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Anne Case

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2021-03-23
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2021-03-23
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  1. This work that's coming out, this work on surprise medical bills, for instance, people who are fully covered, and then they get a $30,000 bill for the ambulance that took them to the hospital. That really did make a lot of people really angry. There's a recent study the other day that when private equity takes over a nursing home, more people die. So there's a lot of stuff like that that I think will get worse and worse. But those things tend to cause reform around the edges. And the surprise medical bills, which almost every politician on both sides wanted to get rid of, and they couldn't, though they seem to have gotten something now, but it took two years.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  2. Well, unions used to have a lot of that power. And so one thing that would happen if there were stronger unions would be workers would be better represented in Washington. And I think that would really help. So backing away from these laws and these laws. The other thing is, you know, when we talk to sympathetic congressmen about this work, they say you need campaign finance reform. Well, we talked about some heavy lifts today, but, you know. You want to really, really heavy lift, try that one. You've got a Supreme Court that's being handpicked by pretty right-wing people, the Federalist Society and so on, in which economists played a big role in doing that. And they've got this very pro-business court, which is not going to help with any of that at all.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  3. Go to insurance. So that was the devil's bargain that Obamacare accepted. And they didn't have much choice on that. But this is just incredibly difficult to oppose this amount of money. This is where inequality really hurts because you've got these incredibly rich people who want to protect their turf. And they all believe that they're entitled to it.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  4. But for instance Bachara, who is, I think that's his name, who is. Reform healthcare. Whether they can get it done given the constraints given the lobbyists, given the huge amount of Of money. And even if you go back to Britain in 1945 when Nye Bevans started the National Health Service, he made it happen by basically buying off the doctors and other people's, giving them huge sums of money to accept this. And I think that's what Obama tried to do with Obamacare. Everybody got rich on that. So they didn't oppose it. On the other hand, it made the problem worse because they were still richer, even though more people were richer.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  5. Of some of these pharma companies at least, they were much, much hated in America because people had to pay so much for drugs. So maybe that'll change, but maybe it'll come back. Also, there's not really been a full accounting. We don't know who is paid how much and how much the executives of JJ and Pfizer and everyone else made as a result of this. And that might cause some problems. As far as hospitalization is concerned, it's too early to tell. A lot of people lost their insurance during COVID because they lost their jobs. That has surprisingly not been a huge lively thread in the public debate. I'm sure there's some there, but you don't see headlines in the papers every day saying here's X they got COVID. They've now got a bill for $100,000 or something. That may come. It may also be that some of these stimulus bills are paying hospitals.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  6. The previous administration wasn't going to do anything about the healthcare system anyway. They liked it. That was an administration of rent seekers and cronyism. So they were absolutely at home with the healthcare system. The question now, I think more is that as the pandemic, as we pick up the wreckage after the pandemic is what will happen then. And one thing we mentioned already is Johnson Johnson, who was growing opium poppies in Tasmania to fuel this epidemic of death in the United States, right? And who paid a huge fine to one of the state attorney generals for doing that is now, you know, just is our savior and has brought these additional vaccines which were approved the other day. So there's certainly going to be a change in reputation.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  7. And I think we have debts to our fellow citizens which are not the same as the debts we have to people in India or in Zambia or in Rwanda or wherever you'd like to think. I do think we have obligations to those other people too, but I don't think they trump the obligations to our fellow systems.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  8. I think we defend them because the alternative is so awful. And I think also, and I think probably differs on this a little bit, that I've never been a cosmopolitan in that sense, which says what we owe most is to the poorest person in the world. I think we owe a lot to our fellow citizens because they're our fellow citizens. You know, we spend this month in Montana in the summer, and a lot of the people we meet there have children who go into the military. So you've got, and that's typical of red states, of states where not so many people are getting educated and where there isn't a lot of work to do, people go into the military. So do we say to these people who are defending us, who are dying for us in Iraq and Afghanistan, that, you know, I'm sorry, but there's a poor person in you who lives in India, and so we're going to reduce your salary.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  9. Think it's retrenching already. It stopped increasing after 2008, after the Great Recession, and there's been quite a bit of decline even pre-COVID. And then I think with COVID, people are going to worry much more about their supply chains just for health reasons. And so there's a real chance to do some of that.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  10. We have a junior college system, which is what is usually called Gives Associate degrees. That doesn't seem to do all that much for people in terms of their wages or their mortality, but I think we need to enhance that and make people realize maybe more salaries. We heard the other day that plumbers are being paid $100,000 a year. There's shortage of skilled artisanal jobs. It's part of this loop we've been talking about. There's so much status given to going to college that parents say, and you know, their kid says, I really want to be a plumber. And look, I like fixing cars. I want to do that. They say, wait, wait a minute, wait a minute. Case and Deaton have just shown, if you don't go to college, you're going to die. We had a friend here who said, you know, my son says, he's not sure he wants to go to college. I know we're bothered about, but now he's going to college.