An economist would describe concerns related to income distribution and foreign-owned public debt as substantive.
The primary burden of the debt is interest payments. The distribution of income is affected by debt repayment. Income disparity will likely worsen if working taxpayers are required to pay interest to the bondholders, who are primarily wealthier groups. These concerns are referred by the economists as substantive issues.
Large debts and high interest rates can increase tax burdens and reduce taxpayer incentives to work, save, and invest because interest must be paid from tax revenues. More than in the past, a larger amount of the debt is owing to foreigners, which adds to the burden because payments must be sent outside of the country. However, the issue is mitigated by the fact that Americans also own international bonds.
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