Saturday, May 19, 2018

I hate to say "I told you so," but. . .

it seems that my speculation a week ago about Israeli and Arab influence upon Trump was right.  See here. 

You saw it here first!

Thursday, May 17, 2018

How the left has gone wrong

Yesterday I caught up with last week's New Yorker on a plane ride.  The issue contained two fascinating articles on left-wing politics, written from entirely different perspectives.  The first, by Jelani Cobb, discussed a North Carolina minister and civil rights activist named William Barber, who wants to build a multiracial coalition of poor blacks and whites in the South.   The second, by Caleb Crain, reviews a new book by the economist Robert Kuttner, Can Democracy Survive Global Capitalism?  In this piece I will be contrasting Barber's views, as related by Cobb, with Kuttner's, as related by Crain.  The two men are both leftists in the current context and both, it seems to me, are concerned about the same trends and want to see similar changes in our world.  Yet they represent very different traditions.  Kuttner and the earlier thinkers he discusses at length in his book--the early twentieth century economists Karol Polanyi and John Maynard Keynes--are very firmly in the Enlightenment tradition and take a scientific approach to discovering what is wrong and how to fix it.  Barber--a remarkable and admirable man, who has also waged a long struggle with painful and debilitating illness--represents a Christian tradition of activism, leavened with the spirit of the late 1960s and the radicalism of the last years of Dr. Martin Luther King, who died when Barber was only four years old.  Barber's kind of activism and the world view behind it, I would argue, has increasingly dominated the left on campus and among activists over the last half century.  Unfortunately, it has been utterly unable to stop, much less reverse, the economic trends that Kuttner focuses on, which have created a new plutocracy in the United States and much of the rest of the world.

Kuttner's book is evidently about the political impact of free-market global capitalism. He does not seem to aware of Strauss and Howe, sadly, but he has a fine understanding of long-term economic and political trends and he recognizes the parallels between the 1930s and our own time.  There is one huge difference which Crain's review, at least, does not mention.  In the 1930s, the world economy had largely broken down; today it is generally thriving.  In both cases, however, profound economic changes had wreaked havoc among the lower classes of society in various parts of the world, causing significant hardship and anxiety.  And in both cases, many voters reacted by turning to strongmen or, in the 1930s, totalitarian movements.  In a scary reversal, today we have a somewhat anti-democratic strongman in the United States, while western European democracy, while threatened with right wing movements, remains intact. In the 1930s dictators ruled Germany, Italy, and Spain, but Franklin Roosevelt presided over a robust democracy in the United States.

While discussing Kuttner's book, Crain refers to Thomas Piketty, but not to Piketty's most fundamental insight: that the natural tendency of capitalism is to produce inequality, because capital accumulates more rapidly than the economy grows as a whole.  That, we should note, is true regardless of the degree of free trade and globalization at any particular moment.  If globalization increases economic growth overall--and it evidently does--it will increase inequality more rapidly, but capitalism itself, not globalization, causes inequality--unless something is done to reduce it.  That is what happened in the middle decades of the 20th century, as Kuttner obviously understands.

Several things combined to reduce inequality.  First of all, the First World War and the Depression both wiped out a great deal of wealth. The financial crisis of 1929-32 led to very tight regulation of financial markets in the United States, and there were no major panics or banking crises for a full 60 years after the Second World War. The two world wars led to the imposition of extraordinarily high marginal tax rates--91% on the highest incomes in the United States, until 1964.  After the Second World War, western societies compensated their veterans and their families with a whole host of benefits.  The experience of the Depression and the Keynesian revolution in economic thought convinced governments that they could and should take fiscal steps to insure the highest possible employment.  The rights of labor, and unionization, were at an all-time high.  Economic equality increased through the 1960s.

Partly under the economic pressure of the Vietnam War and partly because of oil shocks, the postwar economic system (including fixed exchange rates) broke own in the late 1960s and early 1970s. Inflation soared and the Keynesians had no remedy. As Kuttner points out, conservatives led by Alan Greenspan and Milton Friedman saw their chance for a counterattack and pushed a return to the free market.  That led, first, to the return of draconian monetary policy to stop inflation, and then to the beginning of a long series of tax cuts under Reagan.  By the 1990s the Democratic Party had jumped onto the free market bandwagon.  Inequality began to increase, and increased still further after the deregulation of financial markets.  The American and European working classes were hurt, not helped, by globalization.  By the 2010s large numbers of them were voting for extreme right wing parties or candidates--including now-President Donald Trump.  And in the United States, the leadership of both parties was firmly allied with the most powerful new economic interests on Wall Street and in the tech sector.  Kuttner argues, essentially, that political authorities will once again have to intervene in the market to halt and reverse these trends.  I shall return later to how this might happen.

