“All I can say, based on my own experience, is that change isn’t something that can be planned. It’s something that can only be recognized.”
When we ask ourselves whether populist hostility should be directed against the rich or against the professional elite, the answer must be, “Yes, please!” From 1980 to 2007, the financial sector grew from 4 percent of GDP to 8 percent, but it’s shrunk since and may shrink further. The medical sector, on the other hand, grew in the same period from 9 percent to 16 percent — and is expected to account for a full 29 percent of the economy by 2030. Goldman Sachs makes for an attractive monster, but the bigger vampire squid may be the American Medical Association, which has colluded in blocking universal coverage and driving up health costs since World War II.
If not earlier: the AMA owes its authority to America’s most notorious robber barons, who invented philanthropy as we know it by establishing foundations capable of long-term, organized interventions in the country’s political and cultural life. The first foundations poured money into medical schools — but only if those schools followed the example set by Johns Hopkins, which in 1893 had introduced what’s now the standard formula: students attend four years of college, then four years of medical school. Institutions that didn’t follow this model did not get donations, and they also got denounced in a 1910 report sponsored by the Carnegie Foundation. After the Carnegie survey published its “findings,” scores of medical schools — schools whose students could not afford the additional years of study now required, and nearly all of the schools that admitted blacks and women — closed.”
“If the East India Company was the first drug cartel, then the Royal Navy was the first band of violent cartel enforcers. After the two Opium Wars, the company won the right to traffic in 1860. The Chinese kept smoking and took the poppy with them in their diaspora round the planet.”