Videti je, da je vseeno, kdo financira pokojninsko in zdravstveno varstvo. V Evropi pod tem bremenom kleca država, v ZDA posamezniki. In medtem ko Evropa prenaša del stroškov na posameznika, se v ZDA množijo glasovi, da bi del izdatkov za te namene morala prevzeti država.

»If there is one single source of risk our policymakers must tackle, it is health insurance. We must not muddle on, a band-aid here and a band-aid there. We must find some way to provide universal health insurance, especially to cover all children. This is one of the critical reasons that Americans are nervous and no longer believe that the next generation will be better off.«

Ni brez ironije dejstvo, da državo na pomoč kličejo multimilijarderji. Recimo Mortimer Zuckermann, 117. na Forbesovi lestvici najbogatejših Američanov (zgornji navedek). »We need some form of universal coverage that would be funded centrally by the government, but delivered privately through existing mechanisms like HMOs,« pravi Wilbur Ross Jr., številka 322 na isti lestvici.

Timothy F. Geithner, predsednik in CEO Federal Reserve Bank of New York pa politiki našteje celo vrsto izzivov: »Several broad economic forces substantially complicate an already difficult set of political challenges: the long-term increase in income inequality, the slow pace of growth in real wages for the middle quintiles of the population, the increase in the volatility of income that is a reflection of the greater flexibility of the U.S. economy, and the greater exposure of households to the risk in financing retirement and the burden of paying for health care.«

Zdaj je potemtakem dolgoročno naraščanje dohodkovnih razlik, počasna rast plač, povečana negotovost in izpostavljenost pokojninskim in zdravstvenim tveganjem tako rekoč uradna bilanca ameriške ekonomije. In zato tiste, ki so z globalizacijo, Bushevo davčno reformo in sploh liberalizacijo največ pridobili, tudi najbolj skrbi. »If middle-class Americans continue to struggle financially as the ultrawealthy grow ever wealthier, it will be increasingly difficult to maintain political support for the free flow of goods, services, and capital across borders. (…) And when the United States places obstacles in the way of foreign investors and foreign goods, it’s likely to encourage reciprocal action abroad. For people who buy and sell companies, or who allocate capital to markets all around the world, that’s the real nightmare.«

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