Like Martin Luther King,Jr., William Barber finds the roots of his activism in the Bible.  Even irreligious people like myself can recognize the Christian roots of leftist economic thought, and the very important role that Christian activism of various kinds has played in European and US history over the last few centuries.  Cobb's article suggests, moreover, that Barber's Christian approach allows him to move beyond racial categories. Talking to Cobb, Barber says--as I have many times--that the issue of poverty has become so "racialized" that most people don't realize that the majority of poor people in the United States are white.  Barber has established links to what remains of organized labor, and we wants to bring poor white and black voters together.  But there is, to me, a serious falw in his reasoning.

According to Cobb, the Bible was only one of the formative books of Barber's youth.  Another was that very influential tome---now immortalized in Good Will Hunting--A People's History of the United States, by Howard Zinn.  That book argues that every authentic movement for justice and equality in American history came only from the lower classes--and that such movements were consistently betrayed by the upper classes.  It has sold so many copies because it captured the spirit of campus activism in the 1960s.  It implied that the power structure in the United States has always been oppressive and corrupt, and that only activism outside the system has ever been able to bring about any real change.  Those views animated the Black Panthers and the Weathermen and the other revolutionary spin-offs from 1960s campus activism.  More recently they have been very influential among the Occupy Movement and Black Lives Matter.  These views rein on campus, where virtue is found only among oppressed groups.   It is no accident, in my opinion, that none of those movements have yielded any tangible long-term benefits.  They are based on a false understanding of how American politics work.

The great achievements of the mid-century era--including the civil rights acts of 1964 and 1965--came mainly from building broad electoral coalitions and enlisting the whole nation to solve huge problems, including building a whole new infrastructure from the 1930s through the 1960s and fighting the Second World War.  The NAACP successfully fought a long battle on two fronts, legal and political, to end legal segregation.  Its alliances with organized labor, Jewish groups, and mainline Christian churches played a huge role in its legislative victories.  Beginning in 1960 civil disobedience generated pressure for legislative action, but it was only one of many factors responsible for success.  The Progressive and New Deal eras had created a substantial, bipartisan political class genuinely committed to a better life for all Americans, and the civil rights movement could appeal to them.  Those are the very real lessons that most contemporary activists do not understand.

Working in North Carolina--one of the most closely balanced states in the nation, which voted for Obama in 2012 and Trump in 2016--Harris has started a weekly civil disobedience campaign, Moral Mondays, to put pressure on the Republican state legislature.  He is fighting the power of James Arthur Pope, a convenience store magnate who is to North Carolina politics what the Koch brothers are nationwide.  The Democrats managed to regain the governorship of North Carolina in 2016, but the Republican-dominated legislature immediately moved to cut the Governor's power.  The same drama will be played out all around the country this year. Will women's and high school students' marches translate into decisive electoral success? If they do, will that success translate into real legislative progress that will at least halt the trend towards inequality?  These are huge questions.

Few people, I think, could have finished Jelani Cobb's article without feeling great admiration for William Barber.  The tradition he exemplifies reflects the last two years of the life of Martin Luther King, Jr., when King decided that both capitalism and militarism were evils against which he had to struggle.  That decision deprived him of much of his support and influence among white Americans, even as younger black activists challenged his non-violent approach.  Certain evils are definitely inherent in capitalism and militarism, including capitalism's tendency towards economic inequality--but we are stuck with them both, in my opinion, because they have roots in human nature.  Capitalism, we found in the last century, can be tamed and regulated for the benefit of all.  Military power, as I taught for more than twenty years, can be reserved  for rare cases in which its use can effectively meet critical threats and lead to a lasting peace.   No antidote for these evils will be perfect, but history tells me that trying to wipe them off the face of the earth will not work.  Future generations, I hope, will develop new forms of activism based upon reality.  Plenty of historical evidence suggests that such activism can work.

