Brian Alexander > Quotes

“Corporate elites said they needed free-trade agreements, so they got them. Manufacturers said they needed tax breaks and public-money incentives in order to keep their plants operating in the United States, so they got them. Banks and financiers needed looser regulations, so they got them. Employers said they needed weaker unions—or no unions at all—so they got them. Private equity firms said they needed carried interest and secrecy, so they got them. Everybody, including Lancastrians themselves, said they needed lower taxes, so they got them. What did Lancaster and a hundred other towns like it get? Job losses, slashed wages, poor civic leadership, social dysfunction, drugs. Having helped wreck small towns, some conservatives were now telling the people in them to pack up and leave. The reality of “Real America” had become a “negative asset.” The “vicious, selfish culture” didn’t come from small towns, or even from Hollywood or “the media.” It came from a thirty-five-year program of exploitation and value destruction in the service of “returns.” America had fetishized cash until it became synonymous with virtue.”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“Kevin D. Williamson in a sneering screed published in March 2016 in National Review, a leading conservative journal: The problem isn’t that Americans cannot sustain families, but that they do not wish to. If you spend time in hardscrabble, white upstate New York, or eastern Kentucky, or my own native West Texas, and you take an honest look at the welfare dependency, the drug and alcohol addiction, the family anarchy—which is to say, the whelping of human children with all the respect and wisdom of a stray dog—you will come to an awful realization. It wasn’t Beijing. It wasn’t even Washington, as bad as Washington can be. It wasn’t immigrants from Mexico, excessive and problematic as our current immigration levels are. It wasn’t any of that. Nothing happened to them. There wasn’t some awful disaster. There wasn’t a war or a famine or a plague or a foreign occupation. Even the economic changes of the past few decades do very little to explain the dysfunction and negligence—and the incomprehensible malice—of poor white America. So the gypsum business in Garbutt ain’t what it used to be. There is more to life in the 21st century than wallboard and cheap sentimentality about how the Man closed the factories down. The truth about these dysfunctional, downscale communities is that they deserve to die. Economically, they are negative assets. Morally, they are indefensible. Forget all your cheap theatrical Bruce Springsteen crap. Forget your sanctimony about struggling Rust Belt factory towns and your conspiracy theories about the wily Orientals stealing our jobs. Forget your goddamned gypsum, and, if he has a problem with that, forget Ed Burke, too. The white American underclass is in thrall to a vicious, selfish culture whose main products are misery and used heroin needles. Donald Trump’s speeches make them feel good. So does OxyContin. What they need isn’t analgesics, literal or political. They need real opportunity, which means that they need real change, which means that they need U-Haul. For”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“Monomoy sent what was left of Lancaster’s once-grand, 110-year-old employer into bankruptcy court while it made off with millions and the employees walked their wages and benefits backwards in time. Lancaster’s social contract had been smashed into mean little shards by the slow-motion terrorism of pirate capitalism.”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“the standard private equity playbook: jawbone the unions, cut costs even at the price of damaging longer-term success, do a sale-leaseback of real property assets, take whatever public money you can get from communities eager to save their industries, and do an “add-on”—the Indiana Glass buy. And collect fees.”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“A few people had always made lousy choices. But how had a preexisting human propensity for self-destructive behavior exploded into a plague? As Mark’s real, much more complete story—the one he didn’t tell Berens—proved, it wasn’t the increased availability of a drug like heroin, though that was gas on the flames. Lancaster’s drug problem predated heroin, OxyContin, Percs. The problem wasn’t caused by drugs at all, or government handouts, or single-parent families. While addiction could be as individual as people, common themes included alienation and disconnection. *”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“Working-class wages in the United States just about flatlined from 1979 to 2017. Over that thirty-seven years, the bottom 10 percent of earners saw a 4.1 percent rise in wages. Meanwhile, economic productivity rose 70 percent. Most of the reward for that productivity was scooped up by the top 5 percent of earners, who enjoyed a 69.3 percent rise in real wages. The top 0.1 percent increased their haul by over 343 percent.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“The same situation applied to working-class people in big cities. “Health is, for the most part, a commodity which can be purchased,” Matthew Sloan, president of the New York Edison Company—a utility company and one of the nation’s major employers—said in 1929. “The difficulty now is that its cost is beyond the reach of a great majority of people.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“By 1926, medical costs had become a pressing national issue. “When pneumonia or typhoid strikes down a breadwinner or when a major surgical operation becomes necessary, poverty may soon knock on the door,” the New York Times opined.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“The very day the WCTU announced the list of committee members, the county fair in Montpelier, the biggest event in the county by far during the 1920s, opened its gates. There, for the first time in its history—and like many other county and state fairs at the time—the fair held a eugenics-inspired healthy children contest. Just as cows, pigs, and sheep were judged, kids in two classes, ages two to six and six to fourteen, were weighed and measured. Judges examined their teeth, hair, skin, posture, hearts, lungs, noses, and throats. The winning children in each age group received $5.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“Them old Dutchmen, them old Germans—they’d work all day in a factory in Bryan, then head home to work on the farm. It was like they couldn’t be sure the factory would last, and they wanted to hang on to the farm, just in case—because a farm is forever,”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“He’d concluded that “school’s not for smart kids,” a kernel of truth inside an excuse wrapped up as a brag: comfort for a refusenik.”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“Pieces of plastic and paper and sections of tube floated to the floor: a snow of medical garbage.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“He was uncomfortable seeing so many Muslims in one place, “but I have Muslim friends I talk to here and there. Again, it’s one of them things: people get angry about race and things, but it’s just understanding somebody’s culture, where they come from, their background. I mean, knowledge is everything. Ignorance is nothing.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“You know the way the world works?” Brian asked. It’s like that old Warner Bros. cartoon with Ralph the wolf and Sam the sheepdog. All day long, Ralph tried to eat the sheep, and all day long, Sam beat the crap out of Ralph. The sheep were clueless. They just stood around, mindlessly eating grass. And then the work whistle blew, and Sam and Ralph punched out and walked off for a beer: best pals, two sides of the same system.”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“Perhaps even more than he hated environmental laws, Menard hated labor unions. “The Manager’s income shall be automatically reduced by sixty percent (60%) of what it would have been if a union of any type is recognized within your particular operation during the term of this Agreement,” read an employment contract managers were required to sign. “If a union wins an election during this time, your income will automatically be reduced by sixty percent (60%).”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“What free market?” Henry County’s Kim Bordenkircher wanted to know. Politicians, businesspeople, and ideological conservatives “assumed healthcare is a free-market economy. It’s not!” This was the flaw in Tinkel’s push for a consumerist approach. There was no such thing as a free market for medicine in the United States, and there hadn’t been for some time. Asking patients to become consumers burdened them with the responsibility to shop wisely in an opaque economy, even as hospitals introduced high-cost, hotel-like extras to lure them through the doors. The idea that doctors could or would steer patients to low-cost hospitals or to high-quality ones was laughable. Doctors had no idea what hospitals—even hospitals where they worked—charged for services, and neither did most other people. Hospitals and insurers kept their pricing and their insurance contract negotiations confidential. So a broken leg for one patient could wind up costing much more—or much less—than the exact same break would cost someone else.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“They’d been trained to make a tangible thing, and to sell the thing for a little more than the thing cost to make, and then to use that profit to pay people, make better things, and slide a little dividend into the pockets of those who’d risked their money to invest in the creation. The idea was pretty simple. But America had come a long way—and had decided the idea was too simple. So,”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“The nation-state at best is based on the social contract that is also an emotional contract, stamped by the charisma of the past.” —SVETLANA BOYM, The Future of Nostalgia”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“As embarrassing as poor management may have been, though, it was a far better excuse than the alternative theory: EveryWare’s debt was so deep by design—allowing Monomoy to strip the company of cash—that EveryWare couldn’t move.”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“When the universe of patients, small hospitals in rural places, urban hospitals in poor neighborhoods intersected with the universe of the healthcare industrial complex, they were squashed.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“Even suicide could become part of a culture. “If somebody you know, or in your family, has ever taken their life,” Long said, “it is another huge risk factor. It breaks a taboo. It becomes a solution to look at.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“And in some towns benefactors donated money for hospitals just as Andrew Carnegie built libraries. (Bryan took Carnegie’s money to build its library in 1903.)”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“People can become so frustrated, so discouraged, so mystified about what happened to the communities they love and about what they can do about them, they can’t help but cry. Even a cop.”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“One might have thought that a nonprofit hospital system like ProMedica would pass it on to the public. ProMedica, Parkview, OhioHealth, Mercy: most of the consolidated regional systems in the United States, including the state university systems, were all officially nonprofit. They were supposed to serve charitable functions, receiving 501(c)(3) tax-free status from the Internal Revenue Service. That was why their profits were officially called “operating surpluses.” But there was no meaningful difference between the behaviors of for-profit giants like Hospital Corporation of America and those of the big “nonprofit” systems. Michigan’s Spectrum Health, for example, took in $6.9 billion in operating revenue in fiscal year 2019 (for a 14.7 percent total margin), while providing only $6 million in charity care. They were all big corporations. They all acted with the same goal in mind: to increase market share.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“Though Menard believed himself a self-made man, he and the company he controlled craved corporate welfare. After”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“No matter how much money you had, your children attended the public schools or the small Catholic one and made friends across the economic spectrum.”
― Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town

