Brand America 2025
Can't Do. Won't Do. You Do. Fuck You.
It will get worse this go around.
An interesting story in the Financial Times, "What makes the US truly exceptional: Are American pathologies the necessary price of economic dynamism?." From the article:
It is the best of countries, it is the worst of countries, or at least of the high-income ones. The US stands out for its prosperity and its brutality.
This is how I have felt about it since I visited in 1966 and lived there throughout the 1970s. The sustained prosperity of the US is astounding. A few western countries have even higher real incomes per head: Switzerland is one. But real GDP per head in the larger high-income countries is below the US average.
... Not surprisingly, the US economy also remains far more innovative than other large high-income economies. Just look at its leading companies. These are not only far more valuable than those in Europe, but far more concentrated in the digital economy...
... The US then is an economic powerhouse, so much so that it has persistently run a large deficit in its capital account. Donald Trump protests. Yet this is a powerful vote of confidence.
... So, how can such an economic marvel also be “the worst of countries”? Well, its homicide rate of 6.8 per 100,000 inhabitants in 2021 was almost six times as high as that of the UK and 30 times that of Japan.
... More broadly, what does US prosperity mean when combined with such potent indicators of low welfare? These outcomes are the result of high inequality, poor personal choices and crazy social ones. Some 400mn guns are apparently in circulation. This surely is insane.
... Then there is a related question, which is whether the relatively high inequality of the US and the insecurity of those in the bottom and middle of the income distribution inevitably lead to what I called “pluto-populism” in 2006: the political marriage of the ultra-rich, seeking deregulation and low taxes, with the insecure and angry middle and lower middle, seeking people to blame for what is going wrong for them. If so, what made the US dynamic, at least in this age of deindustrialisation and unbridled finance, led to the rise of Trump and so to a shift to a dangerous new demagogic autocracy. A big question for non-Americans, notably Europeans, is whether these pathologies are the necessary price of economic dynamism? Logically, it is not clear why an innovative economy cannot be combined with a more harmonious and healthier society. Denmark would suggest so. One might hope that the scale of the US market, its relatively light regulation, the quality of its science and its attractions to high-quality immigrants are the explanations. But there is this lingering fear that the technologically dynamic society Draghi and other Europeans now seek might require the rugged, nay dog-eats-dog, individualism of the US. It is a sobering possibility.
FWIW, I don't think pathology is necessary to economic dynamism. We have a super conflicting element in American society, rank individualism ("Toward the Land of Self-Defeat," New York Times) versus a more communitarian approach.
But individualism is the side for people who want it all, don't want to share, don't believe in mutually beneficial outcomes. And too much has changed in the economy, from neoliberalism to financialization, a winner take all economy, oligopoly, and the belief by Republicans that taxes are bad.
This extends to the social sphere by denying the value of the safety net, government action of any kind, building the wealth of of the nation by investing in people, etc.
It was pointed out that Reagan's plan was a form of austerity comparable to that of UK's Tories. For a couple decades, because the US had previously overinvested in government and public goods, that could be withstanded.
It ended with the multiple failures of the Bush Administration.
It's amazing that the Trump posse is so focused on the destruction of America, not building its public investment ("Capital shallowing: the effect of disinvestment on government functioning").
We're in for it.
Labels: anti-government philosophy, branding-identity, governance, neoliberalism, provision of public services, public finance and spending, public goods, public investment, return on investment
posted by Richard Layman @ 4:00 AM&Permanent Link
4 Comments:
Going back to previous post, the FT post on health care outcomes validates your point. You can see the divergence around 1980.
I am not enough on expert to point out why, but I do think this is an interesting view here:
https://www.nytimes.com/2018/06/04/upshot/reagan-deregulation-and-americas-exceptional-rise-in-health-care-costs.html
"Gary Gaumer, an associate professor at Simmons College School of Business, pointed to changes in how hospitals and doctors were paid. Before the early 1980s, payments by Medicare and other insurers were tied to costs. If it cost a hospital, say, $5,000 for a patient’s surgery, that’s what the hospital was paid, plus a bit more for reasonable profit.
But then payers (private insurers and government health care programs like Medicare) began to shift financial risk to providers like hospitals and doctors. It started with a law that began affecting most hospitals in 1983, changing how Medicare paid hospitals to a fixed price per visit, regardless of the actual costs. This approach later spread to other Medicare services and other payers, including private insurers. If providers could get costs down, they made money. If they couldn’t, they lost money."
My mother worked in a public hospital, and it strikes me that was about the time when she really began to complain about the administration (hospital that is) and also when my father's income (private practice) shot up.
Democracies are in crisis because trust in institutions is cratering
https://www.washingtonpost.com/opinions/2024/12/06/democracy-crisis-institutions-expertise/
https://www.vox.com/polyarchy/2016/1/6/10725086/promise-of-disharmony
definitely felt that way in 2016 (to me) less sure about this time around. Age of hypocrisy, not of creedal passion.
WRT your health costs comment, it's not unlike the response to the oil crisis. European countries, especially Denmark and the Netherlands, focused on shifting to sustainable mobility, reducing dependence on gasoline.
By contrast the US worked on maintaining access to relative cheaper oil, through own production, the strategic reserve, and yes efficiency--fleet mileage requirements. But really the focus was on the former.
WRT health care it's like that plus the auto industry. With the industry's troubles the big three started strong arming the suppliers to cut costs, without paying attention to quality etc.
WRT health care, the US through Medicare, forced a price reduction, but not a transformation of health services delivery in ways that both improve outcomes and decrease costs.
I'm on Medicaid, Suzanne and I aren't married, and for me the post covid job market has been bleak. So I qualify.
I got into a billing dispute with the imaging provider (the hospital owns the equipment and technicians, but interpretative services are contracted out, like most practices within hospitals). They charged me when Medicaid denied most of their claim. I am in a no co pay program
What happened is that they miscoded and rather than investigating themselves, they just charged me (on their end too, a third party biller). I said not my problem. But I did deal with billing department of my insurance to be able to deal with it.
Anyway, to make a short story long, I was surprised at how little reimbursement there is for such procedures.
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