Friday, May 11, 2018

Trump and foreign powers

Since Donald Trump took office, and increasingly as more evidence has come to light, we have been wondering whether he is somehow under the influence of the Russian government.  That is a very reasonable suspicion.  Paul Manafort, Ray Flynn,  and Carter Page all held important positions in the Trump campaign or the Trump administration, and all of them have clear ties to Russian and Russian interests.  So does his attorney Michael Cohen.  Jeff Sessions and Flynn both seem to have discussed lifting sanctions with the Russians during the campaign.  And the Trump Administration refused for some time to impose new congresssionally mandated sanctions on Russia, although it eventually did.  The Russians clearly waged information warfare to help elect Trump Yet it is fair to say that the Trump Administration has done relatively little to help the Russians in its 16 months in office--perhaps, of course, because anything more that it did would look so suspicious.

The situation is quite different, however, with respect to two other foreign powers with longstanding influence in Washington.  There appears to be nothing that these foreign governments want that they cannot get out of the Trump Administration.  Both have had a lot of Washington leverage for a long time but both have now gotten things that they could not get from any previous administration.  Those powers are Israel and Saudi Arabia.

In the past year, Donald Trump has given Benjamin Netanyahu three things that Netanyahu and his predecessors could not get from other US Presidents.   First, he has officially abandoned US insistence on a two-state solution to the Israeli-Palestinian question.  Secondly, he has agreed to move the US embassy to Jerusalem, which nine previous presidents had declined to do.  And last week, he backed out of the Iran agreement, allowing Israel to unleash a war against the Iranian presence in Syria, and very possibly paving the way for a much bigger war against Iran itself.  Netanyahu, as an excellent Frontline documentary showed, was very close to dragging the US into that war before the Obama Administration and the rest of the great powers of the world reached the nuclear agreement with Iran.  Now things may start moving in that direction again. 

The Saudis, under the leadership of their dynamic, authoritarian new Crown Prince Mohammed bin Salman , are also enjoying new signs of Washington's favor.  They have concluded a $23.7 billion arms deal with Washington, which may eventually rise to over $100 billion.  They are getting encouragement, intelligence, and actual assistance from American military personnel in their war against the Houthi rebels in Yemen.  The United States government appears to have decided to back Riyadh and the Sunnis against Tehran and the Shiites in the new Thirty Years War that threatens to wreak havoc in the Middle East for many years to come.

Other Administrations--most recently that of George W. Bush--have bent over backwards to curry favor with Jerusalem and Riyadh, but neither went that far.  One channel of influence on Trump appears to be Sheldon Adelson, the Las Vegas casino magnate and megadonor, whose wife is Israeli and who emerged late in 2016 as a big donor to Trump's campaign.   No evidence has surfaced that Trump is under some financial obligation to either of these powers, or that one or both of them may have damaging information about him.  But Trump certainly left some grounds for suspicion when he turned one of the most complex foreign policy issues the US faces--the Middle East peace process--over to his son-in-law Jared Kushner.  Kushner is apparently bypassing the entire State Department and dealing personally with the Israelis and Saudis.  This understandably caused friction with Secretary of State Rex Tillerson, who has now been replaced by Mike Pompeo.  It seems to me entirely possible that Kushner knows things about his father-in-law's relationships with Israel and/or Saudi Arabia that cannot be shared with professional American diplomats.

Benjamin Netanyahu--who, like Donald Trump, is under great pressure from official investigations within his own country--seems determined to take advantage of the opportunity offered by Trump, perhaps to impose some kind of one-state solution on the Palestinians, and perhaps to wage war against Iran.  Trump seems quite willing to allow him to do this.  We don't know why.  I don't like raising these possibilities in the absence of the kind of evidence we have about Trump and the Russians, but circumstantial evidence is much better evidence than is commonly supposed.  The circumstantial evidence for some kind of secret connection between Trump and the Israeli government--and perhaps the Saudi government--is significant, and a long-tine Washington insider and observer with whom I shared my speculation about Israel agreed with me on this.

