Cosa Nostra

This is what I think people donโ€™t understand: even if you gain something from it, extortionate items like health care and higher education are still a racket. This is true even if many of the educators and health care providers are โ€œhonest.โ€ As with not understanding risk very well, many people have real trouble with shades of gray and accepting that the world is not completely Manichean in nature.

For instance, the health care system and higher education share many traits with the Mafia. Something that most people donโ€™t realize is that many people didnโ€™t know they were even working for a criminal organization. They sat in offices, worked in factories, drove taxis. All those businesses โ€” many but not all fronts โ€” were legitimate undertakings operating legally as far as anyone could see. But at one point in NYC and Chicago, tens of thousands of people were employed by the largest criminal organization ever to exist in the world.

Health care and higher education are similar, due to who controls them and their methods.

I wonโ€™t argue that higher education and health care in the US are as criminal as the Mafia. Obviously, thatโ€™s absurd. But I do argue that they are also definitionally criminal in nature: their methods are coercive, they swindle their own customers freely, and they offer no guarantees of quality while being very punitive if you stray. In short, they are legally-sanctioned but de facto criminal enterprises in a moral if not legal sense.

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