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Intermediation cost of governance in the United States: $4.98 trillion (95% CI: $4.39 trillion-$5.61 trillion) per year. People employed to execute functions that are algorithmic in nature: millions. Time since the technology to replace them became available: over 15 years. Number of agencies replaced: zero. This is a technical specification for the obvious. It describes plumbing, not a program.
Introduction
A citizen who wants a particular research priority funded must persuade a representative, who must negotiate with other representatives, who must instruct an agency head, who must direct a bureaucracy, who must process applications, who must distribute funds. Six intermediaries sit between “I want this” and “this happens.” Each layer extracts value (salaries, overhead, compliance costs) and introduces preference distortion (lobbying, logrolling, regulatory capture). The aggregate cost of this intermediation in the United States alone is $4.98 trillion (95% CI: $4.39 trillion-$5.61 trillion) per year182, or 17.3% (95% CI: 15.3%-19.5%) of GDP.
Most of what these intermediaries do is mechanical. Tax calculation, benefit distribution, budget execution, auditing, census enumeration: these are algorithms currently executed by humans. Humans are slower, more expensive, and more susceptible to capture than software.
This paper describes a protocol that replaces specific mechanical agency functions with deterministic code while preserving democratic control over what those functions do. Citizens still decide how resources are allocated, through evidence-informed pairwise preference aggregation. The protocol executes their decisions without extracting value at each administrative layer.
The proposal is not to replace government. It is to replace the intermediaries between citizens and governance outcomes. Democracy is a decision-making system, not an employment program. The functions that require human judgment (enforcement, diplomacy, adjudication) remain human. The functions that are arithmetic become arithmetic. This is the same category of change as the ATM, the spreadsheet, and electronic payments: each replaced a specific manual function without any claim to replace the judgment around it. Nobody argued that reconciling a ledger by hand was a sacred act of discretion.
The protocol is empty of policy content. It does not set the size of government, what to tax, or what to fund; it changes only the cost and integrity of executing whatever voters decide.
System Architecture
The protocol has five parts:
Transparent ledger. Every government transaction recorded on a shared, publicly auditable ledger. Private settlements record only the minimal fields needed for tax collection and macroeconomic measurement, with identities and item-level details proved privately. This makes ex-post auditing (GAO) largely unnecessary and closes the opacity that corruption depends on.
Preference aggregation. Verified citizens in the relevant jurisdiction express resource-allocation preferences through a short series of pairwise comparisons. An aggregation algorithm183 produces budget weights via eigenvector decomposition (the same class of mathematics used in web-page ranking) and, where legal change is required, direct rule votes. This replaces the appropriations bottleneck and much committee bargaining without deciding what the budget should contain.
Evidence engine. A cross-jurisdictional causal-inference system that compares policy and budget outcomes across thousands of jurisdictions and identifies which choices actually move two widely shared outcome metrics: growth in real after-tax median income and median healthy life years. It has two components. The Optimal Policy Generator evaluates laws and regulations and produces enact / replace / repeal / maintain recommendations184. The Optimal Budget Generator estimates the spending level in each category at which the marginal dollar stops paying for itself185. Together they supply, in real time, the analysis the CBO and executive-branch scoring offices produce slowly and in isolation.
Identity layer. Continuous, sybil-resistant citizen verification. Every verified citizen counts exactly once for allocation, distribution, and enumeration. This replaces the decennial census headcount and the eligibility-verification bureaucracy without prescribing what anyone is entitled to.
Rules-based monetary policy. A transparent, rule-bound monetary policy targeting stable purchasing power in a rule-defined basket, with money creation tied to measured productivity growth rather than to discretionary committee judgment.
These five primitives are interdependent. The ledger enables accountability without a standing army of auditors. Preference aggregation enables allocation without an appropriations bottleneck. The evidence engine enables informed choice without a scoring monopoly. Identity enables distribution and enumeration without duplicate bureaucracies. Rules-based money enables stable prices without discretionary committees. Remove any primitive and the system degrades.
Monetary Policy and Revenue
Discretionary versus rules-based money
Monetary policy in the United States is set by a committee exercising discretion. The debate over whether a transparent rule would do better is old, mainstream, and cross-ideological: it runs from Milton Friedman’s fixed-growth rule to John Taylor’s interest-rate rule to contemporary nominal-GDP-targeting proposals. The protocol does not resolve that debate on the merits. It observes that a rule, once chosen, can be executed transparently by software rather than opaquely by discretion, and that the distributional consequences of money creation can be made explicit rather than incidental.
The most consequential of those consequences is who receives new money first. When new money enters the economy through banks and large counterparties, those first receivers spend or lend it before prices adjust, capturing purchasing power at the expense of later receivers. This first-receiver advantage (sometimes called the Cantillon effect) is recognized across mainstream and heterodox economics alike; it is arithmetic, not a school of thought. A rules-based protocol can hold the first-receiver question open as an explicit policy choice instead of settling it, by default, in favor of whoever is closest to the central bank.
A second consequence is fiscal accountability. Creating money to finance spending lets a government avoid the visible, felt cost of a direct tax, and a cost that is not felt is harder to refuse. This has mattered most for war: deficit- and inflation-financed conflict does not force the electorate to vote on a war tax, removing a brake that direct taxation would apply. The stakes are not small, since wars since 1900 have killed roughly 310 million people. A transparent, rule-bound monetary policy cannot stop a war, but it makes the fiscal cost of one legible instead of hidden, which is the same accountability logic behind the transparent ledger.
Automated tax collection at settlement
The novel element is not a particular tax; it is the collection mechanism. When money moves on the ledger, the tax due on that transaction is computed and withheld in the same step, so most taxpayers never file a return. This is agnostic about the base. A jurisdiction can settle a broad consumption tax (of the kind that appears in OECD value-added taxes and national-retail-tax proposals) or route income, capital-gains, corporate, estate, or wealth components through the same automatic settlement. What the protocol changes is that collection happens at settlement, the displayed rate is set by a published rule rather than by annual negotiation, and any rebate is delivered as an automatic deposit rather than a filed claim. What to tax, and how progressively, stays a voter choice.
Collection at settlement. Whatever base voters choose, the tax on a covered transaction is withheld automatically when the transaction settles. If the base is a consumption tax, transfers between registered business accounts, capital formation, and pure balance-sheet reallocations can be zero-rated automatically by wallet type so the tax does not pyramid through supply chains; an income, capital, or estate base settles against the relevant flows the same way. Most taxpayers file nothing, because return processing is automated; enforcement against evasion, a judgment function, remains staffed.
Where the base is a single displayed rate, that rate has two destinations behind it. The fiscal component funds the government’s democratically determined budget. The stabilization component does not fund spending; when activated, it is retired or held in a non-spendable reserve until the price basket returns to target. This separation avoids a common conceptual error: the same dollar cannot both finance expenditure and be withdrawn from circulation.
Once citizens and businesses can hold verified settlement wallets directly on the protocol, banks are no longer required as deposit warehouses, payment-rail operators, and first receivers of new money. What survives is lending. Underwriting default risk, duration risk, and project selection remain real work. Mortgages, business loans, and venture finance still exist, funded by competitive credit pools layered on top of the protocol rather than by institutions that also control custody and payments.
Returning recovered value. When the protocol recaptures fiscal cash (eliminated agency overhead, reclaimed direct-spending waste, recovered tax gap), that value has to go somewhere. The protocol is agnostic about where. Four options are on the menu, in no fixed priority, and citizens choose among them through preference aggregation:
- debt reduction;
- expanded funding for public goods that clear the evidence engine’s cost-effectiveness bar;
- an equal per-citizen dividend, of the kind Alaska has paid from resource revenue since 1982; or
- a lower headline tax rate.
Nothing in the mechanism requires the dividend option, and nothing forbids it. New currency created to prevent deflation as output grows (a productivity dividend) still has to enter somewhere, and the design insists only that the entry point be an explicit choice rather than defaulting silently to first receivers via the banking system. Whether that issuance funds a rate cut, debt reduction, public goods, or an equal per-citizen credit is set by voters like any other allocation.
Why target stable prices rather than deflation
A growing economy with a fixed money supply produces mild deflation: more goods, same money, falling prices. Whether that is benign or harmful is contested (the deflationary late-nineteenth-century United States, for instance, coincided with severe agrarian debt distress). The protocol defaults to stable purchasing power for three reasons:
- Legibility. A visible, stable unit of account is easier for households and firms to plan around than a slowly appreciating one, and easier to communicate.
- Debt neutrality. Deflation raises the real burden of existing debts; inflation erodes savers’ balances. A stable target is neutral between borrowers and lenders rather than favoring either.
- Distribution over doctrine. The strongest objection to discretionary money is not that some inflation exists; it is that the gains from money creation accrue to first receivers. A rules-based system can create exactly enough currency to keep prices stable and make the recipient of that new money an explicit choice, rather than defaulting it to the banking system.
This is a pragmatic default, not a monetary doctrine. The rule’s objective is itself a voter choice: a jurisdiction can encode price stability, a nominal-income path that also stabilizes employment, a dual mandate of the kind the Federal Reserve already operates under, or a mild-deflation target. The mechanism executes whichever objective is chosen; it does not select one.
Measuring prices without gaming the measure
If the price index is wrong, the rule stabilizes the wrong thing. The Consumer Price Index has well-documented, technically debated biases (substitution effects, hedonic adjustment, owner’s-equivalent rent, geometric weighting) and is compiled by the same government whose obligations (indexed benefits, inflation-linked securities) move with the reported number. Whatever one concludes about the size of the biases or the good faith of the measurement, the governance problem is structural: the party whose liabilities are indexed to a number should not be the sole party computing it.
The protocol uses a rule-bound purchasibasket derived from actual settlement data on the ledger rather than surveys or imputations. For private transactions, the ledger exposes only the fields needed for macro measurement and tax collection (amount, standardized category, jurisdiction, time bucket); identities, counterparties, and item-level receipts stay private and are validated with zero-knowledge proofs. The basket is anchored to essential categories (energy, food, housing, healthcare). Weights are derived from observed spending, fixed for a governance interval, and updated only on a public schedule. The entire calculation is public and auditable. Anyone can verify it; no single party can quietly adjust it.
Why not simply restore a gold standard
A metallic standard constrains money creation by requiring a physical reserve; a purchasing-power rule constrains it by targeting an index. Both discipline money creation, which is the goal of anyone who wants predictable, rule-bound money. The rule has three practical advantages over metal: it can accommodate real growth without passively rewarding existing holders; it is harder to suspend, because it runs on a distributed ledger rather than a single government’s decree; and it is auditable in real time rather than requiring trust that the metal is in the vault. The “backing” is a commitment that the unit will buy a defined basket tomorrow as it does today.
What this replaces
| Federal Reserve (12 FOMC members, ~24,000 staff, ~$6.8B/year) |
Transparent monetary rule |
Rule chosen democratically, executed by software |
| Discretionary money creation |
Rule-bound issuance |
Recipient of new money made an explicit choice |
| First-receiver advantage (proximity to issuance) |
Explicit first-receiver rule |
Distribution stated, not incidental |
| Commercial banks as money utilities |
Protocol wallets + competitive credit funds |
Custody and settlement become protocol functions; lending remains a risk-priced service |
| Manual filing and return processing |
Automatic collection at settlement |
Base set by voters; returns auto-processed; evasion enforcement retained |
| Annual tax-rate negotiation |
Rule-based fiscal + stabilization adjustment |
Budget funding separated from price stabilization |
The Tax System It Replaces
The federal income tax fit in 27 pages in 1913. The current federal tax system (the Internal Revenue Code plus Treasury regulations, rulings, and case law) fills roughly 74,000 pages of the CCH Standard Federal Tax Reporter. Most of the growth is accreted exemptions, deductions, and credits, each of which had a beneficiary and an advocate. The result is less a revenue mechanism than a sedimentary record of past bargains.
Americans spend about 6.1 billion hours per year on tax compliance, the equivalent of roughly three million people working full-time on paperwork. The IRS employs about 95,000 people186, and its operating budget of roughly $14 billion is dwarfed by the $546 billion (95% CI: $450 billion-$650 billion) per year161 in compliance burden the surrounding system imposes on everyone else. Regulatory compliance adds another $580 billion (95% CI: $290 billion-$1 trillion) per year68.
The compliance industry has a structural interest in complexity. The IRS could pre-fill most returns from data it already receives (wages from employers, interest from banks, gains from brokerages), as many countries do; it largely does not, in part because firms that sell tax-preparation services lobby against it. Taxpayers thus pay to sustain a problem that some of the paid parties have an interest in preserving. Simplifying the base is one of the few reforms with constituencies on both the left (who dislike the regressive burden of compliance) and the right (who dislike the drag and the rent).
What this replaces
| IRS (~100,000 employees) |
Protocol-level settlement tax |
$546 billion (95% CI: $450 billion-$650 billion)/year direct |
| 74,000-page tax code |
One rate, applied uniformly |
6.1B hours/year compliance eliminated |
| Tax-compliance industry |
No longer required |
$200B+/year in private compliance costs |
| Tax evasion (~$600B/year net gap) |
Low-rate settlement tax collected at source |
~$500B+/year recovered |
The 27-page code of 1913 could have been a function. The 74,000-page version is, in effect, a jobs program for the people who interpret the function. Returning to a function is a matter of engineering, not of choosing a party.
Allocation
The problem
The United States federal budget of roughly $6.8 trillion is allocated by 535 members of Congress through committee negotiation, floor votes, conference reports, and roughly $4.4 billion (95% CI: $3.74 billion-$5.06 billion) per year in lobbying. The CBO scores legislation over weeks or months; the OMB prepares the executive budget request. By the time a budget is enacted (when one is: the federal government has lapsed into shutdown more than 20 times since 1976), the document reflects donor preferences filtered through electoral incentives, committee seniority, floor amendments, and conference bargaining. At no point does a citizen directly express a preference over how their money is spent.
Representatives are elected on bundled platforms, so issue-level preference expression is impossible. A voter who wants more medical research and less military spending, or lower taxes and more border security, cannot register that combination. They get a package designed to win an election, not to match any individual’s priorities. This is the principal-agent problem operating at the scale of a multi-trillion-dollar budget.
The protocol
Preference aggregation replaces the appropriations process and, where needed, the committee bottleneck in rulemaking. Each verified citizen in the relevant jurisdiction performs a short series of pairwise comparisons (“$100 toward medical research or $100 toward border security?”), with a continuous slider rather than a binary choice. The aggregation algorithm converts these into budget weights via eigenvector decomposition183.
The evidence engine informs those comparisons. Before allocating, citizens see what the available evidence says each option actually produced where it was tried. This is deliberately symmetric: it does not favor spending or cutting, only whatever the cross-jurisdictional record supports. Budget weights update continuously, so there is no annual cliff, no continuing resolution, and no shutdown.
Some questions are budgetary and some are legal. If the question is how much to spend, the aggregation allocates the money and the Optimal Budget Generator supplies the marginal-return evidence. If the question is whether a tariff, subsidy, mandate, or zoning restriction should exist at all, the Optimal Policy Generator supplies the enact / replace / repeal / maintain evidence and citizens vote on the rule directly.