Friday, May 04, 2018

James Comey's history of the recent United States

James Comey's memoir, A Higher Loyalty, sits deservedly at the top of the best seller list.  Naturally the press comment on the book has focused on his six-month relationship with President Trump--almost leaving out, among other things, his long account of the investigation of Hillary Clinton's use of her own email server while Secretary of State.  My readers, I know, count on me for different kinds of perspectives than those they get from their news feeds, and I do not intend to disappoint them.  Born at the very tail end of the Boom generation, in December of 1960, Comey's career put him at the heart of a number of critical developments during the last 30 years.  He worked in the office of the US Attorney for the Southern District of New York (then Rudy Giuliani) from 1987 to 1993, served in the office of the US Attorney for the Eastern District of  Virginia from 1996 to 2001 (after a brief stint with a Senate Whitewater Committee), became US Attorney for the Southern District of New York in 2001 and was Deputy Attorney General from 2003 through 2005.  Then he went into the world of private law firms and the Bridgewater Associates hedge fund, emerging, according to Wikipedia, with a net worth that has reached $14 million.  (He does not mention this in his autobiography and talks a lot about the strain of raising a large family on a government salary.)  In 2013, Barack Obama surprisingly appointed him as FBI Director, and the rest, as we say, is history.  I may discuss some of the lessons of that experience next week.

Comey dealt intimately with each of our last three Presidents.  He has a lot to say about them all, and about some (though hardly all) of the major achievements and crises of their administrations.  That is where I want to focus, because the book set me thinking, once again, about how we need to think about the last very turbulent 18 years of American history.

Serving as Deputy Attorney General under John Ashcroft and Alberto Gonzales, Comey found himself in the middle of two huge constitutional crises:  the Bush's Administration's attempts to continue an illegal NSA surveillance program instituted in the wake of 9/11, code named Stellar Wind, and the Justice Department's efforts to withdraw its endorsement of the torture of Al Qaeda detainees.  These were issues that the leaders of the Bush Administration cared about very deeply.  Reading Comey's account, I was reminded of their ruthless determination to change US law and US foreign policy, and of how much lasting damage they did to our country.

The people behind both Stellar Wind and "enhanced interrogation" (hereafter "torture," its right name), were Vice President Cheney and his counsel, David Addington--with President Bush, it seems, in their wake.  After 9/11 they convinced themselves that black sites and torture were both necessary and effective tools in the war on terror--overruling the views of the more experienced FBI, CIA, and military intelligence, who knew that while torture might get prisoners to say whatever you wanted them to hear, winning the prisoner's trust was the only way to learn the real truth.  The problem, of course, was that the Bush leadership didn't want the truth--they wanted evidence to back up their post-9/11 world view, which held Saddam Hussein responsible for 9/11 and favored war to eliminate non-existent weapons of mass destruction.  To get the memos they needed from the Justice Department's Office of Legal Council, these men--led by Addington--adopted the view that the Executive Branch was the rightful judge of its own powers.  This view has a long history--Thomas Jefferson, for instance, enunciated it in retirement--and John Yoo of the Office of Legal Counsel confirmed to me that it informed his and his colleagues' work when I met him years later at an academic conference.  George W. Bush, echoing Richard Nixon, echoed it in a meeting with Comey.  In 2005, after Alberto Gonzales had moved from the White House to the Justice Department, Comey and some of his colleagues tried to convince him to refuse any further authorization for enhanced interrogation. They failed.  Eventually, the Supreme Court ruled that the use of torture was unconstitutional.  But when Barack Obama became President, he simply declared that the United States would no longer use these techniques, while taking no action against those who had done so.  That amounted to a statement that the US would use torture on prisoners only under Presidents that wanted to do so--and now a woman who ran a torture site under Bush is poised to become the Director of the CIA.

Comey talks rather guardedly about Stellar Wind, the NSA's surveillance program that was eventually revealed by Edward Snowden.  He indicates quite clearly that in practice, it went further even than had been authorized or than has ever come to light.  Cheney and Addington were behind it as well, and when Comey and his colleagues tried to stop it, Cheney told him that he, Comey, would be responsible for the deaths of thousands.  The White House successfully scared the New York Times out of publishing stories about the program during 2004, ensuring that the American people would not be able to vote on it in the next election. 

