Think of the ObamaCare reform debate now playing in the US Senate as the final gurglings of polity that knows it is whirling around the drain. They’re pretending to attempt to fix a racket that comprises eight percent of the American economy. Yikes! How did that happen? At the beginning of the 20th century it was one-quarter of one percent (.25 percent) of the economy.

The standard explanation is that, first, Medicare jacked up overall healthcare activity in the 1960s, hauling in a customer-base of old folks who previously received no special treatment and were, generally, less well than non-old folk. Secondarily, technological innovation opened up so many new methods of disease control for everybody, young and old, that we’re able to treat more sickness in more complicated ways — and that drove costs up way further.

The greater part of the story remains neatly concealed within the matrix of rackets erected around the money-flows since the big cost bump-up in the 1960s, and these involve insurance companies, Big Pharma, corporatized doctors’ practices, hospital monopolies, and, of course, politicians on-the-take dividing amongst each other a colossal pool of grift that exists mainly for one simple reason: the cost of everything is hidden from public view.

Nobody has any idea what anything costs. Certainly not the patients, sometimes called “customers” or “consumers” — but really hostages. If you go into the hospital for a stent in the left descending coronary artery, nobody will tell you what it costs, starting with the doctors who have performed the procedure a thousand times. They can’t even estimate the cost (or won’t), though they could probably give you a pretty good ballpark number for the cost-and-installation of a new fuel pump on their BMW-28i.

Charges for medical care are never discussed with the patient. Doctors especially pretend to regard such a proposition as beneath the dignity of their profession, rather like British aristocrats regarded all questions pertaining to money in the Downton Abby scheme of things — a filthy business better left to the servants, like disposing of the table-scraps. Of course the “servants” in the hospital scheme of things are a fantastic hierarchy of dangerously overfed clerks overwhelmed by the anomie of spending countless hours typing fictitious numbers into their work stations. A more pointless life can hardly be conceived. If you ask the ones who “interface” with you at the check-out counter how your bill was toted up exactly, you will receive nothing more than a pitiless stare of contempt — which is actually aimed inward at their own existential quandaries, a pathological dynamic that perhaps deserves attention from the research funding troughs.