How to Change the World

1. How to Change the World Economic Realities in a Changing World 18th Annual Honors Symposium Flathead Valley Community College

2. Global Change and Economic Realities in 50 minutes or less… • Really, economic “realities?” • Unified voice on these “realities?” • Has Change Changed? The Great Global Recession of 2008 • Different Strokes for Different Folks • The Global Economic System in 2025

3. No Shortage of Opinions…

4. Change implies uncertainty • Economic reality manifest in • Demography • Economic (income, employment, wealth, etc) • Technological • Institutional (rules of the game)

5. Certainties we’re pretty sure of… • What’s right for one, not necessarily right for another • What’s right today, not necessarily right tomorrow • Policy environment increasingly complex

6. Economic reality lies within Econ 101… • What • How • For Whom • And all within the “Death of Distance”

7. No universal pattern for economic development • Demography • Stock and flow of knowledge • Institutional framework

8. Relative measures of prosperity • Why are we… • 10X prosperous as Guatemalans? • 20X prosperous as North Koreans? • 40X prosperous as Mali, Ethiopia, Congo, Sierra Leone?

9. poverty • Montesquieu • Protestant work ethic • Sachs • Diamond

10. 2008 volatile year • Collapse of Lehman Brothers • Near Systemic worldwide breakdown • Aggressive fiscal and monetary responses • China

11. Who has health care right? • Senate Plan, House Plan, Obama Plan released Monday? • Canada? • Great Britain? • New Zealand with its National Health Service?

12. Commonwealth Fund Comparative Ranking

13. Other Health Care Systems • Any and all systems, for all kinds of goods and services, must ration resources someway, somehow, according to… • price • time in queue • budgets • geography (access) • specialty, type of service • Each has unintended consequences

14. The dilemma worldwide then is providing… • Accessibility • Geographically • Wait time (time is not free) • Affordability • Quality • Personnel • Equipment (technology)

16. All Non US Systems have… • Individual and/or employer mandates • Universal coverage • Less expensive • Better outcomes?

17. Competition: Sown the Seeds of Its Own Destruction? • Private health insurance industry • cherry picking, benefit denial • Physician Services Industry • supplier induced demand • Hospital Services Industry • medical arms race • Pharmaceutical Industry • dominant firms buying generic challenges

18. So Who Has It Right? • France & Japan & Netherlands • Rapidly increasing costs • Benefit reductions • Germany • Increased payroll tax to meet spiraling costs • England • 2006 report “the present system is incomprehensible and its outcomes unjust”

19. The “health” of health systems • Ultimately depends on… • Public values which are culturally dependent • UK: right to free care as citizens • Canada: “just, fair, and equitable principal” • Germany: solidarity and subsidiarity • U.S.: self reliance, aversion to taxation, limited role for government

20. 2025 • Emerging powers (the BRIC’s) • Transfer of wealth • Non state actors • Trade and financial clusters

21. Developing nations • Sovereign wealth funds • Export markets • Value added ladder • State owned enterprises • Unsustainable financial imbalances • Perception of globalization • Decline of dollar • Multiple financial nodes • State centric development

22. We are They, They are Us • New economic paradigm • Apple iPod

23. Smiley Curve of Value Added • Branding-product concept • Manufacturing • Retailing and servicing

26. Relative Certainties • Global multipolar system • Power will be dispersed • Shift of relative wealth • Challenge to western order • Pressure on food, energy, water • Technological innovation • Arc of instability • Destabilizing without development

27. Key Uncertainties • Energy transition and economic power • Conflicts in interest • Future of democracy • China and Russia • Demographical challenges • Europe and Japan • Enlarge economic pie • Or divvy it up?