Edward Conard

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  • “…a comprehensive explanation of the modern economy.” - Julian Robertson, Founder, Tiger Management
  • “Unintended Consequences should be read by anyone who takes for granted the superiority of progressive taxation and has not thought carefully about the trade-offs involved.” - The New Republic
  • “…challenges misconceptions that distort our economic debates.” - Arthur Brooks, President of the American Enterprise Institute
  • “…reminds us that inequality sends a signal of what society lacks most, in America’s case, entrepreneurship and risk taking.” - Lawrence Lindsey, CEO, The Lindsey Group, former Director of the National Economic Council
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  • “…a fresh argument for the productive value of inequality.” - David Autor, Professor of Economics, Massachusetts Institute of Technology
  • “Unintended Consequences is full of substance, it is one of the must-read books of the year, and once I finish it I will be giving it a second read through right away.” - Tyler Cowen, Professor, George Mason University
  • “…challenges misconceptions that distort our economic debates.” - Arthur Brooks, President of the American Enterprise Institute
  • “…a comprehensive explanation of the modern economy.” - Julian Robertson, Founder, Tiger Management
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  • “…a must-read for serious students of economic policy.” - Glenn Hubbard, Dean, Columbia Business School, and former Chairman of the Council of Economic Advisers
  • “Unintended Consequences provides a provocative interpretation of the causes of the global financial crisis and the policies needed to return to rapid growth. Whether you agree or not, this analysis is well worth reading.” - Nouriel Roubini, New York University; Chairman, Roubini Global Economics
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American liberalism, circa 2007

Jeffrey Sachs The Money Illusion
Date Posted:
January 28, 2015
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American liberalism shifted towards market monetarism by 2007, emphasizing monetary policy over fiscal stimulus. @JeffreyASachs

American liberalism shifted towards market monetarism by 2007, emphasizing monetary policy over fiscal stimulus....
By 2007, American liberalism had shifted towards a market monetarist approach, emphasizing monetary policy over fiscal stimulus. This shift was evident in the belief that the fiscal multiplier was close to zero and that deficits were detrimental to economic health. The Clinton Administration's 1993 budget exemplified this approach by focusing on deficit reduction to lower interest rates and promote economic growth, while also ensuring that fiscal restraint primarily impacted those most able to bear it. This strategy was seen as a way to achieve both short-term economic stability and long-term productivity gains. The transformation in liberal economics was marked by a reliance on the Federal Reserve and bond markets to offset the effects of tight budgets, moving away from the previous reliance on deficit spending as a tool for economic growth.

While his points about fiscal austerity in the 1990s and 2013 having little if any effect on growth are noteworthy data points, it’s hard to see how monetary policy had a big impact when it’s clear that 1) the money sat in the bank unused and 2) business investment is short an accumulated $1T, according to reasonable estimates. I suspect neither fiscal or monetary policy had much effect for much the same reason: an unwillingness by the private sector to take risk that truly grow the economy and offsetting rational expectations by the small number of sophisticate companies and individual investors who matter.

He makes his case by doing little more than asserting that the US grew faster with monetary stimulus being the only difference. But there were other important differences 1) Their banks are truly bankrupt. 2) Their governments are a larger share of GDP, which contributes much less than the private sector. 3) They lack the productivity enhancing institutional capabilities of companies like Google and communities of expertise like Silicon Valley. 4) Their talented people don’t work very hard. 5) Their inflexible workforce regulations inhibit (re)hiring. 6) They don’t have as much equity per dollar of GDP to underwrite risk-taking that grows the economy. Their growth (i.e., Germany’s) is more dependent on exports—where the world’s growth is slowing—and manufacturing—where productivity gains are eating up employment growth. I call his mistake “over attributing”—i.e., he overlooks all these factors and attributes their impact to his point alone.

