Writers who want to describe sweeping global change often quote the W.B. Yeats poem, The Second Coming. You’ve probably seen its famous opening:

Turning and turning in the widening gyre
The falcon cannot hear the falconer.
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world…

I found that terrifying when I first read it in high school. Seeing it reduced to a literary trope isn’t all bad.

Nevertheless, “the centre” really wasn’t holding when Yeats composed the poem in 1919 England. The just-ended World War had killed millions, a flu pandemic was killing many more, and British troops were fighting an Irish independence movement. It was a violent, death-filled time. Our economic annoyances are mild in comparison.

Some things are indeed “falling apart,” though. They’re mostly small things. They aren’t killing a bunch of people or crashing the economy. But they’re also not nothing—and may add up to something important.

I’ll illustrate this with some personal anecdotes. These obviously aren’t hard data, but I’ll bet you see the same happening where you live.

We’ll start with a story I told last year. I twisted my ankle and found getting a simple X-ray was surprisingly difficult. As I wrote at the time, the culprit was a shortage of X-ray technicians. Quoting myself…

“A little digging into Texas Department of State Health Services data showed my county had one licensed radiology tech for every 893 residents in 2019. By 2022 it was only one per 1,531 residents—about a 42% drop in three years.

“This is supply and demand. The relatively few people with those skills act rationally and take the best-paying jobs… which apparently aren’t at urgent care centers.

“Nor is it just radiology. Looking again at my own county (Travis), I found the per capita supply of emergency medical technicians and pharmacy technicians had dropped about 10% between 2019 and 2022.”

The data I cited there is now updated for 2023 and looks even worse, at least for Texas. The number of workers in a wide variety of licensed healthcare occupations is shrinking further.

Meanwhile, the population is growing. In particular, the older population that needs the most healthcare is growing. This problem looks certain to get worse.

We also have pharmacy issues. They are chronically understaffed, but that’s not all. They often can’t keep even common medicines in stock. I don’t know why. The result, though, is you really can’t know where to get anything your physician prescribes.

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So what happens? People are constantly transferring prescriptions between pharmacies, making repeated phone calls to see if they have what’s needed, and asking doctors to prescribe alternative drugs.

None of this is productive and could be counterproductive. Employers are losing capacity because their workers stay home sick because they can’t find the medicine they need.

Other sectors have problems, too.

Last month I hit a pothole on Interstate 35. It wasn’t huge but I felt a bump.

(Side question: Why wasn’t the road better maintained? Texas used to be really good at that.)

Looking underneath when I stopped, I saw some loose parts and a small fluid leak. But it seemed minor, and I drove home without further problems. I filed an insurance claim and contacted their recommended shop.

The next appointment to bring the car in was five days later. Then it was 11 more days before anyone looked at it to make an estimate. Then they had to order parts—more delay. It’s now been a month since the bump and I’m still without wheels.

I know someone who owns an expensive, brand-new SUV. Their side mirror got torn off in an otherwise minor accident last fall. Parts delays kept their new vehicle in the shop for six months.

Then there are restaurants. Recently my wife and I went to a place we hadn’t visited in a long time. The dining room was almost empty… but they said it would be a 30-minute wait.

Why? It turns out open tables are no longer the limitation. A restaurant can’t serve you unless it has sufficient staff. This one didn’t.

We waited and had a nice meal, so it wasn’t the end of the world. But this is a new phenomenon. The days when restaurants were overstaffed to minimize customer wait times are gone. Maybe they’re more profitable this way. I don’t know. I do know that as a customer, the experience isn’t the same.

I was sharing some of this with a neighbor who is a commercial real estate agent. He sees the same. Many deals are happening, he said, but they’re taking much longer to close. “Stuff” just keeps coming up. He’s never seen anything like it.

Economically, these delays and inconveniences show an economy stretched to its limits. Businesses can’t meet demand because they can’t get enough labor and materials in the right places at the right times. Everyone is running at full capacity, unable to do much more.

Recession usually ends these situations. The problem there is that so much of today’s demand is non-discretionary. Demographic change may have made recessions impossible.

Inflation is another result. But raising prices doesn’t magically produce more mechanics or waiters. We just pay more and get less—or worse, we get nothing at all.

I wonder sometimes if large, monopolistic companies even want to fix these problems. They’ve transferred to customers much of the work once done by employees. It probably boosts profit margins.

People like me—and probably you, since you’re reading this—are among the lucky ones. We have the means to deal with hassles. Someone like a working single parent may not, leading to even worse problems.

That Yeats poem talks about a world where “the ceremony of innocence is drowned,” which kind of fits. The affordable, efficient, customer-first economy we all enjoyed for decades has lost its innocence. It’s not working the way we expect anymore.

Maybe it will evolve into a better kind of economy. But more things may fall apart first.

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See you at the top,

Patrick Watson
@PatrickW

P.S. If you like my letters, you’ll love reading Over My Shoulder with serious economic analysis from my global network, at a surprisingly affordable price. Click here to learn more.

• economy
• inflation
• labor shortage
• recession
• supply chains