The systems that shape everything
Essays that explain how systems actually work—and the institutional incentives you're not supposed to see.
Second-order thinking
Most analysis stops at "what happened." We ask "why did the incentives make this inevitable?"
Institutional truth
The real explanations that insiders know but can't say publicly. No euphemisms.
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Free issues explain the system. Paid issues name the institutional actors and specific incentives.
Actionable clarity
Understanding incentives lets you predict outcomes, not just react to them.
How it works
Why Your Doctor Won't Tell You the Truth About That Test
When your doctor recommends a screening test, they're not just thinking about your health. They're navigating a system of liability, reimbursement codes, and professional guidelines written by people with financial interests in the answer.
The test itself might be marginally useful. But the system around it—the way doctors get paid, the fear of lawsuits, the guidelines written by specialists who benefit from more referrals—creates a machine that over-tests, over-treats, and calls it "good medicine."
This isn't a conspiracy. It's incentives. Everyone in the system is acting rationally within their constraints. The outcome emerges from structure, not malice.
This is where free issues stop. The paid version names the specific incentives and institutional actors.
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