REPLY TO MAURO (TO QUESTION 7)
When you are talking about debt/GDP ratios of 100 percent or above which is where so many OECD countries stand today there is really no alternative but gradualism in reducing the debt burden if it is to be achieved through budget balance settings. By gradualism, I'm talking about reducing the debt burden significantly over a period of, say, three decades. The maths is pretty simple even if interest rates stay pretty low for all that time, it is necessary to have significant primary surpluses for a long time in order to bring debt/GDP down appreciably.
What this means is that, even if we think that interest rates are going to remain sufficiently low for quite a long time and that there is little other than in the long term of current debt levels leading to a big blowout in interest payments/GDP, the importance of bringing debt/GDP down over the longer-term implies a big and sustained effort of budget discipline. Whether all advanced countries are capable of this is very unclear, and there is a huge danger that debt levels will not be brought down sufficiently and that at some point in the future when interest rates do move up this will cause huge problems. I am rather pessimistic about the prospects in this respect. The danger is increased by complacency due to current low interest rates. It is further aggravated by the growing influence of quack economics such as modern monetary theory which pushes the line that deficits and debt don't matter much. This is very wrong. You can be 100 percent Keynesian (as I am) without signing on to the foolish proposition that the dangers of big deficits are simply a myth.
The structural forces keeping rates low, to which I made reference, include demographic aging and the global savings imbalances. Some also consider, as we touched on before, that inequality has been an important factor.
This raises the prospect that ultimately recourse will be had in at least some advanced countries to other methods of bringing the debt burden down long-term deliberate financial repression by the government (i.e. regulatory action to ensure that rates remain very low), a major one-off wealth tax to pay off some part of the debt (within limits, not a bad idea), debt repudiation and the central bank writing off debt (or even buying it back and then canceling it). In France, there is already a lively push on the left for debt repudiation. The notion of a country like France taking the Argentine route is really depressing. Advocates of repudiation don't seem to realize that this is simply a type of discriminatory wealth tax which hits not just the rich, but many pension funds and others. As for the idea of having the central bank write-off debt, economists have explained time and time again that no country is better off by doing this. The apparent advantage of writing off debt now is, for a given monetary policy, simply offset by an equivalent reduction in future earning streams of the central bank which are passed on to government. The qualification of this in Europe is that if higher-deck countries were to succeed in getting the ECB to write off a lot of debt, they might succeed yet again in effectively passing on some of their debt burden to less indebted EU countries.
Italy, of course, has been one of the most extreme cases of high debt for some time. Because of this, the country has been obliged to run one of the larger primary surpluses among OECD countries, and the pressure to keep on doing this will remain. Italy's problem in keeping its interest rates relatively low is, first and foremost, one of market confidence. As we saw in the wake of the GFC, when the financial markets lose confidence rates can shoot up very fast. To maintain confidence and not have to rely on the ECB to keep on buying its debt to prevent a debt crisis Italy has to maintain budget settings which imply a downward trajectory of debt/GDP. (Incidentally, one question which always springs to mind in the case of Italy is why the country does not levy a significant one-off wealth tax to repay a significant chunk of its debt. The Germans get understandably irritated by the fact that the ratio of private wealth/GDP is much higher in Italy (and Spain, for that matter) than it is in Germany.)
I guess the big point that my book is making is that these challenges would be tough enough if government spending were set to remain at around present levels. The problem I identify is the very powerful forces pushing spending up substantially over the long-term. My analysis of these forces differs significantly from the conventional wisdom in budgeting and fiscal circles. In particular, with respect to health spending, I do not see population aging as the key force. What is most important is the impact of technology the way in which the bioscience revolution is delivering new and expensive treatments which will become increasingly mainstream. The curious thing is that, although fiscal policy specialists so often assume that it is population aging which is driving health spending, this is not a view which is generally held by health economists who really know the field. Health economists have always seen the expanding "capabilities of medicine" as the most important driver of health spending. Even here, however, few have grasped the way in which technological change which is currently underway threatens to significantly increase the rate of growth of health spending.
In addition to health spending, there are the other key areas of spending to fight climate change, long-term care and (in some countries) pensions and infrastructure. Climate change is pretty obvious, and I'm sure everyone understands that the spending effort will have to last for some decades. I don't think there's enough general awareness in the budgeting/fiscal policy community of the importance of long-term care as a source of long-term spending pressure. Yet if you follow the newspapers in many countries (e.g. the UK and France) it rapidly becomes clear just how much pressure many governments are under to step up the public sector role in care provision, particularly for those unfortunate enough to suffer dementia or other enduring disability.