"I've always had trouble succeeding along traditional Bush family lines." So writes Jonathan Bush on p. 1 of his book, Where Does It Hurt? With that one sentence, he had me. Bush is a nephew of George H. W. Bush and a cousin of George W. Bush. I'm not a fan of politicians and those two, especially George W., rank low on my list. So when a Bush tries to make it in the private sector rather than in the government, I'm already somewhat of a fan.
This is the opening paragraph of "You Had Me at Page One," my review of Where Does It Hurt? by Jonathan Bush with Stephen Baker.
I became aware of this book by reading Arnold Kling's review in September. I think it's fair to say that Arnold liked the book. I almost loved the book. As I pointed out in my review, Bush wimps out near the end. But along the way, he and his co-author have magnificent insights.
Another excerpt from my review:
They bring a deep appreciation of the entrepreneur to their analysis of health care. "Entrepreneur" and "health care" in the same sentence? Really?
Yes, really. They write, "From an entrepreneur's point of view, there's something highly appealing, almost intoxicating, about waste and dysfunction in the industry." They continue, "Those who can dig down through the morass of rules, paperwork, and bureaucratic obstacles can find new markets." That last sentence got me thinking back to Austrian economist Israel Kirzner's discussions of "entrepreneurial alertness."
In this digging, Bush does not disappoint. In chapter after chapter, he and Baker not only show how dysfunctional the health care system is, but also discuss ways that entrepreneurs can make it better. For example, after noting that a magnetic resonance imaging (MRI) scan at Massachusetts General Hospital would be billed at $5,315 to an insured patient, Bush runs the numbers and concludes that a business that did three images an hour and was open 12 hours a day could charge $99 per MRI and make huge profits.
And check out this excerpt about his simile for government:
Bush got to see the ugliness of government up close. A single detail in a law, he writes, "can throw lives or entire companies into a tailspin." In one of the most memorable lines in the book, he writes, "Government is like a giant with an Uzi."