Beat the Press

Beat the press por Dean Baker

Beat the Press is Dean Baker's commentary on economic reporting. He is a Senior Economist at the Center for Economic and Policy Research (CEPR). To never miss a post, subscribe to a weekly email roundup of Beat the Press. Please also consider supporting the blog on Patreon.

There is a clear disconnect between how people rate the economy (the general economy, not their own economic condition – which most say is good) and standard measures of economic performance. This disconnect has led to a “vibes” vs economic reality debate, with one side arguing that negative news coverage and social media have led people to rate the economy poorly, while the other side argues that weak or declining real incomes explain negative attitudes.

Nate Cohn entered the vibes vs real economic conditions controversy with a unique contribution. He said that even though most standard economic measures, like employment, wages, and income suggest that people are doing pretty well, “factors dragging down consumers aren’t neatly captured by the usual economic statistics.”

“…some basic things have become harder. It’s harder to hire. It’s harder to get a loan. It’s more expensive to buy things. At times it was impossible to buy things because of supply chain shortages. It’s harder to buy a home. It’s harder to sell a home. If you wanted to engage in these kinds of economic activities, you should have done them before the fall of 2021.”

Cohn’s comments here are obviously speculative, he presents no data to support these assertions, but it’s worth considering the idea more carefully.

Some things definitely are harder today than in prior years, like buying and selling a home. With mortgage rates peaking at over 8.0 percent (they are now back under 7.0 percent), sales of existing homes fell by close to one-third from the 2021 pace. This is bad news, but still, the people who are actively looking to buy or sell a home in a given year (around 6 million, typically) are a relatively small share of the population.  

Also, if we are looking at the negative story of high-interest rates, we should also look at the positive story that 14 million homeowners refinanced a mortgage during the period of low-interest rates from 2020-2022. Those who refinanced without taking out additional cash saved an average of more than $2,600 a year on interest payments. These savings do not show up in our standard data on income or disposable income.

Cohn tells us that it is harder to hire. This is true, but how many of us are looking to hire people? I suppose if we are looking for people to do work around the house, this could be the case. That is “the hard to get good help” theory of economic malaise.

The obvious flip side of it being harder to hire is that it is easier to find work. Ease of finding work is also not picked up in standard economic statistics and, as a practical matter, there are far more people who would be looking to find work than to hire.

We then have the claim that things are more expensive. That is true, but incomes have grown by more, and this is picked up in our economic statistics.

But then we have the claim that it is harder to buy things. There were certainly shortages of many items in 2021 and even into 2022, making it harder to buy many items. But by 2023, most of these shortages have disappeared. If this were a major factor in people’s economic discontent, we should have seen consumer sentiment improving over the course of the year, instead of deteriorating.

There also is another side to this issue. Online sales have exploded since the pandemic. Online sales accounted for 12.6 percent of retail sales in 2019. They now account for 16.7 percent of retail sales, an increase of more than a third. And this only counts the sales by online distributors, it does not include the growth of Internet sales for brick-and-mortar retailers or the explosion in food delivery from restaurants.

There are other important ways in which life has gotten easier that don’t show up in our standard economic data. Perhaps the top item in this category is the increase in the number of people able to work from home. According to the Bureau of Labor Statistics, 38 million people worked from home on average day last year. That’s an increase of more than 11 million from before the pandemic.

For these people, life is presumably considerably easier. In addition to the time saved on commuting, they are likely saving thousands of dollars a year on transportation and other costs associated with going to work at an office or other workplace.

In the same vein, telemedicine has become far more widely used. According to the Department of Health and Human Services, 22 percent of the population used telemedicine for a consultation with a healthcare professional in a typical four-week period. Since most people do not see a healthcare professional in any given four-week period, this implies a very large share of medical consultations are now done remotely.

This is a huge savings on time spent traveling to and from hospitals or other medical facilities. The benefits from being able to have a remote consultation are likely to be especially important to people in poor health, who disproportionately are the individuals seeking medical care.

In short, contrary to Nate Cohn’s assessment, there are many clearly identifiable ways in which life has gotten easier that are not picked up in economic statistics. To be fair, he was clearly just speculating in throwing out his life-getting-harder hypothesis, but it does not look like it holds up well under closer scrutiny.  

There is a clear disconnect between how people rate the economy (the general economy, not their own economic condition – which most say is good) and standard measures of economic performance. This disconnect has led to a “vibes” vs economic reality debate, with one side arguing that negative news coverage and social media have led people to rate the economy poorly, while the other side argues that weak or declining real incomes explain negative attitudes.

Nate Cohn entered the vibes vs real economic conditions controversy with a unique contribution. He said that even though most standard economic measures, like employment, wages, and income suggest that people are doing pretty well, “factors dragging down consumers aren’t neatly captured by the usual economic statistics.”

“…some basic things have become harder. It’s harder to hire. It’s harder to get a loan. It’s more expensive to buy things. At times it was impossible to buy things because of supply chain shortages. It’s harder to buy a home. It’s harder to sell a home. If you wanted to engage in these kinds of economic activities, you should have done them before the fall of 2021.”

Cohn’s comments here are obviously speculative, he presents no data to support these assertions, but it’s worth considering the idea more carefully.

Some things definitely are harder today than in prior years, like buying and selling a home. With mortgage rates peaking at over 8.0 percent (they are now back under 7.0 percent), sales of existing homes fell by close to one-third from the 2021 pace. This is bad news, but still, the people who are actively looking to buy or sell a home in a given year (around 6 million, typically) are a relatively small share of the population.  

Also, if we are looking at the negative story of high-interest rates, we should also look at the positive story that 14 million homeowners refinanced a mortgage during the period of low-interest rates from 2020-2022. Those who refinanced without taking out additional cash saved an average of more than $2,600 a year on interest payments. These savings do not show up in our standard data on income or disposable income.

Cohn tells us that it is harder to hire. This is true, but how many of us are looking to hire people? I suppose if we are looking for people to do work around the house, this could be the case. That is “the hard to get good help” theory of economic malaise.

The obvious flip side of it being harder to hire is that it is easier to find work. Ease of finding work is also not picked up in standard economic statistics and, as a practical matter, there are far more people who would be looking to find work than to hire.

We then have the claim that things are more expensive. That is true, but incomes have grown by more, and this is picked up in our economic statistics.

But then we have the claim that it is harder to buy things. There were certainly shortages of many items in 2021 and even into 2022, making it harder to buy many items. But by 2023, most of these shortages have disappeared. If this were a major factor in people’s economic discontent, we should have seen consumer sentiment improving over the course of the year, instead of deteriorating.

There also is another side to this issue. Online sales have exploded since the pandemic. Online sales accounted for 12.6 percent of retail sales in 2019. They now account for 16.7 percent of retail sales, an increase of more than a third. And this only counts the sales by online distributors, it does not include the growth of Internet sales for brick-and-mortar retailers or the explosion in food delivery from restaurants.

There are other important ways in which life has gotten easier that don’t show up in our standard economic data. Perhaps the top item in this category is the increase in the number of people able to work from home. According to the Bureau of Labor Statistics, 38 million people worked from home on average day last year. That’s an increase of more than 11 million from before the pandemic.

For these people, life is presumably considerably easier. In addition to the time saved on commuting, they are likely saving thousands of dollars a year on transportation and other costs associated with going to work at an office or other workplace.

In the same vein, telemedicine has become far more widely used. According to the Department of Health and Human Services, 22 percent of the population used telemedicine for a consultation with a healthcare professional in a typical four-week period. Since most people do not see a healthcare professional in any given four-week period, this implies a very large share of medical consultations are now done remotely.

This is a huge savings on time spent traveling to and from hospitals or other medical facilities. The benefits from being able to have a remote consultation are likely to be especially important to people in poor health, who disproportionately are the individuals seeking medical care.

In short, contrary to Nate Cohn’s assessment, there are many clearly identifiable ways in which life has gotten easier that are not picked up in economic statistics. To be fair, he was clearly just speculating in throwing out his life-getting-harder hypothesis, but it does not look like it holds up well under closer scrutiny.  

Government-granted patent monopolies have become pretty much sacred in the United States. In fact, when high drug prices become a political issue, most discussion, including from progressives, turns reality on its head. The standard story is that the market creates high drug prices, the issue is whether the government should intervene through some type of negotiation or price control to bring prices down.

Government-granted Patent Monopolies Are the Cause of High-Priced Drugs

In fact, in almost all cases, drugs are cheap to manufacture and distribute. The reason that drugs can be expensive is that the government grants patent monopolies that prevent companies from entering the market.[1] When a single company has a legal monopoly on a drug that is essential to some people’s health or life, they can charge a large amount of money. It is the government-granted monopoly that makes the drug expensive, not the free market.   

President Biden proposes to limit the legal monopoly given to at least some drugs, by using the provision of the Bayh-Dole Act that requires inventions that rely on government-funded research be made available at a reasonable price. The Bayh-Dole Act is a measure passed by Congress in 1980 that formalized the process whereby private companies could secure patents on publicly funded research.

It had a huge impact on research generally, but nowhere is its impact clearer than in the case of prescription drugs. From 1960 to 1980, when the bill was passed, spending on prescription drugs was around 0.4 percent of GDP (around $100 billion a year in today’s economy), with no clear upward trend. After the bill was passed spending on prescription drugs began to rise rapidly. It now stands at more than $500 billion, or 2.0 percent of GDP. If we add in non-prescription drugs (the distinction is not necessarily very useful), it comes to $630 billion or 2.3 percent of GDP.

If these drugs were sold in a free market, without patent monopolies or related protections, we would likely be paying less than $100 billion a year. The difference of $530 billion between the patent-protected price and the free market price, comes to more than $4,000 per family.

The issue here is more than just money. People need drugs when they have health problems. This is not a good time to force someone to have to dig up some vast sum of money to pay for a drug to treat cancer or some other serious illness. Even if they are lucky enough to have insurance, no insurer is happy to pay out tens of thousands of dollars for a drug. It is likely to force a patient to jump through all sorts of hoops to get an expensive drug covered. Again, this is not the sort of thing a person with a serious health problem needs.

The high prices are almost entirely a consequence of protection. A recent study found that prices fall by 80-90 percent after a drug has been subjected to a period of generic competition. In the cases of the highest-priced drugs, the drops can be even more dramatic. When the Hepatitis C drug Solvadi was first introduced it sold for $80,000 in the United States for a three-month course of treatment. At the same time, high-quality generic versions were available in India for $900, just over 1.0 percent of the U.S. price.

It would be a struggle for anyone to come with $80,000 to pay for Sovaldi and no insurer is happy to pay that sort of money. The generic price of $900 is a very different story.

The huge gap between the protected price and the free market price also provides an enormous incentive for corruption. Drug companies want to push their drugs as widely as possible, encouraging people to use them even when they may not be the best course of treatment or could even be harmful.

The most dramatic instance of such abuse is the opioid crisis, where Purdue Pharma and other manufacturers paid out billions of dollars in settlements over allegations they deliberately misled physicians and the general public about the addictiveness of the new generation of opioid drugs. The opioid case is extreme in its consequences however, this sort of abuse happens all the time.

Medical journals have to constantly develop new tactics to ensure that the articles they publish are actually written by the people who appear as their authors, and that they have not been paid to put out claims that may not be accurate. In a recent case, intensive lobbying by a drug manufacturer got the FDA to approve an Alzheimer’s drug, Aduhelm, over the objections of its advisory panel. There was little evidence of the drug’s effectiveness and it did have harmful side effects. The drug was slated to sell for $55,000 for a year’s dose.

For these reasons, it is likely that lowering drug prices will actually result in better health outcomes. If there is no one who has a major incentive to mislead the public about the safety and effectiveness of a drug, we are more likely to get accurate information about the usefulness of different drugs for treating various conditions.

Who Pays for Research?

The pharmaceutical industry always screams bloody murder over any measure that will lower drug prices and reduce its profits. They claim that this will be a huge hit to their research spending, and then we won’t get any new drugs.

There will undoubtedly be some negative effects on research spending if profits fall, but the industry hugely overstates the impact. The industry spends roughly $120 billion a year on research and development. This money comes from the gap of more than $500 billion a year between the revenue from selling their drugs and what it costs to manufacture and distribute them.

Over $100 billion of this is profits, but there are many other uses of the money obtained through patent rents. A substantial chunk goes to the pay of CEOs and other top executives. For example, Pfizer’s CEO was paid $33 million last year. He would have been paid considerably less if the company’s drugs were selling at one-fifth of their current price. The bloated pay goes well beyond the CEO, patent rents lead to considerably higher pay for several layers below the top echelon of employees.

In addition, the huge patent rents lead to large payments for marketing drugs. When drugs can be sold at markups of 500 or 1000 percent above their production costs, it makes sense to spend a lot of money trying to promote them widely. For this reason, drug companies spend tens of billions of dollars every year marketing their drugs. This includes not only the ads they run on TV (which had been illegal until a few decades ago) but also money paid to the drug detailers who push the drugs directly to doctors.

Drug companies also pay out vast sums to lawyers, as intellectual property law is one of the most lucrative areas of law. If you’re suing someone over a patent worth billions of dollars, it is a good investment to spend hundreds of millions pushing your case. And, there are the billions of dollars they have to pay out when they lose a case, as was the situation with Purdue Pharma and the other major opioid makers.

All of these payments can be reduced, rather than cutting research spending, when the pharmaceutical industry’s profits dip as a result of lower prices. There is also another area where savings can be found rather than reducing important research into new drugs.

Much of the industry’s spending goes to drugs that largely duplicate existing drugs. The logic is that if one company is earning large patent rents on a particular drug, say the weight loss drug Wegovy, it makes sense from the standpoint of maximizing profit to try to produce a competitor that can share in these rents.

This is actually desirable in a world where drugs are selling at patent-protected prices. Having two, three, or four drugs that are largely similar, all of which have patent protection, will still help to bring prices down. There is also likely to be some health benefit, since patients react differently to the same drug, so having the option to take a different drug will be valuable to some patients. However, as a general rule, research dollars would likely be better spent trying to develop drugs for conditions where no effective treatment currently exists rather than trying to duplicate the function of existing drugs in order to get a share of patent rents.