"...By early 2013 it was clear that if this new form of liberalism, this rejection of Clintonomics, was going to have any plausibility they needed to be able to show that the Fed could not or would not offset fiscal austerity. And calendar 2013 was the perfect test, as all sorts of austerity came together at the same time. The budget deficit fell by $400 billion in fiscal 2013, but that year begins on October 1st. The tax increases didn’t start until January 1st, 2013, and the deficit fell by an astounding $500 billion during that calendar year. A near perfect test. Some of my critics point out that GDP data is noisy, and that the speed up in growth in 2013 wasn’t particularly significant. Agreed. But the Keynesians didn’t just need a single, they needed a home run. They needed a sharp slowdown. The evidence in favor of monetary offset was becoming increasing persuasive. The Fed doesn’t stop doing monetary policy at the zero bound. If you are going to reject the previous liberal conventional wisdom, reject views held as recently as 2007, ask the public to spend a trillion dollars, you better damn well have a good reason. They desperately needed a slowdown in 2013, and got a speed up in growth instead. That’s why 2013 was so devastating. Not because it was definitive, but because fiscal stimulus was already on its last legs, increasingly rejected even by liberals such as Jeffrey Sachs. Once 2013 went against them, it was game over..."American liberalism, circa 2007

Sumner, Scott, "American liberalism, circa 2007,"The Money Illusion, December 27, 2015. Available at:http://www.themoneyillusion.com/
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Some of my critics point out that GDP data is noisy, and that the speed up in growth in 2013 wasn’t particularly significant. Agreed. But the Keynesians didn’t just need a single, they needed a home run. They needed a sharpslowdown. The evidence in favor of monetary offset was becoming increasing persuasive. The Fed doesn’t stop doing monetary policy at the zero bound. If you are going to reject the previous liberal conventional wisdom, reject views held as recently as 2007, ask the public to spend a trillion dollars, you better damn well have a good reason. They desperately needed a slowdown in 2013, and got a speed up in growth instead. That’s why 2013 was so devastating. Not because it was definitive, but because fiscal stimulus was already on its last legs, increasingly rejected even by liberals such asJeffrey Sachs. Once 2013 went against them, it was game over.

Then Keynesians claimed that even the Fed didn’t believe in monetary offset. That theory lost a bit of force when (in late 2012) Fed officials said they were doing aggressive stimulus (QE3 and forward guidance) partly to keep the recovery going as Congress moved to austerity in 2013. By early 2013 it was clear that if this new form of liberalism, this rejection of Clintonomics, was going to have any plausibility they needed to be able to show that the Fed could not or would not offset fiscal austerity. And calendar 2013 was the perfect test, as all sorts of austerity came together at the same time. The budget deficit fell by $400 billion in fiscal 2013, but that year begins on October 1st. The tax increases didn’t start until January 1st, 2013, and the deficit fell by an astounding $500 billion during that calendar year. A near perfect test.

First the Keynesians argued that monetary stimulus was ineffective at the zero bound. That’s what got me into blogging. But it soon became obvious that monetary policy was still effective. For instance, the dollar dropped 6 cents against the euro on the day QE1 was announced, in March 2009. Then after 2011 we had a controlled experiment, both the US and eurozone did roughly equal amounts of fiscal austerity. But the US did monetary stimulus and the eurozone did not. Both regions had similar unemployment rates as recently at 2010, in the 9% to 10% range. By 2014 the eurozone unemployment rate was twice that of the US (roughly 12% vs. 6%). Monetary policy made the difference.

So “obviously” more G will boost GDP. In fact, it is post-2007 liberals who are the “weirdos,” who have rejected the successful policies of Clinton and replaced them with the failed policies of Obama. (Remember, this is the president who 5 years into the recovery was arguing that unemployment was still so bad that we needed to enact an “emergency” unemployment program.)

GDP = C + I + G

As recently as 2007, the conventional wisdom of American liberals (on fiscal policy) was essentially market monetarist—they believed in monetary offset. The fiscal multiplier is close to zero. Deficits are bad. And yet I get many Keynesian commenters who don’t know this. They act like I’m propounding some sort of weird theory. They tell me that:

Recall that unemployment was pretty high when Clinton took office, much higher than today. Of course today’s liberals would point to one key difference, interest rates were not stuck as zero. (But that’s also true of the eurozone, circa 2008-12.)

Clinton’s 1993 budget bore out these tenets in their purest practical form. Its overall framework was deficit reduction, with the purpose of reducing interest rates and promoting economic health. It also had a strongly progressive tilt, raising the tax rate on the highest earners while expanding low-income subsidies such as the Earned Income Tax Credit (EITC) and Head Start. Six years later, Clinton and his advisers—and even like-minded economists outside the administration—continue to hold up the 1993 budget as their pinnacle achievement.