The reach of the evidence engine is broad, and pointedly nonpartisan about direction. It scores defense spending against a first-principles deterrence baseline the same way it scores social spending against outcomes; a category that is underfunded relative to the evidence is flagged just as loudly as one that is overfunded. Applied to contested areas, this cuts across party lines: drug policy is evaluated on measured outcomes (treatment-versus-incarceration comparisons such as Portugal’s) rather than on rhetoric; occupational licensing and land-use rules are evaluated on their measured effect on income and mobility; the approval of medical treatments can be informed by continuously updated real-world outcome data rather than by a single agency’s slow, all-or-nothing determination; and where the evidence shows an unpriced harm or an under-provided public good (pollution, monopsony wages, neglected public health), the engine flags the gap as loudly as it flags a rule worth repealing. In every case the engine reports what the data support and leaves the vote to citizens.
Direct allocation governs discretionary spending within constitutional limits; it is not a mechanism for a bare majority to suspend protected rights. Individual and minority protections, property rights, and the tax base itself are constitutional parameters, changeable only by supermajority, so the day-to-day allocation layer cannot vote them away.
What this replaces
| Congressional appropriations (535 members) |
Verified citizens, direct allocation |
Eigenvector preference aggregation |
| OMB (~530 staff, $143M/year) |
Democratic budget weights |
Automated |
| CBO (275 analysts, months per score) |
Optimal Budget Generator |
Real-time empirical scoring |
| Regulatory analysis scattered across agencies |
Optimal Policy Generator |
Cross-jurisdictional enact/replace/repeal/maintain evidence |
| Lobbying industry ($4.4 billion (95% CI: $3.74 billion-$5.06 billion)/year) |
No intermediary to lobby |
Function is removed |
A budget that cannot be agreed on does not shut the system down, because there is no negotiation to deadlock. The weights update; the ledger executes.
Distribution
The problem
The United States spends over $1.1 trillion per year on means-tested programs across 89 federal programs, of which roughly $100 billion goes to administration: determining who qualifies, processing applications, verifying eligibility, and policing fraud. A significant fraction of each program’s cost is spent deciding whether a person qualifies rather than helping them, and the people least able to navigate application processes (the disabled, the elderly, non-English speakers, the severely ill) are often those who need help most. Social Security disability determinations averaged 230 days in FY2024, up 81% from 121 days in 2019; appeals take longer still.
Whatever one believes the right level of assistance is, spending a large share of it on gatekeeping is a pure efficiency loss, independent of how generous the policy is.
The protocol
The protocol provides a distribution rail, not a distribution policy. The rail has three properties: the identity layer verifies who counts as a citizen; a formula converts a democratically chosen pool into per-recipient amounts; and settlement deposits those amounts automatically, without applications, caseworkers, or waiting periods. The rail can deliver an unconditional per-citizen payment, a negative income tax, categorical benefits, or a mix. Which of those a jurisdiction runs is set by voters through preference aggregation, not by the protocol.
Two design observations follow:
- Automating delivery removes the gate. Where a benefit is fundamentally a transfer, delivering it automatically to verified recipients removes the eligibility bureaucracy without changing the benefit’s size. Whether that transfer is best delivered as cash or in kind is itself a voter choice: the rail can deposit cash, or it can fund in-kind provision (health coverage, housing, child nutrition) where voters judge it achieves something cash does not.
- Some functions are not ordinary transfers. Catastrophic risk (a loss too large for a household to self-insure), health coverage, support for those who genuinely cannot manage funds on their own behalf, and investments in children are structurally different from ordinary income support, and are better kept as explicit, rule-bound categories than folded into flat cash or dissolved into caseworker discretion.
The evidence engine evaluates outcomes against two widely shared metrics: growth in real after-tax median income and median healthy life years. Median rather than average is a Goodhart safeguard, a figure that a handful of large gains cannot inflate. Voters can weight additional outcomes (aggregate growth, mobility, an economic-freedom index) into the evaluation set; the two median metrics are the default headline, not the only permitted objective.
What this replaces
| SSA benefit calculation and distribution |
Deterministic distribution function |
distribute(pool / citizenCount) for the cash portion |
| Cash-transfer administration (SNAP, TANF, SSI overhead) |
Automatic deposit on the rail |
No eligibility bureaucracy for pure transfers |
| Means-tested eligibility determination |
Identity verification + rule-bound exception categories |
Gate removed where the benefit is a transfer |
| Poverty-determination bureaucracy |
Eliminated for the cash portion |
The protocol distributes; it does not adjudicate desert |
The system currently spends a large share of assistance deciding who deserves it. Automating delivery spends more of the budget on the goal and less on the gate.
Accountability
The problem
The Government Accountability Office employs roughly 3,600 staff, spends about $812 million per year, and produces reports that arrive months or years after the spending they examine, because government financial systems are opaque and must be reconstructed by hand. The Department of Defense has failed its financial audit every year since audits became mandatory in 2018 (seven consecutive failures through FY2024), and the consequence of those failures has been essentially nil. Freedom of Information Act requests, the citizen’s remaining window into spending, are answered in months; complex requests take years, and some agencies carry backlogs in the tens of thousands.
The protocol
When every government transaction is on a public ledger, auditing stops being a periodic activity and becomes a property of the system. Every unit spent by any governance function is visible in real time. There is no document to request and no official to interview. Anyone can verify any public expenditure and trace any allocation from preference to disbursement. A ledger cannot pass or fail an audit; it is the audit.
What this replaces
| GAO (~3,600 staff, $812M/year) |
Transparent ledger |
$812M/year + audit lag eliminated |
| Inspector General offices (per-agency) |
Redundant; the watched activity is public |
Hundreds of millions/year |
| FOIA request processing (months-to-years) |
Unnecessary; spending is public by default |
Administrative cost + delay eliminated |
Transparency of public money is a value both parties claim. The protocol supplies it by construction rather than by promise.
Political Incentives
The problem
Politicians raise campaign funds from donors whose interests need not align with constituents’, and the returns to that spending are documented. Corporate welfare of $181 billion (95% CI: $150 billion-$220 billion) per year68 is, in part, the return on $4.4 billion (95% CI: $3.74 billion-$5.06 billion) per year in lobbying; studies of individual campaigns have found returns in the thousands of percent (the American Jobs Creation Act of 2004 delivered $62.5 billion in tax breaks to 93 corporations that spent $282.7 million lobbying for it187). The revolving door completes the circuit: roughly half of departing members of Congress become lobbyists. None of this is illegal, which is precisely the problem; it is the system operating as designed.
The protocol
Two properties of the transparent ledger reduce the leverage of concentrated money without banning anything. First, an alignment measure183 continuously and publicly compares each representative’s votes to their constituents’ evidence-informed preferences, so divergence is visible rather than buried. Second, because allocation and rulemaking increasingly run through direct preference aggregation and public evidence, the number of discretionary levers available to purchase shrinks. You cannot buy an exemption that no committee has the power to grant.
What this replaces
| FEC (regulator of a donor-driven system) |
Fewer discretionary levers to capture |
Structural reduction |
| Opaque campaign influence |
Public alignment measurement |
Divergence from constituents made visible |
| Lobbying industry ($4.4 billion (95% CI: $3.74 billion-$5.06 billion)/year) |
Fewer purchasable intermediaries |
Targets removed as functions are automated |
The return on lobbying is high because the intermediary it buys is cheap relative to the payoff. Removing the intermediary removes the target. There is no discretionary exemption to sell when there is no discretion to exercise.
Identity, Enumeration, and Migration
The problem
The 2020 census cost $14.2 billion, counted everyone once, took months to process, was out of date by publication, and will not be repeated until 2030. Meanwhile most residents carry a device that reports their location continuously to several private companies. The government spends billions to learn, once per decade and with a lag, a coarse version of what is already measured continuously elsewhere. Separately, immigration mixes two different questions (the rule for who may enter, which is a matter of law and enforcement, and the administration and pricing of whatever entry the law authorizes) into one contested process, so the fiscal and allocative dimension is handled implicitly rather than explicitly.
The protocol
Continuous, sybil-resistant verification through the identity layer. Every verified citizen has exactly one identity in the jurisdiction where they vote and receive distributions, and the population count becomes a real-time view function rather than a decennial survey. The same layer prevents double-counting (census), double-spending (monetary system), and double-voting (allocation): one primitive, three functions.
The identity layer also makes the fiscal side of migration explicit without touching the enforcement side, which remains a matter of law and human judgment. How many people may enter, and by what criteria (lottery, points, family ties, price, humanitarian status, or a mix), is set by voters and law, and may be any level, including a low one; enforcing that rule is an objective the protocol supports, not a cost to minimize. What the mechanism adds is that, for whatever quota voters authorize, allocation and any fee can be handled transparently rather than through smugglers and informal markets, and if a jurisdiction chooses to price entry, the revenue can be shared with existing citizens rather than dissipating into unpriced congestion. This separates two questions current policy conflates: who is permitted to enter (a political and enforcement question, left to law) and how whatever entry voters authorize is administered and priced (a mechanical question the protocol can handle).
What this replaces
| Census Bureau ($14.2B per decade) |
Continuous real-time count |
~$1.4B/year amortized |
| Voter registration (separate bureaucracy) |
Merged into identity layer |
Administrative cost eliminated |
| Per-program eligibility verification |
Unified in identity layer |
Redundant systems eliminated |
| Manual administration of authorized entry |
Transparent allocation and optional pricing of the voter-set quota |
Entry rule and enforcement unchanged; any fee shared with citizens |
Where the Recovered Value Goes
If the protocol saves trillions, it is worth being precise about where that value currently sits and how the savings behave, because the categories differ in kind. The accounting rule below is deliberately conservative.
Agency operating overhead
This is the direct public cost of running intermediary agencies. It is real and recoverable, and smaller than the value diverted by captured policy:
| Federal Reserve |
~$6.8B operational |
Rules-based monetary policy |
| IRS (agency operations) |
~$14B |
Protocol-level settlement tax |
| SSA + welfare administration (not benefits) |
~$100B across 89 programs |
Distribution rail |
| GAO + IG offices |
~$1B+ |
Transparent ledger |
| CBO |
~$60M |
Optimal Budget Generator |
| OMB |
~$143M |
Preference aggregation |
| Census Bureau |
~$1.4B/year amortized |
Identity layer |
| Total public operating overhead |
~$123B/year |
|
Private compliance burn is larger but different in kind. Americans and firms spend $546 billion (95% CI: $450 billion-$650 billion) per year on tax compliance and $580 billion (95% CI: $290 billion-$1 trillion) per year on regulatory red tape. That value returns to households and firms as time, fees not paid, and lower operating costs. It is real gain, but it is not a Treasury pool and is therefore not counted as routable cash.
Note what is not in this table: the benefit pools themselves. The conservative floor below excludes current transfer benefits to avoid mixing transfer policy with waste removal, not because transfer programs are free of waste; improper payments (which the GAO put at about $162 billion federally in FY2024195) and program duplication are audited on the same evidence basis as everything else.
Financial intermediation. The audit totals count government waste, not the private cost of moving money through the same architecture. Finance and insurance grew from about 4% of US GDP in the early 1970s to about 8% (roughly $2.3 trillion/year) by Q3 2025196,197, without a matching improvement in the unit cost of intermediation. A conservative read of the efficiency opportunity is the post-1971 doubling itself, roughly 4% of GDP or about $1.1 trillion/year; supporting micro evidence finds that 30–50% of the finance wage premium is not explained by measured complexity197. The protocol does not seize anything: it ends the requirement that payments, custody, and settlement flow through chartered banks, and lets lenders keep whatever value they add. Credit analysis, bankruptcy workouts, and duration matching remain real work and remain profitable. The sector shrinks only to the extent it cannot compete on price once it is no longer a mandatory tollbooth, a market test rather than a confiscation. The full $2.3 trillion/year is a ceiling, realized only if most money-moving migrates to the protocol.
Lobbying-purchased policy
The larger savings come from ending policies that persist because an intermediary was purchased, not from eliminating agencies. These are the audit’s current findings; each is a level the evidence engine re-scores against voters’ chosen objectives (deterrence, public safety, food security) and that citizens can override, not a fixed verdict:
This money does not vanish; it is transferred to specific industries whose lobbying secured it. Remove the discretionary intermediary and the transfer has no seller.
- Tax-gap recovery: the net tax gap is ~$600B/year. A low-rate settlement tax collected at source is both harder to evade (settlement and collection occur in the same transaction) and less worth evading (a low single- or low-double-digit rate versus a combined income-plus-payroll marginal rate). Conservative estimate: ~$500B/year recovered.
Structural GDP recovery
Some waste is prevented activity rather than misspent money. The audit estimates $1.56 trillion (95% CI: $1.11 trillion-$2.1 trillion)/year in policy-induced GDP loss recoverable at OECD-median performance: housing-supply restrictions cost $1.4 trillion (95% CI: $500 billion-$2 trillion)/year159, and tariffs cost $160 billion (95% CI: $90 billion-$250 billion)/year160. These are the output effects the evidence engine measures; a jurisdiction can still weigh a rule’s other aims (a tariff’s strategic value, a zoning rule’s local ones) and vote it up or down on the evidence. Budget automation alone does not repeal a law, so where evidence and a citizen vote favor changing a rule, and a higher jurisdiction cannot repeal a lower one’s, funding is conditioned on compliance rather than pretending federalism away.
Where the savings flow
The accounting rule is simple. If the protocol directly captures cash, it becomes routable value. If it removes a cost without routing money through the Treasury, the gain shows up as lower prices, lower fees, less compliance labor, or higher wages. Mixing the two is how governance estimates become unreliable.
| Agency operating overhead eliminated |
~$123B/year |
~$370/person |
Routable cash |
| Direct spending waste reclaimed |
$1.1 trillion (95% CI: $1.03 trillion-$1.17 trillion)/year |
~$3,000/person |
Routable cash |
| Tax-gap recovery |
~$500B/year |
~$1,500/person |
Routable cash |
| Total protocol-routable value |
~$1.63T/year |
~$4,900/person |
Returned to citizens (debt reduction, public goods, dividend, or rate cut) |
| Compliance burden removed |
$1.13 trillion (95% CI: $856 billion-$1.49 trillion)/year |
~$3,400/person |
Time back, lower private costs, lower prices |
| Healthcare system waste removed |
$1.2 trillion (95% CI: $1 trillion-$1.44 trillion)/year |
~$3,600/person |
Lower healthcare prices and premiums |
| GDP suppression reversed |
$1.56 trillion (95% CI: $1.11 trillion-$2.1 trillion)/year |
~$4,700/person |
Higher wages, more output |
| Financial intermediation cost reduced (defensible excess) |
~$1.1T/year |
~$3,300/person |
Lower fees and spreads, labor released |
| Total non-cash societal gain |
~$4.99T/year |
~$14,900/person |
Cheaper life rather than a transfer |
| Combined conservative quantified total |
~$6.62T/year |
~$19,800/person |
Recovered value plus lower costs |
Using the full $2.3T/year finance ceiling instead of the $1.1T excess estimate raises the combined total to roughly ~$7.82T/year, or about ~$23,400 per person. That is a ceiling, not the central claim.
The paper therefore makes two conservative claims. First, the protocol can recover roughly $4,900 per person per year in routable value that voters may return however they choose. Second, it can remove an additional ~$14,900 per person per year in diffuse extraction that people experience as cheaper life rather than as a government transfer. Several plausible additional gains (state and local duplication, queue-based workflow automation, the standalone cost of the political-compliance industry) are excluded because they are real but not yet modeled cleanly enough to add without risk of double-counting. A defensible floor is more useful than an inflated ceiling.
Implementation Pathway
The protocol cannot be deployed all at once. Each primitive has prerequisites, and trust must be earned by demonstrated performance rather than assumed. The pathway below is designed so that each stage is bounded, reversible, and independently valuable.
