Redistribution? Depends on Who You Ask

Joel B. Levine MD

Money is thought of differently by those who have it and those who do not. Obviously, the former are more numerous so any head count would be wildly in favor of the more to the merriest. “Fair share” is the term tossed about implying that those with money do not contribute fairly. No one asks what fair means.

The Wolves of Wall Street are always put on display. After all, they make a lot of money. Indeed they do and often unseemly amounts. But they do for a simple reason. Their pay is the rounding error in their transactions. They live and die, sometimes literally, with risk. The economy depends on their madness and, to a degree, their greed. You may not like them, and many are not likable, but when your retirement comes along you pray that they have done the right thing by your 401K. Often 18 hours a day, 7days a week with any single decision sufficient to run you, your company and career. Bear Stearns was buried by a margin call.

Who else can we put in the stock? A neurosurgeon makes a lot of money, even in an academic medial center. A million is not unusual. Neurosurgery is an uncommon skill, decades of training, and work with watchmaker’s accuracy. About 160 neurosurgeons finish training each year. Market competition sets the salary. Do we want more or less than this number?

My point is simple. The vast majority of well-paid people have achieved though substantial effort. By the new tax offerings, a New York City neurosurgeon would give well over half of their income to one government or another. Steven Pinker speaks of the necessity for incentives. I am all for “ do it for the society”. Problem is that line is always short at the tax window.

There is a wealth gap, to be sure. It is very problematic for a society. So is the $ 65,000 Hermes handbag flaunted by Cardi B. Include the 35 million a year paid to many sports figures. What is good for the goose should clearly apply to most of Hollywood and Sports. So, if I said, we will no longer pay these kinds of dollars to athletes, avoid the $10 beer and the 7$ Fenway Frank. I wonder how many would say, “ Oh, that is not what I meant. These people give me pleasure”.

At a more down home level, let’s say you take a bigger chunk from a local company owner. Maybe the lumber yard or the construction company. As his/her income declines, what do you think they are likely to do? A “choose one answer” quiz: Raise the wages of those working for the company, Add more people to further increase costs, Lower the market price for the consumer? “None of the above” is correct and whatever they will do will be done with a snarl.

Incentivizing success is an appealing option. Make our educational system globally competitive (it is not anymore save for the major Universities); create a million ways to learn a skill and craft, reward new ideas or innovations. For example, let’s give Federal dollars to people, young and old, which have clever ideas. Steve Jobs may not have been the nicest guy. Steve Jobs changed the world. Was that, in and of it, enough?

It is easy to define the social problems we have. Why do young people go astray? Why do drugs pervade over 40% of American families, Why is divorce over 50%, Why are so many on anti-depressants or other psychotropic medications? Why is there so much gratuitous violence? What has happened to us, as a nation, over the last half century?

Without knowing the answers to these questions, even the most well intended efforts to improve lives will not likely succeed.

Facing what is really wrong is the first step to offering an effective solution.

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Joel B. Levine MD

Joel B. Levine MD


Professor of Medicine , essayist, practitioner, basic research and education ; reflections on medicine and modern society