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and services they offer, not for the health outcomes that result. As Halvorson grimly notes: “Hospitals in America do not get paid more money if they do great work and are completely infection free. They do get paid a lot more money for patients with infections” (p. 11). He recounts cases where reengineering of services led to lower costs—and a revolt by the doctors, who felt that their incomes and jobs were jeopardized.

19. McKinsey & Company, “Accounting for the Cost of Health Care in the United States,” January 2007, p. 10.

20. For classification details, see Organisation for Economic Co-operation and Development, “OECD Health Data, Part II: International Classification for Health Accounts (ICHA).”

21. U.S. Energy Information Administration, “Net Generation by Energy Source: Total,” January 2011.

22. Lawrence Burns, Vijay Modi, and Jeffrey Sachs, “Transition to a Sustainable Energy System for the United States,” December 16, 2010, unpublished paper.

23. U.S. Department of Defense, “DoD Request: FY 2011,” http://comptroller.defense.gov/Budget2011.html.

24. Robert F. Kennedy, Remarks at the University of Kansas, March 18, 1968.

25. American Human Development Project, “The Measure of America 2010–2011: Mapping Risks and Resilience.”

26. Karma Ura, “Gross National Happiness,” Centre for Bhutan Studies.

27. For a recent useful survey, see David Blanchflower and Andrew Oswald, “International Happiness,” NBER Working Paper No. 16668, January 2011.

28. For more information on these studies, see Organization for Economic Co-operation and Development, “Global Project on Measuring the Progress of Societies”; William Nordhaus and James Tobin, “Is Growth Obsolete?,” in The Measurement of Economic and Social Performance, NBER Book Series Studies in Income and Wealth, 1973; Economist Intelligence Unit, “The Economist Intelligence Unit’s Quality-of-Life Index,” The World in 2005; Joseph Stiglitz and Amartya Sen, “Commission on the Measurement of Economic Performance and Social Progress”; Paul Dolan et al., “Measuring Subjective Well-Being for Public Policy,” Office for National Statistics—Government of the United Kingdom, February 2011.

Chapter 11: Paying for Civilization

1. Congressional Budget Office, “An Analysis of the President’s Budgetary Proposals for Fiscal Year 2012,” Table 1.5.

2. See Table 7.1 of the Office of Management and Budget Historical Tables.

3. Congressional Budget Office, “An Analysis of the President’s Budgetary Proposals for Fiscal Year 2012,” Table 1.5.

4. See Table 8.4 of the Office of Management and Budget Historical Tables.

5. Justice Oliver Wendell Holmes, Jr., attributed in Felix Frankfurter, Mr. Justice Holmes and the Supreme Court (Cambridge: Harvard University Press, 1961), p. 71.

6. Center for Responsive Politics, “Congressional Members’ Personal Wealth Expands Despite Sour Economy,” November 2010.

7. All the calculations that follow are based on the Congressional Budget Office report “The Budget and Economic Outlook: Fiscal Years 2011 to 2021,” January 2011. I do not report the CBO estimates exactly, but rather adjust them according to specific alternative assumptions that I believe form a more accurate baseline. For example, the CBO baseline for 2015 assumes a budget deficit of 3 percent of GDP (Tables 1–4). The CBO baseline assumes that the Bush tax cuts, currently in effect until 2012, are allowed to lapse after 2012. I instead assume for purposes of my baseline that they are continued after 2012. This adds around 2 percentage points of GDP to the CBO baseline deficit. The CBO baseline also assumes that civilian discretionary spending keeps up with inflation but not with GDP growth, causing discretionary civilian spending in 2015 to fall to 3.5 percent of GDP. I instead start with a baseline of discretionary civilian spending of 4 percent of GDP. I also assume that debt servicing in 2015 is 3 percent of GDP, while the CBO assumes 2.5 percent of GDP. The overall effect is a baseline of 6 percent of GDP, rather than the CBO’s 3 percent of GDP.

8. See Tables 1.2 and 8.4 of the Office