Phase 0: Evidence layer (deploy now). The Optimal Policy Generator184 and Optimal Budget Generator185 require no legislative change. They compare existing outcomes across jurisdictions and publish findings. This is research, not governance. Deployment: immediate.
Phase 1: A bounded allocation pilot. Apply preference aggregation to a single, ring-fenced pool of discretionary funds, with outcomes tracked by the evidence layer. One funding stream, one mechanism, measurable results, and a small, contained downside if it underperforms. The pilot can be run at the level of a city, a state, an agency program, or a dedicated fund.
Phase 2: Transparency layer (Years 1–3). Route the piloted funds through a public ledger so that every allocation from preference to expenditure is visible. This demonstrates the accountability model at limited scale before extending it.
Phase 3: Identity and distribution (Years 3–7). The identity layer and automated distribution require the largest infrastructure investment. The engineering is proven at national scale: India enrolled over a billion people in Aadhaar; Estonia runs a national government digitally. Global scale requires coordination between national systems, not new invention, and multiple approaches (biometric, social-graph, zero-knowledge) are already in production.
Phase 4: Revenue and monetary policy (Years 7–15). Replacing the tax and monetary systems requires the most political capital and the highest demonstrated reliability, so it is deployed last, after the earlier phases have shown the model works at increasing scale.
Each phase is a test. If citizens allocate a pilot pool better than committees do, the case for extending the method strengthens on its own evidence. If a transparent ledger reduces waste in that pool, the case for extending transparency strengthens. The protocol earns trust by performing, not by promising, and at no point is an existing system retired before its replacement has proven itself.
Objections
“You can’t replace human judgment with algorithms”
The proposal does not replace judgment; it replaces arithmetic. The IRS does not exercise judgment when it computes a tax liability, the SSA does not when it computes a benefit, and the Census Bureau does not when it counts. Those functions execute a formula, apply a table, and tally a total. The functions that do require judgment (criminal sentencing, disability determination, asylum adjudication, enforcement, diplomacy) remain human. The proposal automates the spreadsheet, not the courtroom.
“This is techno-utopianism”
The claim is narrow. It is not that algorithms will solve governance; it is that the specific functions that are already algorithmic, and are currently executed by millions of expensive and lobbyable people, can be executed by software. The ATM, the spreadsheet, and electronic payments each did exactly this to a specific manual function without any utopian claim about the surrounding judgment.
“The transition would be chaotic”
The status quo is not orderly: recurring shutdowns, billions of hours of compliance labor, months-long waits for benefits, and audits that lag the spending by years. The phased pathway is designed so that each component demonstrates value before the next is deployed, and so that no existing system is retired before its replacement has proven itself. A bounded pilot has a bounded downside.
“What about privacy?”
Government spending should be public by default because it is public money; personal consumption should be private by default because it is not. The current arrangement inverts this, harvesting personal data while hiding public spending behind slow FOIA queues. The protocol reverses it: government transactions are public, while private settlements reveal only the minimum fields needed for tax collection and macro accounting (amount, standardized category, jurisdiction, time bucket), with identities and item-level receipts kept private via zero-knowledge proofs. Public money becomes transparent; private life does not.
Limitations
What cannot be replaced
The protocol replaces mechanical functions. It does not replace enforcement (arrest, investigation, prosecutorial discretion), diplomacy (negotiation, cultural judgment, strategic ambiguity), adjudication (interpretation of law in context), or emergency response (adaptive decisions under uncertainty). It solves the deterministic part, which is the part currently costing $4.98 trillion (95% CI: $4.39 trillion-$5.61 trillion) per year.
Failure modes
Algorithmic capture. If the algorithm’s parameters can be tuned by concentrated interests, the intermediary problem returns in a new form. Mitigation: minimize tunable parameters, treat tax base, wallet classes, basket definition, update schedule, and vote thresholds as public constitutional parameters requiring supermajority approval to change, and have the evidence engine independently verify outcomes.
Identity attacks. If sybil-resistance fails, the whole system (distribution, voting weight, enumeration) is compromised. This is the single highest-risk component and the least technically settled.
Goodhart’s Law. Optimizing for measurable metrics (median income, healthy life years) may degrade unmeasured outcomes. Mitigation: continuously expand the measurement set, and let citizens fund measurement of outcomes they care about.
Transition disruption. The protocol displaces workers, which deserves honest arithmetic rather than hand-waving. The targeted agencies employ roughly 195,000 permanent staff (IRS ~100,000; SSA ~60,000; Federal Reserve ~24,000; Census Bureau ~4,000; GAO ~3,600; CBO, OMB, FEC ~1,100). Not all of those roles are mechanical; enforcement, IT transition, and oversight of the new systems remain human. Perhaps 60–70% of roles perform the deterministic functions the protocol replaces, or roughly 115,000–135,000 workers.
Average federal total compensation (salary plus benefits) is about $130,000 per year, so one year of full pay for every displaced worker is roughly $15–18 billion. Against a conservative quantified annual gain of ~$6.62T (of which ~$1.63T is routable cash), the transition cost is about 1% of the routable cash and under 0.3% of the full gain. A jurisdiction could pay every displaced worker a decade of full salary, fund retraining and early retirement, and offer priority placement in the human-judgment roles that remain, and the total would still be a rounding error against the savings. Displaced public workers are a real constituency with a legitimate interest, and the phased pathway and full-salary transition funding exist so that interest is met rather than overridden. A political barrier remains, since some of the people whose functions are automated also help approve the automation; that is not new (the same was true of every prior office-automation wave), and gradual displacement plus funded transition is how earlier waves were absorbed.
What we do not know
The protocol assumes that citizen preferences, informed by evidence, allocate at least as well as expert committees operating under donor pressure. The supporting evidence (participatory budgeting, direct democracy in Switzerland, digital governance in Estonia) is encouraging but has not been tested at this scale. The phased pathway is designed to generate that evidence incrementally, at bounded cost, before full deployment. The honest position is that some of the design here is wrong in ways only deployment will reveal.
Conclusion
Government is expensive in large part because it is intermediated, and every layer between citizen preference and public outcome extracts value and introduces distortion. A first-principles audit identifies $4.98 trillion (95% CI: $4.39 trillion-$5.61 trillion) per year in intermediation waste in the United States alone; once recovered tax gap and excess financial-sector cost are included, the conservative quantified stack rises to roughly ~$6.62T/year.
This protocol does not replace governance and does not choose a political program. It replaces the mechanical functions that governance currently delegates to humans at extraordinary cost (calculating taxes, distributing benefits, executing budgets, auditing expenditures, counting citizens, and managing the money supply) while leaving the decisions about what to tax, what to fund, and how much to redistribute where they belong: with voters.
The implementation described here is almost certainly wrong in important ways, which is why it is specified to be forked, tested at bounded scale, and improved. What is not wrong is the underlying observation: paying millions of people to execute deterministic functions is an expensive way to avoid writing the code.
1.
NIH Common Fund. NIH pragmatic trials: Minimal funding despite 30x cost advantage.
NIH Common Fund: HCS Research Collaboratory https://commonfund.nih.gov/hcscollaboratory (2025)
The NIH Pragmatic Trials Collaboratory funds trials at $500K for planning phase, $1M/year for implementation-a tiny fraction of NIH’s budget. The ADAPTABLE trial cost $14 million for 15,076 patients (= $929/patient) versus $420 million for a similar traditional RCT (30x cheaper), yet pragmatic trials remain severely underfunded. PCORnet infrastructure enables real-world trials embedded in healthcare systems, but receives minimal support compared to basic research funding. Additional sources: https://commonfund.nih.gov/hcscollaboratory | https://pcornet.org/wp-content/uploads/2025/08/ADAPTABLE_Lay_Summary_21JUL2025.pdf | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5604499/
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4.
Cato Institute. Chance of dying from terrorism statistic.
Cato Institute: Terrorism and Immigration Risk Analysis https://www.cato.org/policy-analysis/terrorism-immigration-risk-analysis Chance of American dying in foreign-born terrorist attack: 1 in 3.6 million per year (1975-2015) Including 9/11 deaths; annual murder rate is 253x higher than terrorism death rate More likely to die from lightning strike than foreign terrorism Note: Comprehensive 41-year study shows terrorism risk is extremely low compared to everyday dangers Additional sources: https://www.cato.org/policy-analysis/terrorism-immigration-risk-analysis | https://www.nbcnews.com/news/us-news/you-re-more-likely-die-choking-be-killed-foreign-terrorists-n715141
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5.
NIH. Antidepressant clinical trial exclusion rates.
Zimmerman et al. https://pubmed.ncbi.nlm.nih.gov/26276679/ (2015)
Mean exclusion rate: 86.1% across 158 antidepressant efficacy trials (range: 44.4% to 99.8%) More than 82% of real-world depression patients would be ineligible for antidepressant registration trials Exclusion rates increased over time: 91.4% (2010-2014) vs. 83.8% (1995-2009) Most common exclusions: comorbid psychiatric disorders, age restrictions, insufficient depression severity, medical conditions Emergency psychiatry patients: only 3.3% eligible (96.7% excluded) when applying 9 common exclusion criteria Only a minority of depressed patients seen in clinical practice are likely to be eligible for most AETs Note: Generalizability of antidepressant trials has decreased over time, with increasingly stringent exclusion criteria eliminating patients who would actually use the drugs in clinical practice Additional sources: https://pubmed.ncbi.nlm.nih.gov/26276679/ | https://pubmed.ncbi.nlm.nih.gov/26164052/ | https://www.wolterskluwer.com/en/news/antidepressant-trials-exclude-most-real-world-patients-with-depression
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7.
CNBC. Warren buffett’s career average investment return.
CNBC https://www.cnbc.com/2025/05/05/warren-buffetts-return-tally-after-60-years-5502284percent.html (2025)
Berkshire’s compounded annual return from 1965 through 2024 was 19.9%, nearly double the 10.4% recorded by the S&P 500. Berkshire shares skyrocketed 5,502,284% compared to the S&P 500’s 39,054% rise during that period. Additional sources: https://www.cnbc.com/2025/05/05/warren-buffetts-return-tally-after-60-years-5502284percent.html | https://www.slickcharts.com/berkshire-hathaway/returns
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8.
World Health Organization. WHO global health estimates 2024.
World Health Organization https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates (2024)
Comprehensive mortality and morbidity data by cause, age, sex, country, and year Global mortality: 55-60 million deaths annually Lives saved by modern medicine (vaccines, cardiovascular drugs, oncology): 12M annually (conservative aggregate) Leading causes of death: Cardiovascular disease (17.9M), Cancer (10.3M), Respiratory disease (4.0M) Note: Baseline data for regulatory mortality analysis. Conservative estimate of pharmaceutical impact based on WHO immunization data (4.5M/year from vaccines) + cardiovascular interventions (3.3M/year) + oncology (1.5M/year) + other therapies. Additional sources: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates
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9.
GiveWell. GiveWell cost per life saved for top charities (2024).
GiveWell: Top Charities https://www.givewell.org/charities/top-charities General range: $3,000-$5,500 per life saved (GiveWell top charities) Helen Keller International (Vitamin A): $3,500 average (2022-2024); varies $1,000-$8,500 by country Against Malaria Foundation: $5,500 per life saved New Incentives (vaccination incentives): $4,500 per life saved Malaria Consortium (seasonal malaria chemoprevention): $3,500 per life saved VAS program details: $2 to provide vitamin A supplements to child for one year Note: Figures accurate for 2024. Helen Keller VAS program has wide country variation ($1K-$8.5K) but $3,500 is accurate average. Among most cost-effective interventions globally Additional sources: https://www.givewell.org/charities/top-charities | https://www.givewell.org/charities/helen-keller-international | https://ourworldindata.org/cost-effectiveness
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11.
U.S. Department of Defense.
5.56mm NATO ammunition bulk procurement pricing. (2024)
The cost of 5.56mm NATO ammunition at military bulk procurement rates is approximately $0.40 per round, based on Lake City Army Ammunition Plant production and commercial market floor prices for mil-spec M855 ammunition.
12.
Pike, J.
U.s. Forces fire 250,000 rounds for every insurgent killed. (2011)
The General Accounting Office reports that US forces used 1.8 billion rounds of small-arms ammunition per year, a level that more than doubled in five years. An estimated 250,000 rounds were fired for every insurgent killed in Iraq and Afghanistan.
13.
AARP. Unpaid caregiver hours and economic value.
AARP 2023 https://www.aarp.org/caregiving/financial-legal/info-2023/unpaid-caregivers-provide-billions-in-care.html (2023)
Average family caregiver: 25-26 hours per week (100-104 hours per month) 38 million caregivers providing 36 billion hours of care annually Economic value: $16.59 per hour = $600 billion total annual value (2021) 28% of people provided eldercare on a given day, averaging 3.9 hours when providing care Caregivers living with care recipient: 37.4 hours per week Caregivers not living with recipient: 23.7 hours per week Note: Disease-related caregiving is subset of total; includes elderly care, disability care, and child care Additional sources: https://www.aarp.org/caregiving/financial-legal/info-2023/unpaid-caregivers-provide-billions-in-care.html | https://www.bls.gov/news.release/elcare.nr0.htm | https://www.caregiver.org/resource/caregiver-statistics-demographics/
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15.
Forbes.
Forbes world’s billionaires list 2024. (2024)
Forbes identified a record 2,781 billionaires worldwide with combined net worth of $14.2 trillion, 141 more than 2023. Bernard Arnault (LVMH) topped the list at $233 billion.
16.
CDC MMWR. Childhood vaccination economic benefits.
CDC MMWR https://www.cdc.gov/mmwr/volumes/73/wr/mm7331a2.htm (1994)
US programs (1994-2023): $540B direct savings, $2.7T societal savings ( $18B/year direct, $90B/year societal) Global (2001-2020): $820B value for 10 diseases in 73 countries ( $41B/year) ROI: $11 return per $1 invested Measles vaccination alone saved 93.7M lives (61% of 154M total) over 50 years (1974-2024) Additional sources: https://www.cdc.gov/mmwr/volumes/73/wr/mm7331a2.htm | https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00850-X/fulltext
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20.
U.S. Bureau of Labor Statistics.
CPI inflation calculator. (2024)
CPI-U (1980): 82.4 CPI-U (2024): 313.5 Inflation multiplier (1980-2024): 3.80× Cumulative inflation: 280.48% Average annual inflation rate: 3.08% Note: Official U.S. government inflation data using Consumer Price Index for All Urban Consumers (CPI-U). Additional sources: https://www.bls.gov/data/inflation_calculator.htm
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21.
James Surowiecki.
The Wisdom of Crowds. (Surowiecki, 2004).
Explores the aggregation of information in groups, arguing that decisions are often better than could have been made by any single member of the group. The opening anecdote relates Francis Galton’s surprise that the crowd at a county fair accurately guessed the weight of an ox when the median of their individual guesses was taken. The three conditions for a group to be intelligent are diversity, independence, and decentralization. Additional sources: https://archive.org/details/wisdomofcrowds0000suro | https://en.wikipedia.org/wiki/The_Wisdom_of_Crowds | https://www.amazon.com/Wisdom-Crowds-James-Surowiecki/dp/0385721706
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22.
ClinicalTrials.gov API v2 direct analysis. ClinicalTrials.gov cumulative enrollment data (2025).
