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Attempting to explain increased income inequality and decreased productivity growth, this book considers distribution not just in terms of income but also in terms of education and health care: two long-term determinants of income. Reviewing partial explanations, it notes the conflict between claims of rapid technological change and decreased productivity growth and shows the limited impact of policies affecting income redistribution. Although education and health care have become more equally distributed, the work notes, higher educational attainment has had a minimal effect on occupational distribution, and with improved access to medical care, the disparity between the health of the poor and the rest of the population has not decreased.

In conclusion, the work notes that attitudes toward income inequality differ from attitudes toward inequality in education and health care. Attitudes toward income inequalty accept a floor but no ceiling; whereas equal access to education, qualified by ability, and access to health care based on need are generally accepted.