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Home Publications Op-Eds & Columns On Generational Equity, Healthcare, and Keynesian Economics

On Generational Equity, Healthcare, and Keynesian Economics

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Dean Baker
American Prospect, February 6, 2014

See article on original website

Forum: The Future of the Social Safety Net
Dean Baker responds to his forum counterparts. 

My co-authors made many useful points in their pieces. They also made some claims with which I disagree. Rather than address their comments individually, I will make three general points in response to issues that came up in several of the pieces.

First, generational equity has almost nothing to do with tax and transfer policy; we give our children a whole economy and society. If we hand our kids a government with no debt burden and no taxes to pay for their parents’ Social Security, but a wrecked infrastructure, a devastated environment, and an antiquated capital stock we’ve have not done well on the generational equity scorecard.

We pointlessly hand the right an enormous political advantage when we imply that the share of tax revenue going to programs for the young versus programs for the old has anything to do with generational equity. We’ve already lost almost $8 trillion in output from the Great Recession (more than $25,000 per person). This lost output, coupled with the destruction to families’ lives resulting from long-term unemployment and underemployment will do hugely more to hurt the life prospects of our children and grandchildren than Social Security and Medicare taxes ever could.  If we want to point fingers at generational villains we should be looking at Greenspan, Rubin, and the Wall Street gang.

If we sustain decent economic growth there is no plausible story in which workers twenty or thirty years from now won’t be far wealthier on average than they are today. Assuming normal economic growth, real wages will be on average more than 40 percent higher in 2040 than they are today. If workers in 2040 have to pay another 2-3 percentage points of their income in taxes, that doesn’t amount to generational inequality in any meaningful sense of the term. If large numbers of workers actually are not living as well as their parents or grandparents it will be due intra-generational inequality, not inter-generational inequality.

As a sidebar, the debt is mostly passed on as assets to our children. We’ll be dead, so they will hold the bonds. There is an issue of debt held by foreigners, but people troubled by that one are looking at the wrong deficit. The problem with foreign debt is the trade deficit, re-read an intro economics textbook if this is not clear.

The second point is that the U.S. health care system is broken. We pay more than twice as much per person as people in other countries without anything to show for it in terms of outcomes. Yes, it is hard politically to attack insurers, doctors, drug companies and other health care providers, but it is also hard politically to cut Social Security and Medicare. It is bizarre that anyone who considers themselves progressive would be anxious to take on the politically difficult task of cutting Social Security and Medicare, but back away from going after the people responsible for outrageous health care costs.

I have repeatedly advocated trying to push for more open trade in health care as an end-run around the powerful interests that keep up costs. This is way of focusing on the fact that the debate has nothing to do with free market ideology, it is a debate over protecting the high incomes of health care providers pure and simple. While I find allies on this one on the more conservative side of the political spectrum, progressives seem to find the concept confusing. I know it’s hard for intellectuals to think about new ideas, but sometimes it is necessary to try. The effort to contain health care costs is one such case. (It should be noted that costs have grown much more slowly over the last six years.)

Third, Keynesian economics is true regardless of its popularity, just like gravity and global warming. If people do not accept Keynesian economics as it has been presented, then we have to find other ways to present it. (It doesn’t help that our “progressive” Democratic president is on the other side on this one.) The reality is that we will not have full employment without large budget deficits or bubbles unless we get the trade deficit down. There is no way around this fact.

As I explained in original piece, any serious effort to get the trade deficit down means lowering the value of the dollar. We could probably reduce the value of the dollar against other currencies if it were a political priority of the Obama administration. Unfortunately that does not appear to be the case. This leaves us budget deficits or bubbles. Better framing or good rhetoric won’t get around this logic.

The one other option is re-dividing the work. Work sharing and more leisure have much to recommend them. If we can’t get around the stalemate blocking the expansion of the pie, a fairer division among the pie-eaters seems the best alternative. After all, it is not their fault they are unemployed. It is the fault of the policymakers in Washington. 


Dean Baker is co-director of the Center for Economic and Policy Research in Washington, D.C. He is the author of several books, including Plunder & Blunder: The Rise and Fall of the Bubble Economy,The Conservative Nanny State: How the Wealthy Use the Government to Stay Rich and Get Richerand The United States Since 1980

 

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