Divide and Conquer: Using an Accessions Tax to Combat Dynastic Wealth Transfers

The current estate tax raises little revenue, yet is ill designed to further the social goals used to justify it. This Article takes one frequently mentioned goal—minimizing dynastic wealth transfers—and explores what insights focusing on that objective yields for the design of the transfer tax system. It starts from the premise that what renders dynastic wealth transfers problematic is that such transfers can bestow upon the recipient unearned political and economic power, which contravenes the democratic ideal that power should be earned, not inherited. Under this view, the tax system should be concerned with neither the build-up of wealth per se nor transfers of wealth that are not large enough to bestow power upon the recipient. Instead, the tax system should be concerned only with transfers of wealth large enough to confer economic and political power on the recipient. The structure that best reflects this concern is a progressive cumulative accessions tax that focuses on the recipient, instead of an estate tax that focuses on the transferor. Each recipient should have an extremely high exemption amount, given that receiving a few hundred thousand or couple million dollars does not give one power. Lastly, there should be no generation-skipping penalty, because what matters is how many individuals have the ability to use the power accompanying the wealth

Charitable Giving and Utilitarianism: Problems and Priorities

Charitable giving is redistributive at heart. It is thus surprising that scholarship on the charitable tax subsidies focuses on the efficient and pluralistic production of public goods while largely ignoring distributive justice concerns. Existing scholarship and current law leave crucial questions unanswered: How should we prioritize among charities? Should subsidized groups be required to help the poor? Are criticisms that charities do too little to help the poor valid? This Article is part of a series that examines how each common theory of distributive justice would answer these questions. More specifically, this Article explores utilitarianism and the charitable tax subsidies using the definitions of “utility” most common in legal scholarship: income, happiness, preference satisfaction, and objective-list well-being. It demonstrates that a careful application of utilitarianism as used by tax scholars (which equates income with utility) suggests that charities assisting the underprivileged deserve special treatment. This contrasts with the current structure, which does not prioritize such organizations, and contradicts the conventional wisdom concerning utilitarianism and charitable giving. Initially, other interpretations of utilitarianism common in the legal literature (focusing on preference satisfaction, subjective well-being, and objective lists) appear to support the conventional wisdom that groups assisting the poor are not special. Each of these approaches, however, has intrinsic drawbacks when it comes to prioritizing among organizations and answering the recurring distributional questions facing the non-profit sector. But viewing these approaches together highlights a commonality: donative organizations that help the poor likely enhance welfare under all of the common welfare-based theories of justice. This is also true of traditional income-based utilitarianism, the leximin, and the most common equality of opportunity theories. This overlap suggests that tax policy should favor such groups, thus reconciling distributional concerns with pluralism by emphasizing what various moral theories have in common

Theorizing the Charitable Tax Subsidies: The Role of Distributive Justice

Distributive justice plays a starring role in many fundamental tax policy debates, from the marginal rate structure to the choice of base to the propriety of wealth transfer taxes. In contrast, current tax scholarship on the charitable tax subsidies generally either ignores or explicitly disavows distributive justice concerns. Instead, it focuses on the efficiency and pluralism-enhancing advantages of having charities provide public goods instead of or in addition to the government. While identifying these advantages is a necessary and important contribution to our understanding of charitable giving policy, avoidance of distributive justice concerns ignores the very purpose of charity: voluntary redistribution. After all, it\u27s called the charitable deduction, not the public goods deduction. As a result, the current body of work on the charitable tax subsidies is incomplete: it purposely under-theorizes what is “good” for society in order to avoid making value judgments about which projects should be subsidized. Although this sounds appealing, completely avoiding such judgments is both impossible and counterproductive. Current scholarship thus excessively under-theorizes the good, creating confusion about the charitable tax subsidies in both theory and practice. Explicitly addressing distributive justice—in addition to pluralism and efficiency—will enhance our understanding of the subsidies for three reasons. First, existing scholarship is incomplete and inconsistent for generally ignoring distributive justice issues. It is incomplete because it does not adequately identify which projects deserve a subsidy; it is inconsistent because it implicitly contains value judgments that have distributive justice implications but that are unacknowledged (and often disavowed) by their proponents. Second, popular criticisms of the charitable tax subsidies raise distributive justice issues that have not been adequately addressed. And lastly, the law governing the charitable tax subsidies is itself confused on the role of distributive justice. Extending our understanding of the subsidies in this manner has three benefits. First, it will help the efficiency- and pluralism-minded scholars better address how to structure the tax subsidies to best promote efficiency and pluralism. Second, a better understanding of distributive justice will help us assess existing justice-related criticisms of the subsidies. And lastly, because our society currently spends a great deal of resources subsidizing charity, such a discussion will help us allocate our resources in a more systematic fashion

