Kelton terms fundamental shortfalls in American society that affect citizens’ daily lives “the deficits that matter.” She identifies six critical areas: employment, savings, healthcare, education, infrastructure, and democracy.

The employment deficit manifests in both quantity and quality of available jobs. Several case studies illustrate this: Rick Marsh lost his position at a GM plant in Ohio; Rocio Caravantes worked multiple minimum-wage jobs in Chicago just to afford basic necessities. Despite low unemployment statistics, post-2008 job growth concentrated in low-wage sectors, with nearly three-quarters of new positions paying under $50,000 annually. The author points out that inflation-adjusted wages for average workers increased only marginally between the 1970s and 2018.

Regarding the savings deficit, Kelton presents stark statistics about retirement preparedness. A significant portion of working-age Americans possess no retirement assets, while those who do have saved inadequate amounts. The author attributes this partly to rising educational costs and student debt, citing examples of couples earning six-figure incomes who struggle with substantial student loans while trying to save for retirement. This deficit, she notes, disproportionately affects racial minorities and women.

The healthcare deficit receives particular attention as Kelton describes how the United States, despite spending more per capita on healthcare than other developed nations, achieves worse outcomes.