Direct analysis via ClinicalTrials.gov API v2 https://clinicaltrials.gov/data-api/api Analysis of 100,000 active/recruiting/completed trials on ClinicalTrials.gov (as of January 2025) shows cumulative enrollment of 12.2 million participants: Phase 1 (722k), Phase 2 (2.2M), Phase 3 (6.5M), Phase 4 (2.7M). Median participants per trial: Phase 1 (33), Phase 2 (60), Phase 3 (237), Phase 4 (90). Additional sources: https://clinicaltrials.gov/data-api/api
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23.
ACS CAN. Clinical trial patient participation rate.
ACS CAN: Barriers to Clinical Trial Enrollment https://www.fightcancer.org/policy-resources/barriers-patient-enrollment-therapeutic-clinical-trials-cancer Only 3-5% of adult cancer patients in US receive treatment within clinical trials About 5% of American adults have ever participated in any clinical trial Oncology: 2-3% of all oncology patients participate Contrast: 50-60% enrollment for pediatric cancer trials (<15 years old) Note: 20% of cancer trials fail due to insufficient enrollment; 11% of research sites enroll zero patients Additional sources: https://www.fightcancer.org/policy-resources/barriers-patient-enrollment-therapeutic-clinical-trials-cancer | https://hints.cancer.gov/docs/Briefs/HINTS_Brief_48.pdf
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24.
ScienceDaily. Global prevalence of chronic disease.
ScienceDaily: GBD 2015 Study https://www.sciencedaily.com/releases/2015/06/150608081753.htm (2015)
2.3 billion individuals had more than five ailments (2013) Chronic conditions caused 74% of all deaths worldwide (2019), up from 67% (2010) Approximately 1 in 3 adults suffer from multiple chronic conditions (MCCs) Risk factor exposures: 2B exposed to biomass fuel, 1B to air pollution, 1B smokers Projected economic cost: $47 trillion by 2030 Note: 2.3B with 5+ ailments is more accurate than "2B with chronic disease." One-third of all adults globally have multiple chronic conditions Additional sources: https://www.sciencedaily.com/releases/2015/06/150608081753.htm | https://pmc.ncbi.nlm.nih.gov/articles/PMC10830426/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC6214883/
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25.
C&EN. Annual number of new drugs approved globally: 50.
C&EN https://cen.acs.org/pharmaceuticals/50-new-drugs-received-FDA/103/i2 (2025)
50 new drugs approved annually Additional sources: https://cen.acs.org/pharmaceuticals/50-new-drugs-received-FDA/103/i2 | https://www.fda.gov/drugs/development-approval-process-drugs/novel-drug-approvals-fda
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26.
Williams, R. J., Tse, T., DiPiazza, K. & Zarin, D. A.
Terminated trials in the ClinicalTrials.gov results database: Evaluation of availability of primary outcome data and reasons for termination.
PLOS One 10, e0127242 (2015)
Approximately 12% of trials with results posted on the ClinicalTrials.gov results database (905/7,646) were terminated. Primary reasons: insufficient accrual (57% of non-data-driven terminations), business/strategic reasons, and efficacy/toxicity findings (21% data-driven terminations).
29.
OpenSecrets. Defense sector lobbying summary.
OpenSecrets https://www.opensecrets.org/federal-lobbying/sectors/summary?id=D (2025)
Military sector federal lobbying totaled $198,009,793 in 2025, up from $159.5 million in 2024 and $142.9 million in 2023. Additional sources: https://www.opensecrets.org/federal-lobbying/sectors/summary?id=D
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30.
Companies Market Cap.
BAE systems and thales market capitalization. (2026)
BAE Systems market capitalization approx $75.80B and Thales approx $56.68B as of June 2026, combined approx $132.5B for the two major allied European military primes. Additional sources: https://companiesmarketcap.com/thales/marketcap/
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31.
Stock Analysis.
Military prime contractor market capitalization and float statistics. (2026)
Combined market capitalization of 11 US military primes approx $835.8B at the 2026-06-11 close: RTX $248.07B, Boeing $174.71B, Lockheed Martin $126.51B, General Dynamics $96.90B, Northrop Grumman $78.48B, L3Harris $58.16B, Leidos $15.36B, Huntington Ingalls $11.86B, CACI $11.61B, Booz Allen Hamilton $9.24B, SAIC $4.86B. Tradeable float across the 13 Western primes (adding BAE Systems and Thales) approx $880B, about 91 percent of combined cap (range $850-900B), from per-company float and shares-outstanding statistics pages; big-5 floats verified individually (RTX 92.6%, BA 96.0%, LMT 85.7%, GD 94.2%, NOC 99.7%); Thales is the outlier at approx 45% float because the French State (26.60%) and Dassault Aviation (26.59%) stakes are locked. Additional sources: https://stockanalysis.com/stocks/rtx/statistics/ | https://www.dassault-aviation.com/en/group/about-us/shareholding-structure-and-organization-chart/
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32.
Rummel, R. J.
Death by Government: Genocide and Mass Murder Since 1900. (Transaction Publishers, 1994).
Political scientist R.J. Rummel’s comprehensive accounting of democide (government murder of unarmed civilians) in the 20th century. His final revised estimate: 262 million people murdered by their own governments from 1900-1999, excluding battle deaths in wars. Range: 200-272+ million. Communist regimes account for the largest share (100-148+ million). Updated figures at hawaii.edu/powerkills.
33.
GiveWell. Cost per DALY for deworming programs.
https://www.givewell.org/international/technical/programs/deworming/cost-effectiveness Schistosomiasis treatment: $28.19-$70.48 per DALY (using arithmetic means with varying disability weights) Soil-transmitted helminths (STH) treatment: $82.54 per DALY (midpoint estimate) Note: GiveWell explicitly states this 2011 analysis is "out of date" and their current methodology focuses on long-term income effects rather than short-term health DALYs Additional sources: https://www.givewell.org/international/technical/programs/deworming/cost-effectiveness
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35.
Calculated from IHME Global Burden of Disease (2.55B DALYs) and global GDP per capita valuation. $109 trillion annual global disease burden.
The global economic burden of disease, including direct healthcare costs ($8.2 trillion) and lost productivity ($100.9 trillion from 2.55 billion DALYs × $39,570 per DALY), totals approximately $109.1 trillion annually.
37.
Think by Numbers. Pre-1962 drug development costs and timeline (think by numbers).
Think by Numbers: How Many Lives Does FDA Save? https://thinkbynumbers.org/health/how-many-net-lives-does-the-fda-save/ (1962)
Historical estimates (1970-1985): USD $226M fully capitalized (2011 prices) 1980s drugs: $65M after-tax R&D (1990 dollars), $194M compounded to approval (1990 dollars) Modern comparison: $2-3B costs, 7-12 years (dramatic increase from pre-1962) Context: 1962 regulatory clampdown reduced new treatment production by 70%, dramatically increasing development timelines and costs Note: Secondary source; less reliable than Congressional testimony Additional sources: https://thinkbynumbers.org/health/how-many-net-lives-does-the-fda-save/ | https://en.wikipedia.org/wiki/Cost_of_drug_development | https://www.statnews.com/2018/10/01/changing-1962-law-slash-drug-prices/
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38.
Biotechnology Innovation Organization (BIO). BIO clinical development success rates 2011-2020.
Biotechnology Innovation Organization (BIO) https://go.bio.org/rs/490-EHZ-999/images/ClinicalDevelopmentSuccessRates2011_2020.pdf (2021)
Phase I duration: 2.3 years average Total time to market (Phase I-III + approval): 10.5 years average Phase transition success rates: Phase I→II: 63.2%, Phase II→III: 30.7%, Phase III→Approval: 58.1% Overall probability of approval from Phase I: 12% Note: Largest publicly available study of clinical trial success rates. Efficacy lag = 10.5 - 2.3 = 8.2 years post-safety verification. Additional sources: https://go.bio.org/rs/490-EHZ-999/images/ClinicalDevelopmentSuccessRates2011_2020.pdf
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39.
Nature Medicine. Drug repurposing rate ( 30%).
Nature Medicine https://www.nature.com/articles/s41591-024-03233-x (2024)
Approximately 30% of drugs gain at least one new indication after initial approval. Additional sources: https://www.nature.com/articles/s41591-024-03233-x
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40.
EPI. Education investment economic multiplier (2.1).
EPI: Public Investments Outside Core Infrastructure https://www.epi.org/publication/bp348-public-investments-outside-core-infrastructure/ Early childhood education: Benefits 12X outlays by 2050; $8.70 per dollar over lifetime Educational facilities: $1 spent → $1.50 economic returns Energy efficiency comparison: 2-to-1 benefit-to-cost ratio (McKinsey) Private return to schooling: 9% per additional year (World Bank meta-analysis) Note: 2.1 multiplier aligns with benefit-to-cost ratios for educational infrastructure/energy efficiency. Early childhood education shows much higher returns (12X by 2050) Additional sources: https://www.epi.org/publication/bp348-public-investments-outside-core-infrastructure/ | https://documents1.worldbank.org/curated/en/442521523465644318/pdf/WPS8402.pdf | https://freopp.org/whitepapers/establishing-a-practical-return-on-investment-framework-for-education-and-skills-development-to-expand-economic-opportunity/
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41.
PMC. Healthcare investment economic multiplier (1.8).
PMC: California Universal Health Care https://pmc.ncbi.nlm.nih.gov/articles/PMC5954824/ (2022)
Healthcare fiscal multiplier: 4.3 (95% CI: 2.5-6.1) during pre-recession period (1995-2007) Overall government spending multiplier: 1.61 (95% CI: 1.37-1.86) Why healthcare has high multipliers: No effect on trade deficits (spending stays domestic); improves productivity & competitiveness; enhances long-run potential output Gender-sensitive fiscal spending (health & care economy) produces substantial positive growth impacts Note: "1.8" appears to be conservative estimate; research shows healthcare multipliers of 4.3 Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC5954824/ | https://cepr.org/voxeu/columns/government-investment-and-fiscal-stimulus | https://ncbi.nlm.nih.gov/pmc/articles/PMC3849102/ | https://set.odi.org/wp-content/uploads/2022/01/Fiscal-multipliers-review.pdf
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42.
World Bank. Infrastructure investment economic multiplier (1.6).
World Bank: Infrastructure Investment as Stimulus https://blogs.worldbank.org/en/ppps/effectiveness-infrastructure-investment-fiscal-stimulus-what-weve-learned (2022)
Infrastructure fiscal multiplier: 1.6 during contractionary phase of economic cycle Average across all economic states: 1.5 (meaning $1 of public investment → $1.50 of economic activity) Time horizon: 0.8 within 1 year, 1.5 within 2-5 years Range of estimates: 1.5-2.0 (following 2008 financial crisis & American Recovery Act) Italian public construction: 1.5-1.9 multiplier US ARRA: 0.4-2.2 range (differential impacts by program type) Economic Policy Institute: Uses 1.6 for infrastructure spending (middle range of estimates) Note: Public investment less likely to crowd out private activity during recessions; particularly effective when monetary policy loose with near-zero rates Additional sources: https://blogs.worldbank.org/en/ppps/effectiveness-infrastructure-investment-fiscal-stimulus-what-weve-learned | https://www.gihub.org/infrastructure-monitor/insights/fiscal-multiplier-effect-of-infrastructure-investment/ | https://cepr.org/voxeu/columns/government-investment-and-fiscal-stimulus | https://www.richmondfed.org/publications/research/economic_brief/2022/eb_22-04
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43.
Mercatus. Military spending economic multiplier (0.6).
Mercatus: Defense Spending and Economy https://www.mercatus.org/research/research-papers/defense-spending-and-economy Ramey (2011): 0.6 short-run multiplier Barro (1981): 0.6 multiplier for WWII spending (war spending crowded out 40¢ private economic activity per federal dollar) Barro & Redlick (2011): 0.4 within current year, 0.6 over two years; increased govt spending reduces private-sector GDP portions General finding: $1 increase in deficit-financed federal military spending = less than $1 increase in GDP Variation by context: Central/Eastern European NATO: 0.6 on impact, 1.5-1.6 in years 2-3, gradual fall to zero Ramey & Zubairy (2018): Cumulative 1% GDP increase in military expenditure raises GDP by 0.7% Additional sources: https://www.mercatus.org/research/research-papers/defense-spending-and-economy | https://cepr.org/voxeu/columns/world-war-ii-america-spending-deficits-multipliers-and-sacrifice | https://www.rand.org/content/dam/rand/pubs/research_reports/RRA700/RRA739-2/RAND_RRA739-2.pdf
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48.
FDA. FDA-approved prescription drug products (20,000+).
FDA https://www.fda.gov/media/143704/download There are over 20,000 prescription drug products approved for marketing. Additional sources: https://www.fda.gov/media/143704/download
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53.
ACLED. Active combat deaths annually.
ACLED: Global Conflict Surged 2024 https://acleddata.com/2024/12/12/data-shows-global-conflict-surged-in-2024-the-washington-post/ (2024)
2024: 233,597 deaths (30% increase from 179,099 in 2023) Deadliest conflicts: Ukraine (67,000), Palestine (35,000) Nearly 200,000 acts of violence (25% higher than 2023, double from 5 years ago) One in six people globally live in conflict-affected areas Additional sources: https://acleddata.com/2024/12/12/data-shows-global-conflict-surged-in-2024-the-washington-post/ | https://acleddata.com/media-citation/data-shows-global-conflict-surged-2024-washington-post | https://acleddata.com/conflict-index/index-january-2024/
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54.
UCDP. State violence deaths annually.
UCDP: Uppsala Conflict Data Program https://ucdp.uu.se/ Uppsala Conflict Data Program (UCDP): Tracks one-sided violence (organized actors attacking unarmed civilians) UCDP definition: Conflicts causing at least 25 battle-related deaths in calendar year 2023 total organized violence: 154,000 deaths; Non-state conflicts: 20,900 deaths UCDP collects data on state-based conflicts, non-state conflicts, and one-sided violence Specific "2,700 annually" figure for state violence not found in recent UCDP data; actual figures vary annually Additional sources: https://ucdp.uu.se/ | https://en.wikipedia.org/wiki/Uppsala_Conflict_Data_Program | https://ourworldindata.org/grapher/deaths-in-armed-conflicts-by-region
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55.
Our World in Data. Terror attack deaths (8,300 annually).
Our World in Data: Terrorism https://ourworldindata.org/terrorism (2024)
2023: 8,352 deaths (22% increase from 2022, highest since 2017) 2023: 3,350 terrorist incidents (22% decrease), but 56% increase in avg deaths per attack Global Terrorism Database (GTD): 200,000+ terrorist attacks recorded (2021 version) Maintained by: National Consortium for Study of Terrorism & Responses to Terrorism (START), U. of Maryland Geographic shift: Epicenter moved from Middle East to Central Sahel (sub-Saharan Africa) - now >50% of all deaths Additional sources: https://ourworldindata.org/terrorism | https://reliefweb.int/report/world/global-terrorism-index-2024 | https://www.start.umd.edu/gtd/ | https://ourworldindata.org/grapher/fatalities-from-terrorism
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56.
Institute for Health Metrics and Evaluation (IHME). IHME global burden of disease 2021 (2.88B DALYs, 1.13B YLD).
Institute for Health Metrics and Evaluation (IHME) https://vizhub.healthdata.org/gbd-results/ (2024)
In 2021, global DALYs totaled approximately 2.88 billion, comprising 1.75 billion Years of Life Lost (YLL) and 1.13 billion Years Lived with Disability (YLD). This represents a 13% increase from 2019 (2.55B DALYs), largely attributable to COVID-19 deaths and aging populations. YLD accounts for approximately 39% of total DALYs, reflecting the substantial burden of non-fatal chronic conditions. Additional sources: https://vizhub.healthdata.org/gbd-results/ | https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00757-8/fulltext | https://www.healthdata.org/research-analysis/about-gbd
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57.
