This is Part 3 in a series. Part 1 ran the numbers — America comes out near the bottom of every developed-world ranking that matters and near the top of every one that doesn’t. Part 2 walked through how language gets weaponized to keep you from noticing. This one is just accounting.
Now That You Can See Through The Language Game
In Part 2 we talked about trigger words — how the second you hear “socialism” or “free market” or “redistribution,” your brain stops analyzing and starts reacting.
Hold onto that. This post is going to trip every one of them. What follows isn’t opinion, though. It’s just where the money goes.
Healthcare: The $5 Trillion Magic Trick
Americans pay $13,500 per person per year for healthcare — the highest figure on Earth, by a margin that isn’t close. In return, we rank 36th in life expectancy, 32nd in infant mortality, and dead last among developed nations on maternal mortality. Two out of every three personal bankruptcies in this country are caused by medical bills. In peer countries the rate is effectively zero.
If the $13,500 isn’t producing health, where is it going?
It’s going to people whose job is not, technically, to provide healthcare.
In 2022, three of the four largest health insurers paid their CEOs within rounding error of each other: UnitedHealth’s Andrew Witty $20.9 million, Cigna’s David Cordani $21.0 million, Elevance’s Gail Boudreaux $20.9 million. That’s not what compensation looks like in a competitive market. That’s what it looks like when a handful of companies have carved up a captive customer base and don’t have to compete on price. The job description for all three is the same: collect premiums, deny claims, post record profits. Health insurance CEOs in other countries don’t make $21 million because health insurance in other countries isn’t structured to. The purpose of those systems is to pay for care, not to extract maximum profit while providing minimum coverage. You can call that socialism if you want. Somebody just did and stopped reading.
Pharma works the same way. Before Medicare’s 2022 insulin price cap, a vial that cost about $5 to produce listed at roughly $300 in the US, versus $32 in Canada. Medicare patients now pay $35 a month under the new cap. Everyone else still pays close to the original markup. The defense is that drug companies need to recoup R&D — except they spend more on marketing than R&D, the median pharma CEO makes $18.5 million a year, the big four (Pfizer, Merck, Johnson & Johnson, AbbVie) post tens of billions in combined annual profit, and every other country manages to invent drugs without charging $300 for a vial of insulin.
Hospitals, increasingly, are owned by private equity — firms like KKR, Blackstone, and Apollo. Buy the hospital with debt, fire the nurses, close the unprofitable departments — the maternity ward in a rural county, say — bill aggressively, extract a 10–15% return for investors, walk away when outcomes collapse. Hospitals in other countries somehow stay open without this. Their maternal mortality rates aren’t three to ten times worse than ours either.
Healthcare is roughly 18% of US GDP — about $4.9 trillion a year. That’s not healthcare spending. That’s extraction with a healthcare label on it. You’re paying for insurance company profits, pharmaceutical company profits, private equity returns, pharmacy benefit manager margins (CVS Caremark, Express Scripts, and OptumRx together control about 80% of US prescriptions and keep the “rebates” instead of passing them through), and an administrative apparatus that eats roughly a third of every dollar — versus 10 to 15 cents in peer countries. After all of that, you can still go bankrupt when you get sick.
Anyone who points this out gets met with “that’s socialism” or “do you want the DMV running your healthcare?” Note that neither response addresses the data. They just trigger the reflex. Meanwhile the VA — literal government healthcare — produces better outcomes than private insurance on most measured quality metrics, at lower cost. RAND, JAMA Internal Medicine, and the VA’s own Health Services Research have shown this for two decades. Medicare runs about 2% administrative overhead. Private insurance runs around 17%. And once you remember that the 33% admin bloat baked into the private system would mostly disappear under a unified one, the comparison gets considerably worse for private.
Mass Incarceration: Charging You To Cage The Poor
The US locks people up at 531 per 100,000, the highest rate in the world. We have 4% of the planet’s population and 25% of its prisoners. We incarcerate at five to fifteen times the rate of our peer nations. None of this makes us safer — our homicide rate, 6.4 per 100,000, is still three to thirty times higher than countries that barely imprison anyone.
So if it’s not about safety, what is it about?
CoreCivic and GEO Group run a chunk of America’s detention infrastructure under contracts that include “occupancy guarantees” — the state promises to keep the beds 90% full or pay a penalty. We have written contracts that financially punish governments if crime drops. The private prison industry has a structural interest in longer sentences, more criminalization, and more bodies through the door. Which is, when you think about it, a pretty strange business model for a country that wants less crime.