I could not read these accounts--including the story of how Comey and a very sick Attorney General Ashcroft headed off Gonzales's attempt to get the AG to approve an extension of Stellar Wind from his hospital bed--without thinking about how the same spirit dominated other aspects of Bush Administration policy, especially abroad. They immediately saw 9/11 as an excuse to change the rules of domestic surveillance and of prisoner interrogation--and also to change the rules of how the United States behaved abroad.  Now we would undertake wars of choice in Afghanistan and Iraq, whether or not the UN and our NATO allies approved of them.  If the facts about Saddam's weapons of mass destruction did not fit their world view, they would impose other fact.  "We're an empire now," a high Bush official--almost certainly Karl Rove--told reporter Ron Susskind in 2004, "and we create our own reality," leaving the "reality-based community" struggling to keep up.  Like so many other Boomers of every political stripe, the men of the Bush Administration sought to remake the world according to their vision of what it should be.  And even though their assumptions were wrong and their policies disastrous--they succeeded.  The wars they began in Afghanistan and Iraq still continue.  The Obama Administration applied the supposed pro-democracy policy of regime change they had tried in Iraq in Libya and tried to do it again in Syria, with disastrous consequences.  Guantanamo is still open for business, and Obama increased drone strikes, another aspect of our new endless war. 

That was not all.  Bush also cut taxes twice while spending $1 trillion on those wars.  That left the government without necessary resources when the economic crisis of 2008 struck.  The appointments of Roberts and Alioto to the Supreme Court led to the Citizens United and Heller decisions, both b 5-4 votes, which have profoundly changed American life.  Cheney's energy task force seems to have put us on the road to fracking and energy independence.  Whether we like it or not, the Bush Administration did what Lincoln and FDR had done before them--used a crisis to work towards a new vision of the United States.  They could not, in fact, create a better world, because their vision was not based upon reality, but they changed the world nonetheless.   And the two Administrations that followed have done remarkably little to undo the changes they made.

One of the more striking features of Comey's book is his great praise of his contemporary Barack Obama (nine months younger than he), whom, he tells us, he never voted for.  Comey has thought a lot about leadership during his career, and he regards Obama as a superb leader because he had a knack for listening and for empathy.  He was intelligent and self-confident enough to get information from subordinates and listen to opposing views.  George W. Bush, Comey makes clear, preferred to bully subordinates into assent, and Donald Trump is of course almost totally impervious to facts.  But Obama simply did not have Bush's determination to change the government and the world.  He wanted to put partisan rancor aside, rather than use it to build a new Democratic coalition and a Democratic agenda.  He decided not to turn the enormous anger over the financial crisis against the big bankers--and allowed the Tea Party to turn it against him.  He thought he could appeal to values shared across the political spectrum--and he could not.  The Congressional Republicans and the Trump Administration are busily unraveling what remains of his legacy.

The Trump Administration is busily undoing what is left of the New Deal and Great Society, removing old and new restraints on corporate behavior.  It has also added a war on immigrants at home to an endless war on Islamic extremists all over the world, but that effort, to date, is nowhere near large enough to make a real dent in our illegal population of 11 million or so immigrants.  It seems that we may emerge from this great crisis, as we did from the Civil War and Reconstruction, with a large minority of inhabitants without political rights.  In the late 1800s those people were freed slaves; now they are illegal immigrants.

I saw clues scattered through Comey's book about why Boomer leadership has been such a failure.  Boomer leaders are self-centered, narcissistic, and focused above all on their own political well being.  Such was Rudy Giuliani, Comey's first government boss, of whom it was said among his underlings, "the most dangerous place in New York is between Rudy and a microphone."  Such were the Clintons, and Hillary's reliance upon tribal lawyers and suspicion of outsiders did a great deal to bring her down in the end.  Barack Obama--who is not a Boomer--was different, but he could not overcome the inertia of the Boomer political class.  Focused on individual self-expression in their youth, Boomers have created an individualist paradise in which we can no longer work together across political or tribal lines.  This is not unprecedented--the aftermath of the Civil War was quite similar.   But its effects will last for a long time.  Comey's book helps persuade me, once again, that the new transformation of the United States that Strauss and Howe predicted more than 25 years ago is nearly over.  We are stuck with the world my generation made.

Thursday, April 26, 2018

The impact of free markets

In 1965-6 I took Economics 1, as it was then called, at Harvard.  The course probably represented the best education that the GI generation had to offer.  It was taught mainly in sections and I was lucky to have a very good section man, who tried and failed to recruit me into economics after I aced the first hour exam.  The rare lectures were spread around the department and featured some giants in the field, such as John Kenneth Galbraith and Otto Eckstein.  The fall term dealt with micro-economics, the spring with macro-economics. The latter was much more interesting, because that generation was so focused on using fiscal policy to ensure the maximum possible employment.  They had learned in the 1930s from John Maynard Keynes that the government had a key role to play in fighting the depression, and the policies they favored had helped prevent anything similar.

