There is a economic concept that would strengthen your argument - inelastic demand. Health care has inelastic demand. If you are healthy you don't use it. If you are sick, like a diabetic, you will pay any price for insulin, because if you don't get it you are dead. Private systems take advantage of this and jack up prices. As you said, government competition, or strict regulation, prevents gouging. The anti-regulatory angle is a tool of wealth to consolidate that wealth. Competition does this too. If public radio and public TV compete with private media for ears and eyes, it keeps private media on their toes. Ending public media ultimately means we rely on corporate propaganda for news. That corporate media, just as happened in corporate health care, consolidates and eventually destroys itself. Regulation and competition keep systems healthy. Our system, as you rightly diagnosed, is sick.
Internet should be free for everyone. So should healthcare, utilities, with affordability in housing, food, and any other necessities. Capitalism is killing this country! Greed is rampant!
You are the voice I've been looking for. The Thomas Paine of our times. I just signed up as a paid SS subscriber last night. I want to help but am 78 and not sure how. My career was in corporate communications. I want to learn how to do video editing to help you. We need to redefine Capitalism that works for working people. We need to build a new taxpayer owned health insurance company that uses AI to review and process claims and doesn't skim profits. A new Manhattan Project to help all working people to be able to afford decent health care. It's TIME TO PUT WORKING PEOPLE FIRST. Thank you for your astounding essays!
The argument that the Health Insurance industry made during ACA drafting was that they can’t “compete” against a “subsidized” plan like Medicare.
They were trying to say that Medicare is inefficient but bilks the taxpayer to “subsidize” rates.
Nothing could be further from the truth. Medicare has a lower admin cost overhead than private insurance (meaning more efficient).
The answer back this time has to be, “Don’t be afraid of real competition, are you a capitalist or a monopolist?”
The other answer is, “we are accountable to voters, if we are bilking them with taxes that are too high, they will vote us out. That’s not Communism, it’s Democracy.”
"Nothing could be further from the truth. Medicare has a lower admin cost overhead than private insurance (meaning more efficient)."
Indeed! Medicare's overhead costs are approximately 3.5%, whereas a full 33-35% of private premiums vanish into the pockets of the executives and shareholders. So government run healthcare insurance is 10 times as efficient as private insurance.
The crux of the problem is that free-market solutions will not work with healthcare... Adam Smith defined a free market as one where a buyer can decline to buy, and a seller can decline to sell; healthcare fails BOTH tests. This is why "market forces" cannot contain healthcare costs... frankly, the only people who don't intuitively understand this are those who seek to gain by not understanding. Either by reform or by guillotine, the obscenely wealthy must be brought to heel. Reform will be much easier for all of us.
"...free-market solutions will not work with healthcare." Thank you! Education, healthcare and defense do NOT belong in the marketplace. They are different from consumable products and the capitalist system does not work for them.
Ohh I love this. Most striking line, for me: "There's nothing inherently better about a corporation than a county." Counties, as you point out, have some democratic accountability baked in -- but they also have the ability to be *inefficient* when necessary. Government doesn't have to move slow and create waste, and it should do far less of that than it does now... but it CAN leave profit on the table or make decisions with a longer-term goal in mind. Corporations can't. The incentives are all messed up. Public competition, in this way, is more nimble.
Incredibly insightful. Healthcare in America is synonymous with health insurance. Once cannot be discussed without the other. No matter where a human is in the world, healthcare is personal - between the human and the provider(s). The ‘personal’ is and has been removed and that is a key ingredient in the mess we see today. “If we can’t get healthcare to become substantially cheaper, I’m talking about half the price, we’re in big trouble” is the conversation everyone needs to consider. Nothing will change without the public asking questions over and over and I imagine this will happen as people either opt out of unprecedented premium rates or loose their minds (and health) hustling to afford while still facing high deductibles and out of pocket costs (not to mention denials, appeals, prior auths etc). The game has been rigged and now is the time to rise and commit to a New Way.