Inside the walls, every inch of life is a profit center. Phone calls run $1 a minute through contractors like Securus — the prisoners’ families are a literally captive market. Commissary, run by companies like Keefe Group, marks ramen that costs a quarter outside up to a dollar inside. Tylenol is $5 a pill. There is no competing provider when you’re locked in a cage.
Then there’s the labor. Inmates produce goods earning between fourteen and sixty-three cents an hour. Alabama prisoners made $450 million worth of goods in 2023 at about thirty-five cents an hour. If that sounds like slavery, that’s because the 13th Amendment carved an exception for exactly this: “Neither slavery nor involuntary servitude, except as a punishment for crime…” Land of the free.
The prison industry pulls more than $80 billion a year out of taxpayers — to cage people, who then work for pennies, producing goods that compete with free labor, suppressing wages for everyone outside. And the system makes us less safe, not more. Recidivism inside three years runs about 68%, against 20–30% in countries that focus on rehabilitation.
Criticism gets “soft on crime” or “what about the victims?” — none of which addresses whether the thing works. The data is clear that it doesn’t. But “tough on crime” sounds strong, sounds decisive, and conveniently leaves the $80 billion untouched.
Military Spending: Welfare For Defense Contractors
We spend $968 billion a year on the military — more than the next ten countries combined, 37% of global military spending, three times what China spends and six times what Russia spends. For that money you’d think we’d be undefeated.
The top five contractors absorb most of it. Lockheed Martin: $67 billion in revenue, CEO comp $27.3 million. Raytheon: $67 billion, CEO comp $22.6 million. General Dynamics, Northrop Grumman, and Boeing fill out the list. These companies don’t just build weapons. They build political dependency.
The F-35 program is the cleanest example. Original projected cost in 2001: $233 billion. Current lifetime projection: $1.7 trillion. Production is spread across 47 states and more than 300 congressional districts — not because it’s the most efficient way to build a plane, but because it makes a vote against the F-35 a vote against jobs in your own district. That’s not procurement strategy. It’s political engineering designed to lock in funding regardless of need or performance.
We spend three times what China spends and lost in Afghanistan and Iraq. The Pentagon has failed every comprehensive audit it has been required to take — seven in a row as of November 2024. In its FY2024 audit, the DoD examined $4.1 trillion in assets and $4.3 trillion in liabilities; nine of twenty-eight subcomponents passed, fifteen received disclaimers of opinion (auditors literally could not form a conclusion), and the rest were qualified or pending. The previous year, the Pentagon could account for only half of its $3.8 trillion in assets. The Department of Defense is the only major federal agency that has never passed an audit.
UMass Political Economy researchers (Pollin and Garrett-Peltier) have repeatedly found that the same money creates roughly twice as many jobs in clean energy as in military spending — about 17 jobs per million dollars in clean energy versus 7 in defense procurement. Education creates 26. Those jobs just don’t concentrate wealth in defense contractors and their shareholders, which is why we don’t hear about them. “Support clean energy” doesn’t hit the same as “support the troops” — so we shovel money toward cost overruns while actual enlisted troops qualify for food stamps.
Pushback gets “you want America to be weak” or “don’t you support the troops?” Nobody is suggesting troops get paid less. The question is why a contractor CEO makes $27 million while a sergeant qualifies for SNAP.
Student Debt: The $1.77 Trillion Generational Trap
US student loan debt sits at $1.77 trillion — more than every other developed nation combined. The average borrower graduates owing between $37,000 and $38,000. And alone among consumer debt types, student loans can’t be discharged in bankruptcy. They follow you to the grave.
How did college become a debt trap that exists nowhere else in the developed world? By making it profitable.
Companies like Navient (the rebranded Sallie Mae), Nelnet, and MOHELA earn fees servicing payments, and their incentive is to maximize the total interest collected. The way they do that is by steering struggling borrowers toward forbearance, which pauses payments while interest piles up, instead of toward income-driven plans that might eventually result in forgiveness. Their profit goes up the longer you pay.
For-profit colleges consume roughly a quarter of federal student aid while enrolling about a tenth of students. The 2012 Harkin Senate report found that across the thirty largest for-profits, federal sources averaged 86% of revenue, with many individual institutions running over 90% — and that’s after the 90/10 rule, which conveniently excludes GI Bill and DoD tuition assistance from the “federal” side of the calculation. Which is exactly why for-profits target veterans so aggressively: GI Bill dollars are federal money the law lets them book as private. The business model is: recruit students (veterans especially), provide a substandard education, collect the loan disbursements, and let the student walk out with debt and a degree no employer values. The University of Phoenix–type schools aren’t in the education business. They’re in the federal loan extraction business.