In 2021, the most recent year for which the data are available, the FDA rated more than 56 percent of its drug reviews as “standard,” meaning that the drugs did not represent a qualitative breakthrough over existing drugs already on the market. It would not in general be a major loss to public health if the research spending on these duplicative drugs was reduced as a result of lower drug prices and profit margins.

Government Spending on Research

But even if the reduction in industry profits will only be reflected in a limited way in reduced research spending, there is no doubt that the companies will be spending somewhat less on money on developing new drugs. This doesn’t have to mean a reduction in total spending on research.

The federal government already spends well over $50 billion a year on biomedical research, primarily through the National Institutes of Health, but also through BARDA, the CDC and a number of other government agencies. This money primarily goes to more basic research, but many drugs have been developed on public money and often tested as well. The most famous recent example was the Moderna COVID vaccine, where Operation Warp Speed paid for both the development and the clinical trials needed for the vaccine’s approval, but there have been many others.

Public funding can serve as a substitute for industry funding. Recent research indicates that increased NIH funding can be a very effective substitute for industry funding. In fact, it suggests that dollar for dollar, NIH funding may be far more effective, with a 10 percent increase in funding (roughly $5 billion a year at present) leading to a 4.5 percent increase in the number of drugs developed. This result, taken crudely, implies that for $110 billion in additional spending, we could fully replace the spending done by the industry, with no loss in the number of new drugs developed.

Of course, the world is far more complicated than this sort of simple multiplication would imply, but most of the complications likely mean the cost of replacing industry research would likely be lower rather than higher. To start with, if we were financing research with the goal of advancing health rather than seeking patent rents, we would likely see much less money wasted in duplicative research.

Again, not all of this money is wasted. It is very often helpful to have a second or third drug to treat a condition, since people react differently to drugs and some drugs interact badly with other drugs a patient may be taking. But the search for patent rents is likely to misdirect much research spending compared to a scenario where the focus is public health.

A second reason we may get more health benefits per buck with direct publicly supported research is that there may be many instances where non-patentable items offer the greatest health benefit. For example, there is some research indicating that vitamin deficiencies may be an important factor in many conditions. Drug companies have little incentive to research this possibility since they can’t get a patent on vitamins that have been known for many decades.

The same applies to older off-patent drugs. If there is some evidence Aspirin can provide important benefits in treating a condition, Pfizer or Merck is not going to spend large sums exploring that possibility. If it turns out to be true, they will not be able to recoup their research expenses selling a drug that has long been available as a cheap generic.

But the most important reason that publicly funded research might be more effective on a per-dollar basis is that we can make openness a condition of getting funding. This means that rather than having an incentive to squirrel away findings, in order to avoid allowing a competitor to get an advantage, we can require that the results of publicly funded research be posted on the Internet as soon as practical.

This means that all researchers can benefit from quickly learning of new breakthroughs as well as being warned off dead ends. This openness requirement would also largely eliminate the risk of drug companies misrepresenting research findings to push their drugs as widely as possible.

Not only would we be removing the incentive by taking away the patent monopoly, we would also be removing the opportunity, since the community of researchers would all have access to the same research. We can’t eliminate all mistakes – some mistakes are inevitable – but we can prevent the sort of deliberate misrepresentation of evidence that had such terrible consequences in the opioid crisis and in many other situations.

 

Patent Monopolies and Inequality

It is common for people in policy circles to assert that the enormous increase in inequality over the last half century was primarily the result of technology. The story is that technology has developed in a way that has benefited people with more education and disadvantaged those with limited education. This is not true.

It is more than a bit absurd to claim that patent monopolies and related protections are necessary for the development of new drugs or to achieve progress in other areas, and then claim that inequality is the result of technology. Our rules on patents and other forms of intellectual property are policy matters, they are not determined by technology.

This point matters hugely in discussions of inequality, since it is policy that determines who benefits from technology and how much. We saw this clearly in the case of Moderna and its development of a COVID vaccine. The contract it signed with the government both paid for the development of the vaccine and then allowed Moderna to keep control of the vaccine.

As a result of this contract, Moderna is selling its boosters for well over $100 a shot, even though it would likely only cost it around $5 a shot to produce and distribute the vaccine. The Moderna contract allowed the company to generate at least five billionaires by the summer of 2022.

The Moderna contract is an extreme case, but it does provide a clear example. How we structure laws around patent monopolies and other protections determines the winners from technology.

It is obviously convenient for the gainers from this upward redistribution to pretend that it was just a natural outcome from technology, but it is not true. If we write the rules differently, we can have much less inequality.

Where Do the Administration’s Bayh-Dole Measures Get Us?

I have long argued for looking to displace the system of patent-supported research for prescription drugs with one of direct public funding. My preferred route is a system of long-term prime contracts, loosely modeled on the sort of prime contracts that the Defense Department awards for military research, where companies would engage in a process of competitive bidding for research in specific areas, such as cancer or heart disease. (I outline this in Chapter 5 of Rigged [it’s free].)

The Biden administration’s proposal is not my proposal for radically overhauling the system of financing the development of prescription drugs. It does, however, raise the issue of how much we will allow pharmaceutical companies to benefit from the patent monopolies we grant them at the expense of the general public.

It allows the government to take advantage of the provision in the Bayh-Dole Act requiring that innovations based on government-funded research be available to the public at a reasonable price. This is a big step forward, since it means that we will not hand drug companies a monopoly on life-saving drugs and then let them charge patients (or insurers or the government) whatever price they feel like. This can save the public and the government billions of dollars each year.  

While this measure is important in establishing that patent monopolies are not absolute, it is limited in that it only applies to a limited set of drugs, only those where government-funded research played a direct role in its development. That may seem fair in some ways, but drug companies often don’t acknowledge that they relied on government research in developing a product.

If a drug company relied on another company’s research in developing a drug, it can count on a patent infringement suit, but the government is generally not aggressive in forcing companies to list government patents that played a role in developing a product. The executive order also does not give clear guidance on what constitutes reasonable pricing. It could, for example, have specified that a reasonable price is some average of prices charged in other wealthy countries, like Germany and Canada, but it backed away from this step.[2]  

There are of course other modest steps that the Biden administration could take to lower drug prices, some of which it already has. For one, it capped the out-of-pocket payments for insulin, although this has the government picking up the tab, so that is not a measure that costs the pharmaceutical industry money. It is also moving to negotiate the prices that Medicare pays for a number of important drugs, this will save the program and beneficiaries billions of dollars in coming years.

But there are also limited steps that it could take that would push the agenda further. Drs. Peter Hotez and Maria Elena Bottazzi and their team at Texas Children’s Hospital developed an effective open-source COVID vaccine. This vaccine, Corbevax has already been used by over 100 million people in India, Indonesia, and elsewhere.

If this vaccine was approved by the FDA, it would mean that people would have a cheap alternative (likely less than $5 a shot) to the vaccines now on the market, which are selling for over $100 a shot. If the vaccine were available here, it would also mean that people have an alternative to the mRNA vaccines produced by Moderna and Pfizer. While there is little basis for the fears of mRNA technology, if these fears prevent people from getting a vaccine that could protect them from COVID, we should be allowing them an alternative.

Getting a cheap vaccine developed outside the patent system would also provide proof of concept. No one cares that I or others claim that we can produce drugs or vaccines without relying on patent monopolies, they need to see proof in the form of facts on the ground that we can have effective products that don’t depend on these monopolies. Corbevax can be an important fact on the ground. (Many people may not be aware of the enormous savings with this vaccine, since in most cases, the government or private insurers will pick up the cost of COVID boosters.)

A Very Important Step

It is always possible to complain that a particular measure does not go as far as it should, but it is very rare that major change is brought about by a single bill or executive order from a president. The question is whether the measure is a step forward and if it opens the door for future progress.

By this standard, the answer is certainly yes. We can think of this executive order as being comparable to the Inflation Reduction Act (IRA). The provisions of the IRA are nowhere near large enough to address the problem of global warming, but they are a huge foot in the door. In the same way, President Biden’s actions on Bayh-Dole are an important step in reining in drug prices and creating a path for further actions in the future.  

 

[1] There are other forms of exclusivity that can be as important as patent monopolies in blocking competition, most notably “data exclusivity.” This means that when a drug company produces data showing a particular drug is safe and effective, another company cannot rely on this data to establish that its own drug is also safe and effective, even if it can be shown to be chemically the same or similar in the case of biological drugs.

[2] This write-up from Knowledge Economy International provides useful background on some of the issues raised by the Biden Administration’s executive order.

Government-granted patent monopolies have become pretty much sacred in the United States. In fact, when high drug prices become a political issue, most discussion, including from progressives, turns reality on its head. The standard story is that the market creates high drug prices, the issue is whether the government should intervene through some type of negotiation or price control to bring prices down.

Government-granted Patent Monopolies Are the Cause of High-Priced Drugs

In fact, in almost all cases, drugs are cheap to manufacture and distribute. The reason that drugs can be expensive is that the government grants patent monopolies that prevent companies from entering the market.[1] When a single company has a legal monopoly on a drug that is essential to some people’s health or life, they can charge a large amount of money. It is the government-granted monopoly that makes the drug expensive, not the free market.   

President Biden proposes to limit the legal monopoly given to at least some drugs, by using the provision of the Bayh-Dole Act that requires inventions that rely on government-funded research be made available at a reasonable price. The Bayh-Dole Act is a measure passed by Congress in 1980 that formalized the process whereby private companies could secure patents on publicly funded research.

It had a huge impact on research generally, but nowhere is its impact clearer than in the case of prescription drugs. From 1960 to 1980, when the bill was passed, spending on prescription drugs was around 0.4 percent of GDP (around $100 billion a year in today’s economy), with no clear upward trend. After the bill was passed spending on prescription drugs began to rise rapidly. It now stands at more than $500 billion, or 2.0 percent of GDP. If we add in non-prescription drugs (the distinction is not necessarily very useful), it comes to $630 billion or 2.3 percent of GDP.

If these drugs were sold in a free market, without patent monopolies or related protections, we would likely be paying less than $100 billion a year. The difference of $530 billion between the patent-protected price and the free market price, comes to more than $4,000 per family.

The issue here is more than just money. People need drugs when they have health problems. This is not a good time to force someone to have to dig up some vast sum of money to pay for a drug to treat cancer or some other serious illness. Even if they are lucky enough to have insurance, no insurer is happy to pay out tens of thousands of dollars for a drug. It is likely to force a patient to jump through all sorts of hoops to get an expensive drug covered. Again, this is not the sort of thing a person with a serious health problem needs.

The high prices are almost entirely a consequence of protection. A recent study found that prices fall by 80-90 percent after a drug has been subjected to a period of generic competition. In the cases of the highest-priced drugs, the drops can be even more dramatic. When the Hepatitis C drug Solvadi was first introduced it sold for $80,000 in the United States for a three-month course of treatment. At the same time, high-quality generic versions were available in India for $900, just over 1.0 percent of the U.S. price.

It would be a struggle for anyone to come with $80,000 to pay for Sovaldi and no insurer is happy to pay that sort of money. The generic price of $900 is a very different story.

The huge gap between the protected price and the free market price also provides an enormous incentive for corruption. Drug companies want to push their drugs as widely as possible, encouraging people to use them even when they may not be the best course of treatment or could even be harmful.

The most dramatic instance of such abuse is the opioid crisis, where Purdue Pharma and other manufacturers paid out billions of dollars in settlements over allegations they deliberately misled physicians and the general public about the addictiveness of the new generation of opioid drugs. The opioid case is extreme in its consequences however, this sort of abuse happens all the time.

Medical journals have to constantly develop new tactics to ensure that the articles they publish are actually written by the people who appear as their authors, and that they have not been paid to put out claims that may not be accurate. In a recent case, intensive lobbying by a drug manufacturer got the FDA to approve an Alzheimer’s drug, Aduhelm, over the objections of its advisory panel. There was little evidence of the drug’s effectiveness and it did have harmful side effects. The drug was slated to sell for $55,000 for a year’s dose.

For these reasons, it is likely that lowering drug prices will actually result in better health outcomes. If there is no one who has a major incentive to mislead the public about the safety and effectiveness of a drug, we are more likely to get accurate information about the usefulness of different drugs for treating various conditions.

Who Pays for Research?

The pharmaceutical industry always screams bloody murder over any measure that will lower drug prices and reduce its profits. They claim that this will be a huge hit to their research spending, and then we won’t get any new drugs.

There will undoubtedly be some negative effects on research spending if profits fall, but the industry hugely overstates the impact. The industry spends roughly $120 billion a year on research and development. This money comes from the gap of more than $500 billion a year between the revenue from selling their drugs and what it costs to manufacture and distribute them.

Over $100 billion of this is profits, but there are many other uses of the money obtained through patent rents. A substantial chunk goes to the pay of CEOs and other top executives. For example, Pfizer’s CEO was paid $33 million last year. He would have been paid considerably less if the company’s drugs were selling at one-fifth of their current price. The bloated pay goes well beyond the CEO, patent rents lead to considerably higher pay for several layers below the top echelon of employees.

In addition, the huge patent rents lead to large payments for marketing drugs. When drugs can be sold at markups of 500 or 1000 percent above their production costs, it makes sense to spend a lot of money trying to promote them widely. For this reason, drug companies spend tens of billions of dollars every year marketing their drugs. This includes not only the ads they run on TV (which had been illegal until a few decades ago) but also money paid to the drug detailers who push the drugs directly to doctors.

Drug companies also pay out vast sums to lawyers, as intellectual property law is one of the most lucrative areas of law. If you’re suing someone over a patent worth billions of dollars, it is a good investment to spend hundreds of millions pushing your case. And, there are the billions of dollars they have to pay out when they lose a case, as was the situation with Purdue Pharma and the other major opioid makers.

All of these payments can be reduced, rather than cutting research spending, when the pharmaceutical industry’s profits dip as a result of lower prices. There is also another area where savings can be found rather than reducing important research into new drugs.

Much of the industry’s spending goes to drugs that largely duplicate existing drugs. The logic is that if one company is earning large patent rents on a particular drug, say the weight loss drug Wegovy, it makes sense from the standpoint of maximizing profit to try to produce a competitor that can share in these rents.