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  11. He tried to be bipartisan and was strung along by Republicans who said if you change a little bit here and change a little bit there and make it more to a ranking. They got a big shift in the bills, but then they voted against it anyway. So this is not, I think Biden learned pretty much from that lesson. And I don't think the Republicans can complain too much about it in this instance. But what Ansa too is the $1,400 checks are not going to anyone. There's a limit which I think is around $70,000. That will decrease inequality by itself because a lot of the really rich people are earning a lot more than that.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  12. We lost as a consequence of that, which no one has yet to discovered. And what that tends to mean, I think, is that many employers are actually underpaying their workers and would be happy to pay them more. And actually, they might be more productive and things. So there's lots of side effects like that. And I think there's been a big change in economics towards favoring that. The other thing here right now is the political situation. This bill, the stimulus bill or whatever it's called, the $1.9 trillion, is enormously popular. There's like 70% people in favor of it, including majority of Republicans, and yet not one Republican senator is going to vote for this bill. And what happened at the beginning of the Obama presidency was

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  13. And I'm sorry about that. I mean, it does seem to me that, and this is true in Britain, I know a lot of Bretts feel the same way, that these essential workers have done incredible service during this epidemic. And is the back time repaid a little bit more? And I think the minimum wage would really help towards that. I think also it would recognize the dignity of low-wage work by just saying we just couldn't have this. So I'm sure that some people would lose their jobs, perhaps in restaurants or perhaps in the south where wages are very low. But I think the benefits would greatly outweigh that and would sort of help. And also economists have really changed their views. And the British experience has been part of this. I mean, you've at a minimum wage since 2000, and there's been a lot of research trying to find jobs.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  14. I don't think the people who have to work in jobs they don't like would be very unkeen to share part of the wages those with people who are not doing anything at all or in wages they do like so I don't think it's a non-starter there was you know it was raised in America in the 70s I guess when Nixon was president under the form of a negative income tax And it gets a lot of traction because it's favored by people in the far right and people on the far left. So that makes it attractive to politicians. But when people see what happened in America is they did some experiments, some social experiments in which they gave people extra money and see what happened. And what happened was there was a big reduction in the amount of work they did. And when Nixon and the Republicans saw that, that was the end of it.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  15. and have to pay for the people who decide not to go to work and use their universal basic income to sit around in hippie groups reading poetry, which is one example that Bob Frank came up with and which we talk about in the book. He has this wonderful example of a Minnesota dentist who's living a really hard life. It's cold. His patients are nasty to him a lot of the time. They refuse to pay their bill. They have bad breath, all that sort of thing. And he gets home exhausted in the evening and he turns on the television. And there's a bunch of 20 hippies in California.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  16. Well, we think it's a disaster. I think it's a really bad idea. In Finland, I think they tried it, experimented with it. I don't think they've instituted it. So there's one circumstance in which it would make sense, and that I think is this dystopia, which has not come yet, when there's no word for anything but robots. And so the only people get paid are the inventors and the owners of the robots. And you couldn't imagine a world like that. But we're a very, very, very long way from that world. The unemployment rate right now is coming down. You know, it's just a few percent. We're not talking about mass unemployment because of robots. The problem with it is that when people think of universal basic income, they seem to think that everybody's going to get paid, which is true. But someone has to pay for it. And so there are people who have to go to work.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  17. And it did open us to a lot of misinterpretation. I mean, some people said, well, they're economists. By despair, they must mean that people have low incomes. Well, that's not what we meant at all. And I think the psychologists and dots and things, they don't work with this term. I mean, if you look at the diagnostic manual, I don't think you'll find despair as a well-defined condition like Alzheimer's disease or something. So people are saying, well, why didn't they define despair? Okay, okay, you know. But the term got the concept well known. And I think it's done its job.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  18. I think the fact that we even asked that question is a problem because it shows a certain patronizing attitudes towards people that we know better what their economic interests are than they know and that at the same time we do nothing to help them just as these democratic administrations in Washington before Trump, they had not helped those people at all. So voting for Hillary Clinton didn't seem like it was in their interest either. And I think it's difficult because it is very patronizing to say, you know, why don't you vote for things that are good for you? Are you stupid or are you demented? So I think we have to think of better solutions than that.