Costs of War Project, Brown University Watson Institute. Environmental cost of war ($100B annually).
Brown Watson Costs of War: Environmental Cost https://watson.brown.edu/costsofwar/costs/social/environment War on Terror emissions: 1.2B metric tons GHG (equivalent to 257M cars/year) Military: 5.5% of global GHG emissions (2X aviation + shipping combined) US DoD: World’s single largest institutional oil consumer, 47th largest emitter if nation Cleanup costs: $500B+ for military contaminated sites Gaza war environmental damage: $56.4B; landmine clearance: $34.6B expected Climate finance gap: Rich nations spend 30X more on military than climate finance Note: Military activities cause massive environmental damage through GHG emissions, toxic contamination, and long-term cleanup costs far exceeding current climate finance commitments Additional sources: https://watson.brown.edu/costsofwar/costs/social/environment | https://earth.org/environmental-costs-of-wars/ | https://transformdefence.org/transformdefence/stats/
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58.
ScienceDaily. Medical research lives saved annually (4.2 million).
ScienceDaily: Physical Activity Prevents 4M Deaths https://www.sciencedaily.com/releases/2020/06/200617194510.htm (2020)
Physical activity: 3.9M early deaths averted annually worldwide (15% lower premature deaths than without) COVID vaccines (2020-2024): 2.533M deaths averted, 14.8M life-years preserved; first year alone: 14.4M deaths prevented Cardiovascular prevention: 3 interventions could delay 94.3M deaths over 25 years (antihypertensives alone: 39.4M) Pandemic research response: Millions of deaths averted through rapid vaccine/drug development Additional sources: https://www.sciencedaily.com/releases/2020/06/200617194510.htm | https://pmc.ncbi.nlm.nih.gov/articles/PMC9537923/ | https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.038160 | https://pmc.ncbi.nlm.nih.gov/articles/PMC9464102/
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59.
SIPRI. 36:1 disparity ratio of spending on weapons over cures.
SIPRI: Military Spending https://www.sipri.org/commentary/blog/2016/opportunity-cost-world-military-spending (2016)
Global military spending: $2.7 trillion (2024, SIPRI) Global government medical research: $68 billion (2024) Actual ratio: 39.7:1 in favor of weapons over medical research Military R&D alone: $85B (2004 data, 10% of global R&D) Military spending increases crowd out health: 1% ↑ military = 0.62% ↓ health spending Note: Ratio actually worse than 36:1. Each 1% increase in military spending reduces health spending by 0.62%, with effect more intense in poorer countries (0.962% reduction) Additional sources: https://www.sipri.org/commentary/blog/2016/opportunity-cost-world-military-spending | https://pmc.ncbi.nlm.nih.gov/articles/PMC9174441/ | https://www.congress.gov/crs-product/R45403
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60.
Think by Numbers. Lost human capital due to war ($270B annually).
Think by Numbers https://thinkbynumbers.org/military/war/the-economic-case-for-peace-a-comprehensive-financial-analysis/ (2021)
Lost human capital from war: $300B annually (economic impact of losing skilled/productive individuals to conflict) Broader conflict/violence cost: $14T/year globally 1.4M violent deaths/year; conflict holds back economic development, causes instability, widens inequality, erodes human capital 2002: 48.4M DALYs lost from 1.6M violence deaths = $151B economic value (2000 USD) Economic toll includes: commodity prices, inflation, supply chain disruption, declining output, lost human capital Additional sources: https://thinkbynumbers.org/military/war/the-economic-case-for-peace-a-comprehensive-financial-analysis/ | https://www.weforum.org/stories/2021/02/war-violence-costs-each-human-5-a-day/ | https://pubmed.ncbi.nlm.nih.gov/19115548/
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61.
PubMed. Psychological impact of war cost ($100B annually).
PubMed: Economic Burden of PTSD https://pubmed.ncbi.nlm.nih.gov/35485933/ PTSD economic burden (2018 U.S.): $232.2B total ($189.5B civilian, $42.7B military) Civilian costs driven by: Direct healthcare ($66B), unemployment ($42.7B) Military costs driven by: Disability ($17.8B), direct healthcare ($10.1B) Exceeds costs of other mental health conditions (anxiety, depression) War-exposed populations: 2-3X higher rates of anxiety, depression, PTSD; women and children most vulnerable Note: Actual burden $232B, significantly higher than "$100B" claimed Additional sources: https://pubmed.ncbi.nlm.nih.gov/35485933/ | https://news.va.gov/103611/study-national-economic-burden-of-ptsd-staggering/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC9957523/
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62.
CGDev. UNHCR average refugee support cost.
CGDev https://www.cgdev.org/blog/costs-hosting-refugees-oecd-countries-and-why-uk-outlier (2024)
The average cost of supporting a refugee is $1,384 per year. This represents total host country costs (housing, healthcare, education, security). OECD countries average $6,100 per refugee (mean 2022-2023), with developing countries spending $700-1,000. Global weighted average of $1,384 is reasonable given that 75-85% of refugees are in low/middle-income countries. Additional sources: https://www.cgdev.org/blog/costs-hosting-refugees-oecd-countries-and-why-uk-outlier | https://www.unhcr.org/sites/default/files/2024-11/UNHCR-WB-global-cost-of-refugee-inclusion-in-host-country-health-systems.pdf
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63.
World Bank. World bank trade disruption cost from conflict.
World Bank https://www.worldbank.org/en/topic/trade/publication/trading-away-from-conflict Estimated $616B annual cost from conflict-related trade disruption. World Bank research shows civil war costs an average developing country 30 years of GDP growth, with 20 years needed for trade to return to pre-war levels. Trade disputes analysis shows tariff escalation could reduce global exports by up to $674 billion. Additional sources: https://www.worldbank.org/en/topic/trade/publication/trading-away-from-conflict | https://www.nber.org/papers/w11565 | http://blogs.worldbank.org/en/trade/impacts-global-trade-and-income-current-trade-disputes
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64.
VA. Veteran healthcare cost projections.
VA https://department.va.gov/wp-content/uploads/2025/06/2026-Budget-in-Brief.pdf (2026)
VA budget: $441.3B requested for FY 2026 (10% increase). Disability compensation: $165.6B in FY 2024 for 6.7M veterans. PACT Act projected to increase spending by $300B between 2022-2031. Costs under Toxic Exposures Fund: $20B (2024), $30.4B (2025), $52.6B (2026). Additional sources: https://department.va.gov/wp-content/uploads/2025/06/2026-Budget-in-Brief.pdf | https://www.cbo.gov/publication/45615 | https://www.legion.org/information-center/news/veterans-healthcare/2025/june/va-budget-tops-400-billion-for-2025-from-higher-spending-on-mandated-benefits-medical-care
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67.
Cybersecurity Ventures. Cybercrime economy projected to reach $10.5 trillion.
Cybersecurity Ventures: $10.5T Cybercrime https://cybersecurityventures.com/hackerpocalypse-cybercrime-report-2016/ (2016)
Global cybercrime costs: $3T (2015) → $6T (2021) → $10.5T (2025 projected) 15% annual growth rate If measured as country, would be 3rd largest economy after US and China Greatest transfer of economic wealth in history Note: More profitable than global trade of all major illegal drugs combined. Includes data theft, productivity loss, IP theft, fraud Additional sources: <https://cybersecurityventures.com/hackerpocalypse-cybercrime-report-2016/> | https://www.boisestate.edu/cybersecurity/2022/06/16/cybercrime-to-cost-the-world-10-5-trillion-annually-by-2025/
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69.
Bolt, J. & Zanden, J. L. van.
Maddison project database 2020. (2020)
Historical GDP per capita estimates from year 1 to present. Global GDP per capita in 1900: approximately 1,260 in 1990 international dollars (roughly 3,150 in 2024 USD after PPP and inflation adjustment). Standard reference for long-run comparative economic history.
70.
Applied Clinical Trials. Global government spending on interventional clinical trials: $3-6 billion/year.
Applied Clinical Trials https://www.appliedclinicaltrialsonline.com/view/sizing-clinical-research-market Estimated range based on NIH ( $0.8-5.6B), NIHR ($1.6B total budget), and EU funding ( $1.3B/year). Roughly 5-10% of global market. Additional sources: https://www.appliedclinicaltrialsonline.com/view/sizing-clinical-research-market | https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30357-0/fulltext
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75.
United Nations Department of Economic and Social Affairs, Population Division.
World population prospects 2024: Summary of results. (2024)
The 2024 Revision of the World Population Prospects provides population estimates and projections for 237 countries or areas. Global median age approximately 30.5 years in 2024, reflecting population-weighted average across all regions.
78.
Estimated from major foundation budgets and activities. Nonprofit clinical trial funding estimate.
Nonprofit foundations spend an estimated $2-5 billion annually on clinical trials globally, representing approximately 2-5% of total clinical trial spending.
79.
ICAN. Global nuclear weapon maintenance cost: $100 billion/year.
ICAN: Global Spending $100B 2024 https://www.icanw.org/global_spending_on_nuclear_weapons_topped_100_billion_in_2024 (2024)
2024: >$100 billion ($190,151/minute) - 11% increase ($9.9B) from 2023 Nine nuclear-armed states: China, France, India, Israel, N. Korea, Pakistan, Russia, UK, US US: $56.8B (more than all other 8 states combined); China: $12.5B; UK: $10B (+26% YoY, biggest increase) Historical trend: $72.9B (2019) → $82.4B (2021) → >$100B (2024) Private sector contracts: $463B ongoing; $42.5B earned from contracts in 2024 alone Note: $100B/year figure accurate for 2024. Rapid growth from $73B (2019). US spends more than rest of world combined on nuclear weapons Additional sources: https://www.icanw.org/global_spending_on_nuclear_weapons_topped_100_billion_in_2024 | https://www.icanw.org/the_cost_of_nuclear_weapons
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80.
Industry reports: IQVIA. Global pharmaceutical r&d spending.
Total global pharmaceutical R&D spending is approximately $300 billion annually. Clinical trials represent 15-20% of this total ($45-60B), with the remainder going to drug discovery, preclinical research, regulatory affairs, and manufacturing development.
81.
UN. Global population reaches 8 billion.
UN: World Population 8 Billion Nov 15 2022 https://www.un.org/en/desa/world-population-reach-8-billion-15-november-2022 (2022)
Milestone: November 15, 2022 (UN World Population Prospects 2022) Day of Eight Billion" designated by UN Added 1 billion people in just 11 years (2011-2022) Growth rate: Slowest since 1950; fell under 1% in 2020 Future: 15 years to reach 9B (2037); projected peak 10.4B in 2080s Projections: 8.5B (2030), 9.7B (2050), 10.4B (2080-2100 plateau) Note: Milestone reached Nov 2022. Population growth slowing; will take longer to add next billion (15 years vs 11 years) Additional sources: https://www.un.org/en/desa/world-population-reach-8-billion-15-november-2022 | https://www.un.org/en/dayof8billion | https://en.wikipedia.org/wiki/Day_of_Eight_Billion
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82.
Harvard Kennedy School. 3.5% participation tipping point.
Harvard Kennedy School https://www.hks.harvard.edu/centers/carr/publications/35-rule-how-small-minority-can-change-world (2020)
The research found that nonviolent campaigns were twice as likely to succeed as violent ones, and once 3.5% of the population were involved, they were always successful. Chenoweth and Maria Stephan studied the success rates of civil resistance efforts from 1900 to 2006, finding that nonviolent movements attracted, on average, four times as many participants as violent movements and were more likely to succeed. Key finding: Every campaign that mobilized at least 3.5% of the population in sustained protest was successful (in their 1900-2006 dataset) Note: The 3.5% figure is a descriptive statistic from historical analysis, not a guaranteed threshold. One exception (Bahrain 2011-2014 with 6%+ participation) has been identified. The rule applies to regime change, not policy change in democracies. Additional sources: https://www.hks.harvard.edu/centers/carr/publications/35-rule-how-small-minority-can-change-world | https://www.hks.harvard.edu/sites/default/files/2024-05/Erica%20Chenoweth_2020-005.pdf | https://www.bbc.com/future/article/20190513-it-only-takes-35-of-people-to-change-the-world | https://en.wikipedia.org/wiki/3.5%25_rule
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83.
International IDEA.
International IDEA voter turnout database world export. (2026)
Best current register-based estimate of global registered voters. Sum of the latest available country-level Registration counts in International IDEA’s world export on 2026-04-22 = 4,128,142,495 registered voters across 199 countries and political entities. Methodology notes that Registration is the number of names on the voters’ register as reported by electoral management bodies, and comparability is imperfect because voter rolls and registration systems differ across countries. Additional sources: https://www.idea.int/data-tools/data/voter-turnout-database | https://www.idea.int/data-tools/export?type=region_only&themeId=293&world=all&loc=home
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85.
Federation of American Scientists. World nuclear forces.
Federation of American Scientists https://fas.org/issues/nuclear-weapons/status-world-nuclear-forces/ (2024)
As of early 2025, we estimate that the world’s nine nuclear-armed states possess a combined total of approximately 12,241 nuclear warheads. Additional sources: https://fas.org/issues/nuclear-weapons/status-world-nuclear-forces/
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86.
OpenSecrets.
Top lobbying industries 2025. (2025)
Sector ranks and per-company federal lobbying spending for 2025. Combined market capitalization of the top-5 publicly traded US lobbying spenders in each government-controlling sector: pharmaceuticals $1,794.7B; technology $13,279.5B; insurance $385.6B; oil and gas $1,246.9B; four-sector total approx $16.71T. Caveats: Meta (Zuckerberg holds 60.8% of voting power) and Alphabet (Page and Brin hold 52.3%) cannot be majority-acquired; Ellison owns 40.6% of Oracle; the largest insurance lobbyists are mutuals with no public shares; trade associations (PhRMA, AHIP, SIFMA, API) are not acquirable. Additional sources: https://stockanalysis.com/stocks/
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87.
NHGRI. Human genome project and CRISPR discovery.
NHGRI https://www.genome.gov/11006929/2003-release-international-consortium-completes-hgp (2003)
Your DNA is 3 billion base pairs Read the entire code (Human Genome Project, completed 2003) Learned to edit it (CRISPR, discovered 2012) Additional sources: https://www.genome.gov/11006929/2003-release-international-consortium-completes-hgp | https://www.nobelprize.org/prizes/chemistry/2020/press-release/
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88.
PMC. Only 12% of human interactome targeted.
PMC https://pmc.ncbi.nlm.nih.gov/articles/PMC10749231/ (2023)
Mapping 350,000+ clinical trials showed that only 12% of the human interactome has ever been targeted by drugs. Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC10749231/
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89.
WHO. ICD-10 code count ( 14,000).
WHO https://icd.who.int/browse10/2019/en (2019)
The ICD-10 classification contains approximately 14,000 codes for diseases, signs and symptoms. Additional sources: https://icd.who.int/browse10/2019/en
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91.
McFarland, M. J., Hauer, M. E. & Reuben, A.
Half of US population exposed to adverse lead levels in early childhood.
Proceedings of the National Academy of Sciences 119, e2118631119 (2022)
Leaded gasoline, used in the US from 1923 until its on-road ban in 1996, exposed more than half of the 2015 US population to adverse blood-lead levels in early childhood. The authors estimate childhood lead exposure cost the population a cumulative 824 million IQ points, an average of 2.6 points per person, rising to 5.9 points for the most-exposed 1966-1970 birth cohort.