This is actually desirable in a world where drugs are selling at patent-protected prices. Having two, three, or four drugs that are largely similar, all of which have patent protection, will still help to bring prices down. There is also likely to be some health benefit, since patients react differently to the same drug, so having the option to take a different drug will be valuable to some patients. However, as a general rule, research dollars would likely be better spent trying to develop drugs for conditions where no effective treatment currently exists rather than trying to duplicate the function of existing drugs in order to get a share of patent rents.

In 2021, the most recent year for which the data are available, the FDA rated more than 56 percent of its drug reviews as “standard,” meaning that the drugs did not represent a qualitative breakthrough over existing drugs already on the market. It would not in general be a major loss to public health if the research spending on these duplicative drugs was reduced as a result of lower drug prices and profit margins.

Government Spending on Research

But even if the reduction in industry profits will only be reflected in a limited way in reduced research spending, there is no doubt that the companies will be spending somewhat less on money on developing new drugs. This doesn’t have to mean a reduction in total spending on research.

The federal government already spends well over $50 billion a year on biomedical research, primarily through the National Institutes of Health, but also through BARDA, the CDC and a number of other government agencies. This money primarily goes to more basic research, but many drugs have been developed on public money and often tested as well. The most famous recent example was the Moderna COVID vaccine, where Operation Warp Speed paid for both the development and the clinical trials needed for the vaccine’s approval, but there have been many others.

Public funding can serve as a substitute for industry funding. Recent research indicates that increased NIH funding can be a very effective substitute for industry funding. In fact, it suggests that dollar for dollar, NIH funding may be far more effective, with a 10 percent increase in funding (roughly $5 billion a year at present) leading to a 4.5 percent increase in the number of drugs developed. This result, taken crudely, implies that for $110 billion in additional spending, we could fully replace the spending done by the industry, with no loss in the number of new drugs developed.

Of course, the world is far more complicated than this sort of simple multiplication would imply, but most of the complications likely mean the cost of replacing industry research would likely be lower rather than higher. To start with, if we were financing research with the goal of advancing health rather than seeking patent rents, we would likely see much less money wasted in duplicative research.

Again, not all of this money is wasted. It is very often helpful to have a second or third drug to treat a condition, since people react differently to drugs and some drugs interact badly with other drugs a patient may be taking. But the search for patent rents is likely to misdirect much research spending compared to a scenario where the focus is public health.

A second reason we may get more health benefits per buck with direct publicly supported research is that there may be many instances where non-patentable items offer the greatest health benefit. For example, there is some research indicating that vitamin deficiencies may be an important factor in many conditions. Drug companies have little incentive to research this possibility since they can’t get a patent on vitamins that have been known for many decades.

The same applies to older off-patent drugs. If there is some evidence Aspirin can provide important benefits in treating a condition, Pfizer or Merck is not going to spend large sums exploring that possibility. If it turns out to be true, they will not be able to recoup their research expenses selling a drug that has long been available as a cheap generic.

But the most important reason that publicly funded research might be more effective on a per-dollar basis is that we can make openness a condition of getting funding. This means that rather than having an incentive to squirrel away findings, in order to avoid allowing a competitor to get an advantage, we can require that the results of publicly funded research be posted on the Internet as soon as practical.

This means that all researchers can benefit from quickly learning of new breakthroughs as well as being warned off dead ends. This openness requirement would also largely eliminate the risk of drug companies misrepresenting research findings to push their drugs as widely as possible.

Not only would we be removing the incentive by taking away the patent monopoly, we would also be removing the opportunity, since the community of researchers would all have access to the same research. We can’t eliminate all mistakes – some mistakes are inevitable – but we can prevent the sort of deliberate misrepresentation of evidence that had such terrible consequences in the opioid crisis and in many other situations.

 

Patent Monopolies and Inequality

It is common for people in policy circles to assert that the enormous increase in inequality over the last half century was primarily the result of technology. The story is that technology has developed in a way that has benefited people with more education and disadvantaged those with limited education. This is not true.

It is more than a bit absurd to claim that patent monopolies and related protections are necessary for the development of new drugs or to achieve progress in other areas, and then claim that inequality is the result of technology. Our rules on patents and other forms of intellectual property are policy matters, they are not determined by technology.

This point matters hugely in discussions of inequality, since it is policy that determines who benefits from technology and how much. We saw this clearly in the case of Moderna and its development of a COVID vaccine. The contract it signed with the government both paid for the development of the vaccine and then allowed Moderna to keep control of the vaccine.

As a result of this contract, Moderna is selling its boosters for well over $100 a shot, even though it would likely only cost it around $5 a shot to produce and distribute the vaccine. The Moderna contract allowed the company to generate at least five billionaires by the summer of 2022.

The Moderna contract is an extreme case, but it does provide a clear example. How we structure laws around patent monopolies and other protections determines the winners from technology.

It is obviously convenient for the gainers from this upward redistribution to pretend that it was just a natural outcome from technology, but it is not true. If we write the rules differently, we can have much less inequality.

Where Do the Administration’s Bayh-Dole Measures Get Us?

I have long argued for looking to displace the system of patent-supported research for prescription drugs with one of direct public funding. My preferred route is a system of long-term prime contracts, loosely modeled on the sort of prime contracts that the Defense Department awards for military research, where companies would engage in a process of competitive bidding for research in specific areas, such as cancer or heart disease. (I outline this in Chapter 5 of Rigged [it’s free].)

The Biden administration’s proposal is not my proposal for radically overhauling the system of financing the development of prescription drugs. It does, however, raise the issue of how much we will allow pharmaceutical companies to benefit from the patent monopolies we grant them at the expense of the general public.

It allows the government to take advantage of the provision in the Bayh-Dole Act requiring that innovations based on government-funded research be available to the public at a reasonable price. This is a big step forward, since it means that we will not hand drug companies a monopoly on life-saving drugs and then let them charge patients (or insurers or the government) whatever price they feel like. This can save the public and the government billions of dollars each year.  

While this measure is important in establishing that patent monopolies are not absolute, it is limited in that it only applies to a limited set of drugs, only those where government-funded research played a direct role in its development. That may seem fair in some ways, but drug companies often don’t acknowledge that they relied on government research in developing a product.

If a drug company relied on another company’s research in developing a drug, it can count on a patent infringement suit, but the government is generally not aggressive in forcing companies to list government patents that played a role in developing a product. The executive order also does not give clear guidance on what constitutes reasonable pricing. It could, for example, have specified that a reasonable price is some average of prices charged in other wealthy countries, like Germany and Canada, but it backed away from this step.[2]  

There are of course other modest steps that the Biden administration could take to lower drug prices, some of which it already has. For one, it capped the out-of-pocket payments for insulin, although this has the government picking up the tab, so that is not a measure that costs the pharmaceutical industry money. It is also moving to negotiate the prices that Medicare pays for a number of important drugs, this will save the program and beneficiaries billions of dollars in coming years.

But there are also limited steps that it could take that would push the agenda further. Drs. Peter Hotez and Maria Elena Bottazzi and their team at Texas Children’s Hospital developed an effective open-source COVID vaccine. This vaccine, Corbevax has already been used by over 100 million people in India, Indonesia, and elsewhere.

If this vaccine was approved by the FDA, it would mean that people would have a cheap alternative (likely less than $5 a shot) to the vaccines now on the market, which are selling for over $100 a shot. If the vaccine were available here, it would also mean that people have an alternative to the mRNA vaccines produced by Moderna and Pfizer. While there is little basis for the fears of mRNA technology, if these fears prevent people from getting a vaccine that could protect them from COVID, we should be allowing them an alternative.

Getting a cheap vaccine developed outside the patent system would also provide proof of concept. No one cares that I or others claim that we can produce drugs or vaccines without relying on patent monopolies, they need to see proof in the form of facts on the ground that we can have effective products that don’t depend on these monopolies. Corbevax can be an important fact on the ground. (Many people may not be aware of the enormous savings with this vaccine, since in most cases, the government or private insurers will pick up the cost of COVID boosters.)

A Very Important Step

It is always possible to complain that a particular measure does not go as far as it should, but it is very rare that major change is brought about by a single bill or executive order from a president. The question is whether the measure is a step forward and if it opens the door for future progress.

By this standard, the answer is certainly yes. We can think of this executive order as being comparable to the Inflation Reduction Act (IRA). The provisions of the IRA are nowhere near large enough to address the problem of global warming, but they are a huge foot in the door. In the same way, President Biden’s actions on Bayh-Dole are an important step in reining in drug prices and creating a path for further actions in the future.  

 

[1] There are other forms of exclusivity that can be as important as patent monopolies in blocking competition, most notably “data exclusivity.” This means that when a drug company produces data showing a particular drug is safe and effective, another company cannot rely on this data to establish that its own drug is also safe and effective, even if it can be shown to be chemically the same or similar in the case of biological drugs.

[2] This write-up from Knowledge Economy International provides useful background on some of the issues raised by the Biden Administration’s executive order.

New York Times columnist Steve Rattner told readers that people think the economy is terrible and then gave some not very plausible reasons why.  As Rattner explains:

“As I’ve engaged with my many interlocutors, I’ve concluded that voters have valid reasons for their negativity. In my view, blame two culprits: one immediate and impacting everybody, and another that particularly affects young people and is coming into view like a giant iceberg. Both sit atop the leaderboard of reasons for the sour national mood.”

Okay, first on Rattner’s list, people care about inflation, not jobs.

“To them, higher prices just means less spending power. A recent Blueprint/YouGov poll on the economy found that just 7 percent of respondents were principally concerned about the availability of jobs, while 64 percent were most worried about prices.

“The problem for President Biden is that by a margin of 43 percent to 23 percent, voters believe that he is more focused on jobs.”

Let’s apply a little common sense here. Let’s imagine that people care about both prices and jobs. Right now, because of Biden administration policies, unemployment is very low, so people have jobs. That means they probably are not worried about jobs.

It’s sort of like if you had a patient with a heart problem and a bad knee. After the doctor prescribes a medication that addresses the heart problem, it’s likely that they will be primarily worried about their bad knee. That doesn’t mean they didn’t care about their heart problem, it just means that for the time being, their heart problem is under control.

We also get the refrain that people expect prices to come down. We keep hearing that line in the media. Suppose some number of people expect pigs to fly.

Would we see the line repeated endlessly that people expect pigs to fly? My guess is that we would see some number of pieces ridiculing the fact that some people are expecting the impossible. Then the media would stop reporting it, rather than what we see now where the media continually repeats the idea that people expect prices to go down.

For what is worth, virtually no one expected prices to go back down in the 1980s after the 1970s inflation. And, a point that Rattner neglects to mention, wages have been outpacing prices, so people’s purchasing power has been increasing. That was not true in the 1980s when the media were celebrating the “Reagan boom.”

Then we get to the long-term story.

“The longer-term issue that bubbles up from polls and other data is deep pessimism about the future. Uncharacteristically, a stunning majority of Americans now believe that the next generation is likely to have a lower standard of living.

“A Wall Street Journal-NORC poll from March found that just 21 percent of respondents felt confident that life for their children’s generation will be better, matching the record low since this question was first asked.”

Actually, pessimism about the future is not uncharacteristic. A poll taken in March of 1998, when the economy was in the middle of a five year long boom, found that the number of people who thought that life would be better in the next century was tied with the number of people who thought it would be worse, at 36 percent each.

Rattner’s next step in making his case is that more young people are living at home.

“Consider one marker of generational progress: moving out. Nearly half of all Americans aged 18-29 live at home with their parents, the highest share since the Great Depression.”

Rattner is playing more than a bit fast and loose here. The share of young people living at home was rising through most of the last decade. It jumped during the pandemic, and has been trailing downward in the last year.

He also tells us that high house prices and high interest rates make it difficult for young people to buy homes. That’s true, but until interest rates jumped last year, the number of young people owning homes was increasing and it’s still above pre-pandemic levels. Perhaps Rattner thinks high rates will persist indefinitely, but he is very much in the minority on that point.

Then we get to the big kicker:

“Even more fundamentally, voters — admittedly, not economists — may deserve credit for at least subconsciously comprehending two immense longer-term challenges: lagging productivity and a huge and fast-rising national debt.”

It’s a bit hard to believe that anyone who has followed the economy for the last five decades would cite slow productivity growth as a reason for the current pessimism about the economy. We’ve had slow productivity growth for most of the last half century, why is it just now bothering young people?

The other irony of this comment is that we just got a report showing that productivity grew at an incredibly fast 5.2 percent annual rate in the third quarter. No one expects this pace to continue, and the productivity data are highly erratic, but it is a bit bizarre right now to be claiming that slow productivity growth is the reason for people’s discontent.

Then we get the national debt. The fact is, no one has any clue what the size of the national debt is. If it were half its current size it would still sound like a huge number to people. It’s pretty hard to believe that many people have looked carefully and thought about the consequences of the national debt, although hearing politicians and pundits whine about the debt may have scared them.

If they did want to worry about something that would cost them real money, they might worry about the trillions of dollars they will pay out in future years to drug companies, medical equipment suppliers, and other companies that have government-granted patent and copyright monopolies. But, the recipients of these rents are probably Steven Rattner’s friends, and they don’t allow for such things to be talked about in the New York Times anyhow.  

Ironically, Rattner doesn’t mention global warming. The damage that we are doing to the planet gives young people very serious grounds to be worried about the future. But I suppose preventing environmental destruction doesn’t matter to Rattner.

Anyhow, it is possible to make a case in the NYT that things are really bad right now and people should be worried about the economy. It may not be a very solid case, but who cares?

New York Times columnist Steve Rattner told readers that people think the economy is terrible and then gave some not very plausible reasons why.  As Rattner explains:

“As I’ve engaged with my many interlocutors, I’ve concluded that voters have valid reasons for their negativity. In my view, blame two culprits: one immediate and impacting everybody, and another that particularly affects young people and is coming into view like a giant iceberg. Both sit atop the leaderboard of reasons for the sour national mood.”

Okay, first on Rattner’s list, people care about inflation, not jobs.

“To them, higher prices just means less spending power. A recent Blueprint/YouGov poll on the economy found that just 7 percent of respondents were principally concerned about the availability of jobs, while 64 percent were most worried about prices.

“The problem for President Biden is that by a margin of 43 percent to 23 percent, voters believe that he is more focused on jobs.”

