Why Were They Called "Trusts" Anyway?

I think it's been a while since I posted about one of Cory Doctorow's thought pieces. Since he coined 2023's word of the year, and had another great article on the AI bubble that I already passed up on including, I think I've held off long enough and deserve to mention him again.

His recent post starts out talking about the proposed merger of Spirit and Jetblue, which was recently turned down by a Reagan-appointed judge, based on antitrust principles. Yes, a Reagan-appointed judge. Yes, based on anti-trust principles.

The decision came just after that door blew off in midair on an Alaska airlines Boeing 737.

Doctorow explains that the reason the two airlines want to merge is because monopoly has created a supply chain crisis through the entire airline industry — so there are no routes, pilots, or air traffic controllers left for anyone but the big four airlines, and no quality planes or engines. Boeing's quality is a known problem, and their market share has been declining for years as a result; the main supplier of planes, Airbus, can't keep up with the demand, however.

The U.S. government, meanwhile, is full of ex-Boeing execs, and Boeing is home to ex-FAA execs — the classic revolving door we see in too many parts of U.S. government a large industry sectors.

From there, Doctorow moves on to pharmaceutical companies:

[After deregulation p]harma companies interbred with one another in a string of incestuous marriages that produced these dysfunctional behemoths that were far better at shifting research costs to governments and squeezing customers than they were at making drugs. The pharma giants gouged hospitals for their products, and in response, hospitals underwent their own cousin-fucking merger orgy, producing regional monopolies that were powerful enough to resist pharma's price-hikes. But in growing large enough to resist pharma profiteering, the hospitals also became powerful enough to screw over insurers. Insurers then drained their own gene pool by combining with one another until most of us have three or fewer insurers we can sign up with – companies that are both big enough to refuse hospital price-hikes, and to hike premiums on us.

Thus monopoly begets monopoly: with health sewn up by monopolies in medical tech, drugs, pharmacy benefit managers, insurance, and hospitals, the only easy targets for goosing profits are people.

And so we pay more for our medical care than any other rich country, with worse outcomes, as retail pharmacies across the country close with their profits squeezed out of existence.