Fiscal Therapy

Abstract

America faces two distinct but related economic challenges. Steadily rising federal debt—largely fueled by rising healthcare costs and an aging population that will boost spending on Social Security, Medicare, and Medicaid—will make it harder to grow the nation’s economy, boost living standards, respond to wars or recessions, address social needs, and maintain the US role as a global leader. At the same time, an increasingly fractured society has left many people behind and let critical investments lag, even as overall prosperity has grown. How and when US citizens address these challenges will help determine the future they build for themselves and their children. This book proposes a remedy with three core elements: controlling entitlement spending in ways that preserve and enhance the programs’ anti-poverty and social insurance roles; betting on the future by stipulating major new public investments in human and physical capital; and raising and reforming taxes to pay for government services fairly and efficiently. Together, these changes would control federal borrowing, strengthen the economy, increase opportunity, reduce inequality, and build better lives for current and future generations. There is no need to kill popular programs or starve government. Indeed, a primary goal of fiscal reform is to maintain and enhance the vital functions that government provides. The country needs to act responsibly, pay for the government it wants, and shape that government in ways that serve it best.