Let’s apply a little common sense here. Let’s imagine that people care about both prices and jobs. Right now, because of Biden administration policies, unemployment is very low, so people have jobs. That means they probably are not worried about jobs.

It’s sort of like if you had a patient with a heart problem and a bad knee. After the doctor prescribes a medication that addresses the heart problem, it’s likely that they will be primarily worried about their bad knee. That doesn’t mean they didn’t care about their heart problem, it just means that for the time being, their heart problem is under control.

We also get the refrain that people expect prices to come down. We keep hearing that line in the media. Suppose some number of people expect pigs to fly.

Would we see the line repeated endlessly that people expect pigs to fly? My guess is that we would see some number of pieces ridiculing the fact that some people are expecting the impossible. Then the media would stop reporting it, rather than what we see now where the media continually repeats the idea that people expect prices to go down.

For what is worth, virtually no one expected prices to go back down in the 1980s after the 1970s inflation. And, a point that Rattner neglects to mention, wages have been outpacing prices, so people’s purchasing power has been increasing. That was not true in the 1980s when the media were celebrating the “Reagan boom.”

Then we get to the long-term story.

“The longer-term issue that bubbles up from polls and other data is deep pessimism about the future. Uncharacteristically, a stunning majority of Americans now believe that the next generation is likely to have a lower standard of living.

“A Wall Street Journal-NORC poll from March found that just 21 percent of respondents felt confident that life for their children’s generation will be better, matching the record low since this question was first asked.”

Actually, pessimism about the future is not uncharacteristic. A poll taken in March of 1998, when the economy was in the middle of a five year long boom, found that the number of people who thought that life would be better in the next century was tied with the number of people who thought it would be worse, at 36 percent each.

Rattner’s next step in making his case is that more young people are living at home.

“Consider one marker of generational progress: moving out. Nearly half of all Americans aged 18-29 live at home with their parents, the highest share since the Great Depression.”

Rattner is playing more than a bit fast and loose here. The share of young people living at home was rising through most of the last decade. It jumped during the pandemic, and has been trailing downward in the last year.

He also tells us that high house prices and high interest rates make it difficult for young people to buy homes. That’s true, but until interest rates jumped last year, the number of young people owning homes was increasing and it’s still above pre-pandemic levels. Perhaps Rattner thinks high rates will persist indefinitely, but he is very much in the minority on that point.

Then we get to the big kicker:

“Even more fundamentally, voters — admittedly, not economists — may deserve credit for at least subconsciously comprehending two immense longer-term challenges: lagging productivity and a huge and fast-rising national debt.”

It’s a bit hard to believe that anyone who has followed the economy for the last five decades would cite slow productivity growth as a reason for the current pessimism about the economy. We’ve had slow productivity growth for most of the last half century, why is it just now bothering young people?

The other irony of this comment is that we just got a report showing that productivity grew at an incredibly fast 5.2 percent annual rate in the third quarter. No one expects this pace to continue, and the productivity data are highly erratic, but it is a bit bizarre right now to be claiming that slow productivity growth is the reason for people’s discontent.

Then we get the national debt. The fact is, no one has any clue what the size of the national debt is. If it were half its current size it would still sound like a huge number to people. It’s pretty hard to believe that many people have looked carefully and thought about the consequences of the national debt, although hearing politicians and pundits whine about the debt may have scared them.

If they did want to worry about something that would cost them real money, they might worry about the trillions of dollars they will pay out in future years to drug companies, medical equipment suppliers, and other companies that have government-granted patent and copyright monopolies. But, the recipients of these rents are probably Steven Rattner’s friends, and they don’t allow for such things to be talked about in the New York Times anyhow.  

Ironically, Rattner doesn’t mention global warming. The damage that we are doing to the planet gives young people very serious grounds to be worried about the future. But I suppose preventing environmental destruction doesn’t matter to Rattner.

Anyhow, it is possible to make a case in the NYT that things are really bad right now and people should be worried about the economy. It may not be a very solid case, but who cares?

The NYT had an interesting column today on the growing problem of drug shortages by Emily Tucker. The piece made several important points, but one of them could use a bit more attention.

Tucker notes that a resilient supply chain is not necessarily a domestic supply chain. This is exactly right, but the point deserves far more emphasis than it is given in this piece.

At the height of the pandemic there were shortages of a wide range of items, as demand increased and production was often curtailed due to pandemic conditions. This led to a call for increased domestic sourcing.

Some of this effort was badly misplaced, as stockpiling failings were often treated as supply chain issues. The lack of availability of masks and other protective gear was a stockpile problem, not a supply chain problem.

Even if all our masks were produced in Ohio, we could not get the hundreds of millions of masks needed at the start of the pandemic. It takes time to produce a huge number of masks and large volumes of protective gear more generally. These should have been stockpiled.

The fact that the country did not have a substantial stockpile at the start of the pandemic was a major failing of the Trump administration. This made it harder to curtail the spread of the disease and needlessly exposed many healthcare workers at a time when there were no vaccines or effective treatments.

Part of the problem with drugs in short supply is that many have limited markets. If a drug is designed to treat a relatively rare disease, there will not be an incentive for a company to have large amounts of backup capacity, or to spend a lot of money ensuring the quality of its manufacturing process, once it is available as a low-priced generic.

However, if the drug is being produced for a worldwide market, and not just the U.S. market, it is more likely that there will be several manufacturers producing any given drug. In that scenario, there will be a higher probability that one company’s output can be replaced by competitors, if it is forced to temporarily stop operating due to mechanical problems or quality control issues.

For this reason, it is important that we look to make the market as large as possible. This means removing barriers, other than necessary quality controls, to imports and encouraging other countries to do the same. In this story, a resilient supply chain is an international supply chain that encompasses as large a share of the world as possible. Restricting ourselves to domestic producers is the wrong way to go.

The NYT had an interesting column today on the growing problem of drug shortages by Emily Tucker. The piece made several important points, but one of them could use a bit more attention.

Tucker notes that a resilient supply chain is not necessarily a domestic supply chain. This is exactly right, but the point deserves far more emphasis than it is given in this piece.

At the height of the pandemic there were shortages of a wide range of items, as demand increased and production was often curtailed due to pandemic conditions. This led to a call for increased domestic sourcing.

Some of this effort was badly misplaced, as stockpiling failings were often treated as supply chain issues. The lack of availability of masks and other protective gear was a stockpile problem, not a supply chain problem.

Even if all our masks were produced in Ohio, we could not get the hundreds of millions of masks needed at the start of the pandemic. It takes time to produce a huge number of masks and large volumes of protective gear more generally. These should have been stockpiled.

The fact that the country did not have a substantial stockpile at the start of the pandemic was a major failing of the Trump administration. This made it harder to curtail the spread of the disease and needlessly exposed many healthcare workers at a time when there were no vaccines or effective treatments.

Part of the problem with drugs in short supply is that many have limited markets. If a drug is designed to treat a relatively rare disease, there will not be an incentive for a company to have large amounts of backup capacity, or to spend a lot of money ensuring the quality of its manufacturing process, once it is available as a low-priced generic.

However, if the drug is being produced for a worldwide market, and not just the U.S. market, it is more likely that there will be several manufacturers producing any given drug. In that scenario, there will be a higher probability that one company’s output can be replaced by competitors, if it is forced to temporarily stop operating due to mechanical problems or quality control issues.

For this reason, it is important that we look to make the market as large as possible. This means removing barriers, other than necessary quality controls, to imports and encouraging other countries to do the same. In this story, a resilient supply chain is an international supply chain that encompasses as large a share of the world as possible. Restricting ourselves to domestic producers is the wrong way to go.

The reported saving rate has fallen sharply from its pandemic peaks, causing many commentators to speculate that people are running out of savings.  At first glance, that is what the data show, with the saving rate for the most recent quarter coming in at 4.0 percent. That is up somewhat from the 3.3 percent rate of 2022, but down sharply from the double-digit rates of 2021, and well below the 7.0 percent plus rate we saw just before the pandemic. But there are some complicating factors that could change the picture.

 

National Income Versus Gross Domestic Product: The Mystery of the Statistical Discrepancy

In principle, we can measure gross domestic product on either the income side, adding up wages, rents, profits, and other forms of income or measure it on the output side, summing consumption, investment, government spending and net exports. We should get the same number either way, every dollar we spend buying things is income for someone.

As a practical matter, they never come out to be exactly the same, which is not surprising in a $27 trillion economy. The gap between the two is the statistical discrepancy. It usually is less than 1.0 percent of GDP in absolute value (it is positive if output exceeds income, negative when income is higher), but it can be larger, especially before the data are subject to comprehensive revisions over two or three years.

In recent quarters it has grown to be a large positive number, with measured output exceeding income by 2.5 percent of GDP ($688 billion). Most likely neither the income measure or output measure is exactly right, with the true number being somewhere in the middle. It is common to simply take the average of the two, with the idea that this is likely to be closer to the mark.

If we do this, we get that personal income is higher than the figure used to calculate the saving rate in the third quarter. (Saving is calculated as personal income, minus taxes and consumption.) I calculated an adjusted measure for personal income that assumes that the actual level of national income is equal to reported national income, plus half of the statistical discrepancy. (I adjusted for the small difference between personal income and national income by multiplying by the reported ratio for the two [NIPA Table 1.7.5, Line 25 divided by Line 16].)

I then calculated an adjusted saving rate, using this measure of adjusted personal income, instead of the reported measure of personal income. This came to 5.7 percent in the most recent quarter, as opposed to the 4.0 percent shown in the published data. This is shown in the figure below.

Source: Bureau of Economic Analysis and Author’s Calculations, see text.

 

 

However, if we think that the true measure of GDP lies halfway between the output side measure and the income side measure, then we should also adjust the output side of the calculation. This means that consumption will be somewhat lower than is reported. This will further increase the saving rate as shown in the adjusted saving rate line with both income and outlays adjusted.[1]

With this adjustment, the drop in the saving rate is largely eliminated. The saving rate in the third quarter, with both income and consumption adjusted, is 6.8 percent, higher than the averages for both 2017 and 2018. This implies that the widely touted drop in the saving rate in 2023 might just be a problem with measurement.

 

Taxes and Savings

 

There is one other point worth making about the saving rate. Savings are measured as income minus taxes. Taxes jumped in 2022. This was not because of an increase in the tax rate, it was due to the fact that people were paying capital gains taxes on stocks that they sold. Since capital gains do not count as income, selling stock at a profit and paying taxes on the gains, means households have lower disposable income.

This means, for example, if a household paid $2,000 in taxes on $10,000 in gains, its disposable income would be $2,000 lower in the year it sold the stock than in the prior year, even if its other income was exactly the same.

We can adjust for the impact of tax payments by simply taking savings (adjusted savings here), plus taxes, as a share of adjusted personal income. This is shown in the figure below.    

Source: Bureau of Economic Analysis and Author’s Calculations, see text.

As can be seen, there is a modest dip in this measure in the second half of 2022, but the most recent figure of 17.9 percent is above the 2017 and 2018 averages. By this measure also, it seems that the drop in the saving rate is just the result of measurement error.  

[1] I multiplied reported outlays by 1 minus half the size of the statistical discrepancy (Table 2.1, Line 28 *(1-0.5*(Table 1.7.5 (Line 15/Line1).

The reported saving rate has fallen sharply from its pandemic peaks, causing many commentators to speculate that people are running out of savings.  At first glance, that is what the data show, with the saving rate for the most recent quarter coming in at 4.0 percent. That is up somewhat from the 3.3 percent rate of 2022, but down sharply from the double-digit rates of 2021, and well below the 7.0 percent plus rate we saw just before the pandemic. But there are some complicating factors that could change the picture.

 

National Income Versus Gross Domestic Product: The Mystery of the Statistical Discrepancy

In principle, we can measure gross domestic product on either the income side, adding up wages, rents, profits, and other forms of income or measure it on the output side, summing consumption, investment, government spending and net exports. We should get the same number either way, every dollar we spend buying things is income for someone.

As a practical matter, they never come out to be exactly the same, which is not surprising in a $27 trillion economy. The gap between the two is the statistical discrepancy. It usually is less than 1.0 percent of GDP in absolute value (it is positive if output exceeds income, negative when income is higher), but it can be larger, especially before the data are subject to comprehensive revisions over two or three years.

In recent quarters it has grown to be a large positive number, with measured output exceeding income by 2.5 percent of GDP ($688 billion). Most likely neither the income measure or output measure is exactly right, with the true number being somewhere in the middle. It is common to simply take the average of the two, with the idea that this is likely to be closer to the mark.

If we do this, we get that personal income is higher than the figure used to calculate the saving rate in the third quarter. (Saving is calculated as personal income, minus taxes and consumption.) I calculated an adjusted measure for personal income that assumes that the actual level of national income is equal to reported national income, plus half of the statistical discrepancy. (I adjusted for the small difference between personal income and national income by multiplying by the reported ratio for the two [NIPA Table 1.7.5, Line 25 divided by Line 16].)

I then calculated an adjusted saving rate, using this measure of adjusted personal income, instead of the reported measure of personal income. This came to 5.7 percent in the most recent quarter, as opposed to the 4.0 percent shown in the published data. This is shown in the figure below.

Source: Bureau of Economic Analysis and Author’s Calculations, see text.

 

 

However, if we think that the true measure of GDP lies halfway between the output side measure and the income side measure, then we should also adjust the output side of the calculation. This means that consumption will be somewhat lower than is reported. This will further increase the saving rate as shown in the adjusted saving rate line with both income and outlays adjusted.[1]

With this adjustment, the drop in the saving rate is largely eliminated. The saving rate in the third quarter, with both income and consumption adjusted, is 6.8 percent, higher than the averages for both 2017 and 2018. This implies that the widely touted drop in the saving rate in 2023 might just be a problem with measurement.

 

Taxes and Savings

 

There is one other point worth making about the saving rate. Savings are measured as income minus taxes. Taxes jumped in 2022. This was not because of an increase in the tax rate, it was due to the fact that people were paying capital gains taxes on stocks that they sold. Since capital gains do not count as income, selling stock at a profit and paying taxes on the gains, means households have lower disposable income.

This means, for example, if a household paid $2,000 in taxes on $10,000 in gains, its disposable income would be $2,000 lower in the year it sold the stock than in the prior year, even if its other income was exactly the same.