That intellectual breakthrough forms the bedrock of progressive fiscal conservatism. The principles of this economic synthesis are eminently clear. It begins with a recognition that the Federal Reserve and the bond market wield an effective control over the economy and that these instruments, rather than deficit spending, have become the most effective levers available to government for promoting economic growth. At the same time, there is an understanding among liberals that the burdens of fiscal restraint should fall primarily upon those most able to bear it and that the government should make a special effort to ensure that the benefits of economic growth also flow to those at the bottom.

The question that so bedeviled the White House in 1993——can the Fed and the bond market overcome the effects of tight budgets?——is no longer in doubt, and therein lies the great transformation of liberal economics. Previously, even liberals who favored deficit reduction considered it a painful trade-off: Reducing government borrowing would free up more savings for private investment and, in the long run, improve productivity, but in the short run, it would slow or even halt economic growth and throw millions out of work. The White House accepted this bargain in 1993 and hoped it would work out for the best. Now fiscal restraint is seen not even as a trade-off but, rather, as a way of getting the best of both worlds. This does not mean that forbearance is the one true answer, now and forever. It merely suggests that, under the present economic and political circumstances, the interests of current and future prosperity both argue for reducing deficits or expanding surpluses.

All of these developments were known at the time, but they had not fully cohered when Clinton began to construct his first economic plan. The key decision was not whether to reduce the deficit——given its size, the White House had no other realistic option——but rather what effect this would have upon the economy. Everyone present assumed that raising taxes or cutting spending would, at least in the short run, dampen economic growth. White House economists gave serious consideration to the possibility that their plan would throw the economy into recession. The only way to avoid this dismal fate was if the Federal Reserve or the bond market would lower interest rates to spur economic activity and make up for the depressing effects of deficit reduction. According to Bob Woodward’s account in The Agenda, Clinton replied to this news in a half whisper: “You mean to tell me that the success of my program and my reelection hinges on the Federal Reserve and a bunch of fucking bond traders?”

Marcus Nunes directed me to a very interesting piece by Jonathan Chait in theAmerican Prospect,from 2001. It begins by pointing out that by the early 1990s American liberals had turned against the deficit spending policy of Ronald Reagan. Then it moves on to the Clinton Administration:

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Previous articleJanuary 27, 2015A Summary of Trends in American Time Allocation: 1965–2005Higher income workers increased hours worked from 1965 to 2005, while lower income workers saw an increase in leisure time, highlighting a growing disparity in work-life balance btw income groups.Next articleJanuary 28, 2015Unemployment insurance and unemploymentUI can influence unemployment rates, with studies showing increased benefits lead to higher unemployment. A 1% reduction in benefit duration resulted in 1.8m additional jobs in 2014.
Showing 193 database articles primarily about Government Spending

The Fairest Way to Reform Social Security May Also Be the Worst Way to Grow the Economy

AI Summary. Raising payroll taxes to fix Social Security's funding gap preserves earned benefits but reduces take-home pay without added compensation, shrinking labor supply and slowing economic growth.

Andrew Biggs American Enterprise Institute
Date Posted:
May 28, 2026
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Biggs argues that “fair” approaches to restoring Social Security solvency – those that do not cut already accrued benefits – are less effective than “unfair” ones that do, because the latter incentivize increased work effort, raising growth and revenue.

Biggs argues that “fair” approaches to restoring Social Security solvency – those that do not cut already accrued...

Does preserving Social Security benefits require sacrificing economic growth?

Core argument: A 5.2 pts payroll tax increase to 17.6% drives reduced labor supply and slower economic growth vs. the status quo.

Imagine that Social Security reform follows the fairness model, in which accrued benefits are paid in full but the rate at which future benefits are earned is reduced. A simple way to do this is to increase the payroll tax rate To keep Social Security permanently solvent, meaning through 75 years and beyond, would require an immediate and permanent increase in the payroll tax rate [from] 12.4% to 17.6%. The higher rate would decrease labor supply and reduce economic growth. [Consider] an alternate reform, which looks clearly unfair: fix Social Security’s funding gap entirely by reducing accrued benefits that Americans already have earned. As of 2025, Americans had accrued $54 trillion in Social Security benefits. Social Security’s unfunded obligation as of 2025 was $26 trillion. So, roughly, this means cutting Americans’ “earned benefits” in half. [Analyzing the 1977 reform that undid the notorious 1972 “double-indexing” of benefits, a group of economists], using SSA earnings data, found that, for every dollar of lost benefits, the affected Americans increased their earnings by 61 cents. Moreover, these additional earnings would be taxed by Social Security, further strengthening the program’s finances. In effect, this makes cutting benefits a “cheaper” way to fix Social Security than raising taxes, because people respond in ways that also increase tax revenues.

