics, Gender, and Cost Disease

• Commenters link “care doesn’t scale” to Baumol’s cost disease: sectors that can’t increase output per worker (care, teaching, therapy) get relatively more expensive as scalable sectors (software, manufacturing) advance.
• Feminist perspective: most care jobs are done by women; their unscalable nature helps explain persistent gender wage gaps and under-valuation of this work.
• Effective‑altruism style “maximize lives saved per dollar” is contrasted with local, relational caring; some find the former compelling, others emotionally and morally unsatisfying.

Family, Totalitarianism, and Social Structures

• One thread contrasts family‑centered care with state‑centered or totalitarian models that try to “own” children or collectivize parenting.
• Others call this a false dichotomy: states can expand socialized care without becoming authoritarian; many abusive families show that “more family control” isn’t automatically better.
• Historical examples (early Soviet experiments with family abolition, later reversions to traditional family policy) are debated, with disagreement over how much these regimes truly tried to replace families versus pragmatically backtracking.

Slack, Personal Bandwidth, and Attention

• Several note they are simply “out of spare energy to care”; emotional bandwidth is exhausted by work, self‑optimization, and constant demands on attention.
• Ideas from “slack”/“margin” discussions are applied: both organizations and individuals need unused capacity to respond to crises and to care; relentlessly targeting 100% utilization destroys that capacity.
• Attention is described as heavily commoditized (ads, social media), leaving less room for genuine care.

Alternative Organizational Models and Infrastructure

• Buurtzorg (Dutch home‑care) is highlighted as a model: small, autonomous nurse teams with flat structure delivering high‑quality, lower‑cost care by minimizing bureaucracy and trusting professionals.
• This supports the idea that while the act of care is 1:1, organizational design around it can still be optimized.
• Some point to infrastructure (water, housing systems, co‑op housing, food systems) as “care at scale” for basic needs, enabling individualized care to happen.
• Centralization vs decentralization is contested: centralized production can scale materials (e.g., nails, food), but critics argue scale often reduces individual quality and increases fragility unless carefully regulated.