Matt Bai is right to say that the world has changed, but that change probably really started in the late 70s. We just haven’t figured out how to deal with it yet.

US per capita GDP growth has been fairly constant in the long run since WWII. We remember the first quarter of the century after the war as one of great prosperity because the federal government, unions, and the big manufacturing companies conspired fruitfully to distribute fairly widely the goods that we got. A new era of global competition pulled the carpet from underneath America’s manufacturing base and the resulting economic chaos let in the deregulators and market-fundamentalists who kept growth up and helped make the transition to a broader service economy. That growth, though, didn’t benefit most Americans, who were stuck with stagnant real wages and left adrift as the institutions they relied upon and had invested their lives in (those pesky gigantic business enterprises) melted away or set sail.

I now better appreciate Bill Clinton’s rhetoric of building a bridge to the 21st century. It deserves to be resurrected. What Clinton saw, and what still remains true, is that health care should be seen as infrastructure. As long as GM or Kodak or their equivalents were around, many communities could survive on company-based health plans. Private actors promising a life-time of support were covering local infrastructure costs, just like they donated money to local colleges and schools. With those actors out of the picture, and with the expectation that workers be flexible, jumping from job to job, it has become incumbent on government to fill in the infrastructure gap: to build that necessary bridge to an economy with a fast and flexible work force. And despite efforts to sell off the New Jersey turnpike, we can still generally agree that government ought to be involved in infrastructure.

Speaking of “health care as infrastructure,” the new PBS series on health care (“Unnatural Causes”) focuses in part on the idea that urban infrastructure and design is part of the story of public health: access to transportation, grocery stores, parks, good water, good housing, doctors and dentists, etc. plays a huge role in determining one’s overall health, susceptibility to disease, and life expectancy. Add to that the role of good nutrition and exercise in early childhood development and it compounds across generations.

Health, education, and infrastructure — sounds like a winning trio for public investment.