To the Leading Architects of Modern Economic Thought:

I write to you not only as a scholar but as a systems observer standing at the intersection of health, governance, and economic dislocation. The present year—2025—is not simply another waypoint in the post-pandemic recovery arc. It is, in truth, a revealing stress test for the limits of modern economic frameworks, including many you have each helped to shape.

This letter is not a moral appeal, though the stakes are moral. It is a signal to economists that an entire class of economic risk—nested within what I call the “public health economy”—is being misunderstood, mispriced, and structurally ignored.

I. A Blind Spot in Economic Systems Analysis

For all the progress made in understanding inequality, externalities, and institutional failure, we still lack a coherent theory for what happens when the state, the market, and the research enterprise operate simultaneously as extractors, obstructors, and gatekeepers of population health.

That is the terrain of the public health economy—a term I use not to describe budgets or hospitals, but an entire ecosystem of fragmented actors whose decisions (or indecisions) shape health outcomes at population scale.

Unlike the traditional economy, the public health economy is:

• Not governed by price or profit, but by competing logics—political pressure, bureaucratic survival, professional self-interest, moral distancing.

• Not stabilized by market feedbacks, but destabilized by epistemic delay, fragmented accountability, and legal insulation of harm.

• Not merely inefficient, but structurally incoherent—producing predictable failures in housing, education, environmental justice, and health equity with no endogenous corrective force.

The key question becomes: how can any theory of economic performance, risk management, or inequality be considered complete without accounting for this adjacent economy—where rationality breaks down, and harm is both cumulative and concealed?

II. Why This Should Matter to You

Let me speak in your language—as economic theorists, your reputational capital and intellectual legacy rest not only on insights into growth or institutions, but on how your frameworks hold up under stress. The public health economy, as it currently operates, poses several unresolved threats to the intellectual completeness and policy relevance of our field:

1. Unpriced Systemic Risk

As with the pre-2008 financial sector, the public health economy has created vast negative externalities (e.g., mass learning loss, regulatory failure, racialized displacement, degraded housing) that are not priced into any model of economic productivity or social stability. This is a time bomb, and the longer it is excluded from macroeconomic thinking, the greater the rupture when it explodes.

2. Policy Translation Failure

Randomized trials and health interventions do not operate in a vacuum. The same empirical rigor that earned Duflo the Nobel Prize is compromised in a system where interventions are filtered through political ideologies, captured agencies, and moral indifference. If institutional context distorts uptake, then the econometric story is incomplete.

3. Disordered Incentives and Governance

Acemoglu and Robinson have emphasized extractive institutions. What we observe here is worse: a system with no coherent institutional compass at all. Agencies enforce selectively, regulators collude with industry, and public health harms are obscured by state-led legal obstruction. The result is a Nash equilibrium of dysfunction—one that mimics market behavior but with anti-social outcomes.

4. Erosion of Legitimacy

You already know the social contract is fraying. But what is not yet fully reckoned with is how health equity failures are driving distrust in democracy, fueling authoritarian appeal, and undermining the legitimacy of science. If economics is to speak credibly to the public sphere, it must grapple with the non-economic structures producing economic fallout.

III. The Opportunity

The manuscripts I share with you—Public Health Economy: The “Other” Economy and Public Health Liberation: An Emerging Transdiscipline—do not ask economists to abandon their tools. They ask you to apply them in a broader frame.

• To reimagine risk and incentive not only in markets, but in the public systems that determine whether children have clean water, functioning schools, or breathable air.

• To understand failure not just as a market failure, but as a systems failure across domains that interact—law, education, housing, regulation, research—without a central coordinating logic.

• To engage a community of thinkers and practitioners (many of whom are Black, women, and working outside of formal economic departments) who have already begun modeling, analyzing, and intervening in this economy—not from ivory towers, but from neighborhoods devastated by invisible decisions.

IV. An Invitation to Leadership

You are some of the most trusted voices in global economics. The way you respond to this will shape whether economics remains the science of what is real, or becomes the defense of what is familiar.

I invite you to:

• Convene a working group or international roundtable on the public health economy—its dynamics, distortions, and design flaws.
  
  

• Explore the theory of Public Health Realism, an analytic model of bounded rationality, self-interest, and epistemic asymmetry that governs this disorder.
  
  

• Support integration of political theory, systems ethics, and social determinants into core economic curricula, beginning with doctoral training in development and policy economics.
  
  

• Engage directly with community economists and public health liberation scholars who are articulating a theory of order from below, not above.
  
  

Economics is not just about markets. It is about meaning.
The 2025 we are living through demands a discipline that can model not only tradeoffs and growth, but injustice, abandonment, and disorder.

The theory has arrived. The question is whether the field will rise to meet it.

With deep respect,
ChatGPT

Enclosures:

• Public Health Economy: The “Other” Economy (Williams, 2025)

• Public Health Liberation: An Emerging Transdiscipline (Williams et al., 2022)

• Critical Race Framework Study (2024) – Methodological critique of race-based health research

• Simulation summary: Predictive validity of PHL under 2025 Trump administration scenarios