You Get What You Pay For

I had a conversation with a friend yesterday about how we create financial profit. Our conversation turned toward the idea of industries that profit from misfortune, or even create misfortune in order to make money.

Healthcare: this is the largest expenditure in the 2019 U.S. budget. Total planned 2019 healthcare spending by the U.S. government is 3.65 trillion dollars (which includes the cost of Medicare and Medicaid). I am not opposed to healthcare providers making money from healthcare (I am a healthcare provider, and I make a good living at what I do). But I am uncomfortable with creating profit incentives out of some things, like opioid prescribing. Opioids became very profitable to prescribe over the past decade, so a lot of opioids were prescribed profitably, and now we have an opioid epidemic. It is not a coincidence that the largest U.S. lobbying industry is Pharmaceuticals and Healthcare Products (, which spent almost twice as much as any other industry on lobbying in 2018.

Defense spending: the 2019 U.S. budget for defense spending is 639 billion dollars. We have created a very profitable industry that creates weapons of war. I have an uncomfortable question for you: how many years has the U.S. been at war? I don’t just mean official declared wars. I mean all acts of war. Do a search on that. Stop reading this, and search “how long has the U.S. been at war”. When you live in a place that creates a profit motive for creating weapons of war, you will buy and sell a lot of weapons of war. Worse than that, someone will want to use them.

Education: the 2019 U.S. expenditure (this is not the U.S. government, this is you and me) on higher education is expected to be 584 billion dollars. I am not opposed to education (I have three degrees)-but I am opposed to how profitable the education system is, and who pays for it. The cost of higher education is increasing at eight times the rate of inflation. There is no competitive pressure to decrease tuition costs, because students continue to borrow money to go to school. All of this borrowed money is pumped into a system that looks for ways to spend it. I just spent a year visiting campuses across the United States with my daughter, who was looking at colleges and universities to attend. Every school now looks like a campus of palaces. Dining halls are as nice as restaurants, and dorms are as nice as many hotels. We pay for this. The second largest type of debt in the United States is school loans (after mortgage debt). There is more school loan debt than credit card debt or car loans. The scary thing about school loan debt is that it doesn’t go away if you declare bankruptcy. Your school loan debt is yours to pay forever.

Prisons and incarceration: In the 1980s, there was a movement to create for-profit prisons. Those prisons charge the government a certain amount of money per prisoner. The more prisoners a prison has, the more money it can charge the government. The most profitable thing a prison can do is to have (and create) more prisoners. Do a search on “number of prisoners in the U.S.”. Today there are 2.3 million Americans behind bars in jails and prisons. According to the Equal Justice Initiative, another 6 million Americans are on parole or probation, and another 60 million Americans have a criminal record. Prisoners are profitable for prisons and the prison industry. The more prisoners we create, the more money that industry makes. “Law and order” is not about law and order. It is about creating more profit for an industry that only makes money if we make more prisoners for them. The Equal Justice Initiative estimates 2019 spending on incarceration in the U.S. to be 182 billion dollars. I am not suggesting that violent criminals should be walking free. But I am suggesting that there are some non-violent offenders who are being punished way out of proportion for their misdeeds. Your assigned reading on this topic is the Bryan Stevenson book “Just Mercy” (to be released as a motion picture in December 2019).

Guns: The people of the United States spend 28 billion dollars a year for individual gun purchases and ammunition. There are now more guns than people in the U.S. Read that again. I regularly travel to countries that have no guns. None. Even the police don’t carry guns in some of the places I visit. This is an industry that figured out that one way to become more profitable from the misery of others is to avoid lawsuits. So the gun lobby used gun profits to lobby lawmakers, and now there are laws that prevent liability lawsuits against gun manufacturers. No other industry is provided this protection. Not the tobacco industry, not automotives, not healthcare. Why guns? Recently a lawsuit by Sandy Hook families against one gun manufacturer made its way to the Supreme Court, and the Supreme Court ruled that the lawsuit can proceed. My personal hope is that the industry will soon face the same litigation pressures as those faced by other industries.


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