Then there’s the trick most people don’t know about. Student loans get bundled into securities — Student Loan Asset-Backed Securities, or SLABS — and sold to investors. The more outstanding debt exists, the more those securities are worth. Which is part of why blanket student loan forgiveness gets fought so hard. The debt itself is the asset. Wipe it and you wipe out a financial product.
The retort is always “personal responsibility — you took the loans.” Right. Eighteen-year-olds made fully-informed financial decisions about non-dischargeable loans, for an education they were told was mandatory, at prices that climbed 200% while wages stagnated, for a job market that started demanding degrees for jobs that never used to need them. Personal responsibility.
Run the math. In 1970, a year of tuition at a public four-year university averaged about $480. Federal minimum wage was $1.60 an hour. You could pay for a year of college with 300 hours of work — a summer job. Today, average in-state tuition at a public four-year runs about $11,000. Minimum wage is $7.25. That’s 1,517 hours of work — roughly 29 hours every week, every week of the year — just to cover tuition. Not room, not board, not books, not food, not transportation, not actually being a student. Tuition alone, on a near-full-time, year-round job, at minimum wage.
That’s why your parents could “work their way through school” and you can’t. The thing they did doesn’t exist anymore. They’re not lying when they say they did it — they’re just describing an economic reality that no longer exists. “Work your way through college” is about as useful today as “just buy a house for $25,000 like I did.”
Meanwhile every country we like to compare ourselves to charges nothing or close to it. Germany, Denmark, Finland, and Norway charge no tuition — Denmark actually pays you to study. France runs around $200 a year. The UK lets debt size grow but ties repayment to your income; if you don’t earn enough, you don’t pay. We’re the only developed country where college is a wealth-extraction engine.
Any move toward forgiveness gets “what about the people who already paid?” — a question whose only job is to pit generations against each other instead of asking why we’re the only country with this problem in the first place. The goal of a society shouldn’t be making sure the next generation suffers the same as the last.
The Same Con, Four Different Costumes
You pay more than anyone else. You get worse outcomes than anyone else. The difference gets pocketed by a small number of industries — insurers, pharma, private equity, private prisons, defense contractors, loan servicers, SLABS holders — that donate to both parties simultaneously. Healthcare alone fields roughly 3,000 federal lobbyists. Defense fields another 800. The financial sector fields several thousand more. Whichever party wins the election, the contracts continue. And any attempt to name what’s happening triggers a vocabulary defense (“socialism,” “soft on crime,” “anti-troops,” “personal responsibility”) designed to stop the conversation before it gets to the accounting.
You’ll hear “but that’s just capitalism” a lot. Is it though? Capitalism requires four things to function: competition, transparent pricing, freedom to enter and exit markets, and consequences for failure. Look at the four cons above. Healthcare runs on consolidated giants — three insurers, three PBMs, four pharma majors. Costs are deliberately hidden; try getting a price for a procedure before they bill you. Workers can’t quit a bad employer without losing insurance, and students can’t discharge debt in bankruptcy. When banks fail, they get bailouts and bonuses. None of the four prerequisites is intact. What we have isn’t capitalism. It’s extraction, protected by regulatory capture, defended by linguistic conditioning, and funded by both parties at once.
If this made you angry: good. The question worth sitting with is who you’re angry at — the person showing you the receipts, or the people printing them.
Next time: the plan Congress wrote for itself versus the one it wrote for you. The cleanest single tell that the system isn’t broken — it’s working exactly as designed, just not for you.
Sources
OECD Health Statistics; CMS National Health Expenditure Data, 2023; SEC filings and company proxy statements (UnitedHealth, Cigna, Elevance, Lockheed Martin, Raytheon); CoreCivic and GEO Group annual reports; the Sentencing Project; Prison Policy Initiative; SIPRI 2024; DoD FY2024 Agency Financial Report and DoD Office of Inspector General audit results; GAO reports on F-35 program costs; Federal Reserve and Department of Education student loan data; College Board Trends in College Pricing; Bureau of Labor Statistics historical minimum wage data; 2012 U.S. Senate HELP Committee report on for-profit colleges (Harkin); OpenSecrets federal lobbying database; UMass Political Economy Research Institute jobs analyses (Pollin and Garrett-Peltier); RAND and JAMA Internal Medicine studies on VA care quality.
Even that's Odd 
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