When people speak of the "rigged economy" one part of the concept has to do with the idea that if the upper 1% of the population controls 43% of the economy there is "something wrong" with that. Nobody, this line of thinking goes, can deserve so much.
This is an argument that goes way back to the kings of France, where the starving masses asked why they should live in squalor while the aristocracy lived in opulence and the king answered basically God, (some higher power) wants it this way.
I got my wealth legally, playing the game by the rules.
"Behind every fortune is a crime," no longer applies.
In some cases, the manipulations which allowed the winning of a fortune are occult, like those of Mitt Romney, who, at least one story goes, made his money at Bain Capital, by using his company's money to buy up one company at a time, and each time using the newly acquired company to borrow money, then awarding himself and his partners huge "fees" or bonuses from the new capital, and escaping from the company before it's inevitable collapse and bankruptcy, only to move on to the next victim. All perfectly legal, leaving ruined companies, ruined lives, lost jobs, lost pensions behind, as the "vulture capitalists" moved on.
Then there is the story of the financial men who saw the Great Crash of 2007 coming and rather than warning the driver of the great 18 wheeler that around the bend the road was washed out, they unloaded all the value from the truck, said nothing and allowed the truck to go off roaring around the bend and off the cliff into the chasm. They did not cause the crash; they simply saw it coming and joined the upper 1%. In that case you can argue, well, they were smarter, and they deserved to win.
But these are extreme cases. What of the every day sort of person who is made rich enough, makes a salary of over $400,000 and simply does not do a good job, but is rewarded anyway? If the CEO is really incompetent, does he or she deserve that reward?
From my worm's eye view, I saw the unfolding of a much smaller, but likely more representative, disaster in the management of a hospital system.
In this case, the CEO, who was an employee of a large corporation which manages scores of hospital systems across the country, and she arrived on the job, fresh from managing a much smaller hospital.
She was confronted with trouble in the Emergency Room-- falling numbers of patients, a relatively high overhead for physician salaries. She responded by selling the Emergency Room concession to a company that manages Emergency Rooms. Same thing with the hospitalists, who admitted and cared for the patients in the hospital: Falling admissions, shorter hospital stays, fixed salaries. Sold that concession to another company. Radiology, ordinarily a rich source of income for any hospital, was run by a private group bt she did nothing to capture that income for the hospital. Same process with the doctors running the intensive care unit--sold off that concession. She was like the spider wasp, who eats out the wasp host from the inside and emerges eventually, leaving only the outside husk behind.
It was true, she had unloaded overhead, but she had also hollowed out the parts of the hospital which generated income and profit. You have to, at some point, spend money to make money. She did not seem to understand that.
Through it all, the big problem was falling numbers of patients crossing the thresholds of the hospital entrances, whether for elective surgeries, through the ER or for admissions.
It finally dawned on the CEO that the patients who crossed those thresholds were mostly sent in by doctors; they didn't come to the hospital because they had seen the advertising or the sign from the road; they came because their doctors referred them.
Across the street from the hospital were two buildings filled with those doctors in practices of all sorts. These physicians, mostly, were also employees of the same corporation which owned what was left of the hospital.
And there was trouble in these practices. Many specialty groups were dissolving: Endocrinology, Pulmonary, Neurology, Cardiology and Oncology were hemorrhaging doctors as contracts came up for renewal and the young MBA's in corporate headquarters in Richmond and Nashville told these doctors to "take it or leave it" and most of the doctors left. All of these practices closed, save Oncology.
But some months before these practices fell off the cliff, the CEO called the doctors from across the street into her office to "open lines of communication" so the doctors could send the hospital more patients. One of the doctors said, well, the corporation was undermining the health of the hospital by dismantling the practices which fed the hospital.
The CEO replied, "Well, I don't want to hear about any of that. That's not my problem. My problem is I haven't been able to meet a budget in the hospital for 3 years."
"Well, but when you lose a single endocrinologist, you lose $850,000 worth of lab fees which your hospital lab gets from doing the studies he sends in. So that's a loss to your budget."
"That's not my job," the CEO said."I don't control the practices."
Everyone laughed. The CEO, by this time, had been called, "Ms. Thatsnotmyjob,"
among the doctors. She, famously, refused to allow her name or picture to be used in the hospital website or in any of the promotional material because, she said, she didn't want to get hate mail at her home mail box. She wanted to remain the anonymous head of the hospital. Don't bring me problems. Just give me my $400K.
"Well, you asked us here to discuss improving communication and the first thing you do when we try to tell you something is to tell us you don't want to hear about it."
We could all see so clearly what this woman, whose job it was to see this, could or would not see. But didn't matter. She still got her salary.
What could she have done? Well, her predecessor had called up the powers that were at headquarters in Nashville and raised a howl. "You are killing the practices that feed my hospital!" he had railed. "If you want the system to work, you can't cut it into pieces, and bleed it dry and expect the heart to keep beating. These parts are all connected. You are creating silos."
This sort of thing must happen at all sorts of companies, from small to large. When the CEO's and their minions in the hierarchy at GM and VW failed, they were not fired or punished.
And workers below can see all this, can see what is not working and yet they take home the small paychecks while the fools at the top continue to thrive. To the underlings, the people they can see in the upper 1% do not deserve to be there.
That, too, is part of the "system is rigged" story.
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