A HISTORICAL PUZZLE
The odds that a child born inAmerica today will lead a life of extraordinary materialcomfort and benefit from all manner of exexpensive medicalwonders are higher, it is fair to say, than anywhere else in the world. Born in a country like Sweden, with an economy at a roughlyequal level of development, that child would start withdifferent, and in a way, better odds: less chance of luxury, but also less chance of misery. In other words, a Swedish childis more likely to reach old age without ever having to faceeconomic privation and an avoidable or surmountable medicalcatastrophe. For those reasons, quite possibly, even theprospects of surviving infancy and growing old in Sweden arehigher. 1
Acrossthe world, large differences in labor markets and welfare statesaccount for most of people's uneven life chances as theygo from cradle to grave. Today, for example, Swedish employerspay about the most egalitarian wages and salaries in the world. The Swedish government also enjoys, or suffers, a reputation asa vanguard among welfare states. It is hardly surpassed in the generosity of its monetary benefits and supply of services for peopleneeding them because of childbearing, child rearing, unemployment, sickness, disability, and old age. America, bycontrast, stands out among affluent capitalist societies withits highly unequal distribution of pay and benefits, includingprivate health insurance, attached to gainful employment. Likewise, its welfare state, though important for keeping manyout of poverty, is rather meager. For example, it is the onlywealthy nation where vast numbers of people, roughly 40 millionat current count, have no health insurance and therefore often miss out on timely, high quality medical care—that is to say, if theyget any care at all.
That market-generated inequalities are high in the United States iswell known. It is also beyond dispute that the American welfarestate deserves to be characterized as laggard or limited incomparison to other affluent societies.