If we look around at the things that make our society work and our lives better, we can see we’ve been duped from the start. This didn’t all come from some pure, untouched version of the free market. Our roads, our bridges, libraries, fire departments, the internet, Social Security. All of these things happened because we came together as people and decided we wanted them.
These weren’t accidents. They weren’t side effects of private competition. They came out of a period when ordinary people had power. Real power. Power to demand that the systems they paid for actually delivered. The government was the instrument of that power. Not a side player. Not a check writer. Not a referee. A doer. A builder of things, on behalf of the people who built it.
In 1981, more than 40% of the hospitals in this country were owned by federal, state, or local government. Cities and counties ran their own hospitals.
That’s the idea we don’t name anymore. The idea that the public has the right to organize, to own, and to demand. That’s the competing idea. And without it, the system has no counterweight.
That tension mattered. It forced decisions. It forced investment. It forced the country to build.
Now that pressure is gone. Not completely, but enough that it doesn’t function anymore. There’s no real counterweight shaping outcomes. And what you’re left with is a system that just expands in the direction of profit. Profit over efficiency. Profit over outcomes. Profit over people.
You can see it most clearly in healthcare. We spend nearly six trillion dollars a year on it. Six trillion. And we are not the healthiest country on earth. We are not even close. We are paying the most and getting the least. That’s not an efficiency problem. That’s a power problem.
We’ve run this experiment for decades now. Consolidation, extraction, pricing that has no relationship to reality. It’s not competitive in any meaningful sense. It’s a closed loop. The product isn’t working. People feel it every day. They don’t need a study to tell them.
And here’s the thing nobody remembers. We used to own a lot of this. In 1981, more than 40% of the hospitals in this country were owned by federal, state, or local government. Cities and counties ran their own hospitals. States ran academic medical centers. The federal government ran the VA, military hospitals, the Indian Health Service. We the people owned the means of caring for ourselves.
That’s what made the whole system function. Not the charity of it. The leverage of it. We knew what it cost to set a bone. We knew what it cost to do a bypass. We knew what it cost to deliver a baby. Because we ran the hospitals where it happened. We paid the salaries. We bought the supplies. The numbers were public and the numbers were real.
You can’t lie to someone about the price of something they already produce. Public ownership wasn’t an alternative to the market. It was the thing that kept the market honest. It was the public’s seat at the table. It was the public’s power over the price. Strip it out and the private side stops competing and starts extracting. That’s not a hypothetical. That’s what happened. We sold the seat. We lost the power. The bills came due.
There was a time when we knew certain things were too important to leave entirely to the market. We didn’t let private companies own nuclear weapons.
Today that public share is closer to 15%. Most of the rest has been sold off, shut down, or absorbed into chains. What’s left is doing the hardest work the private system refuses to do. Public hospitals still handle most of the trauma care and most of the burn care in this country’s cities. They are the safety net. They are also the proof that we know how to do this. We just decided to stop.
Same thing starting to happen with AI. Something as transformative as the Industrial Revolution, arguably bigger, is being built and controlled by a handful of private actors. Massive margins. Massive control. No real public stake. No real competition in the way we used to understand it. No seat at the table for the rest of us.
There was a time when we knew certain things were too important to leave entirely to the market. We didn’t let private companies own nuclear weapons. We didn’t let them build private armies with that kind of power. We understood the scale of the risk. The consequence of getting it wrong.
AI sits in that category. Healthcare sits in that category. These are not normal sectors. They shape everything else. And the question of who owns them is the question of who has power in the country that comes next.
It’s not about fairness. Fuck fairness. This is about power. About whether ordinary people have any leverage left in a system that has spent forty years stripping it from them. About whether the country we live in is something we shape or something that happens to us.
Here are the numbers. The top 20% of earners in this country now account for nearly 60% of all consumer spending. Consumer spending is about two-thirds of GDP. So a small slice of households is propping up the entire economy. And the jobs most exposed to AI displacement, finance, law, software, analysis, corporate work, are concentrated in exactly that slice.