92.
Wikipedia. Longevity escape velocity (LEV) - maximum human life extension potential.
Wikipedia: Longevity Escape Velocity https://en.wikipedia.org/wiki/Longevity_escape_velocity Longevity escape velocity: Hypothetical point where medical advances extend life expectancy faster than time passes Term coined by Aubrey de Grey (biogerontologist) in 2004 paper; concept from David Gobel (Methuselah Foundation) Current progress: Science adds 3 months to lifespan per year; LEV requires adding >1 year per year Sinclair (Harvard): "There is no biological upper limit to age" - first person to live to 150 may already be born De Grey: 50% chance of reaching LEV by mid-to-late 2030s; SENS approach = damage repair rather than slowing damage Kurzweil (2024): LEV by 2029-2035, AI will simulate biological processes to accelerate solutions George Church: LEV "in a decade or two" via age-reversal clinical trials Natural lifespan cap: 120-150 years (Jeanne Calment record: 122); engineering approach could bypass via damage repair Key mechanisms: Epigenetic reprogramming, senolytic drugs, stem cell therapy, gene therapy, AI-driven drug discovery Current record: Jeanne Calment (122 years, 164 days) - record unbroken since 1997 Note: LEV is theoretical but increasingly plausible given demonstrated age reversal in mice (109% lifespan extension) and human cells (30-year epigenetic age reversal) Additional sources: https://en.wikipedia.org/wiki/Longevity_escape_velocity | https://pmc.ncbi.nlm.nih.gov/articles/PMC423155/ | https://www.popularmechanics.com/science/a36712084/can-science-cure-death-longevity/ | https://www.diamandis.com/blog/longevity-escape-velocity
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95.
OpenSecrets. Lobbyist statistics for washington d.c.
OpenSecrets: Lobbying in US https://en.wikipedia.org/wiki/Lobbying_in_the_United_States Registered lobbyists: Over 12,000 (some estimates); 12,281 registered (2013) Former government employees as lobbyists: 2,200+ former federal employees (1998-2004), including 273 former White House staffers, 250 former Congress members & agency heads Congressional revolving door: 43% (86 of 198) lawmakers who left 1998-2004 became lobbyists; currently 59% leaving to private sector work for lobbying/consulting firms/trade groups Executive branch: 8% were registered lobbyists at some point before/after government service Additional sources: https://en.wikipedia.org/wiki/Lobbying_in_the_United_States | https://www.opensecrets.org/revolving-door | https://www.citizen.org/article/revolving-congress/ | https://www.propublica.org/article/we-found-a-staggering-281-lobbyists-whove-worked-in-the-trump-administration
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96.
MDPI Vaccines. Measles vaccination ROI.
MDPI Vaccines https://www.mdpi.com/2076-393X/12/11/1210 (2024)
Single measles vaccination: 167:1 benefit-cost ratio. MMR (measles-mumps-rubella) vaccination: 14:1 ROI. Historical US elimination efforts (1966-1974): benefit-cost ratio of 10.3:1 with net benefits exceeding USD 1.1 billion (1972 dollars, or USD 8.0 billion in 2023 dollars). 2-dose MMR programs show direct benefit/cost ratio of 14.2 with net savings of $5.3 billion, and 26.0 from societal perspectives with net savings of $11.6 billion. Additional sources: https://www.mdpi.com/2076-393X/12/11/1210 | https://www.tandfonline.com/doi/full/10.1080/14760584.2024.2367451
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100.
U.S. Government Accountability Office.
Electronic Health Records: First Year of CMS’s Incentive Programs Shows Opportunities to Improve Processes to Verify Providers Met Requirements.
https://www.gao.gov/products/gao-12-481 (2012).
106.
Calculated from Orphanet Journal of Rare Diseases (2024). Diseases getting first effective treatment each year.
Calculated from Orphanet Journal of Rare Diseases (2024) https://ojrd.biomedcentral.com/articles/10.1186/s13023-024-03398-1 (2024)
Under the current system, approximately 10-15 diseases per year receive their FIRST effective treatment. Calculation: 5% of 7,000 rare diseases ( 350) have FDA-approved treatment, accumulated over 40 years of the Orphan Drug Act = 9 rare diseases/year. Adding 5-10 non-rare diseases that get first treatments yields 10-20 total. FDA approves 50 drugs/year, but many are for diseases that already have treatments (me-too drugs, second-line therapies). Only 15 represent truly FIRST treatments for previously untreatable conditions.
107.
NIH. NIH budget (FY 2025).
NIH https://www.nih.gov/about-nih/organization/budget (2024)
The budget total of $47.7 billion also includes $1.412 billion derived from PHS Evaluation financing... Additional sources: https://www.nih.gov/about-nih/organization/budget | https://officeofbudget.od.nih.gov/
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108.
Bentley et al. NIH spending on clinical trials: 3.3%.
Bentley et al. https://pmc.ncbi.nlm.nih.gov/articles/PMC10349341/ (2023)
NIH spent $8.1 billion on clinical trials for approved drugs (2010-2019), representing 3.3% of relevant NIH spending. Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC10349341/ | https://catalyst.harvard.edu/news/article/nih-spent-8-1b-for-phased-clinical-trials-of-drugs-approved-2010-19-10-of-reported-industry-spending/
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109.
PMC. Standard medical research ROI ($20k-$100k/QALY).
PMC: Cost-effectiveness Thresholds Used by Study Authors https://pmc.ncbi.nlm.nih.gov/articles/PMC10114019/ (1990)
Typical cost-effectiveness thresholds for medical interventions in rich countries range from $50,000 to $150,000 per QALY. The Institute for Clinical and Economic Review (ICER) uses a $100,000-$150,000/QALY threshold for value-based pricing. Between 1990-2021, authors increasingly cited $100,000 (47% by 2020-21) or $150,000 (24% by 2020-21) per QALY as benchmarks for cost-effectiveness. Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC10114019/ | https://icer.org/our-approach/methods-process/cost-effectiveness-the-qaly-and-the-evlyg/
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110.
Xia et al., Nature Food. Nuclear winter famine.
Xia et al. https://www.nature.com/articles/s43016-022-00573-0 (2022)
We estimate that a nuclear war between the United States and Russia would produce 150 Tg of soot and lead to 5 billion people dying at the end of year 2. Additional sources: https://www.nature.com/articles/s43016-022-00573-0
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111.
Manhattan Institute. RECOVERY trial 82× cost reduction.
Manhattan Institute: Slow Costly Trials https://manhattan.institute/article/slow-costly-clinical-trials-drag-down-biomedical-breakthroughs RECOVERY trial: $500 per patient ($20M for 48,000 patients = $417/patient) Typical clinical trial: $41,000 median per-patient cost Cost reduction: 80-82× cheaper ($41,000 ÷ $500 ≈ 82×) Efficiency: $50 per patient per answer (10 therapeutics tested, 4 effective) Dexamethasone estimated to save >630,000 lives Additional sources: https://manhattan.institute/article/slow-costly-clinical-trials-drag-down-biomedical-breakthroughs | https://pmc.ncbi.nlm.nih.gov/articles/PMC9293394/
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112.
Trials. Patient willingness to participate in clinical trials.
Trials: Patients’ Willingness Survey https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-015-1105-3 Recent surveys: 49-51% willingness (2020-2022) - dramatic drop from 85% (2019) during COVID-19 pandemic Cancer patients when approached: 88% consented to trials (Royal Marsden Hospital) Study type variation: 44.8% willing for drug trial, 76.2% for diagnostic study Top motivation: "Learning more about my health/medical condition" (67.4%) Top barrier: "Worry about experiencing side effects" (52.6%) Additional sources: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-015-1105-3 | https://www.appliedclinicaltrialsonline.com/view/industry-forced-to-rethink-patient-participation-in-trials | https://pmc.ncbi.nlm.nih.gov/articles/PMC7183682/
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113.
The Commune. Pentagon audit failures ($2.46T unaccounted).
The Commune https://thecommunemag.com/the-pentagon-misplaced-2-46-trillion-an-in-depth-look-at-the-financial-audit-failures (2024)
In the most recent audit, the Department of Defense (DoD) could not account for approximately 60% of its \(4.1 trillion in assets, amounting to\)2.46 trillion unaccounted for. Alternative title: Pentagon unsupported accounting adjustments (\(6.5T, single year, US Army) In 2015, the Department of Defense's Inspector General reported that the Army could not adequately support\)6.5 trillion in year-end adjustments, indicating severe accounting discrepancies. Additional sources: https://thecommunemag.com/the-pentagon-misplaced-2-46-trillion-an-in-depth-look-at-the-financial-audit-failures | https://accmag.com/audit-pentagon-cannot-account-for-6-5-trillion-dollars-is-taxpayer-money/
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114.
Tufts CSDD. Cost of drug development.
Various estimates suggest $1.0 - $2.5 billion to bring a new drug from discovery through FDA approval, spread across 10 years. Tufts Center for the Study of Drug Development often cited for $1.0 - $2.6 billion/drug. Industry reports (IQVIA, Deloitte) also highlight $2+ billion figures.
115.
Value in Health. Average lifetime revenue per successful drug.
Value in Health: Sales Revenues for New Therapeutic Agents https://www.sciencedirect.com/science/article/pii/S1098301524027542 Study of 361 FDA-approved drugs from 1995-2014 (median follow-up 13.2 years): Mean lifetime revenue: $15.2 billion per drug Median lifetime revenue: $6.7 billion per drug Revenue after 5 years: $3.2 billion (mean) Revenue after 10 years: $9.5 billion (mean) Revenue after 15 years: $19.2 billion (mean) Distribution highly skewed: top 25 drugs (7%) accounted for 38% of total revenue ($2.1T of $5.5T) Additional sources: https://www.sciencedirect.com/science/article/pii/S1098301524027542
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116.
Lichtenberg, F. R.
How many life-years have new drugs saved? A three-way fixed-effects analysis of 66 diseases in 27 countries, 2000-2013.
International Health 11, 403–416 (2019)
Using 3-way fixed-effects methodology (disease-country-year) across 66 diseases in 22 countries, this study estimates that drugs launched after 1981 saved 148.7 million life-years in 2013 alone. The regression coefficients for drug launches 0-11 years prior (beta=-0.031, SE=0.008) and 12+ years prior (beta=-0.057, SE=0.013) on years of life lost are highly significant (p<0.0001). Confidence interval for life-years saved: 79.4M-239.8M (95 percent CI) based on propagated standard errors from Table 2.
117.
Deloitte. Pharmaceutical r&d return on investment (ROI).
Deloitte: Measuring Pharmaceutical Innovation 2025 https://www.deloitte.com/ch/en/Industries/life-sciences-health-care/research/measuring-return-from-pharmaceutical-innovation.html (2025)
Deloitte’s annual study of top 20 pharma companies by R&D spend (2010-2024): 2024 ROI: 5.9% (second year of growth after decade of decline) 2023 ROI: 4.3% (estimated from trend) 2022 ROI: 1.2% (historic low since study began, 13-year low) 2021 ROI: 6.8% (record high, inflated by COVID-19 vaccines/treatments) Long-term trend: Declining for over a decade before 2023 recovery Average R&D cost per asset: $2.3B (2022), $2.23B (2024) These returns (1.2-5.9% range) fall far below typical corporate ROI targets (15-20%) Additional sources: https://www.deloitte.com/ch/en/Industries/life-sciences-health-care/research/measuring-return-from-pharmaceutical-innovation.html | https://www.prnewswire.com/news-releases/deloittes-13th-annual-pharmaceutical-innovation-report-pharma-rd-return-on-investment-falls-in-post-pandemic-market-301738807.html | https://hitconsultant.net/2023/02/16/pharma-rd-roi-falls-to-lowest-level-in-13-years/
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118.
Nature Reviews Drug Discovery. Drug trial success rate from phase i to approval.
Nature Reviews Drug Discovery: Clinical Success Rates https://www.nature.com/articles/nrd.2016.136 (2016)
Overall Phase I to approval: 10-12.8% (conventional wisdom 10%, studies show 12.8%) Recent decline: Average LOA now 6.7% for Phase I (2014-2023 data) Leading pharma companies: 14.3% average LOA (range 8-23%) Varies by therapeutic area: Oncology 3.4%, CNS/cardiovascular lowest at Phase III Phase-specific success: Phase I 47-54%, Phase II 28-34%, Phase III 55-70% Note: 12% figure accurate for historical average. Recent data shows decline to 6.7%, with Phase II as primary attrition point (28% success) Additional sources: https://www.nature.com/articles/nrd.2016.136 | https://pmc.ncbi.nlm.nih.gov/articles/PMC6409418/ | https://academic.oup.com/biostatistics/article/20/2/273/4817524
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119.
SofproMed. Phase 3 cost per trial range.
SofproMed https://www.sofpromed.com/how-much-does-a-clinical-trial-cost Phase 3 clinical trials cost between $20 million and $282 million per trial, with significant variation by therapeutic area and trial complexity. Additional sources: https://www.sofpromed.com/how-much-does-a-clinical-trial-cost | https://www.cbo.gov/publication/57126
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120.
Ramsberg, J. & Platt, R. Pragmatic trial cost per patient (median $97).
Learning Health Systems https://pmc.ncbi.nlm.nih.gov/articles/PMC6508852/ (2018)
Meta-analysis of 108 embedded pragmatic clinical trials (2006-2016). The median cost per patient was $97 (IQR $19–$478), based on 2015 dollars. 25% of trials cost <$19/patient; 10 trials exceeded $1,000/patient. U.S. studies median $187 vs non-U.S. median $27. Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC6508852/
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121.
WHO. Polio vaccination ROI.
WHO https://www.who.int/news-room/feature-stories/detail/sustaining-polio-investments-offers-a-high-return (2019)
For every dollar spent, the return on investment is nearly US$ 39." Total investment cost of US$ 7.5 billion generates projected economic and social benefits of US$ 289.2 billion from sustaining polio assets and integrating them into expanded immunization, surveillance and emergency response programmes across 8 priority countries (Afghanistan, Iraq, Libya, Pakistan, Somalia, Sudan, Syria, Yemen). Additional sources: https://www.who.int/news-room/feature-stories/detail/sustaining-polio-investments-offers-a-high-return
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122.
ICRC. International campaign to ban landmines (ICBL) - ottawa treaty (1997).
ICRC https://www.icrc.org/en/doc/resources/documents/article/other/57jpjn.htm (1997)
ICBL: Founded 1992 by 6 NGOs (Handicap International, Human Rights Watch, Medico International, Mines Advisory Group, Physicians for Human Rights, Vietnam Veterans of America Foundation) Started with ONE staff member: Jody Williams as founding coordinator Grew to 1,000+ organizations in 60 countries by 1997 Ottawa Process: 14 months (October 1996 - December 1997) Convention signed by 122 states on December 3, 1997; entered into force March 1, 1999 Achievement: Nobel Peace Prize 1997 (shared by ICBL and Jody Williams) Government funding context: Canada established $100M CAD Canadian Landmine Fund over 10 years (1997); International donors provided $169M in 1997 for mine action (up from $100M in 1996) Additional sources: https://www.icrc.org/en/doc/resources/documents/article/other/57jpjn.htm | https://en.wikipedia.org/wiki/International_Campaign_to_Ban_Landmines | https://www.nobelprize.org/prizes/peace/1997/summary/ | https://un.org/press/en/1999/19990520.MINES.BRF.html | https://www.the-monitor.org/en-gb/reports/2003/landmine-monitor-2003/mine-action-funding.aspx
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123.
