President Biden has promised an economic plan to Build Back Better. After the disaster wrought by the coronavirus disease 2019 (COVID-19) pandemic, that is absolutely necessary. But rebuilding involves more than just repairing the damage from the virus itself. The US economy had glaring weak points before COVID-19, and President Biden will need to address those flaws. Of necessity, this will take the president into the economics of health care. The 2 central features of an economy are how much

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... ncome it produces and who receives the income. Even before COVID-19, overall income growth was not particularly rapid. From 2007 to 2019, the 2 most recent business cycle peaks, the growth of inflation-adjusted GDP per person averaged only 1.0% annually. That is down from 2.2% per year in the 1990s. An enormous share of this economic growth was taken by health care, about 32% of increased GDP between 2007 and 2019 and an even larger share, 39%, between 2000 and 2007. Put another way, roughly one-third of every additional dollar earned in the economy during the past 2 decades was used to pay for medical care. Families experience this in every way possible. Paychecks are smaller because employers pay for health care and, as a result, defer wage increases. The amount paid out of pocket for insurance premiums and direct medical care rise as well. Governments also spend more on health care, raising taxes or cutting other spending to do so.