Takeaways by Macro Roundup® AI

  1. A 5.2 pts payroll tax increase to 17.6% drives reduced labor supply and slower economic growth vs. the status quo.
  2. $54 trillion in accrued Social Security benefits vs. the unfunded obligation reveals that benefit cuts would reduce growth drag but.

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  • How Federal Spending is Distributed by Age — Retirees receive 62 cents of every age-assignable federal dollar, driven primarily by Social Security and Medicare, which together account for 80% of all federal spending directed at adults over 65.
  • The Great “Transfer”-mation — Transfer payments made up 18% of all US personal income in 2022, up from 8% in 1970. Social Security/Medicare made up 56% of the increase from 1970 to 2022…
  • Government Spending
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    • Taxation

The World’s Most Surprising Capitalist Makeover Is Under Way in Sweden

AI Summary. Sweden has privatized nearly half of primary healthcare and one in three public high schools, shrinking public social spending to 24% of GDP — comparable to the U.S. and well below France and Italy — while projecting ~2% annual growth through 2030, double the rate of France and Germany.

Tom Fairless Wall Street Journal
Date Posted:
May 12, 2026
Is Database:
Database

Swedish public social spending is now 23.7% of GDP, just 1pp above that of the US and well under France’s 31.6%. Market-based reforms in the 1990s brought overall government spending down from 69.4% to 49.3% in 2024.

How is Sweden's shift to privatization impacting its economic growth?

Core argument: Sweden’s public social spending fell to 24% of GDP, matching the U.S. and 6+ pts below France/Italy, driving lower taxes.

For decades, Sweden was shorthand for the brand of high-tax, high-spend government that managed people’s lives from cradle to grave through state-run hospitals, schools and care homes. No longer. With little fanfare, this Nordic country of 11 million has embraced capitalism. Today, nearly half of primary healthcare clinics are privately owned, many by private-equity firms. One in three public high schools is privately run, up from 20% in 2011. School operators are listed on the stock exchange. The capitalist makeover has allowed Sweden to do what few industrialized countries have managed in recent years: shrink the size of the state. That has enabled the government to sharply lower taxes and, economists say, sparked a surge in entrepreneurship and economic growth. Its total public social spending bill—which includes healthcare, education and all welfare payments—has fallen to 24% of gross domestic product, similar to the U.S. and well below the over 30% for nations like France and Italy. Sweden’s economy is expected to grow by around 2% a year through 2030, roughly the same pace as the U.S. and double the growth rates of France and Germany, according to an April forecast by the International Monetary Fund.

Takeaways by Macro Roundup® AI

  1. Sweden’s public social spending fell to 24% of GDP, matching the U.S. and 6+ pts below France/Italy, driving lower taxes.
  2. Privately-run primary healthcare clinics reached nearly 50% of the market vs. 20% for high schools in 2011, demonstrating accelerating privatization.
  3. Sweden’s projected 2% annual GDP growth through 2030 doubles France and Germany’s rates, resulting from state downsizing and capitalist sector.

Related Articles:

  • How Sweden Overcame Socialism — Sweden’s market reforms: Govt spend cut 70% to <50% GDP, debt 80% to 41%, corp tax -6pts to 22%. Results: Growth +1pt vs EU since 1995, GDP/capita now at…
  • Reforming the Welfare State: Recovery and Beyond in Sweden — Sweden’s structural reforms, initiated in response to the 1990s crisis, included adopting flexible exchange rates & inflation targeting, leading to…
  • The US Has One of the Highest Fertility Rates Among Peer Countries — As of 2022, the US had a “tempo fertility rate,” which is adjusted for life-cycle effects, of 1.82 – among the highest of advanced economies, and ~ on…
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How Policy and Demographics Are Reshaping SNAP: From Families with Children to Older Adults

AI Summary. SNAP enrollment has doubled from 6% to 12% of the U.S. population since 2000, with real costs per capita rising 179% to $279 annually, driven by policy expansions and benefit increases that prevent costs from fully retreating after economic downturns.