Well said. Bear in mind that everything out of the mouths of Repugnicans is a lie of bad faith. "Socialism" is meant to tar public expenditures when they benefit the public -- an absurd position, manifestly stupid but caterwauled often enough to sound menacing. Socialism for the rich is what we have, but they call it "capitalism". which is also wrong. Why do "free market" enthusiasts clamor constantly for their "right" to free money, protection of their idle riches, and protection of their propertied privilege? It's not an ideology, it's not "conservatism", it's not capitalism -- it's corruption. Let's democratize the economy, democratize capital, democratize corporations, so that our collective strength builds our collective wealth instead of getting it siphoned off to holders of pieces of paper? I've stopped listening to bullshit. Let's drop the lamentations and build ourselves a more perfect union. Finish the War of Independence, preserve government for the people.
I think you should get together with Saikat Chakrabarti,, who is running for Nancy P{elosi's seat... he has much the same view, but calls it a return to FDR days... I agree with both of you...
I’m largely on board, but I can see a couple of “flies“ in the proverbial ointment:
1. When there’s a public option, corporate America will always be at a disadvantage because the former doesn’t need (and shouldn’t) make a profit. That’s why they fight it tooth and nail. Years ago, I was part of a Single Payer Now delegation that went to Los Angeles for an Obamacare meeting. They wouldn’t even let us in the building.
1. When it comes to the matter of regulation as a means to rein in abuse, I refer to green architect and Time Magazine “hero of the planet“ William McDonough’s observation that “The need for regulation is a symptom of a poorly designed system”.
In this case, the poorly designed system is one where all actors are struggling to get more than their proportionate share (a.k.a. “profit“). Even a child can see that a system requiring everyone to extract more value than they put in will eventually become problematic- leading to destabilizing inequality. Such a consequence can be delayed for a time by constant growth, yet in a closed system (like planet Earth) it cannot be sustained in the long run. I believe we are now hitting that wall.
We’re probably not going to get rid of the profit motive anytime soon, but failing that, simply putting an upper limit on personal and corporately held wealth would achieve much the same effect
Meh, the capitalist model is a competitive market that first rewards the most efficient profit generators, and then evolves into monopolies where capital doesn't matter because nobody can compete. It doesn't have any business in our system of distributing basic needs like food, clothing, housing, healthcare, and security. It's for luxuries that people can thrive without, and will fight for status over, which can be taxed at the corporate level to regulate exploitative and monopolistic power concentration without anyone complaining except the psychopaths that rise to the top of such competitive economic models.
The only reason to fight for privatization of essential goods and services, is to use them as a kudgel for controlling people under threat of deprivation and death, which is a proxy for overthrowing the government.
Collectivise the essentials, capitalize the luxuries, redistribute the excessive gains of labor and market exploitation to fund the socialized essentials.
Right now, all we do is allow oligarchs to hide behind a paper shield of "corporation" and reward themselves by practicing capital efficiency through wage suppression and market cornering. They have the privilege of calling the success of their workers and the opportunities provided by civilization "profit", but that privilege is supposed to be given with an expectation of receiving a greater benefit in return. When they're simply destroying the environment, paying workers 10% of their actual value, manipulating the market to pillage small businesses unjustly forced to close, and using their privilege of access to easy credit and capital to declare a paper "person" with rights to speech through money so we never see a political candidate, budget, or legislation the people want... well, that's not capitalism, and it's not scary at all to turn on such cannibalistic forces and cannibalize them to build something else.
Gen pop has a negative net worth mostly, and it's not because they don't provide enough value, it's because the system overall is rigged to keep them in perpetual debt slavery or exiled to the streets. The fed actively practices wage suppression, exorbitant inflation, and manipulates markets to ensure most people can't get what they need without begging for credit and 60+ hours of labor.