In one section, I remember, we spent perhaps 20 minutes discussing a maverick economist from that generation--a certain Milton Friedman, an apostle of the free market.  Dr. Major made clear that he did not take Friedman's ideas very seriously, but, he said, "I think it's good for you to be exposed to this."  We smiled.  Little did we know.  I doubt any other economist that we studied that term has had more influence on the actual shape of the world in which we have spent our adult lives than Milton Friedman.

I am not going to go over the various specific advances that free market ideology has made since the Reagan years or review their economic effects.  Markets have become much freer and we now now what the effects of that are.  Free markets make it easier for rich people and institutions to become much richer. In a globalized economy, they make labor cheaper.  This in turn shifts more political power to the wealthy who can use it to make markets even freer.  One result of free financial markets was the great crash of 2008, but now, with the Republicans back in power, even the mild reforms in the wake of that crisis are being repealed.  In the last few days, however, I have seen two striking stories about the impact of free markets which show their effects on key areas of our lives.

One is housing in our major cities.  In the middle of the century, rent control held down rents in many areas (including Cambridge, Massachusetts, where I lived under it for six years), saving opportunities for students and the working class. Now it hardly exists anywhere, and it is almost impossible for such people to live within the city.  The student apartments that my friends and I lived in in the 1970s have been condoized, and sell for more than half a million dollars a bedroom, in many cases.  Now comes the latest development: the influence on the market of AirBnB.  Apartment prices are being bid even higher by speculators who want to turn units into short-term rental properties, and a lonely city councilman who wants to do something about it is encountering heavy political pressure.  The same drama is playing out elsewhere.

The second story is much more interesting and much more frightening.  It concerns the impact of markets on health care, and specifically, on drug-makers choices of diseases which they wish to attack.

A note to clients--apparently, pharmaceutical companies--from a Goldman Sachs analyst has been leaked.  A new form of gene therapy has been remarkably successful in curing hepatitis C, a sometimes deadly disease, and in ridding patients of the infection so that they can no longer infect others.  While antibiotics originally cured a great many bacterial infections, this is a chronic viral infection--like HIV--and its potential disappearance should be grounds for rejoicing.  Yet the Goldman Sachs analyst sees it as something to worry about.  The drug maker made a great deal of money in a short time, but the the new therapy is now going to disappear. Curing diseases is not a particularly good model in the long run.  Finding long-term palliative care for a chronic condition is much better--and that is the kind of care big pharma wants to develop.

This was not news to me.  Big pharma has been very slow to develop new antibiotics, which cure people, even when they are desperately needed to deal with resistant bacterial strains.  They like pain relievers and other drugs which people can take for the rest of their lives.  I asked a friend of mine who has run numbers for drug companies whether they prefer working on treatments for long-term illnesses at least a decade ago, and he smiled and replied, "Sure! They have stockholders."  Any corporation wants to  get the public to spend the maximum amount of money on its products.  In no other advanced country is the health care industry as economically powerful as in the US--and we spend about twice as much on health care as other advanced countries. This is anything but accidental.  Drug research should be government-funded and directed towards vaccines and cures for the worst diseases.  The biggest breakthroughs in medicine in the 19th and 20th centuries came from individual scientists working on their own like Pasteur, Ehrlich and Fleming--not from pharmaceutical companies.

Another dysfunctional market probably helped produce the Goldman Sachs letter--the labor market for our smartest young people.  Since the deregulation of our financial markets, our largest financial institutions have been paying the highest salaries.  They have successfully been recruiting the smartest college graduates and PH.d students in almost every field--even fields like civil engineering.  They like people who are smart and competitive, and they educate them to see the world in a certain way. Because that world view has such a terrifying internal consistency, it is easy for people to assimilate into it.

Four years ago, I did four long blogs here about Thomas Piketty's book, Capitalism in the 21st Century.  (Here is the first--the others followed.)  It began with a simple insight, one I think that was also at the foundation of the first Capital, by Karl Marx: capital tends to accumulate faster than the rate of economic growth.  That's another way of saying that the rich get richer and the poor get poorer.  And because their whole goal is to get richer, those who make drugs don't want to cure diseases, they want to treat chronic ones.  This is one spectacular instance of how capitalism can work against the public good.  Western Europeans still understand some of these issues, but there, too, capitalism and inequality are gaining ground.  We may be headed for a world of capitalist dynasties.