The Architecture of a Basic Income

The notion of a universal basic income (UBI) has captivated academics, entrepreneurs, policymakers, and ordinary citizens in recent months. Pilot studies of a UBI are underway or in the works on three continents. And prominent voices from across the ideological spectrum have expressed support for a UBI or one of its variants, including libertarian Charles Murray, Facebook co-founder Chris Hughes, labor leader Andy Stern,and—most recently—former President Barack Obama.Although even the most optimistic advocates for a UBI will acknowledge that nationwide implementation lies years away, the design of a basic income will require sustained scholarly attention. This Article seeks to advance the conversation among academics and policymakers about UBI implementation. Our prior work has focused on the philosophical foundations of a basic income; here, we build up from those foundations to identify the practical building blocks of a large-scale cash transfer program. After canvassing the considerations relevant to the design of a UBI, we arrive at a set of specific recommendations for policymakers. We propose a UBI of $6,000 per person per year, paid to all citizens and lawful permanent residents via direct deposit in biweekly installments. We argue—contrary to other UBI proponents—that children and seniors should be included, that marriage penalties and cost-of-living adjustments should be rejected, that recipients should have a limited ability to use future payments as collateral for short-and medium-term loans, and that the Social Security Administration should carry out the program. We also explain how a UBI could be financed through the consolidation of existing cash and near-cash transfer programs as well as the imposition of a relatively modest surtax on all earners. Importantly, the building blocks of a UBI do not necessarily determine its out-ward face. By this, we mean that economically identical programs can be described in very different ways—for example, as a UBI with no phaseout, a UBI that phases out with income, and a “negative income tax”—without altering any of the essential features. To be sure, packaging matters to the public perception of a UBI, and we consider reasons why some characterizations of the program may prove more popular than others. Our Article seeks to sort the building blocks of a UBI out from the cosmetic components, thereby clarifying which elements of a UBI shape implementation and which ones affect only the outward appearance

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Libertarianism and the Charitable Tax Subsidies

Despite libertarianism’s political popularity, tax scholarship is largely silent about the interaction between libertarian principles and the structure of our tax system. To fill that gap, this Article mines the nuances of libertarian theory for insights into one feature of our tax system—the charitable tax subsidies—and finds some surprising insights. Although one strand of libertarianism suggests that charitable tax subsidies are in and of themselves illegitimate, several other understandings of libertarianism see a role for the state to engage in a varying amount of redistribution or to provide varying amounts of public goods. Surprisingly, some readings even lend weight to the common criticism that the charitable tax subsidies do not do enough to assist the poor and disadvantaged. Only a lenient interpretation of classical liberalism that conceives of a vibrant non-profit sector as a public good in and of itself and an expansive reading of left-libertarianism support something akin to our current structure, in which elite cultural institutions such as the opera are subsidized even if they provide no free or discounted services to the poor. In addressing these questions, this Article rounds out a series on the interaction of distributive justice and the charitable tax subsidies

Charitable Giving and Utilitarianism: Problems and Priorities

Charitable giving is redistributive at heart. It is thus surprising that scholarship on the charitable tax subsidies focuses on the efficient and pluralistic production of public goods while largely ignoring distributive justice concerns. Existing scholarship and current law leave crucial questions unanswered: How should we prioritize among charities? Should subsidized groups be required to help the poor? Are criticisms that charities do too little to help the poor valid? This Article is part of a series that examines how each common theory of distributive justice would answer these questions. More specifically, this Article explores utilitarianism and the charitable tax subsidies using the definitions of “utility” most common in legal scholarship: income, happiness, preference satisfaction, and objective-list well-being. It demonstrates that a careful application of utilitarianism as used by tax scholars (which equates income with utility) suggests that charities assisting the underprivileged deserve special treatment. This contrasts with the current structure, which does not prioritize such organizations, and contradicts the conventional wisdom concerning utilitarianism and charitable giving. Initially, other interpretations of utilitarianism common in the legal literature (focusing on preference satisfaction, subjective well-being, and objective lists) appear to support the conventional wisdom that groups assisting the poor are not special. Each of these approaches, however, has intrinsic drawbacks when it comes to prioritizing among organizations and answering the recurring distributional questions facing the non-profit sector. But viewing these approaches together highlights a commonality: donative organizations that help the poor likely enhance welfare under all of the common welfare-based theories of justice. This is also true of traditional income-based utilitarianism, the leximin, and the most common equality of opportunity theories. This overlap suggests that tax policy should favor such groups, thus reconciling distributional concerns with pluralism by emphasizing what various moral theories have in common