The rising tide hasn't lifted many boats at all. You can see that in the comparison of wages, GDP, and income distribution over time. There are hoarders at the top, doing what hoarders do. When civilization gets destitute enough to go out manifesting destiny, there are no frontiers left, no kingdoms to sack worth the effort, just those hoarders who've had the privilege because "when we have it all, we'll manifest our utopia"... but hey, the whole thing looks like hell with different set dressing.
I mean, I was talking to a guy just a few hours ago. He was at his full time job, and the van he lives in was parked outside. The corporation he works for has been bragging about record profits for decades, and I'm absolutely certain they're actually bragging about forcing their workers to generate a dollar of value for every penny they pay them. It's not a choice of where to work when the entire system incentivises this kind of exploitation and prints free money for those who do it with the greatest excess.
When we actually get to a capitalist economy, maybe your model will have some useful application somewhere, but we're not in a capitalist economy.
Such relevant and well written information for those, like me, who haven’t paid serious attention to these issues and benefit from your timely teaching. Thank you. Between you, Marianne Williamson, Heather Cox Richardson, and Robert Reich, I’m learning A LOT.
The problem with your premise is that socialism is not a party or political movement. It is a morality of behavior that is deeply religious as well as emminently practical. Of course intelligent governments and industrialists practice socialism in the interests of transport, education, and communication, as in America from the Eirie Canal to the US Postal Service. In time, smart industrial capitalists figured out that labor was their most precious resource and took good care of their workforce. When capitalism collapsed in the Great Depression, FDR extended socialism to wider reaches of society and the economy. Tragically, neoliberalism lacks morality and intelligence and its privatization has clearly ruined the economies of its practitioners. China always offers a counterpoint of a socialist economy that prospers.
Corbin, your statement: 'When government competes in markets, costs drop and quality rises; not because bureaucrats are smarter, but because public alternatives don’t extract profit for shareholders.' is now painfully naive under trump corruption and grifting. Economic models meet real corruption.
There is a economic concept that would strengthen your argument - inelastic demand. Health care has inelastic demand. If you are healthy you don't use it. If you are sick, like a diabetic, you will pay any price for insulin, because if you don't get it you are dead. Private systems take advantage of this and jack up prices. As you said, government competition, or strict regulation, prevents gouging. The anti-regulatory angle is a tool of wealth to consolidate that wealth. Competition does this too. If public radio and public TV compete with private media for ears and eyes, it keeps private media on their toes. Ending public media ultimately means we rely on corporate propaganda for news. That corporate media, just as happened in corporate health care, consolidates and eventually destroys itself. Regulation and competition keep systems healthy. Our system, as you rightly diagnosed, is sick.
Internet should be free for everyone. So should healthcare, utilities, with affordability in housing, food, and any other necessities. Capitalism is killing this country! Greed is rampant!
You are the voice I've been looking for. The Thomas Paine of our times. I just signed up as a paid SS subscriber last night. I want to help but am 78 and not sure how. My career was in corporate communications. I want to learn how to do video editing to help you. We need to redefine Capitalism that works for working people. We need to build a new taxpayer owned health insurance company that uses AI to review and process claims and doesn't skim profits. A new Manhattan Project to help all working people to be able to afford decent health care. It's TIME TO PUT WORKING PEOPLE FIRST. Thank you for your astounding essays!
The argument that the Health Insurance industry made during ACA drafting was that they can’t “compete” against a “subsidized” plan like Medicare.
They were trying to say that Medicare is inefficient but bilks the taxpayer to “subsidize” rates.
Nothing could be further from the truth. Medicare has a lower admin cost overhead than private insurance (meaning more efficient).
The answer back this time has to be, “Don’t be afraid of real competition, are you a capitalist or a monopolist?”
The other answer is, “we are accountable to voters, if we are bilking them with taxes that are too high, they will vote us out. That’s not Communism, it’s Democracy.”
"Nothing could be further from the truth. Medicare has a lower admin cost overhead than private insurance (meaning more efficient)."
Indeed! Medicare's overhead costs are approximately 3.5%, whereas a full 33-35% of private premiums vanish into the pockets of the executives and shareholders. So government run healthcare insurance is 10 times as efficient as private insurance.
