So, what he says is that productivity gains in the U.S. are: 1. Only apparent when measured at 2017 prices but not when measured at PPP (purchase power). 2. I

So, what he says is that productivity gains in the U.S. are: 1. Only apparent when measured at 2017 prices but not when measured at PPP (purchase power). 2. In the US most of productivity gains are concentrated at the tech industry and California. The rest of the economy (and most of non-California states) are less productive than Europe. Personally, I am not entirely convinced but these are interesting arguments. It is loudly obvious to any non-American that the US healthcare is very far away from being "productive".