We can adjust for the impact of tax payments by simply taking savings (adjusted savings here), plus taxes, as a share of adjusted personal income. This is shown in the figure below.    

Source: Bureau of Economic Analysis and Author’s Calculations, see text.

As can be seen, there is a modest dip in this measure in the second half of 2022, but the most recent figure of 17.9 percent is above the 2017 and 2018 averages. By this measure also, it seems that the drop in the saving rate is just the result of measurement error.  

[1] I multiplied reported outlays by 1 minus half the size of the statistical discrepancy (Table 2.1, Line 28 *(1-0.5*(Table 1.7.5 (Line 15/Line1).

The Washington Post ran a lengthy article about how Ava DuVernay is having her latest film financed by the Ford Foundation, as well as foundations supported by Melinda French Gates and Lauren Jobs. The piece describes the film, and notes how this can be a new model for financing artistic films that for-profit studios may not support:

“It’s a patronage model reminiscent of the charity bestowed on art museums or opera companies — high-cultural institutions that couldn’t survive without deep-pocketed benefactors.”

However, an important fact that did not get mentioned in the Post’s piece is that the charitable contributions made by the rich people who finance these foundations involve a large taxpayer subsidy.

While the size of the charitable contribution tax deduction has varied, depending on the tax rates at the time on incomes and estates, it has been roughly 40 percent. This means that taxpayers are picking up the tab for 40 cents of every dollar that these rich people choose to contribute to support Ms. DuVernay’s film. (To be clear, this is not at all a criticism of her new film. She is an accomplished filmmaker, and from the write-up in the article, it sounds like a very worthwhile project.)

The fact that the “patronage model” involves a large element of taxpayer subsidy seems an important point that might have been worth noting. While many of us may think it is a good idea for the government to support creative work and creative workers, we might not think that it’s best that the rich be the ones who decide which work deserves the taxpayers’ support.

A Democratic Alternative to the “Patronage” Model

Under the current system, the rich get the vast majority of the benefits from the charitable contribution tax deduction. This is both because they are taxed at a higher rate, so that $1 off of their taxable income saves them more money than $1 off the taxable income of a moderate or middle-income person, and also because the rich are far more likely to itemize their tax deductions.

Only 11.4 percent of taxpayers itemize their deductions, most of whom are at the top end of the income distribution. The overwhelming majority of taxpayers use the standard deduction. For them, the charitable contribution tax deduction is of no value whatsoever.

However, we could redesign this structure to make the benefits more evenly spread by changing the tax deduction to a credit. And, if we think it is important for the government to subsidize creative work, we could designate that this credit be used to support creative work.

The way this could work is that we would give every adult a credit of some size (say $100 to $200), which would be used to support the creative worker or organization that supports creative work, of their choosing. If we assume that every adult in the country could use their credit, this comes to between $25 billion and $50 billion a year, which would be a good chunk of change to support creative work.[1]

To be eligible to receive money through this system, a person or organization would register with the I.R.S., or a new agency, indicating what creative work they did. This registration would be similar to what non-profits do now to get tax-exempt status from the I.R.S.

They must say what they do that qualifies them for tax-exempt status; are they a church, a charity that provides food to the poor, or a think tank? The I.R.S. doesn’t make an effort to determine whether they are a good church, charity, or think tank, they just determine whether they do what they claim and if that would qualify them for tax-exempt status.

The same would be the case for individuals or organizations that register to be eligible for the creative work tax credit. They would indicate they are a writer, a movie producer, a singer, etc. Alternatively, an organization could register saying that they support blues musicians, mystery writers, or historical movies.

A condition of getting the money could be that the recipients are not eligible for copyright protection for a substantial period of time, say three to five years. The logic here is that the government gives people one subsidy for their work, not two. Copyright monopolies are one mechanism the government uses to support creative work. There is no reason that it should give people who benefit from this mechanism an additional subsidy in the form of money from a tax credit.

There is also the issue that the point of the credit is to support creative work for people to enjoy. If the work produced with the credit is paywalled and comes with a high price tag, not many people will see it. By contrast, if any work supported through this system is freely available over the web, it should attract the widest possible audience.

This copyright provision also has the benefit that it is largely self-enforcing. If someone who was getting money through the system tries to get a copyright during the period in which they are ineligible for copyright protection, their copyright is simply unenforceable. If a false copyright claimant attempts to bring a suit for copyright violation against someone, the person simply points out that the claimant was in the tax credit system and therefore their copyright is not valid.  

The system for taxpayers using the credit would be similar to what is now in place for the charitable deduction. They could just indicate on their tax return that they had paid a certain amount to a qualified person or organization, with the understanding that they could be later asked for evidence that they had made this contribution.

Also, since the plan would be that everyone would have access to the credit, even if they did not pay income taxes, the system could be designed so that the government makes this payment directly on the taxpayer’s behalf. This would mean that they could fill out a form indicating which creative workers or organizations they wanted to support, and the government would make the payment.[2]

There obviously are many details that would need to be worked out in designing this sort of system, and there will undoubtedly be problems, but that is true with any system, including the current charitable contribution deduction. We could design the system to prevent obvious scams, for example, requiring that people get at least $3,000 in credit money, in order to be able to collect anything through the system, would prevent any sort of simple trading of credits. The key point is that we could design a government-funded system for supporting creative work that does not rely on the whims of the rich, as is now the case.

Journalism, a Special Case

The collapse of newspapers over the last quarter century, and especially local newspapers, has created interest in devising a system whereby the government supports this vital service. There have been various routes proposed, but there are efforts in at least two cities, Washington and Seattle, that have proposed this sort of individual credit or voucher system.

If one of these cities can get a news voucher system up and running, it would both do much to revitalize journalism in their community, and also provide a model for a more democratic system of taxpayer funding for creative work. The fact is, we do not need rich people to decide which creative work the government should support.

We should have a broader discussion on how taxpayer funding for the arts should be used. That would require some clearer thinking on this topic than what we see in public discussions today. It might also require some new ideas. We know the old saying that intellectuals have a hard time dealing with new ideas, but we need to have the discussion anyhow.   

 

 

 

 

 

 

[1] I outline this sort of system in my book Rigged (it’s free).

[2] This route of direct payments might be preferable in a start-up phase where participation could be low. Suppose the credit was set at $100 a person, with the idea that if 250 million people took advantage of the credit, $25 billion would be paid out to creative workers. If the payments were made through a centralized system, and just a small number – say 25 million people – opted to use the credit, then the value of the credit could just be increased by a factor of ten. This would mean that each person who used their credit would effectively be contributing $1,000 to the creative workers/organizations of their choice.

The fact that the credits were initially far more valuable than originally intended should provide people with a strong incentive to participate in future years. In any case, this system would ensure that a substantial pot of money was available to support creative work.

The Washington Post ran a lengthy article about how Ava DuVernay is having her latest film financed by the Ford Foundation, as well as foundations supported by Melinda French Gates and Lauren Jobs. The piece describes the film, and notes how this can be a new model for financing artistic films that for-profit studios may not support:

“It’s a patronage model reminiscent of the charity bestowed on art museums or opera companies — high-cultural institutions that couldn’t survive without deep-pocketed benefactors.”

However, an important fact that did not get mentioned in the Post’s piece is that the charitable contributions made by the rich people who finance these foundations involve a large taxpayer subsidy.

While the size of the charitable contribution tax deduction has varied, depending on the tax rates at the time on incomes and estates, it has been roughly 40 percent. This means that taxpayers are picking up the tab for 40 cents of every dollar that these rich people choose to contribute to support Ms. DuVernay’s film. (To be clear, this is not at all a criticism of her new film. She is an accomplished filmmaker, and from the write-up in the article, it sounds like a very worthwhile project.)

The fact that the “patronage model” involves a large element of taxpayer subsidy seems an important point that might have been worth noting. While many of us may think it is a good idea for the government to support creative work and creative workers, we might not think that it’s best that the rich be the ones who decide which work deserves the taxpayers’ support.

A Democratic Alternative to the “Patronage” Model

Under the current system, the rich get the vast majority of the benefits from the charitable contribution tax deduction. This is both because they are taxed at a higher rate, so that $1 off of their taxable income saves them more money than $1 off the taxable income of a moderate or middle-income person, and also because the rich are far more likely to itemize their tax deductions.

Only 11.4 percent of taxpayers itemize their deductions, most of whom are at the top end of the income distribution. The overwhelming majority of taxpayers use the standard deduction. For them, the charitable contribution tax deduction is of no value whatsoever.

However, we could redesign this structure to make the benefits more evenly spread by changing the tax deduction to a credit. And, if we think it is important for the government to subsidize creative work, we could designate that this credit be used to support creative work.

The way this could work is that we would give every adult a credit of some size (say $100 to $200), which would be used to support the creative worker or organization that supports creative work, of their choosing. If we assume that every adult in the country could use their credit, this comes to between $25 billion and $50 billion a year, which would be a good chunk of change to support creative work.[1]

To be eligible to receive money through this system, a person or organization would register with the I.R.S., or a new agency, indicating what creative work they did. This registration would be similar to what non-profits do now to get tax-exempt status from the I.R.S.

They must say what they do that qualifies them for tax-exempt status; are they a church, a charity that provides food to the poor, or a think tank? The I.R.S. doesn’t make an effort to determine whether they are a good church, charity, or think tank, they just determine whether they do what they claim and if that would qualify them for tax-exempt status.

The same would be the case for individuals or organizations that register to be eligible for the creative work tax credit. They would indicate they are a writer, a movie producer, a singer, etc. Alternatively, an organization could register saying that they support blues musicians, mystery writers, or historical movies.

A condition of getting the money could be that the recipients are not eligible for copyright protection for a substantial period of time, say three to five years. The logic here is that the government gives people one subsidy for their work, not two. Copyright monopolies are one mechanism the government uses to support creative work. There is no reason that it should give people who benefit from this mechanism an additional subsidy in the form of money from a tax credit.

There is also the issue that the point of the credit is to support creative work for people to enjoy. If the work produced with the credit is paywalled and comes with a high price tag, not many people will see it. By contrast, if any work supported through this system is freely available over the web, it should attract the widest possible audience.

This copyright provision also has the benefit that it is largely self-enforcing. If someone who was getting money through the system tries to get a copyright during the period in which they are ineligible for copyright protection, their copyright is simply unenforceable. If a false copyright claimant attempts to bring a suit for copyright violation against someone, the person simply points out that the claimant was in the tax credit system and therefore their copyright is not valid.  

The system for taxpayers using the credit would be similar to what is now in place for the charitable deduction. They could just indicate on their tax return that they had paid a certain amount to a qualified person or organization, with the understanding that they could be later asked for evidence that they had made this contribution.

Also, since the plan would be that everyone would have access to the credit, even if they did not pay income taxes, the system could be designed so that the government makes this payment directly on the taxpayer’s behalf. This would mean that they could fill out a form indicating which creative workers or organizations they wanted to support, and the government would make the payment.[2]

There obviously are many details that would need to be worked out in designing this sort of system, and there will undoubtedly be problems, but that is true with any system, including the current charitable contribution deduction. We could design the system to prevent obvious scams, for example, requiring that people get at least $3,000 in credit money, in order to be able to collect anything through the system, would prevent any sort of simple trading of credits. The key point is that we could design a government-funded system for supporting creative work that does not rely on the whims of the rich, as is now the case.

Journalism, a Special Case

The collapse of newspapers over the last quarter century, and especially local newspapers, has created interest in devising a system whereby the government supports this vital service. There have been various routes proposed, but there are efforts in at least two cities, Washington and Seattle, that have proposed this sort of individual credit or voucher system.

If one of these cities can get a news voucher system up and running, it would both do much to revitalize journalism in their community, and also provide a model for a more democratic system of taxpayer funding for creative work. The fact is, we do not need rich people to decide which creative work the government should support.

We should have a broader discussion on how taxpayer funding for the arts should be used. That would require some clearer thinking on this topic than what we see in public discussions today. It might also require some new ideas. We know the old saying that intellectuals have a hard time dealing with new ideas, but we need to have the discussion anyhow.   

 

 

 

 

 

 

[1] I outline this sort of system in my book Rigged (it’s free).

[2] This route of direct payments might be preferable in a start-up phase where participation could be low. Suppose the credit was set at $100 a person, with the idea that if 250 million people took advantage of the credit, $25 billion would be paid out to creative workers. If the payments were made through a centralized system, and just a small number – say 25 million people – opted to use the credit, then the value of the credit could just be increased by a factor of ten. This would mean that each person who used their credit would effectively be contributing $1,000 to the creative workers/organizations of their choice.

The fact that the credits were initially far more valuable than originally intended should provide people with a strong incentive to participate in future years. In any case, this system would ensure that a substantial pot of money was available to support creative work.

The revisions to the third quarter growth data were striking. After an initial report showing GDP grew at a very strong 4.9 percent annual rate, the revised data show growth was actually somewhat faster at 5.2 percent. 

No one expects the economy to sustain anything like this rate of growth going forward. Most likely the growth rate will fall back somewhere close to the 2.0 percent pace that is generally viewed as the sustainable rate, but many economists were projecting a recession this year. It’s clear the economy was not listening to these projections.

Most aspects of the economy look very good right now. Job growth is continuing at a healthy pace. Wage growth has moderated, but it is outpacing inflation. And, we are seeing an extraordinary boom in factory construction as a result of the Inflation Reduction Act and CHIPS Act, laying the basis for a future surge in manufacturing.

However, one aspect remains troubling. The profit share of national income rose sharply in the pandemic, and it continues to be elevated compared to pre-pandemic levels, which were already considerably higher than the profit shares at the start of the century.

We can argue about the cause of the rise in the profit share, but the fact that it has risen is not really in dispute. Here’s the picture since 2018.

Source: Bureau of Economic Analysis and author’s calculations (see text).

 

These data are taken from the Bureau of Economic Analysis (BEA). There are always difficulties in measurement, and the shares will be revised when the BEA does comprehensive revisions next summer, but for now, these are the best data available.    

The profit share jumped early in the pandemic recovery, going from an average of 24.1 percent of income in the corporate sector to 26.8 percent in the third quarter of 2020.[1] It peaked at 27.0 percent in the second quarter of 2022. The rise in profit shares is clearly what drove inflation, just as an accounting matter. It doesn’t make sense to say that wages are driving inflation if they are not even keeping pace with prices, which was true in most of 2022.

