The central issue in American politics isn't health reform, though you'd never know it from watching the news. Rather, the central issue, the one that helps define all others, is wages. When real wages increase, societies tend to be more open and generous. But when living standards are under pressure, a climate of distrust prevails. People grow fearful of losing what they have, and so they question the ambitions of social reformers and free-traders and others who promise to overturn old and familiar ways of doing business, whether from the right or the left.