I read very little Cory Doctorow. I have his Enshittification book on the shelf; haven’t read it yet. But I can’t pass up an interview that crosses my podcast path:
My thesis is that for the last 25 years, we’ve been systematically dismantling the sources of discipline in firms, such that the worst people at the worst companies who have the worst ideas make the most money. I call it an enshitogenic policy environment.
You know, when we decided that we were going to let companies buy their direct rival — a thing that’s illegal under American antitrust law — we eliminated their competition. And when we let firms merge to monopoly, well, it became much easier for them to capture their regulators.
When we expanded IP law to make it increasingly illegal to modify technology, so that, for example, if you put too many ads in it, people can’t make an ad blocker for it— Almost everyone who has a web browser has an ad blocker. No one who uses an app has an ad blocker because reverse engineering an app is a felony under a law called the Digital Millennium Copyright Act. So an app is just like a website skinned with the right kind of IP to make it a crime to defend your privacy while you use it.
So you take away all those constraints. And these companies that have always had a mix of impulses, both within the individuals who run them and among the factions within them, they start to yield to temptation. And the worst ideas of the worst people make the most money.
[…]
And what happened was in 1998, Bill Clinton signed a law called the Digital Millennium Copyright Act, DMCA. And section 1201 of the DMCA establishes a felony punishable by a five-year prison sentence and a $500,000 fine for modifying technology if it’s been designed not to be modified. And that means that anyone who designs a digital product just has to kind of wrap it in the right kind of IP to make it illegal to fix it.
So a printer comes with ink that costs $10,000 a gallon. It’s the most expensive fluid that a civilian can purchase without getting a special permit. It would be cheaper to print your grocery list with the semen of a Kentucky Derby winning stallion. But there’s a cartel of four firms that control the inkjet market because, again, we stopped enforcing antitrust laws. We let all those companies buy their direct competitors and they’ve rigged the price. And because they’ve added the right kind of IP to the printer to make it illegal to reverse engineer it, it’s against the law for me to sell you the tool that just reliably disables the thing where your printer checks whether the ink is generic. And so you have to buy their colored water.
Every single sentence from that interview is worth quoting.
In fact, listening to Cory Doctorow is remarkably similar to going to church and hearing a sermon that helps you make sense of your entire life.
Here’s another bit that stuck out:
The squeeze that they put on was not to become operationally sustainable. It was to extract more profit after saturating a market. So I want to say that there’s a big difference between a company that squeezes you in order to extract more revenue and a company that squeezes you because they’re doomed and they’re basically, like, grabbing onto you and pushing you under the water to kind of buoy themselves up to get a few more sips of air before they sink too.
I’ve worked in healthcare as a surgical tech for close to 18 years. I hate it. Don’t misunderstand me; I like Medicine, and I like working in surgery. I hate working in “healthcare.” For years I have complained about working in a career field which for two decades has made not one single change that benefits its workers on the ground. (You probably don’t have to imagine what this is like.) And for years, when I have wanted to speak generically about what working in healthcare feels like, I’ve said it feels like being on a giant, secretly sinking ship where the suits-in-the-know are just getting as much out of it as they can before it goes under or they get out.
Without some secret knowledge, it’s difficult to make sense of anything. The general trend is this: hospitals (those no longer exist) “healthcare delivery networks” known as Entities systematically chip away at any and all incentives for long term employment. These Entities proceed to slowly lower the bar across the board — pay, PTO, health insurance, retirement benefits, all get worse, steadily and then all at once driving employees either out or mad, replaced largely by untrained personnel, locums, and travelers. These entities publish in local newspapers about how the travelers are bleeding them dry — and yet they change not one single thing to incentivize long term employment while spending billions to buy up more land and expand the empire.
I have no idea how this works. And that ignorance is just part of the job now. Someday I’ll get around to writing an overly self-indulgent post about my job, which can range from a tooth extraction to a total joint replacement to massive trauma to an organ harvest and all things between these. But what I have really wanted, short of actually righting the ship, is for some investigative journalist to tell me how the fuck this “healthcare” system works.
I think just such a journalist has been sitting under my nose.