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  19. The drug enforcement agency tried to stop them, and politicians changed the law or block them, or fired people. So it's just like, you know, these people are supposed to be representing you and protecting you are doing exactly the opposite. And, you know, it's very easy to, it's not, of course, completely true to think of the government as a sort of criminal conspiracy that's trying to collude with these criminals to really make things worse. I mean, that's why we told the story of the opium war at the beginning of the opium chapter, which is, you know, when these Scottish thugs essentially prophets were being threatened because the emperor didn't want his subjects to be addicted, then turned to the British government who lent them the gunboats to go and fix it. And we think, well, that was a long time ago, but what we're doing now is not so different.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  20. It's very strongly connected with pain. And Anne is someone who's lived through a lot of pain in recent years. And, you know, when you're writing about suicide and seeing this link with pain, you think, oh my God, how would I feel if the pain were that bad? And what seems to be increasing in America, we have a chapter on pain too, is there's been this huge increase in pain. And probably in social pain as well as physical pain, you know, social pain associated with isolation, with all that sort of stuff. And, you know, all of us see pain in our lives. And when you see those connections, you think, oh, dear, you know, this is something that's much closer to us than you might think. It's not just something adds to other people on the other side of the world or something.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  21. Think there's a fairly good research program on that suggesting that just not having other people around poses a danger for suicide. It's sort of like if you're just feeling really, really bad and you run into someone they can pull you out of it. Whereas if you're away by yourself, that's much harder. So if it's true, as I think we both suspect it is, that social media has made loneliness worse, not better. You're looking at pictures of people on Instagram who are having a wonderful time and you're feeling totally alone and miserable. If social media are making isolation worse, then you could certainly build a plausible case that social media is linked to suicide.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  22. There is a long tradition in the suicide literature of attributing social isolation to suicide so that we write in the book about the suicide belt in the United States, which runs right up the rocky mountains. Where we spend a month in the summer in Montana and the mountains, the suicide rate is about five times as high as it is where we spent most of the rest of the year.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  23. I'd love to know the answer to that. I don't think we have really almost any good work on that, or if there is. Really don't know

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  24. What we saw is the beginning of that. I mean, you've got these right wing groups storming the capital. Large sections since the election, there have been something like 400 new laws proposed by state legislatures to limit voting. There's a very large number of Americans who don't believe in democracy at all. On both the left and the right, And, you know, people looked at China and say, well, even though there's bad things happening in China, but it's not so great what's happening here either.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  25. Well, I think it's going to have to, the change is going to have to heal those divisions to some extent. And, you know, we're going to have to share. Economic growth better across the spectrum of skills and education than we've been doing. So the division is in part the problem. And it makes the problem harder to solve very much like the rich do so well and they can use their money to protect themselves. But they run the risk of bringing on a revolution if you do that. And it was sort of like, you know. The French aristocrats didn't think that they should have to pay taxes to fight all the wars that the French were fighting before the revolution. The French Revolution was the result of that. It would be good not to have a revolution here, but I think in some ways.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  26. How many million Americans have been hospitalized during COVID, but a lot. And it depends a bit on where they come from. Most of them are less educated or black or Hispanic. They're much less political power than if they were white middle class, better off people. So we don't know about that yet.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  27. I think they want the reform but as soon as the lobbyists get to work and the television ads and all the rest of it and the system is exquisitely constructed to avoid reform. You know, in Britain when you don't put enough money into the health service, people start walking around on broken hips and have to wait years to get into service and there's a public outcry. But here none of that happens and that's because most people are happy with the health insurance they have and they think someone else is paying for it. You know, if they had to pay for it every month, I think reform would be much easier.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  28. So we've got to try to undermine that and find some way of bringing it under control. But the vested interests are just so powerful, so rich. And part of the, there's a horrible loop here, which is you let this happen. They make so much money and they can use that money to defend themselves against any change. And the danger is you can't have reform and all that you have is a catastrophe. We sort of wondered if COVID would provide that impetus, but it's very unclear. It's too early to tell there. And obviously the pharma companies, which were most famous for addicting everybody with opioids, are now most famous for generating vaccines at record speed. And that's probably done quite a lot for the public image.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  29. And so you really need two things to make a healthcare system work. There are lots of ways of getting them. One is that you need people to be insured automatically, preferably from birth. So the day you're born, you're in the healthcare system. And you can't get out of it. So if it doesn't depend on you paying voluntary contributions or someone else paying them on your behalf. The second thing you need is some form of cost control. And all European countries do that in one way or another. And that's anathema to the healthcare industry here because so many people in hospitals, hospital administrators, device manufacturers, executives and pharma companies are earning enormous salaries which would be destroyed by cost control, even doctors. Doctors in Britain probably get paid too much, but here they get paid about twice as much. And that's just because they won't let kids go to medical school.