This article first appeared in the St. Louis Beacon, Oct. 25, 2011 - If you are a Republican, you see our economic circumstance as reflecting too much of too many things: government, taxation, regulation, deficits. You see these excesses as stifling a market that would lift all boats if we would only leave it alone.
For you, the naissance of our current plight lies in inadequate obeisance to the Reagan-era mantra that "government is the enemy."
If you are a Democrat, market amorality is central. Since markets are about profit, it is unlikely that they will build roads or sewers, facilitate breathable air if polluting is more lucrative or provide affordable health insurance to expensive high-risk patients. You see historical validation of your conviction that reduced government spending is a formula for renewed recession.
For you, the naissance of our current plight lies in blind obeisance to the Reagan-era mantra that "government is the enemy."
It sounds like a clean dichotomy until you consider that both narratives share a critical misperception that the 1980s mark the beginning of our economic problems. Instead, our defining economic paradigm was nurtured decades earlier, during the post-war years when 50 percent of global production was ours, when we were the singular source of redevelopment know-how for Europe and Japan.
The seeds of today's economy sprouted in those moments when our wealth was so massive that we could apply spendthrift wastefulness to everything, especially health care and energy use, and remain an economic juggernaut. We could be global cop for a divided planet without regard to cost.
They were heady days when wealth beyond imagination produced ribbons of highway connecting cities with energy-intensive homes in far-flung suburbs. People drove to the jobs in the city in gass-guzzlers; oil was the eternal and inexpensive enabler of ever-expanding extravagance. We underwrote our addiction with more than $2 trillion post-war military spending and countless lives to ensure access to Middle Eastern crude. It was the price of our lifestyle.
We did the same with health care when the profit motive was attached to an employer-based system. It was axiomatic that more must be better and that, relative to our wealth, health care would always be cheap.
Build the multimillion dollar imaging machine, and they will come. And if they don't come because of proven medical necessity, prescribe the imaging anyway while rationalizing theoretical benefits. Insurance will pay, and profits will multiply if the machine is fully used. But that was easy because, after all, where else can the patient go? What will he not do in the name of his own health? How many will question that white coat of authority?
And why should it matter? The insurers were rich. Whether medically beneficial or not, the insured had comforting access to every feasible technology. Employers could negotiate the details with insurance companies and pay with more markets abroad or more productive technology at home. No matter how expensive a wasteful health-care system became, all parties were rolling in money and it wasn't really relevant.
But today it matters. As a percent of gross domestic product, our energy, health care and military cost more than $4 trillion a year, about twice the per capita average in the rest of the developed world. If we spent like our competitors in these three domains, the savings would be $2 trillion a year or $20 trillion a decade. That dwarfs President Barack Obama's $800 billion stimulus and even the $5 trillion or so in unfunded wars, tax cuts and Medicare drug program of the Bush years.
A tax change here or a spending cut there are small ball remedies that will do little to address our underlying ailment.
We will never again enjoy so much wealth that $2 trillion can be squandered each year with impunity. A myopic reliance on a modest stimulus or a grand deficit reduction bargain will doom us to permanent second-class status. Educating our children, building a modern infrastructure, encouraging innovation and controlling long-term deficits are essential steps. But they are grossly inadequate.
Endemic post-war profligacy would remain a flourishing straitjacket following either Democratic or Republican remedies. Either solution steals resources from the broader economy and, therefore, is linked to three decades of wage stagnation, burgeoning debt and the widespread denial of basic services.
Genuine solutions require new paradigms that redefine approaches to the three pillars of profligacy: global military commitments, health-care delivery, and energy use. Without no new visions, there will be no genuine economic renaissance.
Ken Schechtman is a freelance writer and a professor at the Washington University School of Medicine.