The prospects for the U.S. economy have become uniquely dreadful, if not frightening. In this paper we argue, as starkly as we can, that the United States and the rest of the world's economies will not be able to achieve balanced growth and full employment unless they are able to agree and implement an entirely new way of running the global economy. Yet we should admit up front that while we feel able to outline the nature and magnitude of the emerging crisis, and even to set down some of the things that must happen, we have few solid suggestions as to how these changes can now be brought about.