I had hoped that as the impact of the Covid pandemic lessened, and supply chains normalized, that we would see the profit share return to its pre-pandemic level. I was not alone in this hope, the Congressional Budget Office projected that profits would fall by 6.7 percent from fiscal year 2022 to fiscal year 2023.

That proved not to be the case. Instead, profits increased by 13.1 percent, and the profit share rose from 26.1 percent to 26.8 percent. This is both surprising and disturbing. It means that whatever factors allowed corporations to increase their profit margins during the pandemic were still allowing them to maintain elevated profit margins even as the impact of the pandemic subsided.

Again, the reasons for why profit margins have increased can be debated, but not the fact that they have increased. The Biden administration has been calling attention to this with recent comments by President Biden and other members of his administration.

While it’s not clear that his haranguing of corporations for excessive margins will affect their behavior, it is still worth calling attention to the issue. First, everyone should be clear (especially Jerome Powell and the Fed) that inflation is not a problem of excessive wage growth.

In fact, we should expect wage growth to exceed inflation by a larger than normal amount for a period of time to at least restore profit margins to their pre-pandemic level. It would not be unreasonable to think that we could get margins back to their 2000 level, but getting back to the pre-pandemic level would at least be a good start.

Second, workers should understand that they can demand higher pay because companies have the money. We saw this story clearly with the UAW strike. The Big Three automakers started with stingy offers, claiming that their backs were against the wall. The UAW held out and insisted that they get a decent contract restoring wage cuts they had accepted in hard times. This resulted in a contract where they got pay increases of close to 30 percent, with larger increases for lower-paid workers.

Third, it is important that the public be clear on the cause of the problem. They can blame or not blame politicians as they like, but what has changed over the last four years since the pandemic is that companies have increased their profit margins. It is understandable they would do this, corporations are in business to make a profit, but this is where the money went. We should all be clear on that fact.

Corporate Tax Rates Have Risen Sharply

While the high profit share can be seen as bad news, there is a positive part of the story that has not gotten the attention it deserves. For reasons that I don’t understand, the share of corporate profits going to pay taxes has risen under the Biden administration.

Trump cut the corporate tax rate from 35 percent to 21 percent in his 2017 tax cut. This led to a drop in the share of corporate profits going to taxes from around 18 percent to just over 13 percent. The share began to rise in the second half of 2021 and has averaged 17.7 percent over the last four quarters.

This is not obviously attributable to legislated increases in tax rates. There was a 1.0 percent tax on share buybacks included in the Inflation Reduction Act, which took effect at the start of this year. While this is great policy, it cannot plausibly explain much of the rise in corporate taxes over the last two years.

It is possible that greater enforcement has played an important role here. The Trump administration seemed to view tax evasion as a sport that was all fun and games. If a Biden I.R.S. decided that laws actually should be enforced, and taxes are not voluntary, that may have had a big impact on tax collections.

I’m sure there are people that have more insight into the causes of the increase in corporate tax payments, who can give a fuller picture. In any case, it is a big deal and the Biden administration deserves some serious credit here.

[1] This calculation takes the net operating surplus (Table 1.14, Line 8) minus the profits of Federal Reserve Banks (Table 6.16D, Line 11) over the combination of compensation of employees (Table 1.14, Line 4) plus net operating surplus. The after-tax line subtracts out taxes from this sum (Table 1.14, Line 12).

The revisions to the third quarter growth data were striking. After an initial report showing GDP grew at a very strong 4.9 percent annual rate, the revised data show growth was actually somewhat faster at 5.2 percent. 

No one expects the economy to sustain anything like this rate of growth going forward. Most likely the growth rate will fall back somewhere close to the 2.0 percent pace that is generally viewed as the sustainable rate, but many economists were projecting a recession this year. It’s clear the economy was not listening to these projections.

Most aspects of the economy look very good right now. Job growth is continuing at a healthy pace. Wage growth has moderated, but it is outpacing inflation. And, we are seeing an extraordinary boom in factory construction as a result of the Inflation Reduction Act and CHIPS Act, laying the basis for a future surge in manufacturing.

However, one aspect remains troubling. The profit share of national income rose sharply in the pandemic, and it continues to be elevated compared to pre-pandemic levels, which were already considerably higher than the profit shares at the start of the century.

We can argue about the cause of the rise in the profit share, but the fact that it has risen is not really in dispute. Here’s the picture since 2018.

Source: Bureau of Economic Analysis and author’s calculations (see text).

 

These data are taken from the Bureau of Economic Analysis (BEA). There are always difficulties in measurement, and the shares will be revised when the BEA does comprehensive revisions next summer, but for now, these are the best data available.    

The profit share jumped early in the pandemic recovery, going from an average of 24.1 percent of income in the corporate sector to 26.8 percent in the third quarter of 2020.[1] It peaked at 27.0 percent in the second quarter of 2022. The rise in profit shares is clearly what drove inflation, just as an accounting matter. It doesn’t make sense to say that wages are driving inflation if they are not even keeping pace with prices, which was true in most of 2022.

I had hoped that as the impact of the Covid pandemic lessened, and supply chains normalized, that we would see the profit share return to its pre-pandemic level. I was not alone in this hope, the Congressional Budget Office projected that profits would fall by 6.7 percent from fiscal year 2022 to fiscal year 2023.

That proved not to be the case. Instead, profits increased by 13.1 percent, and the profit share rose from 26.1 percent to 26.8 percent. This is both surprising and disturbing. It means that whatever factors allowed corporations to increase their profit margins during the pandemic were still allowing them to maintain elevated profit margins even as the impact of the pandemic subsided.

Again, the reasons for why profit margins have increased can be debated, but not the fact that they have increased. The Biden administration has been calling attention to this with recent comments by President Biden and other members of his administration.

While it’s not clear that his haranguing of corporations for excessive margins will affect their behavior, it is still worth calling attention to the issue. First, everyone should be clear (especially Jerome Powell and the Fed) that inflation is not a problem of excessive wage growth.

In fact, we should expect wage growth to exceed inflation by a larger than normal amount for a period of time to at least restore profit margins to their pre-pandemic level. It would not be unreasonable to think that we could get margins back to their 2000 level, but getting back to the pre-pandemic level would at least be a good start.

Second, workers should understand that they can demand higher pay because companies have the money. We saw this story clearly with the UAW strike. The Big Three automakers started with stingy offers, claiming that their backs were against the wall. The UAW held out and insisted that they get a decent contract restoring wage cuts they had accepted in hard times. This resulted in a contract where they got pay increases of close to 30 percent, with larger increases for lower-paid workers.

Third, it is important that the public be clear on the cause of the problem. They can blame or not blame politicians as they like, but what has changed over the last four years since the pandemic is that companies have increased their profit margins. It is understandable they would do this, corporations are in business to make a profit, but this is where the money went. We should all be clear on that fact.

Corporate Tax Rates Have Risen Sharply

While the high profit share can be seen as bad news, there is a positive part of the story that has not gotten the attention it deserves. For reasons that I don’t understand, the share of corporate profits going to pay taxes has risen under the Biden administration.

Trump cut the corporate tax rate from 35 percent to 21 percent in his 2017 tax cut. This led to a drop in the share of corporate profits going to taxes from around 18 percent to just over 13 percent. The share began to rise in the second half of 2021 and has averaged 17.7 percent over the last four quarters.

This is not obviously attributable to legislated increases in tax rates. There was a 1.0 percent tax on share buybacks included in the Inflation Reduction Act, which took effect at the start of this year. While this is great policy, it cannot plausibly explain much of the rise in corporate taxes over the last two years.

It is possible that greater enforcement has played an important role here. The Trump administration seemed to view tax evasion as a sport that was all fun and games. If a Biden I.R.S. decided that laws actually should be enforced, and taxes are not voluntary, that may have had a big impact on tax collections.

I’m sure there are people that have more insight into the causes of the increase in corporate tax payments, who can give a fuller picture. In any case, it is a big deal and the Biden administration deserves some serious credit here.

[1] This calculation takes the net operating surplus (Table 1.14, Line 8) minus the profits of Federal Reserve Banks (Table 6.16D, Line 11) over the combination of compensation of employees (Table 1.14, Line 4) plus net operating surplus. The after-tax line subtracts out taxes from this sum (Table 1.14, Line 12).

All the normal economic data tell us that people should feel pretty good about the economy right now. Unemployment has been below 4.0 percent for 21 consecutive months for the first time in more than half a century.

Tens of millions of people have left jobs they didn’t like to find better ones. As a result, workplace satisfaction is at the highest level it has been in the nearly forty years the Conference Board has done its survey.

The recent jump in mortgage rates has made it difficult for first-time home buyers, but homeownership rates are still well above pre-pandemic levels overall and for young people, Blacks and Hispanics, and people with below the median income.

The number of workers who can work from home, saving themselves thousands a year in commuting costs and hundreds of hours of time spent commuting, has increased by roughly 11 million.

Fifteen million households have been able to refinance their mortgages and save themselves thousands of dollars a year on interest payments.

And, real wages are above pre-pandemic levels, as wage growth has outpaced inflation. With inflation slowing, this pattern should continue. The biggest wage gains were for those at the bottom of the wage distribution.

All of these factors suggest that people should be feeling pretty good about the economy right now, but polls consistently show that people think the economy is doing terribly. Those of us who point to the data are told that we can’t argue with people’s lived experience, people feel what they feel.

That’s fair enough, except I want to know how people’s lived experience can tell them that their local economy is doing okay, it’s only the national economy that is in the tank?

A recent poll by Bloomberg found that 49 percent of respondents said their local economy is on the right track. Now that’s not great, but pretty damn close to half.

By contrast, only 26 percent said that the national economy was on the right track. This means that 23 percent of the people answering the poll thought things were going well where they lived, but were bad in the rest of the country.

My question then is, how this 23 percent could, based on their lived experience, determine that things were worse where they didn’t live than where they did live?

My working hypothesis is that they are likely reflecting the media’s endless trash-talking of the economy. The problem is not just Fox, which sees its purpose as advancing the Republican agenda, but also CNN, the NYT, the WaPo, and other major news outlets. Stories about inflation and prices not falling (they never do) fill their pages.

Stories about record-low unemployment are few and far between, and pieces on workplace satisfaction, the surge in mortgage refinancing and interest savings, and explosion in work-from-home are virtually none existent.

In my working hypothesis, when people tell us the national economy is bad, they are not reporting on their lived experience, they are repeating what they have heard directly or indirectly from the media. Everyone knows the economy is bad, they don’t want to look stupid so they give what they have been told is the correct answer.

I am open to other explanations for how 23 percent of the people think their local economy is on the right track, but the national economy is not.

All the normal economic data tell us that people should feel pretty good about the economy right now. Unemployment has been below 4.0 percent for 21 consecutive months for the first time in more than half a century.

Tens of millions of people have left jobs they didn’t like to find better ones. As a result, workplace satisfaction is at the highest level it has been in the nearly forty years the Conference Board has done its survey.

The recent jump in mortgage rates has made it difficult for first-time home buyers, but homeownership rates are still well above pre-pandemic levels overall and for young people, Blacks and Hispanics, and people with below the median income.

The number of workers who can work from home, saving themselves thousands a year in commuting costs and hundreds of hours of time spent commuting, has increased by roughly 11 million.

Fifteen million households have been able to refinance their mortgages and save themselves thousands of dollars a year on interest payments.

And, real wages are above pre-pandemic levels, as wage growth has outpaced inflation. With inflation slowing, this pattern should continue. The biggest wage gains were for those at the bottom of the wage distribution.

All of these factors suggest that people should be feeling pretty good about the economy right now, but polls consistently show that people think the economy is doing terribly. Those of us who point to the data are told that we can’t argue with people’s lived experience, people feel what they feel.

That’s fair enough, except I want to know how people’s lived experience can tell them that their local economy is doing okay, it’s only the national economy that is in the tank?

A recent poll by Bloomberg found that 49 percent of respondents said their local economy is on the right track. Now that’s not great, but pretty damn close to half.

By contrast, only 26 percent said that the national economy was on the right track. This means that 23 percent of the people answering the poll thought things were going well where they lived, but were bad in the rest of the country.

My question then is, how this 23 percent could, based on their lived experience, determine that things were worse where they didn’t live than where they did live?

My working hypothesis is that they are likely reflecting the media’s endless trash-talking of the economy. The problem is not just Fox, which sees its purpose as advancing the Republican agenda, but also CNN, the NYT, the WaPo, and other major news outlets. Stories about inflation and prices not falling (they never do) fill their pages.

Stories about record-low unemployment are few and far between, and pieces on workplace satisfaction, the surge in mortgage refinancing and interest savings, and explosion in work-from-home are virtually none existent.

In my working hypothesis, when people tell us the national economy is bad, they are not reporting on their lived experience, they are repeating what they have heard directly or indirectly from the media. Everyone knows the economy is bad, they don’t want to look stupid so they give what they have been told is the correct answer.

I am open to other explanations for how 23 percent of the people think their local economy is on the right track, but the national economy is not.

Like many self-imagined “free-traders,” the Washington Post editorial board cannot even conceive of free trade when it comes to prescription drugs. They demonstrated this fact yet again in discussing ways to deal with the high price of effective weight-loss drugs like Wegovy. These drugs carry price tags of more than $1,000 a month, making them costly for insurers, governments, or individuals who have to pick up the tab themselves.

The Post throws out a couple of ideas that could allow for a lower price, but never considers the fact that these drugs would be cheap without the government-granted patent monopolies that prevent generic manufacturers from entering the market. The monopolies are of course to provide an incentive to undertake the research, but there are other mechanisms for providing incentives, like paying people.

We did this when we wanted Moderna to develop a Covid vaccine, paying the company almost a billion dollars to develop and then test the vaccine. In the standard for our government, we then gave Moderna control over the vaccine, creating at least five Moderna billionaires. (Tell me again how conservatives want less government.) If we adopted the policy of only paying for research once, we would have both had the vaccine and low prices, since it likely could be manufactured and distributed for around $4 or $5 a shot.