The crux of the problem is that free-market solutions will not work with healthcare... Adam Smith defined a free market as one where a buyer can decline to buy, and a seller can decline to sell; healthcare fails BOTH tests. This is why "market forces" cannot contain healthcare costs... frankly, the only people who don't intuitively understand this are those who seek to gain by not understanding. Either by reform or by guillotine, the obscenely wealthy must be brought to heel. Reform will be much easier for all of us.
"...free-market solutions will not work with healthcare." Thank you! Education, healthcare and defense do NOT belong in the marketplace. They are different from consumable products and the capitalist system does not work for them.
Here’s another bullet point for your evidence section - North Dakota’s public bank. Gets a mention in the link below.
https://scheerpost.com/2025/11/17/ellen-brown-why-new-york-city-needs-a-public-bank/?utm_source=substack&utm_medium=email
Ohh I love this. Most striking line, for me: "There's nothing inherently better about a corporation than a county." Counties, as you point out, have some democratic accountability baked in -- but they also have the ability to be *inefficient* when necessary. Government doesn't have to move slow and create waste, and it should do far less of that than it does now... but it CAN leave profit on the table or make decisions with a longer-term goal in mind. Corporations can't. The incentives are all messed up. Public competition, in this way, is more nimble.
Socialism: expecting government services in exchange for the money you pay in taxes. Is that really such a radical idea?
Incredibly insightful. Healthcare in America is synonymous with health insurance. Once cannot be discussed without the other. No matter where a human is in the world, healthcare is personal - between the human and the provider(s). The ‘personal’ is and has been removed and that is a key ingredient in the mess we see today. “If we can’t get healthcare to become substantially cheaper, I’m talking about half the price, we’re in big trouble” is the conversation everyone needs to consider. Nothing will change without the public asking questions over and over and I imagine this will happen as people either opt out of unprecedented premium rates or loose their minds (and health) hustling to afford while still facing high deductibles and out of pocket costs (not to mention denials, appeals, prior auths etc). The game has been rigged and now is the time to rise and commit to a New Way.
Well said. Bear in mind that everything out of the mouths of Repugnicans is a lie of bad faith. "Socialism" is meant to tar public expenditures when they benefit the public -- an absurd position, manifestly stupid but caterwauled often enough to sound menacing. Socialism for the rich is what we have, but they call it "capitalism". which is also wrong. Why do "free market" enthusiasts clamor constantly for their "right" to free money, protection of their idle riches, and protection of their propertied privilege? It's not an ideology, it's not "conservatism", it's not capitalism -- it's corruption. Let's democratize the economy, democratize capital, democratize corporations, so that our collective strength builds our collective wealth instead of getting it siphoned off to holders of pieces of paper? I've stopped listening to bullshit. Let's drop the lamentations and build ourselves a more perfect union. Finish the War of Independence, preserve government for the people.
I think you should get together with Saikat Chakrabarti,, who is running for Nancy P{elosi's seat... he has much the same view, but calls it a return to FDR days... I agree with both of you...
You got me. You make a lot of sense and I’m paying to keep you going!
I’m largely on board, but I can see a couple of “flies“ in the proverbial ointment:
1. When there’s a public option, corporate America will always be at a disadvantage because the former doesn’t need (and shouldn’t) make a profit. That’s why they fight it tooth and nail. Years ago, I was part of a Single Payer Now delegation that went to Los Angeles for an Obamacare meeting. They wouldn’t even let us in the building.
1. When it comes to the matter of regulation as a means to rein in abuse, I refer to green architect and Time Magazine “hero of the planet“ William McDonough’s observation that “The need for regulation is a symptom of a poorly designed system”.
In this case, the poorly designed system is one where all actors are struggling to get more than their proportionate share (a.k.a. “profit“). Even a child can see that a system requiring everyone to extract more value than they put in will eventually become problematic- leading to destabilizing inequality. Such a consequence can be delayed for a time by constant growth, yet in a closed system (like planet Earth) it cannot be sustained in the long run. I believe we are now hitting that wall.