The same people whose spending holds the economy up are the ones whose work is about to be automated.
That’s not a labor problem. That’s a structural problem. You can’t retrain your way out of it. You can’t UBI your way out of it at the scale required. The CEOs warning you about 20-30% unemployment are running companies with 40% margins. They’re not wrong about the disruption. They’re wrong about it being something the private sector can absorb.
The market is facing a situation it cannot handle.
The market is the thing that brought us here.
Here’s the part people don’t say out loud. A future of plenty is possible. Not in some abstract, theoretical way. In a very real, material sense.
Health. Wellness. Safety. Time. Travel. Freedom. Education. Meaning. Food. Clothing. Shelter. All high quality and abundant. Enough for everyone.
Most people want that. You can feel it when you talk to them. But they don’t say it plainly because it sounds naive. It sounds like something you’re supposed to grow out of. Like if you take it seriously, you won’t be taken seriously.
Here’s the part people don’t say out loud. A future of plenty is possible. Not in some abstract, theoretical way. In a very real, material sense.
It reminds me a little of The Matrix. The idea that a version of the world that actually worked for people would be rejected because it didn’t match what they believed was real or possible. So instead, we settle into something worse and call it reality.
I grew up in East Tennessee, in the Bible Belt. And one of the things that always stuck with me was how religion was used. Not as a mission to improve people’s lives through effort and sacrifice, but as a way to sort people. To rank them. To separate. To justify who had what and why.
That same instinct shows up here. The idea that wanting a system that delivers for everyone is childish. That building something better is unrealistic. That you’re supposed to accept what exists and work within it, even if it’s clearly failing.
Here’s what gets forgotten. This country has done it before. Not once. Many times.
The New York City subway was built and is owned by the public. The interstate highway system is public. The Hoover Dam, the TVA, every river dam that powers the South and the West, public. The arsenal that won the Second World War was organized and largely paid for by the federal government. Rural electrification was a public project because no private company would run wire to a farmhouse for a price the farmer could pay. The internet started as a public research program. Public universities trained the engineers and doctors and scientists who built the modern American economy. Medicare is a public health insurance program that works better and costs less than what the private market offers people under 65.
Every one of those is a story about power. The public looked at a sector that mattered too much to leave to private capital, and the public took it. Owned it. Ran it. Set the terms. Made it deliver.
This is not foreign. This is not theoretical. This is the history of our country.
What comes next has to be built in public, owned in public, and run in public. The market had its turn at healthcare. The market is having its turn at AI. We’ve seen how this ends.
If we want a different future, we have to build it.
That’s not a metaphor.
We need hospitals, clinics, wellness centers. That means training tens of thousands of doctors, nurses, mental health professionals, dentists, physical trainers. Not hoping the market decides to produce them. Deciding to produce them. Owning them. Running them. Setting the price by knowing the cost.
What comes next has to be built in public, owned in public, and run in public. The market had its turn at healthcare. The market is having its turn at AI. We’ve seen how this ends.
We need millions of homes. New cities. New towns. That means builders, electricians, plumbers, framers, engineers. It means supply chains based in America that can deliver materials at scale. It means breaking the leverage that landlords and developers have spent decades accumulating.
We need to transition energy. Renewable generation. Storage. Transmission. A modern grid that can handle it. High-speed rail. A competitive EV industry that isn’t just a handful of companies protected by scale and capital. Independence from utilities that have spent a century turning a public good into a private toll booth.
Every one of these is a sector where the public used to have power and gave it up. Every one is a sector where the public can take that power back, if it decides to.
There is more to build in this country than we currently have people trained to build it. The bottleneck is not technology. It is not money. It is the decision to organize the effort. Those decisions will never be made by the market.
Solutions are going to take public action and competition. A new way of thinking.
Real work. Coordination. Training. Time. Effort. Change.
It’s a shame but nobody is coming to do this for us.
