What does the Occupy Wall Street slogan of the 99% and the 1% have to do with bioethics? I have just worked through edits with Kate Caras, our senior managing editor at IJFAB, of my review essay, “Piketty and the body” (forthcoming in the fall, issue 8.2).

Thomas Piketty, if you missed the excitement last year, is the French economist who, with many collaborators, is doing the rigorous economic analysis behind the OWS slogans. He and his collaborators have demonstrated not just the increasing concentration of income but also (more controversially) the increasing accumulation of wealth over the course of the last decades. In his Capital in the 21st Century—a surprisingly readable 700-page tome—he proposes the market mechanisms behind this, which he calls the fundamental laws of capital, the tendency of wealth (measured in ratio to income, called β) to accumulate when the rate of return on capital is greater than the rate of economic growth—or, as his famous formula has it, r > g. His conclusion, in its broadest terms, is that without the political will and appropriate policy—or the destruction of wealth brought about by the kinds of wars we saw in the 20th century—inequality will once again reach the dizzying heights of the 18th and 19th centuries. We’ll all be living in a world like that of Jane Austen or Honoré de Balzac, trying to marry into the right family, rather than focusing on the development of our own skills and talents. In short we’ll leave behind our meritocracy for a world dominated by questions of inheritance. (How real that meritocracy has been is open to debate, of course. See, for a recent example, Chris Bertram on Rawls and Piketty at Crooked Timber here.)

If you’re not ready to read 700 pages, you can read a reasonable summary at the New Republic by Robert Solow here, and the 4-page version of the data that Piketty and his Berkeley collaborator Emmanuel Saez wrote up for Science Magazine is here.

The idea that economic wellbeing has an influence on health is the most obvious relevance of Piketty to bioethics, of course. The connection (among others) is indicated by the idea of the “social determinants of health.” In my forthcoming review essay, I discuss a few more specific connections between rising inequality and accumulating wealth and health/healthcare. The issue that Piketty is trying to focus public debate on is around wealth accumulation. He challenges us to ask the question: what would a more egalitarian world look like when it comes to ownership of capital?

This week, I had the sabbatical-enabled opportunity to sit in on a half-day session on Piketty, politics, and social policy at the London School of Economics, organized by the Comparative and International Political Economy group in the Government Department, Catherine Boone, David Soskice, Jonathan Hopkin, and Steffen Hertog.

Tony Atkinson, who was on staff the LSE when Piketty was a PhD student there, is the eminence gris of inequality studies, and a mentor and collaborator to Piketty and his generation of inequality studies economists. The LSE has hosted lectures and events since the book’s release—see a video of Piketty presenting at the LSE here.

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David Soskice (article here) kicked the day off by raising questions about Piketty’s neoclassical economic standpoint. One of the things that’s both exciting about Piketty but limiting at the same time is that he warns us of the dangers of capitalism from the inside: he’s no “heterodox” economist, and no Marxist. (Despite the book’s title, he vows he’s never read Marx; and despite the title, the book is about wealth, really—technically—not capital.)

This means that Piketty’s concerns may mean something in all those corridors of power where Marx means nothing. But Soskice has three main points of criticism around this: Piketty is surprisingly loose with some central commitments from the orthodox neoclassical perspective he occupies; for all his concern with inequality, he focuses on the rich and not the poor; and for all his interest in fostering political economy, there is none of it in Capital.

“Political economy” refers to the tradition in which Smith and Marx wrote, where economic thought was integrated with social, political, historical, and normative inquiry. In a comparison that may be significant to me alone (how many people write their dissertations on Wittgenstein’s Tractatus and then end up at the political economy end of bioethics?), by the time I’d been through my second read of Piketty’s Capital, his work brought me back to the Tractatus. Just as Wittgenstein in the Tractatus takes metaphysics on its own terms in order to show its failure at every turn (on the “resolute reading”), Piketty takes neoclassical economics on its own terms, and shows us that each and every prediction/explanation that economists offer for why the markets will limit inequality fails. On the contrary, markets increase economic inequality, of both income and wealth. (Part of why the book is 700 pages is that Piketty carefully distinguishes and relates these, and so there are many strands to his argument.)

Piketty has been credited with the rebirth of political economy. But in the book itself, political economy is what he gestures at as the solution to rising inequality: market trends that increase inequality can be radically disrupted by political processes and policies designed to limit inequality. But he doesn’t say anything of any depth about political economy. In that sense, political economy is “that of which one cannot speak” in this book. It’s the “everything else” he wants us to talk about after he shows us that neoclassical economics alone can’t comfort us with promises of a more just world. Piketty wants us to talk about it—not to pass over it in silence.

Part of his silence on the topic is that he’s a true quant: he delights in accumulating and analyzing his data. More deeply, he doesn’t want economists to lead the conversation. He believes the conversation has to be a democratic one, engaging the broader public and including the perspectives of the social sciences, normative inquiry, and literature. Economics should be more like a handmaiden to our social conversations about how we think society should be shaped, and less the leader in the conversation that constitutes political economy. In that sense, his political economy is more distributed than that of Marx and Smith, who took the “lone grand theorist” approach.