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  30. Gotta stop spending 20% of GDP on healthcare. And for the worst life expectancy of any rich country in the world. So this is just nuts. And, you know, we did not commit in the book quite deliberately to any particular form of healthcare reform, just because this is an open debate. There's been huge pressure. You know, Bernie Sanders has pressed for a single payer forever. There are various other forms of public option would probably help. But, you know, there's lots of models out there, different European countries fund their healthcare systems in different ways. You know, the Swiss and the French spend more than the British do, as the share of GDP, for example. All of those systems are better than ours and promote better health and cost less. And the cost is strangling good jobs.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  31. I think we could also decelerate the rate at which good jobs for less educated Americans are going away. So, you know, one thing that has been written about us is that we have investment incentives for firms to put robots in place. Well, that doesn't make a lot of sense. I mean, maybe we could let the market take care of that and not hasten the arrival of robots. But also, as we write in the book, we think American healthcare is a terrible drag on the economy, and particularly on working class jobs, just because it's so expensive and so much of it is funded through labor market. And then at the same time, you've got these pharma firms that are pumping out legalized heroin and addicting people so that you get this terrible crisis of addiction and death at the same time. So the healthcare Has a lot to answer for.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  32. Well, I don't think they see anyone who's putting in policies that would actually help them. And they feel sort of betrayed for a long time. We write quite a lot in the book, and other people have written about it too, but what meritocracy has done to America and also to Britain, Anna and I are meritocrats who sort of climb the ladder from relatively not rich, not poor.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  33. I don't think you could quite say that because all of us are better off for 250 years of capitalism since the Enlightenment. It's been an incredible engine of bringing up people out of poverty and giving us today's living standards. What's happening though is it's not delivering for a long time. It delivered pretty widely and there's a lot of people who are now not sharing in that growing prosperity. So there's been quite a lot of economic growth in America since the war, even since 1970, though growth has been slowered since 1970. But it's just not being shared with a very large chunk of the population, the population that doesn't have a BA is two-thirds of the American population.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  34. Even in the union. They did a lot of stuff within a plant in making sure that it was safe and enforcing regulations. They were part of the local community. We always like to tell the story of Bob Putnam's guy who was bowling alone. He was bowling alone in a union hall. Well, now he couldn't bowl alone in a union hall because there's no union hall anymore. And I think a lot of that is a matter of public policy. Governments, state and federal governments in the US have persecuted unions for many years, making harder for them to organize, you know, taking their privileges away.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  35. Attack on the capital or indeed if they elect populists, you know, who's going to bring the whole system down? And I think Joe Biden, who's sort of more an old-fashioned democratic politician, who remembers when the Democratic Party was rooted in the union movement really does understand a lot about the distress of working class people. And certainly, you know, our work is well known among the new appointees in Washington like Janet Yellen, who we've talked about this work on many occasions, Cece Rouse, who was our boss, you know, and knows us very well. So, you know, there's a real understanding of some of the things that have to be done. One thing was unions have been almost vanished in the private sector. And unions really did things for working class people. You know, they got them better wages. They got better wages for other people who weren't.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  36. I think ultimately it would have to be government, and there are some things that you can see, you know, this group is, of course, very like the group that voted for Donald Trump. And, you know, they're very angry in Britain. They're not so different from the group that voted for Brexit. They hate what's going on in London. There's this grand cosmopolitan city where you were sitting there, and it's the center of the world, and they ate it. Or they see it as very different from what's happening to them. And I think in America there's a lot of disgust that the educated cosmopolitan coastal elites. But, you know, it's in everybody's interest to fix this because very angry people for whom not much has been done for a very long time are going to, you know, it's just very dangerous, as we saw in the...

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source

  37. Know no one's really understands. Durkheim is still one of the best books on it, even though it was written in the 1890s. And predicting suicide is very hard. It tends to be true that during recessions, suicide do go up a bit, but it certainly was not true in the last recession. So, you know, in the Great Recession, and it's one of the things we argue in the book, not just suicides, but also the other deaths of despair were rising before the Great Recession. They rose during the Great Recession, and they rose after the Great Recession. So you just don't see this effect. So sometimes very puzzling, but it's like there's something specially wrong with America in that suicides are declining all around the world, except in America and now more recently in Britain. So there's something going on that's not a good sign.

    2021-03-23 · Intelligence Squared · A New Vision for Capitalism, with Anne Case, Angus Deaton and Francine Lacqua · IDENTIFIED FROM THE TRANSCRIPT · source