In the case of Wegovy and other weight loss drugs, it’s likely the case that we would be talking about a cost of $20 or $30 a month in the absence of the patent monopoly. In this case, the monopoly is raising the price by a factor of 30 or 40, the equivalent of a tariff of 3,000 or 4,000 percent.

While the WaPo would usually go on the warpath over a tariff of 10 or 25 percent, it is apparently just fine with this much larger tariff that keeps drug prices high. Needless to say, we would not be debating how to cover the cost if Wegovy was selling for $30 for a month’s dosage.

We should also recognize this is real money. We will spend over $600 billion this year (almost $5,000 per family) on drugs that would likely cost less than $100 billion in a free market. This dwarfs the money at stake in tariffs on items like cars or steel, but it goes unmentioned at the Washington Post and in polite circles more generally.

In addition to lower prices, there is a second very important reason we should want free trade in prescription drugs. As the Post mentions, there are serious questions about the long-term side effects of Wegovy and other weight-loss drugs.

It would be good to have honest assessments of these side effects. While the researchers doing studies of these side effects may all be doing credible research, it is likely that there will be some ambiguities in the results. The billions of dollars on the table, in the form of prospective profits, puts a very big thumb on the scale towards minimizing negative side effects.

We would likely get a more honest scientific debate, and better outcomes for patients, if there wasn’t so much money on one side of this issue. For that reason also, we should want to see a free market for weight-loss drugs and drugs more generally.

Like many self-imagined “free-traders,” the Washington Post editorial board cannot even conceive of free trade when it comes to prescription drugs. They demonstrated this fact yet again in discussing ways to deal with the high price of effective weight-loss drugs like Wegovy. These drugs carry price tags of more than $1,000 a month, making them costly for insurers, governments, or individuals who have to pick up the tab themselves.

The Post throws out a couple of ideas that could allow for a lower price, but never considers the fact that these drugs would be cheap without the government-granted patent monopolies that prevent generic manufacturers from entering the market. The monopolies are of course to provide an incentive to undertake the research, but there are other mechanisms for providing incentives, like paying people.

We did this when we wanted Moderna to develop a Covid vaccine, paying the company almost a billion dollars to develop and then test the vaccine. In the standard for our government, we then gave Moderna control over the vaccine, creating at least five Moderna billionaires. (Tell me again how conservatives want less government.) If we adopted the policy of only paying for research once, we would have both had the vaccine and low prices, since it likely could be manufactured and distributed for around $4 or $5 a shot.

In the case of Wegovy and other weight loss drugs, it’s likely the case that we would be talking about a cost of $20 or $30 a month in the absence of the patent monopoly. In this case, the monopoly is raising the price by a factor of 30 or 40, the equivalent of a tariff of 3,000 or 4,000 percent.

While the WaPo would usually go on the warpath over a tariff of 10 or 25 percent, it is apparently just fine with this much larger tariff that keeps drug prices high. Needless to say, we would not be debating how to cover the cost if Wegovy was selling for $30 for a month’s dosage.

We should also recognize this is real money. We will spend over $600 billion this year (almost $5,000 per family) on drugs that would likely cost less than $100 billion in a free market. This dwarfs the money at stake in tariffs on items like cars or steel, but it goes unmentioned at the Washington Post and in polite circles more generally.

In addition to lower prices, there is a second very important reason we should want free trade in prescription drugs. As the Post mentions, there are serious questions about the long-term side effects of Wegovy and other weight-loss drugs.

It would be good to have honest assessments of these side effects. While the researchers doing studies of these side effects may all be doing credible research, it is likely that there will be some ambiguities in the results. The billions of dollars on the table, in the form of prospective profits, puts a very big thumb on the scale towards minimizing negative side effects.

We would likely get a more honest scientific debate, and better outcomes for patients, if there wasn’t so much money on one side of this issue. For that reason also, we should want to see a free market for weight-loss drugs and drugs more generally.

As a Thanksgiving present to readers, Washington Post columnist Catherine Rampell decided to tell us again how old-timers are robbing from our children with their generous Social Security and Medicare benefits. This is always a popular theme at the WaPo, especially around the holiday season.

The story is infuriating for four reasons:

  • Even by the calculations highlighted in the piece, Social Security is not a big subsidy to retirees,
  • Medicare appears to be a large subsidy only because our healthcare system is so inefficient,
  • What counts as a government payment, as opposed to a market outcome, is arbitrary, and
  • We pass on a whole society to our children, focusing on these programs to the neglect of the larger social and physical environment is close to absurd.

Social Security

The Social Security program has always been reasonably well-funded, even as slower growth and the upward redistribution of income over the last five decades have hurt the program’s finances. It is now projected to face a shortfall in a bit over a decade, but the gap between scheduled benefits and taxes is not exceptionally large, as calculated by Gene Steurele and Karen Smith, Rampell’s source.

Source: Steurele and Smith, 2023.

The chart below above shows Steurele and Smith’s calculations for lifetime Social Security benefits and taxes, for people turning 65 in 2025, for men and women at different earnings levels. There are a few points worth noting on these calculations.

First, they are highly stylized, assuming that a worker puts in 43 years from age 22 to age 65 always earning the same wage relative to the overall average. This means that their wage rises year by year in step with inflation and the increase in average wages. No one actually would follow this pattern.

They are likely to earn less early in their career and more later in their career. They also are likely to have some years of little or no earnings. This is especially the case for women who are likely to spend some time outside of the paid labor force caring for children or parents. These adjustments would generally lead to higher benefits relative to taxes.

The second point is that the calculations assume that everyone lives to age 65 at which point they start to collect benefits. Some people will die before they can collect benefits, so we are looking at the benefits for workers who survive to collect benefits. (Social Security also has survivors’ benefits that go to spouses and minor children of deceased workers, so their tax payments are not necessarily a complete loss.)

The third point is that Steurele and Smith have opted to use a 2.0 percent real (inflation-adjusted) interest rate to discount taxes and benefits. This is a standard rate to use in this sort of analysis, but one could argue for a higher or lower rate. A higher rate would make the program seem less generous, while a lower rate would raise benefits relative to taxes.

As can be seen, low earners are projected to receive more in benefits than they pay in taxes. An important qualification here is that there is a large and growing gap in life expectancies between low and higher earners. These calculations assume that everyone of the same gender has the same life expectancy regardless of their income. This means that the benefits will be somewhat overstated for low earners and understated for high earners.

Ignoring the life expectancy issue, the chart shows that projected benefits end up being less than taxes once we get to high earners ($105,800 in 2023). For men projected lifetime taxes exceed benefits by $106,000. For women the gap is smaller at $49,000, reflecting their longer life expectancy.

Moving to maximum earners, people who earn the income at which the payroll tax is capped ($160,200 in 2023), the gaps become larger. In the case of men, projected lifetime taxes exceed benefits by $319,000. For women, projected lifetime taxes are $249,000 more than benefits.

There are some simple takeaways we can get from the Steurele and Smith analysis. First, for low and middle-wage earners Social Security does indeed pay out more in benefits than workers pay in taxes. However, the gap is not very large. For average earners, who got $66,100 in 2023, (not shown to keep the size of the graph manageable), the gap is $3,000 for men and $46,000 for women.

For higher income earners taxes actually exceed benefits. In the case of maximum earners, these excess payments are actually fairly large, as noted $319,000 for men and $249,000 for women.

This raises an interesting issue, if we are looking to cut benefits to reduce the “subsidy” to the elderly provided by Social Security. We can cut back benefits by a substantial percentage for low earners to bring their lifetime benefits more closely in line with their lifetime taxes, but do we really want to reduce retirement benefits for people who had average earnings of $29,700?

We can make some cuts for more middle-income workers, but someone earning $66,100 during their working lifetime was not terribly comfortable, and there is not much subsidy here to start, especially with men. When we get to higher earners, taxes already exceed benefits. We can still make cuts to their benefits, but we would not be taking back a subsidy by this calculation, we would be increasing their net overpayment to the program.

It’s also worth noting who is a high earner in this story. The high earner had annual earnings of $105,800 in 2023. President Biden promised that he would not raise taxes on couples earning less than $400,000. That puts his cutoff of $200,000 at almost twice the high earner level, and the calculation of lifetime benefits and taxes turns negative at a considerably lower income than the stylized high earner.

These calculations show that if we just take Social Security in isolation and want to reduce the subsidy implied here we either have to cut benefits for people who are not living comfortably by most standards, or we have to cut benefits for people who are not currently receiving a subsidy. We may decide that the latter is good policy, but we should be clear that it is not taking back a subsidy.

There is an important qualification to this discussion. Married couples will generally do better in these calculations than single workers. This is because the spousal benefit allows the spouse to collect the greater of their own benefit or half of their spouse’s benefit. Also, a surviving spouse will receive the greater of their own or their deceased spouse’s benefit. For these reasons, lifetime benefits for couples will generally be higher relative to taxes than for single individuals.

The Medicare Subsidy and the Broken Healthcare System Story

The Steurele and Smith analysis shows much larger subsidies for the Medicare program, as shown below.

 

 

There are a few qualifications to these calculations that should be noted. First, the same caveats about earnings patterns that were noted with the Social Security calculations also apply to the projected value of Medicare taxes.

Second, the differences in life expectancies by income matter here also when assessing the size of the tax penalty or subsidy. The program is less generous for low earners than shown in this figure and more generous for high earners.

The third point is that, unlike with the designated Social Security tax, the Medicare tax is not capped. This means that people earning above the Social Security cap will be paying more taxes to support the program. For very high earners ($185,000 for men and $207,000 for women), projected taxes would exceed benefits. The size of the tax penalty increases further up the income scale.

Finally, high-income people also pay a designated Medicare tax on capital income, like dividends and capital gains. For these people, it is virtually guaranteed that their Medicare taxes exceed their projected benefits.

With these caveats, we see the same general story as with Social Security, where there is more of a subsidy for lower earners than higher earners. While the overall gaps are larger for Medicare, projected benefits exceed taxes by a larger amount, this changes less with income than in the case of Social Security.

This is due to the fact that, unlike Social Security, the payout is not designed to be progressive, with all retirees getting in principle the same benefit.[1] This is qualified by the fact that higher-income retirees can expect to receive benefits for a considerably longer period of time, making the benefit regressive.

I have added a third bar to this graph, labeled “Benefits-Canada.” This is a calculation of what the cost of benefits would be if we paid the same amount per person for our healthcare as Canada does. The Medicare program appears as a huge subsidy to beneficiaries primarily because we pay so much more for our health care than people in other wealthy countries.

According to the OECD, we pay 57 percent more per person than Germany, 107 percent more than France, and 99 percent more than Canada. This sort of massive gap can be shown with U.S. costs relative to every other wealthy country. We don’t get any obvious benefit in terms of better healthcare outcomes from this additional spending. Life expectancy in the United States is considerably shorter than in most other wealthy countries.

The “Benefits-Canada” bar allows us to assess the value of Medicare benefits if our healthcare costs were more in line with those in other countries. It multiplies the projected value of Medicare benefits by the ratio of per person health care costs in Canada to costs in the United States (50.3 percent).

As can be seen, if we calculate Medicare benefits assuming that we pay as much for our health care as people in Canada, most of the calculated subsidy goes away. Low earners still receive a substantial subsidy, $102,000 for men and $122,000 for women, but this quickly goes away higher up the income ladder.

If we assume Canadian health care costs, a high-earning male has a net Medicare tax penalty of $21,000, while a high-earning woman has a net tax penalty of just under $1,000. For those earning at the Social Security maximum, the net tax penalty for men is $111,000, and for women it’s $91,000.

The implication of this calculation is that the seemingly large subsidies that Medicare provides to retirees is not due to the generosity of benefits, it is due to the fact that we overpay for our healthcare. Medicare is not providing a large subsidy to retirees, it is providing a large subsidy for drug companies, medical equipment suppliers, insurers, and doctors. (In case you are wondering, people in the U.S. are not generally paid much more than people in other wealthy countries. Our manufacturing workers get considerably lower pay.)

We pay roughly twice as much in all of these categories as people in other wealthy countries. It is misleading to imply that these overpayments are generous to retirees. While all of these interest groups have powerful lobbies, which makes it politically difficult to bring their compensation in line with other wealthy countries, we should at least be honest about who is getting subsidized by the high cost of our Medicare program.

What Do Subsidies Mean, When the Government Structures the Market?

There is another aspect of these calculations that should have jumped out at people when I noted that the designated Medicare tax is not capped and also applies to capital income. The taxes that are designated for these programs are arbitrary. We can designate other taxes that people pay as being Social Security and Medicare taxes, and apparent subsidies will disappear.

In fact, the idea that we can make a clear distinction between income that people have somehow earned, and income that is given to them by the government, is in fact an illusion. The government structures the markets in ways that allow some people to get very wealthy and keep others on the edge of subsistence.

Those who make big bucks in the healthcare industry are just one example. While our trade policy was quite explicitly designed to open the door to cheap manufactured goods, we actually have increased the barriers that make it difficult for foreign-trained doctors to practice in the United States.

We have made patent and copyright monopolies longer and stronger. The government subsidizes bio-medical research and then gives private companies monopoly control over the product. In a recent example, we paid Moderna to develop a COVID vaccine and then gave them control over it, creating at least five Moderna billionaires.  

We have allowed our financial sector to become incredibly bloated, creating many millionaires and billionaires, even as we demand efficiency elsewhere. We give Elon Musk and Mark Zuckerberg Section 230 protection against defamation suits that their counterparts in print and broadcast media do not enjoy.

And, as was recently highlighted with the UAW strike, our CEOs make far more than the CEOS of comparably sized companies in other wealthy countries. The difference is as much as a factor of ten in the case of Japanese companies. This is not due to the natural workings of the market, this is the result of a corrupt corporate governance structure that allows the CEOs to have their friends set their pay.

Yes, I am again talking about my book (it’s free). It is absurd to obsess about tax and transfer policy while ignoring the ways in which the government structures the market to determine winners and losers. It is understandable that the right would like tax and transfer policy to be the focus of public debate, since the default is a market outcome that leaves most money with the rich.

However, it is beyond absurd that people who consider themselves progressive would accept this framing. We can structure the market differently to get more equitable market outcomes. This should be front and center in public debate. Unfortunately, the right wants to hide the fact that we can structure the market differently, and progressives are all too willing to go along.  