Angela Rachidi American Enterprise Institute
Date Posted:
May 1, 2026
Is Database:
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About 40mm Americans, 12% of the population, receive SNAP benefits, up from 6% in 2000. In 2023, only 34% of these households included children, down from 49% in 2010, while 36% contained an elderly person, up from 16% in FY2010.

How Are Policy Changes and Demographic Shifts Impacting SNAP Enrollment?

Core argument: SNAP participation doubled from 6% to 12% of the population between FY2000–FY2025, driven by policy expansions and demographic shifts outpacing.

Comparing FY2000 with FY2025, the share of the population receiving SNAP doubled from 6% to 12%, while real SNAP costs per capita increased by 179%—from roughly $100 per year to $279 (in 2024 dollars). Despite this growth, per capita participation and costs in FY2025 remained below their pre-pandemic peak in 2013, which coincided with the aftermath of the Great Recession and changes in eligibility and other policies stemming from the 2008 Farm Bill. SNAP is countercyclical, meaning that all else equal, the number of people receiving SNAP should rise during recessions because of increased unemployment and decline as the economy recovers, [though] overall SNAP participation has grown faster than changes in the unemployment rate alone would predict. Over the long run, and especially since FY2020 (due to the Thrifty Food Plan’s increase in the maximum SNAP benefit), costs per capita have not returned to prerecession levels after a period of high unemployment. In FY2023, the share of SNAP households containing an elderly person (36%) exceeded the share containing a child (34%) for the first time. This was a sharp departure from the early 2000s, when more than half of SNAP households contained a child and less than 20% included an elderly person (Figure 2).

Takeaways by Macro Roundup® AI

  1. SNAP participation doubled from 6% to 12% of the population between FY2000–FY2025, driven by policy expansions and demographic shifts outpacing.
  2. Real per capita SNAP costs rose 179% from $100 to $279 (2024 dollars) over 25 years, with the Thrifty Food.
  3. FY2025 SNAP enrollment remains 8–12% below the FY2013 peak despite 25-year growth, indicating countercyclical policy design successfully targets recession-driven need.

Related Articles:

  • The Great “Transfer”-mation — Transfer payments made up 18% of all US personal income in 2022, up from 8% in 1970. Social Security/Medicare made up 56% of the increase from 1970 to 2022…
  • Poverty and Dependency in the United States, 1939–2023 — Btw 1939 and 1963, the % of Americans below LBJ’s absolute poverty line (3× the cost of a minimal meal plan), fell from 48.5 to 19.5, driven by rising market…
  • Government Benefit Programs Already Do A Lot To Help Low Income Families — A 2-adult, 3-child US family with $20,000 of market income receives at least $61,000 in annual benefits and has $79,000 of disposable income. That same family…
  • Government Spending
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  • Workforce
    • Poverty/Crime

Washington’s Growing Portfolio: Tracking U.S. Government Investments

AI Summary. The U.S. government has deployed $20.9bn across 16 direct equity deals, expanding beyond grants, loans, and tax incentives into direct ownership stakes. This approach has mobilized an additional $4.75bn in private co-investment alongside the government's positions.

Jonathan Hillman Council On Foreign Relations
Date Posted:
April 23, 2026
Is Database:
Database

Since January 2025, the USG has taken equity stakes totaling $20.9B in 16 American businesses. $8.6B, ~41% of the total, was invested in critical mineral miners and processors, while $8.9B, ~43% of the total, funded the government’s 10% stake in Intel.

Core argument: The U.S. government deployed $20.9bn in direct equity investments since January 2025, expanding beyond traditional grants and loans to drive.

Since January 2025, the U.S. government has invested $20.9 billion across sixteen deals involving direct ownership, broadening a toolkit that has traditionally focused on grants, loans, and tax incentives. The Department of Commerce has participated in six such deals, including taking a 10% stake in Intel. The Development Finance Corporation, the United States’ development bank, has executed three equity transactions in critical minerals, healthcare, and infrastructure. The Department of Defense leads the way with seven such deals. The U.S. government is also working with a range of partners and has mobilized an additional $4.75 billion in investment. Private co-investors include J.P. Morgan, Goldman Sachs, and others.

Takeaways by Macro Roundup® AI

  1. The U.S. government deployed $20.9bn in direct equity investments since January 2025, expanding beyond traditional grants and loans to drive.
  2. The Department of Defense leads with seven equity deals of the sixteen total, establishing direct ownership as a core national.
  3. Commerce Department’s 10% Intel stake exemplifies government equity participation in critical infrastructure, mobilizing private capital alongside public investment to strengthen.