OpenSecrets.
Revolving door: Former members of congress. (2024)
388 former members of Congress are registered as lobbyists. Nearly 5,400 former congressional staffers have left Capitol Hill to become federal lobbyists in the past 10 years. Additional sources: https://www.opensecrets.org/revolving-door
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124.
Kinch, M. S. & Griesenauer, R. H.
Lost medicines: A longer view of the pharmaceutical industry with the potential to reinvigorate discovery.
Drug Discovery Today 24, 875–880 (2019)
Research identified 1,600+ medicines available in 1962. The 1950s represented industry high-water mark with >30 new products in five of ten years; this rate would not be replicated until late 1990s. More than half (880) of these medicines were lost following implementation of Kefauver-Harris Amendment. The peak of 1962 would not be seen again until early 21st century. By 2016 number of organizations actively involved in R&D at level not seen since 1914.
125.
Baily, M. N. Pre-1962 drug development costs (baily 1972).
Baily (1972) https://samizdathealth.org/wp-content/uploads/2020/12/hlthaff.1.2.6.pdf (1972)
Pre-1962: Average cost per new chemical entity (NCE) was $6.5 million (1980 dollars) Inflation-adjusted to 2024 dollars: $6.5M (1980) ≈ $22.5M (2024), using CPI multiplier of 3.46× Real cost increase (inflation-adjusted): $22.5M (pre-1962) → $2,600M (2024) = 116× increase Note: This represents the most comprehensive academic estimate of pre-1962 drug development costs based on empirical industry data Additional sources: https://samizdathealth.org/wp-content/uploads/2020/12/hlthaff.1.2.6.pdf
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126.
Think by Numbers. Pre-1962 physician-led clinical trials.
Think by Numbers: How Many Lives Does FDA Save? https://thinkbynumbers.org/health/how-many-net-lives-does-the-fda-save/ (1966)
Pre-1962: Physicians could report real-world evidence directly 1962 Drug Amendments replaced "premarket notification" with "premarket approval", requiring extensive efficacy testing Impact: New regulatory clampdown reduced new treatment production by 70%; lifespan growth declined from 4 years/decade to 2 years/decade Drug Efficacy Study Implementation (DESI): NAS/NRC evaluated 3,400+ drugs approved 1938-1962 for safety only; reviewed >3,000 products, >16,000 therapeutic claims FDA has had authority to accept real-world evidence since 1962, clarified by 21st Century Cures Act (2016) Note: Specific "144,000 physicians" figure not verified in sources Additional sources: https://thinkbynumbers.org/health/how-many-net-lives-does-the-fda-save/ | https://www.fda.gov/drugs/enforcement-activities-fda/drug-efficacy-study-implementation-desi | http://www.nasonline.org/about-nas/history/archives/collections/des-1966-1969-1.html
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127.
GAO. 95% of diseases have 0 FDA-approved treatments.
GAO https://www.gao.gov/products/gao-25-106774 (2025)
95% of diseases have no treatment Additional sources: https://www.gao.gov/products/gao-25-106774 | https://globalgenes.org/rare-disease-facts/
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129.
NHS England; Águas et al. RECOVERY trial global lives saved ( 1 million).
NHS England: 1 Million Lives Saved https://www.england.nhs.uk/2021/03/covid-treatment-developed-in-the-nhs-saves-a-million-lives/ (2021)
Dexamethasone saved 1 million lives worldwide (NHS England estimate, March 2021, 9 months after discovery). UK alone: 22,000 lives saved. Methodology: Águas et al. Nature Communications 2021 estimated 650,000 lives (range: 240,000-1,400,000) for July-December 2020 alone, based on RECOVERY trial mortality reductions (36% for ventilated, 18% for oxygen-only patients) applied to global COVID hospitalizations. June 2020 announcement: Dexamethasone reduced deaths by up to 1/3 (ventilated patients), 1/5 (oxygen patients). Impact immediate: Adopted into standard care globally within hours of announcement. Additional sources: https://www.england.nhs.uk/2021/03/covid-treatment-developed-in-the-nhs-saves-a-million-lives/ | https://www.nature.com/articles/s41467-021-21134-2 | https://pharmaceutical-journal.com/article/news/steroid-has-saved-the-lives-of-one-million-covid-19-patients-worldwide-figures-show | https://www.recoverytrial.net/news/recovery-trial-celebrates-two-year-anniversary-of-life-saving-dexamethasone-result
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132.
National September 11 Memorial & Museum.
September 11 attack facts. (2024)
2,977 people were killed in the September 11, 2001 attacks: 2,753 at the World Trade Center, 184 at the Pentagon, and 40 passengers and crew on United Flight 93 in Shanksville, Pennsylvania.
133.
World Bank. World bank singapore economic data.
World Bank https://data.worldbank.org/country/singapore (2024)
Singapore GDP per capita (2023): $82,000 - among highest in the world Government spending: 15% of GDP (vs US 38%) Life expectancy: 84.1 years (vs US 77.5 years) Singapore demonstrates that low government spending can coexist with excellent outcomes Additional sources: https://data.worldbank.org/country/singapore
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134.
International Monetary Fund.
IMF singapore government spending data. (2024)
Singapore government spending is approximately 15% of GDP This is 23 percentage points lower than the United States (38%) Despite lower spending, Singapore achieves excellent outcomes: - Life expectancy: 84.1 years (vs US 77.5) - Low crime, world-class infrastructure, AAA credit rating Additional sources: https://www.imf.org/en/Countries/SGP
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135.
World Health Organization.
WHO life expectancy data by country. (2024)
Life expectancy at birth varies significantly among developed nations: Switzerland: 84.0 years (2023) Singapore: 84.1 years (2023) Japan: 84.3 years (2023) United States: 77.5 years (2023) - 6.5 years below Switzerland, Singapore Global average: 73 years Note: US spends more per capita on healthcare than any other nation, yet achieves lower life expectancy Additional sources: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-life-expectancy-and-healthy-life-expectancy
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137.
PMC. Contribution of smoking reduction to life expectancy gains.
PMC: Benefits Smoking Cessation Longevity https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447499/ (2012)
Population-level: Up to 14% (9% men, 14% women) of total life expectancy gain since 1960 due to tobacco control efforts Individual cessation benefits: Quitting at age 35 adds 6.9-8.5 years (men), 6.1-7.7 years (women) vs continuing smokers By cessation age: Age 25-34 = 10 years gained; age 35-44 = 9 years; age 45-54 = 6 years; age 65 = 2.0 years (men), 3.7 years (women) Cessation before age 40: Reduces death risk by 90% Long-term cessation: 10+ years yields survival comparable to never smokers, averts 10 years of life lost Recent cessation: <3 years averts 5 years of life lost Additional sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447499/ | https://www.cdc.gov/pcd/issues/2012/11_0295.htm | https://www.ajpmonline.org/article/S0749-3797(24)00217-4/fulltext | https://www.nejm.org/doi/full/10.1056/NEJMsa1211128
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138.
ICER. Value per QALY (standard economic value).
ICER https://icer.org/wp-content/uploads/2024/02/Reference-Case-4.3.25.pdf (2024)
Standard economic value per QALY: $100,000–$150,000. This is the US and global standard willingness-to-pay threshold for interventions that add costs. Dominant interventions (those that save money while improving health) are favorable regardless of this threshold. Additional sources: https://icer.org/wp-content/uploads/2024/02/Reference-Case-4.3.25.pdf
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139.
GAO. Annual cost of u.s. Sugar subsidies.
GAO: Sugar Program https://www.gao.gov/products/gao-24-106144 Consumer costs: $2.5-3.5 billion per year (GAO estimate) Net economic cost: $1 billion per year 2022: US consumers paid 2X world price for sugar Program costs $3-4 billion/year but no federal budget impact (costs passed directly to consumers via higher prices) Employment impact: 10,000-20,000 manufacturing jobs lost annually in sugar-reliant industries (confectionery, etc.) Multiple studies confirm: Sweetener Users Association ($2.9-3.5B), AEI ($2.4B consumer cost), Beghin & Elobeid ($2.9-3.5B consumer surplus) Additional sources: https://www.gao.gov/products/gao-24-106144 | https://www.heritage.org/agriculture/report/the-us-sugar-program-bad-consumers-bad-agriculture-and-bad-america | https://www.aei.org/articles/the-u-s-spends-4-billion-a-year-subsidizing-stalinist-style-domestic-sugar-production/
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140.
World Bank. Swiss military budget as percentage of GDP.
World Bank: Military Expenditure https://data.worldbank.org/indicator/MS.MIL.XPND.GD.ZS?locations=CH 2023: 0.70272% of GDP (World Bank) 2024: CHF 5.95 billion official military spending When including militia system costs: 1% GDP (CHF 8.75B) Comparison: Near bottom in Europe; only Ireland, Malta, Moldova spend less (excluding microstates with no armies) Additional sources: https://data.worldbank.org/indicator/MS.MIL.XPND.GD.ZS?locations=CH | https://www.avenir-suisse.ch/en/blog-defence-spending-switzerland-is-in-better-shape-than-it-seems/ | https://tradingeconomics.com/switzerland/military-expenditure-percent-of-gdp-wb-data.html
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141.
World Bank. Switzerland vs. US GDP per capita comparison.
World Bank: Switzerland GDP Per Capita https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?locations=CH 2024 GDP per capita (PPP-adjusted): Switzerland $93,819 vs United States $75,492 Switzerland’s GDP per capita 24% higher than US when adjusted for purchasing power parity Nominal 2024: Switzerland $103,670 vs US $85,810 Additional sources: https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?locations=CH | https://tradingeconomics.com/switzerland/gdp-per-capita-ppp | https://www.theglobaleconomy.com/USA/gdp_per_capita_ppp/
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142.
OECD.
OECD government spending as percentage of GDP. (2024)
OECD government spending data shows significant variation among developed nations: United States: 38.0% of GDP (2023) Switzerland: 35.0% of GDP - 3 percentage points lower than US Singapore: 15.0% of GDP - 23 percentage points lower than US (per IMF data) OECD average: approximately 40% of GDP Additional sources: https://data.oecd.org/gga/general-government-spending.htm
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143.
OECD.
OECD median household income comparison. (2024)
Median household disposable income varies significantly across OECD nations: United States: $77,500 (2023) Switzerland: $55,000 PPP-adjusted (lower nominal but comparable purchasing power) Singapore: $75,000 PPP-adjusted Additional sources: https://data.oecd.org/hha/household-disposable-income.htm
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144.
Wikipedia. Thalidomide scandal: Worldwide cases and mortality.
Wikipedia https://en.wikipedia.org/wiki/Thalidomide_scandal The total number of embryos affected by the use of thalidomide during pregnancy is estimated at 10,000, of whom about 40% died around the time of birth. More than 10,000 children in 46 countries were born with deformities such as phocomelia. Additional sources: https://en.wikipedia.org/wiki/Thalidomide_scandal
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145.
PLOS One. Health and quality of life of thalidomide survivors as they age.
PLOS One https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210222 (2019)
Study of thalidomide survivors documenting ongoing disability impacts, quality of life, and long-term health outcomes. Survivors (now in their 60s) continue to experience significant disability from limb deformities, organ damage, and other effects. Additional sources: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210222
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147.
FDA Study via NCBI. Trial costs, FDA study.
FDA Study via NCBI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248200/ Overall, the 138 clinical trials had an estimated median (IQR) cost of $19.0 million ($12.2 million-$33.1 million)... The clinical trials cost a median (IQR) of $41,117 ($31,802-$82,362) per patient. Additional sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248200/
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148.
GBD 2019 Diseases and Injuries Collaborators.
Global burden of disease study 2019: Disability weights.
The Lancet 396, 1204–1222 (2020)
Disability weights for 235 health states used in Global Burden of Disease calculations. Weights range from 0 (perfect health) to 1 (death equivalent). Chronic conditions like diabetes (0.05-0.35), COPD (0.04-0.41), depression (0.15-0.66), and cardiovascular disease (0.04-0.57) show substantial variation by severity. Treatment typically reduces disability weights by 50-80 percent for manageable chronic conditions.
149.
WHO. Annual global economic burden of alzheimer’s and other dementias.
WHO: Dementia Fact Sheet https://www.who.int/news-room/fact-sheets/detail/dementia (2019)
Global cost: $1.3 trillion (2019 WHO-commissioned study) 50% from informal caregivers (family/friends, 5 hrs/day) 74% of costs in high-income countries despite 61% of patients in LMICs $818B (2010) → $1T (2018) → $1.3T (2019) - rapid growth Note: Costs increased 35% from 2010-2015 alone. Informal care represents massive hidden economic burden Additional sources: https://www.who.int/news-room/fact-sheets/detail/dementia | https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12901
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150.
JAMA Oncology. Annual global economic burden of cancer.
JAMA Oncology: Global Cost 2020-2050 https://jamanetwork.com/journals/jamaoncology/fullarticle/2801798 (2020)
2020-2050 projection: $25.2 trillion total ($840B/year average) 2010 annual cost: $1.16 trillion (direct costs only) Recent estimate: $3 trillion/year (all costs included) Top 5 cancers: lung (15.4%), colon/rectum (10.9%), breast (7.7%), liver (6.5%), leukemia (6.3%) Note: China/US account for 45% of global burden; 75% of deaths in LMICs but only 50.0% of economic cost Additional sources: https://jamanetwork.com/journals/jamaoncology/fullarticle/2801798 | https://www.nature.com/articles/d41586-023-00634-9
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152.
Diabetes Care. Annual global economic burden of diabetes.
Diabetes Care: Global Economic Burden https://diabetesjournals.org/care/article/41/5/963/36522/Global-Economic-Burden-of-Diabetes-in-Adults 2015: $1.3 trillion (1.8% of global GDP) 2030 projections: $2.1T-2.5T depending on scenario IDF health expenditure: $760B (2019) → $845B (2045 projected) 2/3 direct medical costs ($857B), 1/3 indirect costs (lost productivity) Note: Costs growing rapidly; expected to exceed $2T by 2030 Additional sources: https://diabetesjournals.org/care/article/41/5/963/36522/Global-Economic-Burden-of-Diabetes-in-Adults | https://doi.org/10.1016/S2213-8587(17)30097-9
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154.
World Bank, Bureau of Economic Analysis. US GDP 2024 ($28.78 trillion).
World Bank https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?locations=US (2024)
US GDP reached $28.78 trillion in 2024, representing approximately 26% of global GDP. Additional sources: https://data.worldbank.org/indicator/NY.GDP.MKTP.CD?locations=US | https://www.bea.gov/news/2024/gross-domestic-product-fourth-quarter-and-year-2024-advance-estimate
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155.
Environmental Working Group. US farm subsidy database and analysis.
Environmental Working Group https://farm.ewg.org/ (2024)
US agricultural subsidies total approximately $30 billion annually, but create much larger economic distortions. Top 10% of farms receive 78% of subsidies, benefits concentrated in commodity crops (corn, soy, wheat, cotton), environmental damage from monoculture incentivized, and overall deadweight loss estimated at $50-120 billion annually. Additional sources: https://farm.ewg.org/ | https://www.ers.usda.gov/topics/farm-economy/farm-sector-income-finances/government-payments-the-safety-net/
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156.
Drug Policy Alliance.