We’re probably not going to get rid of the profit motive anytime soon, but failing that, simply putting an upper limit on personal and corporately held wealth would achieve much the same effect
Meh, the capitalist model is a competitive market that first rewards the most efficient profit generators, and then evolves into monopolies where capital doesn't matter because nobody can compete. It doesn't have any business in our system of distributing basic needs like food, clothing, housing, healthcare, and security. It's for luxuries that people can thrive without, and will fight for status over, which can be taxed at the corporate level to regulate exploitative and monopolistic power concentration without anyone complaining except the psychopaths that rise to the top of such competitive economic models.
The only reason to fight for privatization of essential goods and services, is to use them as a kudgel for controlling people under threat of deprivation and death, which is a proxy for overthrowing the government.
Collectivise the essentials, capitalize the luxuries, redistribute the excessive gains of labor and market exploitation to fund the socialized essentials.
Right now, all we do is allow oligarchs to hide behind a paper shield of "corporation" and reward themselves by practicing capital efficiency through wage suppression and market cornering. They have the privilege of calling the success of their workers and the opportunities provided by civilization "profit", but that privilege is supposed to be given with an expectation of receiving a greater benefit in return. When they're simply destroying the environment, paying workers 10% of their actual value, manipulating the market to pillage small businesses unjustly forced to close, and using their privilege of access to easy credit and capital to declare a paper "person" with rights to speech through money so we never see a political candidate, budget, or legislation the people want... well, that's not capitalism, and it's not scary at all to turn on such cannibalistic forces and cannibalize them to build something else.
Gen pop has a negative net worth mostly, and it's not because they don't provide enough value, it's because the system overall is rigged to keep them in perpetual debt slavery or exiled to the streets. The fed actively practices wage suppression, exorbitant inflation, and manipulates markets to ensure most people can't get what they need without begging for credit and 60+ hours of labor.
The rising tide hasn't lifted many boats at all. You can see that in the comparison of wages, GDP, and income distribution over time. There are hoarders at the top, doing what hoarders do. When civilization gets destitute enough to go out manifesting destiny, there are no frontiers left, no kingdoms to sack worth the effort, just those hoarders who've had the privilege because "when we have it all, we'll manifest our utopia"... but hey, the whole thing looks like hell with different set dressing.
I mean, I was talking to a guy just a few hours ago. He was at his full time job, and the van he lives in was parked outside. The corporation he works for has been bragging about record profits for decades, and I'm absolutely certain they're actually bragging about forcing their workers to generate a dollar of value for every penny they pay them. It's not a choice of where to work when the entire system incentivises this kind of exploitation and prints free money for those who do it with the greatest excess.
When we actually get to a capitalist economy, maybe your model will have some useful application somewhere, but we're not in a capitalist economy.
Such relevant and well written information for those, like me, who haven’t paid serious attention to these issues and benefit from your timely teaching. Thank you. Between you, Marianne Williamson, Heather Cox Richardson, and Robert Reich, I’m learning A LOT.
The problem with your premise is that socialism is not a party or political movement. It is a morality of behavior that is deeply religious as well as emminently practical. Of course intelligent governments and industrialists practice socialism in the interests of transport, education, and communication, as in America from the Eirie Canal to the US Postal Service. In time, smart industrial capitalists figured out that labor was their most precious resource and took good care of their workforce. When capitalism collapsed in the Great Depression, FDR extended socialism to wider reaches of society and the economy. Tragically, neoliberalism lacks morality and intelligence and its privatization has clearly ruined the economies of its practitioners. China always offers a counterpoint of a socialist economy that prospers.
Corbin, your statement: 'When government competes in markets, costs drop and quality rises; not because bureaucrats are smarter, but because public alternatives don’t extract profit for shareholders.' is now painfully naive under trump corruption and grifting. Economic models meet real corruption.