Last week I wrote about the scammy way in which a large hospital system, Johns Hopkins, tried to bully us into paying them money we didn’t owe. The responses to it on Mastodon after a boost from Corey Doctorow were unlike anything I have received before, at least in the English language. There was a period of about a year or two, early 2020 to late 2021, when a thing I tweeted in Serbian ended up in a tabloid. Around the same time a Serbian TV station lifted an annotated covid graph I had been updating, without attribution of course. Crazy times, may they never return. Who knew that American “health” “care” “system” could arouse such strong feelings.
An unexpected turn in the conversation was towards veterinary medicine and how it too is undergoing general enshittification under pressure from private equity and no regulatory barriers. Which got me thinking: could veterinary medicine serve as a proxy for what would happen to human medicine if it were to become deregulated? What would a wholly free-market medicine, a libertarian’s wet dream, look like? Now clearly I have neither the time nor the will to sink hours into this kind of research, but do you know who does?
Yes, I asked Gemini to formulate a research plan, then passed on the plan with the Deep Research toggle on to create a report titled “A Comparative Analysis of Veterinary and Human Medicine: Evaluating Deregulation Proxies in the United States Healthcare System”. The goal was to test whether veterinary medicine could serve as a proxy for deregulated human healthcare and personally I don’t think it achieved that objective — this could be just my anti-AI bias — but it did provide a few juicy quotes, such as:
Theoretical free-market economics suggests that corporate consolidation should benefit the consumer by driving down costs through supply-chain efficiencies, centralized administrative services, and immense economies of scale. The empirical data from the veterinary sector directly contradicts this theory. Instead of utilizing their massive scale to lower consumer costs, corporate consolidators have leveraged their localized monopolies to exercise extreme, unchecked pricing power.
And two paragraphs down:
Furthermore, corporate management fundamentally alters the clinical culture at the ground level. Veterinarians operating within these corporate structures report worsening working conditions, including intense pressure from non-medical corporate managers to “do more and see more patients,” meet specific monthly revenue quotas, and upsell clients on expensive and potentially unnecessary diagnostics to satisfy debt obligations. (21) To protect their market share and ensure high practitioner retention despite these conditions, these corporations frequently deploy aggressive non-compete and non-solicitation agreements, legally preventing veterinarians from opening independent practices nearby and artificially suppressing labor mobility. (21) This data definitively indicates that in a deregulated medical market, institutional capital prioritizes relentless profit extraction and margin expansion over consumer cost-savings or provider well-being.
Reference 21, to save you a click, is a letter from Elizabeth Warren to CEO and President of Mars Inc — which in addition to hocking teeth-numbing treats is also apparently a veterinary behemoth — outlining her concerns about the industry consolidation with ever more references. An actual report would have to dig down into them and find primary sources for Gemini’s claims, but even this is publishable.
And here is the conclusion:
Ultimately, the hypothesis that veterinary medicine serves as a highly accurate proxy for human medical deregulation is remarkably robust. The comprehensive data confirms that stripping away third-party mandates, emergency care obligations, and unlimited tort liabilities yields a highly efficient, point-of-care transaction model that eliminates administrative bloat, enforces total price transparency, and accelerates clinical innovation. Yet, it simultaneously exposes the harsh, unyielding realities of a pure free-market health economy. The veterinary paradigm proves definitively that while deregulation optimizes the speed of scientific advancement and the profitability of specialty providers, it structurally abandons the foundational concept of healthcare as a universal human right, replacing it entirely with a ruthless, capital-gated commodity market.
Woah there, Gemini. With such strong language I do feel obligated to declare that the original prompt was as neutral as possible. I wonder what ChatGPT, Claude or Grok would have to say on the topic, and if Grok in particular would have a different view.