The drug war by the numbers. (2021)
Since 1971, the war on drugs has cost the United States an estimated $1 trillion in enforcement. The federal drug control budget was $41 billion in 2022. Mass incarceration costs the U.S. at least $182 billion every year, with over $450 billion spent to incarcerate individuals on drug charges in federal prisons.
157.
International Monetary Fund.
IMF fossil fuel subsidies data: 2023 update. (2023)
Globally, fossil fuel subsidies were $7 trillion in 2022 or 7.1 percent of GDP. The United States subsidies totaled $649 billion. Underpricing for local air pollution costs and climate damages are the largest contributor, accounting for about 30 percent each.
158.
Papanicolas, Irene et al. Health care spending in the united states and other high-income countries.
Papanicolas et al. https://jamanetwork.com/journals/jama/article-abstract/2674671 (2018)
The US spent approximately twice as much as other high-income countries on medical care (mean per capita: $9,892 vs $5,289), with similar utilization but much higher prices. Administrative costs accounted for 8% of US spending vs 1-3% in other countries. US spending on pharmaceuticals was $1,443 per capita vs $749 elsewhere. Despite spending more, US health outcomes are not better. Additional sources: https://jamanetwork.com/journals/jama/article-abstract/2674671
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159.
Hsieh, C.-T. & Moretti, E. Housing constraints and spatial misallocation.
American Economic Journal: Macroeconomics https://www.aeaweb.org/articles?id=10.1257/mac.20170388 (2019)
We quantify the amount of spatial misallocation of labor across US cities and its aggregate costs. Tight land-use restrictions in high-productivity cities like New York, San Francisco, and Boston lowered aggregate US growth by 36% from 1964 to 2009. Local constraints on housing supply have had enormous effects on the national economy. Additional sources: https://www.aeaweb.org/articles?id=10.1257/mac.20170388
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161.
Tax Foundation. Tax compliance costs the US economy $546 billion annually.
https://taxfoundation.org/data/all/federal/irs-tax-compliance-costs/ (2024)
Americans will spend over 7.9 billion hours complying with IRS tax filing and reporting requirements in 2024. This costs the economy roughly $413 billion in lost productivity. In addition, the IRS estimates that Americans spend roughly $133 billion annually in out-of-pocket costs, bringing the total compliance costs to $546 billion, or nearly 2 percent of GDP.
162.
Cook, C., Cole, G., Asaria, P., Jabbour, R. & Francis, D. P. Annual global economic burden of heart disease.
International Journal of Cardiology https://www.internationaljournalofcardiology.com/article/S0167-5273(13)02238-9/abstract (2014)
Heart failure alone: $108 billion/year (2012 global analysis, 197 countries) US CVD: $555B (2016) → projected $1.8T by 2050 LMICs total CVD loss: $3.7T cumulative (2011-2015, 5-year period) CVD is costliest disease category in most developed nations Note: No single $2.1T global figure found; estimates vary widely by scope and year Additional sources: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001258
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163.
Source: US Life Expectancy FDA Budget 1543-2019 CSV.
US life expectancy growth 1880-1960: 3.82 years per decade. (2019)
Pre-1962: 3.82 years/decade Post-1962: 1.54 years/decade Reduction: 60% decline in life expectancy growth rate Additional sources: https://ourworldindata.org/life-expectancy | https://www.mortality.org/ | https://www.cdc.gov/nchs/nvss/mortality_tables.htm
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164.
Source: US Life Expectancy FDA Budget 1543-2019 CSV.
Post-1962 slowdown in life expectancy gains. (2019)
Pre-1962 (1880-1960): 3.82 years/decade Post-1962 (1962-2019): 1.54 years/decade Reduction: 60% decline Temporal correlation: Slowdown occurred immediately after 1962 Kefauver-Harris Amendment Additional sources: https://ourworldindata.org/life-expectancy | https://www.mortality.org/ | https://www.cdc.gov/nchs/nvss/mortality_tables.htm
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165.
Centers for Disease Control and Prevention.
US life expectancy 2023. (2024)
US life expectancy at birth was 77.5 years in 2023 Male life expectancy: 74.8 years Female life expectancy: 80.2 years This is 6-7 years lower than peer developed nations despite higher healthcare spending Additional sources: https://www.cdc.gov/nchs/fastats/life-expectancy.htm
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166.
US Census Bureau.
US median household income 2023. (2024)
US median household income was $77,500 in 2023 Real median household income declined 0.8% from 2022 Gini index: 0.467 (income inequality measure) Additional sources: https://www.census.gov/library/publications/2024/demo/p60-282.html
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167.
Manuel, D. U.s. Defense spending history: 100 years of military budgets.
DaveManuel.com https://www.davemanuel.com/us-defense-spending-history-military-budget-data.php (2025)
US military spending in constant 2024 dollars: 1939 $29B (pre-WW2 baseline), 1940 $37B, 1944 $1,383B, 1945 $1,420B (peak), 1946 $674B, 1947 $176B, 1948 $117B, 2024 $886B. The post-WW2 demobilization cut spending 88% in two years (1945-1947). Current peacetime spending ($886B) is 30x the pre-WW2 baseline and 62% of peak WW2 spending, in inflation-adjusted dollars.
168.
Statista. US military budget as percentage of GDP.
Statista https://www.statista.com/statistics/262742/countries-with-the-highest-military-spending/ (2024)
U.S. military spending amounted to 3.5% of GDP in 2024. In 2024, the U.S. spent nearly $1 trillion on its military budget, equal to 3.4% of GDP. Additional sources: https://www.statista.com/statistics/262742/countries-with-the-highest-military-spending/ | https://www.sipri.org/sites/default/files/2025-04/2504_fs_milex_2024.pdf
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169.
US Census Bureau. Number of registered or eligible voters in the u.s.
US Census Bureau https://www.census.gov/newsroom/press-releases/2025/2024-presidential-election-voting-registration-tables.html (2024)
73.6% (or 174 million people) of the citizen voting-age population was registered to vote in 2024 (Census Bureau). More than 211 million citizens were active registered voters (86.6% of citizen voting age population) according to the Election Assistance Commission. Additional sources: https://www.census.gov/newsroom/press-releases/2025/2024-presidential-election-voting-registration-tables.html | https://www.eac.gov/news/2025/06/30/us-election-assistance-commission-releases-2024-election-administration-and-voting
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170.
U.S. Senate. Treaties.
U.S. Senate https://www.senate.gov/about/powers-procedures/treaties.htm The Constitution provides that the president ’shall have Power, by and with the Advice and Consent of the Senate, to make Treaties, provided two-thirds of the Senators present concur’ (Article II, section 2). Treaties are formal agreements with foreign nations that require two-thirds Senate approval. 67 senators (two-thirds of 100) must vote to ratify a treaty for it to take effect. Additional sources: https://www.senate.gov/about/powers-procedures/treaties.htm
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172.
Federal Election Commission.
Statistical summary of 24-month campaign activity of the 2023-2024 election cycle. (2023)
Presidential candidates raised $2 billion; House and Senate candidates raised $3.8 billion and spent $3.7 billion; PACs raised $15.7 billion and spent $15.5 billion. Total federal campaign spending approximately $20 billion. Additional sources: https://www.fec.gov/updates/statistical-summary-of-24-month-campaign-activity-of-the-2023-2024-election-cycle/
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173.
OpenSecrets.
Federal lobbying hit record $4.4 billion in 2024. (2024)
Total federal lobbying reached record $4.4 billion in 2024. The $150 million increase in lobbying continues an upward trend that began in 2016. Additional sources: https://www.opensecrets.org/news/2025/02/federal-lobbying-set-new-record-in-2024/
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174.
Columbia/NBER. Odds of a single vote being decisive in a u.s. Presidential election.
Columbia/NBER: What Is the Probability Your Vote Will Make a Difference? https://sites.stat.columbia.edu/gelman/research/published/probdecisive2.pdf (2012)
National average: 1 in 60 million chance (2008 election analysis by Gelman, Silver, Edlin) Swing states (NM, VA, NH, CO): 1 in 10 million chance Non-competitive states: 34 states >1 in 100 million odds; 20 states >1 in 1 billion Washington DC: 1 in 490 billion odds Methodology: Probability state is necessary for electoral college win × probability state vote is tied Additional sources: https://sites.stat.columbia.edu/gelman/research/published/probdecisive2.pdf | https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1465-7295.2010.00272.x
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175.
Hutchinson and Kirk.
Valley of death in drug development. (2011)
The overall failure rate of drugs that passed into Phase 1 trials to final approval is 90%. This lack of translation from promising preclinical findings to success in human trials is known as the "valley of death." Estimated 30-50% of promising compounds never proceed to Phase 2/3 trials primarily due to funding barriers rather than scientific failure. The late-stage attrition rate for oncology drugs is as high as 70% in Phase II and 59% in Phase III trials.
176.
DOT. DOT value of statistical life ($13.6M).
DOT: VSL Guidance 2024 https://www.transportation.gov/office-policy/transportation-policy/revised-departmental-guidance-on-valuation-of-a-statistical-life-in-economic-analysis (2024)
Current VSL (2024): $13.7 million (updated from $13.6M) Used in cost-benefit analyses for transportation regulations and infrastructure Methodology updated in 2013 guidance, adjusted annually for inflation and real income VSL represents aggregate willingness to pay for safety improvements that reduce fatalities by one Note: DOT has published VSL guidance periodically since 1993. Current $13.7M reflects 2024 inflation/income adjustments Additional sources: https://www.transportation.gov/office-policy/transportation-policy/revised-departmental-guidance-on-valuation-of-a-statistical-life-in-economic-analysis | https://www.transportation.gov/regulations/economic-values-used-in-analysis
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177.
PLOS ONE. Cost per DALY for vitamin a supplementation.
PLOS ONE: Cost-effectiveness of "Golden Mustard" for Treating Vitamin A Deficiency in India (2010) https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0012046 (2010)
India: $23-$50 per DALY averted (least costly intervention, $1,000-$6,100 per death averted) Sub-Saharan Africa (2022): $220-$860 per DALY (Burkina Faso: $220, Kenya: $550, Nigeria: $860) WHO estimates for Africa: $40 per DALY for fortification, $255 for supplementation Uganda fortification: $18-$82 per DALY (oil: $18, sugar: $82) Note: Wide variation reflects differences in baseline VAD prevalence, coverage levels, and whether intervention is supplementation or fortification Additional sources: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0012046 | https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266495
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180.
PMC. Cost-effectiveness threshold ($50,000/QALY).
PMC https://pmc.ncbi.nlm.nih.gov/articles/PMC5193154/ The $50,000/QALY threshold is widely used in US health economics literature, originating from dialysis cost benchmarks in the 1980s. In US cost-utility analyses, 77.5% of authors use either $50,000 or $100,000 per QALY as reference points. Most successful health programs cost $3,000-10,000 per QALY. WHO-CHOICE uses GDP per capita multiples (1× GDP/capita = "very cost-effective", 3× GDP/capita = "cost-effective"), which for the US ( $70,000 GDP/capita) translates to $70,000-$210,000/QALY thresholds. Additional sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC5193154/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC9278384/
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181.
Integrated Benefits Institute. Chronic illness workforce productivity loss.
Integrated Benefits Institute 2024 https://www.ibiweb.org/resources/chronic-conditions-in-the-us-workforce-prevalence-trends-and-productivity-impacts (2024)
78.4% of U.S. employees have at least one chronic condition (7% increase since 2021) 58% of employees report physical chronic health conditions 28% of all employees experience productivity loss due to chronic conditions Average productivity loss: $4,798 per employee per year Employees with 3+ chronic conditions miss 7.8 days annually vs 2.2 days for those without Note: 28% productivity loss translates to roughly 11 hours per week (28% of 40-hour workweek) Additional sources: https://www.ibiweb.org/resources/chronic-conditions-in-the-us-workforce-prevalence-trends-and-productivity-impacts | https://www.onemedical.com/mediacenter/study-finds-more-than-half-of-employees-are-living-with-chronic-conditions-including-1-in-3-gen-z-and-millennial-employees/ | https://debeaumont.org/news/2025/poll-the-toll-of-chronic-health-conditions-on-employees-and-workplaces/
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183.
Sinn, M. P.
Wishocracy: Solving the Democratic Principal-Agent Problem Through Pairwise Preference Aggregation.
https://manual.warondisease.org/knowledge/appendix/wishocracy-paper.html (2025) doi:
10.5281/zenodo.18205881 Representative democracy suffers from an inescapable principal-agent problem where elected officials’ incentives diverge from citizen welfare. Wishocracy introduces RAPPA (Randomized Aggregated Pairwise Preference Allocation), which aggregates citizen preferences through cognitively tractable pairwise comparisons and creates accountability via Citizen Alignment Scores that channel electoral resources toward politicians who actually represent what citizens want.
184.
Sinn, M. P.
The Optimal Policy Generator: A Causal Inference Protocol for Maximizing Median Health and Wealth Through Public Policy.
https://manual.warondisease.org/knowledge/appendix/optimal-policy-generator-spec.html (2025) doi:
10.5281/zenodo.18603834 The Optimal Policy Generator (OPG) produces systematic public policy recommendations for jurisdictions at any level (country, state, city), generating prioritized enact/replace/repeal/maintain recommendations to maximize real after-tax median income growth and median healthy life years, based on quasi-experimental evidence from centuries of policy variation data.
185.
Sinn, M. P.
The Optimal Budget Generator: A Causal Inference Protocol for Maximizing Median Health and Wealth Through Public Goods Funding.
https://manual.warondisease.org/knowledge/appendix/optimal-budget-generator-spec.html (2025) doi:
10.5281/zenodo.18356209 The Optimal Budget Generator (OBG) uses causal inference, diminishing returns modeling, and cost-effectiveness evidence to determine optimal public goods funding levels that maximize two welfare metrics: real after-tax median income growth and median healthy life years. For each spending category, OBG estimates an Optimal Spending Level (OSL) and produces a gap analysis showing where current government budgets are over- or underfunded relative to evidence-based benchmarks. The Budget Impact Score (BIS) measures confidence in each recommendation based on the quality of causal evidence.
188.
SEC. SEC definition of an accredited investor.
SEC: Accredited Investor Definition https://www.sec.gov/education/capitalraising/building-blocks/accredited-investor (2020)
Individual: $1M net worth (excluding primary residence) OR $200K annual income ($300K joint) Entity: $5M+ in assets; all equity owners are accredited; knowledgeable employees of private funds Updated 2020: Includes professional certifications (Series 7, 65, 82) and "knowledgeable employees Additional sources: https://www.sec.gov/education/capitalraising/building-blocks/accredited-investor | https://www.sec.gov/files/rules/final/2020/33-10824.pdf
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199.
Abers, R., Brandão, I., King, R. & Votto, D.
Porto alegre: Participatory budgeting and the challenge of sustaining transformative change. (2018)
Examines transformative urban change in Porto Alegre, Brazil, through the lens of participatory budgeting. However, political support for participatory budgeting in its birthplace has declined through the years, culminating in its suspension in Porto Alegre in 2017. The success of participatory budgeting as a tool of transformative urban change is contingent on four conditions: (1) well-structured participatory arrangements to ensure participation from a wide range of actors across society; (2) adequate financial resources; (3) political commitment and flexibility to adjust to changing political realities; and (4) government commitment to implement the proposals the process generates. Additional sources: https://www.wri.org/research/porto-alegre-participatory-budgeting-and-challenge-sustaining-transformative-change | https://www.oidp.net/docs/repo/doc415.pdf
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