“Foster had misread Ennen. Change was part of his agenda, and it had been since he assumed the CEO job. But he believed that, like an experienced comic, he knew his audience. Abrupt change was neither the Bryan way nor the CHWC way. It was certainly not in keeping with the hospital’s family ethos. So, as with the vaccine policy, Ennen preferred to execute change gradually whenever possible, in a person-to-person way, and with a minimum of drama. Foster viewed this as conflict avoidance; Ennen viewed it as tactical prudence.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“month waiting list. And Parkview doctors weren’t much happier with the center, Sunderhaus believed, “because they’re charging hospital outpatients for everything. And their job in Bryan is to refer those patients to big services in Fort Wayne. Their job is merely as a feeder site for testing. And for their specialists. That is their only purpose for having family practice there, to feed their beast. Feed the beast of the MRI, the CAT scan machine. They keep track of those docs: how much they prescribe, how many tests they ordered. That’s how they decide who gets bonuses and who gets big bucks. Yeah! We piss everybody off!”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“always be in tension with the other. To make matters worse, the board, a huddle of local pooh-bahs,”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town

“Both were told there was one version of a successful American life, and it was the consumerist ideal. Those who succeeded in aping that version were seen not only as successful and smarter but also as good. Only flawed people failed to achieve it. But even those who seemed to have won the American race could suffer, because “when the storm comes—and it comes to all of us—they find out having that perfect pair of jeans and the right manicure doesn’t help you in this situation. That can be devastating. That’s one reason why suicide cuts across everything. That is really a dark place to be, to make the decision you want to end your life.”
― Brian Alexander, The Hospital: Life, Death, and Dollars in a Small American Town