Category: Uncategorized

Summary: Modern Monetary Theory establishes the principles that can — indeed must — guide the federal government’s spending on essential population needs, like universal health care. The government’s fiscal tools enable these commitments, even beyond what taxes can cover.

The Deficit Myth: Modern Monetary Theory and the Birth of the People’s Economy
By Stephanie Kelton
Professor of Economics and Public Policy, Stony Brook University

To begin, I tackle the idea that the federal government should budget like a household. Perhaps no myth is more pernicious. The truth is, the federal government is nothing like a household or a private business. That’s because Uncle Sam has something the rest of us don’t – the power to issue the US dollar. Uncle Sam doesn’t need to come up with dollars before he can spend. The rest of us do. Uncle Sam will never go broke. The rest of us could. When governments try to manage their budgets like households, they miss out on the opportunity to harness the power of their sovereign currencies to substantially improve life for their people. We will show how MMT (Modern Monetary Theory) demonstrates that the federal government is not dependent on revenue from taxes or borrowing to finance its spending.

The sixth myth that we’ll consider is that entitlements are propelling us toward a long-term fiscal crisis. Social Security, Medicare, and Medicaid are the supposed culprits. I will show you why this way of thinking is wrong. Our government will always be able to meet future obligations because it can never run out of money. Instead of arguing over the monetary cost of these programs, lawmakers should be fighting about whose policies stand the best chance of meeting the needs of our entire population. The money can always be there. The question is, What will that money buy?

The Health-Care Deficit

At the very least, we know from MMT that our failure to provide proper insurance and care for every American isn’t because the government can’t “afford” to cover the cost. By settling for a system that provides coverage through a fractured web of private insurers, employer plans, and patchwork government programs, we’ve created a system of bottlenecks in which hospitals, providers, drug companies, and the private insurance companies can squeeze us for every last dollar – and in which bigger profits lie in making it harder for people to access care. If we’re going to set up a system where everyone has a right to the health care they need, we’ll have to make sure we’ll have the real resources to do it.

Building an Economy for the People

In the United States, where we have an abundance of resources and labor, there is no reason we cannot embark on a policy agenda that results in provisioning our entire population with quality health services, providing each worker with adequate and appropriate advanced education and job training, upgrading our infrastructure to meet the demands of a low-carbon world, and ensuring adequate housing for everyone while redesigning our cities to be clean, beautiful, and nurturing of community spirit.

With the knowledge of how we can pay for it, it’s now in your hands to imagine and to help build the people’s economy.

Comment by: Don McCanne

This book was released last year to widespread critical acclaim. But listening to members of Congress and others in the policy arena it is clear that the message has not adequately penetrated our dialogue on the essential government spending that must now take place. If you read the entire book, which you should, you will be able to dismiss the budget hawks who oppose the spending that is needed to make our society the greatest in history.

Modern Monetary Theory reminds us how government spending is fundamentally different from household or business budgets. Sovereign currency governments, such as ours, have economic tools to expand resources to provide all essential needs for everyone. For those of us at Health Justice Monitor, that means that we can provide comprehensive, equitable, affordable, high quality health care services for absolutely everyone … even if higher taxes don’t fully cover the added government costs.

But that also means that those who establish our public policies, such as the members of Congress, must understand Modern Monetary Theory and how it can help us achieve our goals of health care justice for all.

Summary: A survey of 700 US primary care physicians found burnout much less likely in solo and physician-owned (non-corporate) practices and much more likely with ACOs and other value-based care. Lesson: current health system trends are hazardous to the health of doctors … and thus harm patient care.

Cultural and Structural Features of Zero-Burnout Primary Care Practices
Health Affairs
June 2021
By ST Edwards et al.  

From the Abstract:

Survey of 715 small-to-medium-size primary care practices in the US.

Compared with high-burnout practices, zero-burnout practices  . . . more commonly were solo [odds ratio 5.3] and clinician owned [odds ratio 2.6], and less commonly had participated in accountable care organizations [odds ratio 0.5] or other demonstration projects [odds ratio 0.6].”

(Note: Odds ratios in brackets from Exhibit 3 of the article. An odds ratio approximates relative risk, so OR=5 means 5 times more likely, and 0.5 means half as likely.)

Comment by David Himmelstein and Steffie Woolhandler

Many studies have documented a growing epidemic of physician burnout, and its deleterious effects on physicians’ quality of life and the quality of patient care. To date most efforts to address burnout have focused on adapting physicians to make them more “resilient”, e.g. through wellness initiatives, yoga classes, or “thank you” gestures (one Boston hospital rewarded house officers for their efforts in staffing COVID-19 ICUs by handing out M&Ms – both plain and peanut – stamped with the hospital’s logo).

This survey of 715 primary care practices suggests that the health care system – not fragile doctors – is the problem.  So-called “value-based care” and the galloping corporate takeover, changes driven by market-oriented health policies and championed by policy wonks, are driving doctors to despair.  Doctors continue to bear responsibility for life and death, but have little control over the pace of their own work, or authority to address the barriers to care that they and their patients routinely encounter.