Future of the Planet

There is a final point on the sort of generational scorecard implied by these calculations of Social Security and Medicare benefits. We don’t just hand our children a tax bill, we hand them an entire economy, society, and planet.

If we experience anything resembling normal economic growth, average wages will be far higher twenty or thirty years from now than they are today. Will the typical worker see these wage gains? That will depend on distribution within generations, not between generations.

We also see costs from items like the military. When I was growing up in the 1960s we paid a much larger share of our GDP to support the Cold War. (Young men were also drafted.) We will again pay lots more money for the military if we have a new Cold War with China. The implied taxes don’t figure into the Social Security and Medicare calculations, but will be every bit as much of a drain on the income of people in the future as taxes for these programs.

And, we should always have global warming front and center. If we paid off the national debt and eliminated the programs to support retirees, but did nothing to restrain global warming, our children and grandchildren would not have much reason to thank us. First and foremost, we must give them a livable planet.

Phony Answers to a Phony Question

The whole subsidy to retiree story is a diversion from the many important issues facing the country. Even the core idea, that we don’t adequately support the young because we give too much to the elderly is wrong.

We saw this very clearly in the debate over the extension of the child tax credit. As with everything in Congress, much is determined by narrow political considerations. Republicans had no interest in giving President Biden and the Democrats a win, but the bill could have passed without Republican votes.

The deciding factor was the refusal of West Virginia Senator Joe Manchin to support the bill. Senator Manchin was very clear on his concerns. He didn’t argue that we were spending too much on retirees, he didn’t want low-income people to have the money.

This is in general the story as to why we don’t have adequate funding for early childhood education, children’s nutrition, day care and other programs that would benefit children. There is a substantial political bloc that does not want to fund these programs. And, they still would not want to fund these programs even if we didn’t pay a dime for Social Security and Medicare.

[1] This is not strictly true, since the premium payment that retirees make for Part B and Part D of the Medicare program depends on income in retirement.

As a Thanksgiving present to readers, Washington Post columnist Catherine Rampell decided to tell us again how old-timers are robbing from our children with their generous Social Security and Medicare benefits. This is always a popular theme at the WaPo, especially around the holiday season.

The story is infuriating for four reasons:

  • Even by the calculations highlighted in the piece, Social Security is not a big subsidy to retirees,
  • Medicare appears to be a large subsidy only because our healthcare system is so inefficient,
  • What counts as a government payment, as opposed to a market outcome, is arbitrary, and
  • We pass on a whole society to our children, focusing on these programs to the neglect of the larger social and physical environment is close to absurd.

Social Security

The Social Security program has always been reasonably well-funded, even as slower growth and the upward redistribution of income over the last five decades have hurt the program’s finances. It is now projected to face a shortfall in a bit over a decade, but the gap between scheduled benefits and taxes is not exceptionally large, as calculated by Gene Steurele and Karen Smith, Rampell’s source.

Source: Steurele and Smith, 2023.

The chart below above shows Steurele and Smith’s calculations for lifetime Social Security benefits and taxes, for people turning 65 in 2025, for men and women at different earnings levels. There are a few points worth noting on these calculations.

First, they are highly stylized, assuming that a worker puts in 43 years from age 22 to age 65 always earning the same wage relative to the overall average. This means that their wage rises year by year in step with inflation and the increase in average wages. No one actually would follow this pattern.

They are likely to earn less early in their career and more later in their career. They also are likely to have some years of little or no earnings. This is especially the case for women who are likely to spend some time outside of the paid labor force caring for children or parents. These adjustments would generally lead to higher benefits relative to taxes.

The second point is that the calculations assume that everyone lives to age 65 at which point they start to collect benefits. Some people will die before they can collect benefits, so we are looking at the benefits for workers who survive to collect benefits. (Social Security also has survivors’ benefits that go to spouses and minor children of deceased workers, so their tax payments are not necessarily a complete loss.)

The third point is that Steurele and Smith have opted to use a 2.0 percent real (inflation-adjusted) interest rate to discount taxes and benefits. This is a standard rate to use in this sort of analysis, but one could argue for a higher or lower rate. A higher rate would make the program seem less generous, while a lower rate would raise benefits relative to taxes.

As can be seen, low earners are projected to receive more in benefits than they pay in taxes. An important qualification here is that there is a large and growing gap in life expectancies between low and higher earners. These calculations assume that everyone of the same gender has the same life expectancy regardless of their income. This means that the benefits will be somewhat overstated for low earners and understated for high earners.

Ignoring the life expectancy issue, the chart shows that projected benefits end up being less than taxes once we get to high earners ($105,800 in 2023). For men projected lifetime taxes exceed benefits by $106,000. For women the gap is smaller at $49,000, reflecting their longer life expectancy.

Moving to maximum earners, people who earn the income at which the payroll tax is capped ($160,200 in 2023), the gaps become larger. In the case of men, projected lifetime taxes exceed benefits by $319,000. For women, projected lifetime taxes are $249,000 more than benefits.

There are some simple takeaways we can get from the Steurele and Smith analysis. First, for low and middle-wage earners Social Security does indeed pay out more in benefits than workers pay in taxes. However, the gap is not very large. For average earners, who got $66,100 in 2023, (not shown to keep the size of the graph manageable), the gap is $3,000 for men and $46,000 for women.

For higher income earners taxes actually exceed benefits. In the case of maximum earners, these excess payments are actually fairly large, as noted $319,000 for men and $249,000 for women.

This raises an interesting issue, if we are looking to cut benefits to reduce the “subsidy” to the elderly provided by Social Security. We can cut back benefits by a substantial percentage for low earners to bring their lifetime benefits more closely in line with their lifetime taxes, but do we really want to reduce retirement benefits for people who had average earnings of $29,700?

We can make some cuts for more middle-income workers, but someone earning $66,100 during their working lifetime was not terribly comfortable, and there is not much subsidy here to start, especially with men. When we get to higher earners, taxes already exceed benefits. We can still make cuts to their benefits, but we would not be taking back a subsidy by this calculation, we would be increasing their net overpayment to the program.

It’s also worth noting who is a high earner in this story. The high earner had annual earnings of $105,800 in 2023. President Biden promised that he would not raise taxes on couples earning less than $400,000. That puts his cutoff of $200,000 at almost twice the high earner level, and the calculation of lifetime benefits and taxes turns negative at a considerably lower income than the stylized high earner.

These calculations show that if we just take Social Security in isolation and want to reduce the subsidy implied here we either have to cut benefits for people who are not living comfortably by most standards, or we have to cut benefits for people who are not currently receiving a subsidy. We may decide that the latter is good policy, but we should be clear that it is not taking back a subsidy.

There is an important qualification to this discussion. Married couples will generally do better in these calculations than single workers. This is because the spousal benefit allows the spouse to collect the greater of their own benefit or half of their spouse’s benefit. Also, a surviving spouse will receive the greater of their own or their deceased spouse’s benefit. For these reasons, lifetime benefits for couples will generally be higher relative to taxes than for single individuals.

The Medicare Subsidy and the Broken Healthcare System Story

The Steurele and Smith analysis shows much larger subsidies for the Medicare program, as shown below.

 

 

There are a few qualifications to these calculations that should be noted. First, the same caveats about earnings patterns that were noted with the Social Security calculations also apply to the projected value of Medicare taxes.

Second, the differences in life expectancies by income matter here also when assessing the size of the tax penalty or subsidy. The program is less generous for low earners than shown in this figure and more generous for high earners.

The third point is that, unlike with the designated Social Security tax, the Medicare tax is not capped. This means that people earning above the Social Security cap will be paying more taxes to support the program. For very high earners ($185,000 for men and $207,000 for women), projected taxes would exceed benefits. The size of the tax penalty increases further up the income scale.

Finally, high-income people also pay a designated Medicare tax on capital income, like dividends and capital gains. For these people, it is virtually guaranteed that their Medicare taxes exceed their projected benefits.

With these caveats, we see the same general story as with Social Security, where there is more of a subsidy for lower earners than higher earners. While the overall gaps are larger for Medicare, projected benefits exceed taxes by a larger amount, this changes less with income than in the case of Social Security.

This is due to the fact that, unlike Social Security, the payout is not designed to be progressive, with all retirees getting in principle the same benefit.[1] This is qualified by the fact that higher-income retirees can expect to receive benefits for a considerably longer period of time, making the benefit regressive.

I have added a third bar to this graph, labeled “Benefits-Canada.” This is a calculation of what the cost of benefits would be if we paid the same amount per person for our healthcare as Canada does. The Medicare program appears as a huge subsidy to beneficiaries primarily because we pay so much more for our health care than people in other wealthy countries.

According to the OECD, we pay 57 percent more per person than Germany, 107 percent more than France, and 99 percent more than Canada. This sort of massive gap can be shown with U.S. costs relative to every other wealthy country. We don’t get any obvious benefit in terms of better healthcare outcomes from this additional spending. Life expectancy in the United States is considerably shorter than in most other wealthy countries.

The “Benefits-Canada” bar allows us to assess the value of Medicare benefits if our healthcare costs were more in line with those in other countries. It multiplies the projected value of Medicare benefits by the ratio of per person health care costs in Canada to costs in the United States (50.3 percent).

As can be seen, if we calculate Medicare benefits assuming that we pay as much for our health care as people in Canada, most of the calculated subsidy goes away. Low earners still receive a substantial subsidy, $102,000 for men and $122,000 for women, but this quickly goes away higher up the income ladder.

If we assume Canadian health care costs, a high-earning male has a net Medicare tax penalty of $21,000, while a high-earning woman has a net tax penalty of just under $1,000. For those earning at the Social Security maximum, the net tax penalty for men is $111,000, and for women it’s $91,000.

The implication of this calculation is that the seemingly large subsidies that Medicare provides to retirees is not due to the generosity of benefits, it is due to the fact that we overpay for our healthcare. Medicare is not providing a large subsidy to retirees, it is providing a large subsidy for drug companies, medical equipment suppliers, insurers, and doctors. (In case you are wondering, people in the U.S. are not generally paid much more than people in other wealthy countries. Our manufacturing workers get considerably lower pay.)

We pay roughly twice as much in all of these categories as people in other wealthy countries. It is misleading to imply that these overpayments are generous to retirees. While all of these interest groups have powerful lobbies, which makes it politically difficult to bring their compensation in line with other wealthy countries, we should at least be honest about who is getting subsidized by the high cost of our Medicare program.

What Do Subsidies Mean, When the Government Structures the Market?

There is another aspect of these calculations that should have jumped out at people when I noted that the designated Medicare tax is not capped and also applies to capital income. The taxes that are designated for these programs are arbitrary. We can designate other taxes that people pay as being Social Security and Medicare taxes, and apparent subsidies will disappear.

In fact, the idea that we can make a clear distinction between income that people have somehow earned, and income that is given to them by the government, is in fact an illusion. The government structures the markets in ways that allow some people to get very wealthy and keep others on the edge of subsistence.

Those who make big bucks in the healthcare industry are just one example. While our trade policy was quite explicitly designed to open the door to cheap manufactured goods, we actually have increased the barriers that make it difficult for foreign-trained doctors to practice in the United States.

We have made patent and copyright monopolies longer and stronger. The government subsidizes bio-medical research and then gives private companies monopoly control over the product. In a recent example, we paid Moderna to develop a COVID vaccine and then gave them control over it, creating at least five Moderna billionaires.  

We have allowed our financial sector to become incredibly bloated, creating many millionaires and billionaires, even as we demand efficiency elsewhere. We give Elon Musk and Mark Zuckerberg Section 230 protection against defamation suits that their counterparts in print and broadcast media do not enjoy.

And, as was recently highlighted with the UAW strike, our CEOs make far more than the CEOS of comparably sized companies in other wealthy countries. The difference is as much as a factor of ten in the case of Japanese companies. This is not due to the natural workings of the market, this is the result of a corrupt corporate governance structure that allows the CEOs to have their friends set their pay.

Yes, I am again talking about my book (it’s free). It is absurd to obsess about tax and transfer policy while ignoring the ways in which the government structures the market to determine winners and losers. It is understandable that the right would like tax and transfer policy to be the focus of public debate, since the default is a market outcome that leaves most money with the rich.

However, it is beyond absurd that people who consider themselves progressive would accept this framing. We can structure the market differently to get more equitable market outcomes. This should be front and center in public debate. Unfortunately, the right wants to hide the fact that we can structure the market differently, and progressives are all too willing to go along.  

Future of the Planet

There is a final point on the sort of generational scorecard implied by these calculations of Social Security and Medicare benefits. We don’t just hand our children a tax bill, we hand them an entire economy, society, and planet.

If we experience anything resembling normal economic growth, average wages will be far higher twenty or thirty years from now than they are today. Will the typical worker see these wage gains? That will depend on distribution within generations, not between generations.

We also see costs from items like the military. When I was growing up in the 1960s we paid a much larger share of our GDP to support the Cold War. (Young men were also drafted.) We will again pay lots more money for the military if we have a new Cold War with China. The implied taxes don’t figure into the Social Security and Medicare calculations, but will be every bit as much of a drain on the income of people in the future as taxes for these programs.

And, we should always have global warming front and center. If we paid off the national debt and eliminated the programs to support retirees, but did nothing to restrain global warming, our children and grandchildren would not have much reason to thank us. First and foremost, we must give them a livable planet.

Phony Answers to a Phony Question

The whole subsidy to retiree story is a diversion from the many important issues facing the country. Even the core idea, that we don’t adequately support the young because we give too much to the elderly is wrong.

We saw this very clearly in the debate over the extension of the child tax credit. As with everything in Congress, much is determined by narrow political considerations. Republicans had no interest in giving President Biden and the Democrats a win, but the bill could have passed without Republican votes.

The deciding factor was the refusal of West Virginia Senator Joe Manchin to support the bill. Senator Manchin was very clear on his concerns. He didn’t argue that we were spending too much on retirees, he didn’t want low-income people to have the money.

This is in general the story as to why we don’t have adequate funding for early childhood education, children’s nutrition, day care and other programs that would benefit children. There is a substantial political bloc that does not want to fund these programs. And, they still would not want to fund these programs even if we didn’t pay a dime for Social Security and Medicare.

[1] This is not strictly true, since the premium payment that retirees make for Part B and Part D of the Medicare program depends on income in retirement.

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