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  • Capital Is Making a Comeback — Btw 1985-2021 the capital intensity of the American economy was relatively flat as a rise in intangible investment was offset by a decline in tangible…
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  • Fiscal Policy
  • Politics
  • Productivity
    • Investment
  • Security

How Federal Spending is Distributed by Age

AI Summary. Retirees receive 62 cents of every age-assignable federal dollar, driven primarily by Social Security and Medicare, which together account for 80% of all federal spending directed at adults over 65.

Kent Smetters University of Pennsylvania
Date Posted:
April 2, 2026
Is Database:
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In 2025, of the 62.5% of Federal spending that is age-assignable on a per-capita basis, US retirees aged 65+ were given $43,700, working-age adults 26–64 got $7,300, and children and young adults got $4,300.

Core argument: Federal spending heavily favors retirees, who receive 38.6 percent of total outlays through Social Security, Medicare, and related programs.

We trace spending items within 52 general spending categories, totalling $7T for the 2025 Fiscal Year. We are able to classify a total of $4.4T across three broad age categories and assign the remaining $2.6T to an all-ages residual. Retirees (adults age 65 and older) receive $2.7T, equal to 38.6% of total federal outlays and 61.9% of age-assignable spending. Working-age adults (ages 26-64) receive $1.2T (27.9% of age-assignable), and children and young adults (under age 26) receive $449B (10.3%). The dominance of the retiree category reflects two programs above all others: Social Security and Medicare. Social Security directs $1.3T to retirees, and Medicare sends $835B. Together, they account for 80% of all age-assignable spending on older adults. But the retiree total extends beyond these two entitlements. Federal employee retirement benefits ($169B), housing assistance for older households, Medicaid long-term-care spending, and VA medical care all contribute, making the federal budget more retiree-focused than a Social Security–only lens would suggest.

Takeaways by Macro Roundup® AI

  1. Federal spending heavily favors retirees, who receive 38.6 percent of total outlays through Social Security, Medicare, and related programs.
  2. Working-age adults and children combined receive less than half the spending directed to retirees despite representing larger population segments.
  3. Social Security and Medicare alone account for 80 percent of all federal spending on older Americans, dominating the retiree budget.

Related Articles:

  • The Great “Transfer”-mation — Transfer payments made up 18% of all US personal income in 2022, up from 8% in 1970. Social Security/Medicare made up 56% of the increase from 1970 to 2022…
  • France and Britain Are In Thrall To Pensioners — Since 1970, cumulative real income growth for pensioners in France and the UK has outpaced that of the workers who support them. French pensioners over the age…
  • The Budgetary Impact of the Abandonment of Federalism — John Cogan finds federal budget deficits are driven by items “originally considered to be the responsibility of state and local governments or private-sector…
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  • Fiscal Policy
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    • Poverty/Crime

Has the United States Bent the Health Care Cost Curve?

David Cutler and Lev Klarnet Brookings Papers On Economic Activity
Date Posted:
March 30, 2026
Is Database:
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In 2024, medical spending as a share of GDP was just above its 2010 level and 15% ($977B) below its 2010 forecast; 21% of the gap was due to technology, 24% to price reductions, and 11–27% to reforms such as prior authorization and higher deductibles.

Five factors are important in the slowdown in spending [Figure 16]. The first is technology-associated changes in health and site of care. These correspond to the subsequent innovations in our model. Together, technologies along these lines account for 21% of the overall cost slowdown and double that in Medicare. Second, long-run supply is more elastic than short-run supply, which lowers spending over time. This is particularly apparent in the impact of patent expiration for pharmaceuticals and in relative declines in imaging reimbursement. We estimate that greater long-run supply explains 6% of the spending slowdown. Third, a variety of market changes contribute to reduced and more elastic demand, including increased cost sharing paid by consumers, physicians not paid as much for using technologies, and insurers imposing restrictions on technology use - a rough guess is that these account for 11 to 27% of the spending slowdown. Fourth, the population is healthier in ways that reduce spending. This includes fewer hospitalizations for smoking-related conditions and reduced need for formal home health care. The birth rate has fallen as well, which reduces the need for care. We estimate improved population health explains 7% of the spending slowdown. A major component is slower price growth. Net of upcoding, we estimate lower price growth explains 24% of the spending slowdown.

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