In the morning, I shower right after I wake up. I choose from a number of products to clean myself, yet they are made by just two companies: Unilever and Johnson & Johnson. I brush my teeth with a toothbrush and toothpaste made by Procter & Gamble but sold under the separate brands Oral-B and Crest. Before I eat breakfast, because I have Type 1 diabetes, I take insulin, a drug that, because of pharmaceutical consolidation and anticompetitive patent hoarding allowed to run amok, cost about $20 for a vial in 1996 but now costs $275. Lunch isn’t any better. The peanut butter for my sandwich almost certainly comes from one of three companies; same with the jelly. We all have “choices,” but do we really get to choose?

Once you put on your “monopoly decoder ring,” David Dayen writes in his new book Monopolized: Life in the Age of Corporate Power, you start to see how this power influences every part of our lives. There’s a baby formula monopoly: Three companies—Abbott Laboratories (which makes Similac), Reckitt Benckiser (which makes Enfamil), and Nestlé—control about 95 percent of the US market. It even follows us after our deaths: Service Corporation International keeps buying up funeral homes and now earns more than $1 out of every $5 in profit from funeral services, and two companies, Hillenbrand and Matthews, make 82 percent of the country’s coffins and caskets.

Some monopolies have become so obvious that everyone can spot them. If you want to fly anywhere in the United States, you basically have four choices, all of which offer increasingly bad service. If you want cable and Internet, you usually have only one or two high-cost options and no power to fight back when the company tells you a technician will be coming anywhere between 8 am and 8 pm to set it up. If you want to search for information or buy something on the Internet, there’s one choice for each that dominates all the rest: Google and Amazon.

But monopolies crop up in all sorts of unexpected places. Match Group, the parent company that owns Match.com, also owns OkCupid, Tinder, and Hinge. Berkshire Hathaway, the holding company empire of billionaire Warren Buffett, owns brands as diverse as Duracell, Dairy Queen, Benjamin Moore, and Fruit of the Loom. The coffee brands Caribou, Peet’s, Intelligentsia, and Stumptown are all owned or partly controlled by the European firm JAB.

Our country is saturated with monopolies, but some might ask, does it matter? As Dayen shows, monopolies make it harder for workers to wield power when there are fewer and fewer employers to choose from. They make the economy less dynamic and innovative. They make society less equal, and by amassing so many resources, they are able to amass power to protect those resources. Monopolies are even a threat to our very democracy, drowning out the voices of the people.

Worries about monopolies date as far back as ad 483. At the beginning of his book, Dayen quotes Emperor Zeno decreeing, “No one may presume to exercise a monopoly of any kind.” Going as far back as the railroad barons of the 19th century, Americans have worried about the ill effects of economic consolidation. Theodore Roosevelt famously took them on as a populist trustbuster. The Granger farmers’ movement and Progressive era activists fought monopolies.

Dayen mentions much of this history, but his aim is not simply to recount it or engage in the contemporary debates over the ways monopolies warp our economy and our society; instead, he wants to spark a modern movement through real, human stories. Corporate concentration and antitrust regulation can sound like dry issues. Dayen seeks to remind us of the very real consequences they have in our everyday lives.

The stories he tells can often be heartbreaking. There’s Travis Bornstein, whose son, Tyler Bornstein, died of a heroin overdose at 23 after getting hooked on opioids that were prescribed for his elbow surgery when he was 18. Rather than call an ambulance or take him to a hospital, the friend Tyler Bornstein was with when he overdosed dumped him in a vacant lot in Akron, Ohio, and fled. “You can’t prepare to lose a child,” Travis Bornstein tells Dayen. “I felt like I failed as a father.” But the Bornsteins were failed by the rampant cartelization and concentration in the pharmaceutical industry: Tyler Bornstein’s death is one of over 200,000 related to opioids since OxyContin, manufactured by one of the Big Pharma companies, was introduced in 1996.

OxyContin, Dayen insists, is just one stark example of the dangers in an industry in which, as he puts it, “monopolies at every stage of the supply chain placed their bottom lines ahead of the health of the recipients of those drugs.” For example, “If you have glaucoma, the reason liquid from your eye drops constantly rolls down your cheeks is that companies deliberately make the drop larger than the human eye can hold. Every milliliter that falls out of your eye represents a tiny profit, and it adds up.”

Dayen also introduces us to Chris Petersen, a third-generation hog farmer in Iowa whose farm has been so battered by agricultural monopolies that his daughter, who grew up aspiring to join the family business, had to find work at a hotel instead. After several generations of farmers, “I’m it,” he tells Dayen. “This is the dead end. You know, it’s sad.” It’s hard for Petersen to compete with concentrated animal feeding operations, which shove thousands of hogs into giant feedlots without sunlight and with scant room to move, whose cost cutting has sent hog prices plummeting. As Dayen notes, four hog firms control two-thirds of today’s market.

We also meet Kate Hanni, who, with her husband and two children, was stuck on a grounded American Airlines flight in 2006 for nine hours without food or water, watching mothers use barf bags for diapers and others puke into them as the smell of overflowing bathrooms wafted through the cabin. The airline refused to let passengers off because doing so would have cost it money through mandated refunds. One claustrophobic traveler even tried to flash SOS signs through the window with his cell phone.

One might wonder if this is an isolated incident. But the entire industry is dominated by just four major airlines, and as Dayen writes, “as long as passengers have nowhere else to go, there’s no incentive to fix a perpetually broken system,” one in which long flight delays are frequent and the service gets worse and worse.

In Dana Chisholm’s quest for an affordable rental house in Southern California, Dayen gives us a story of how monopolization in real estate is running rampant: Chisholm eventually rented from the private-equity-backed landlord Starwood Waypoint, one of several Wall Street real estate companies that have become huge players in the rental market. In 2017, Starwood Waypoint merged with Invitation Homes and is now the nation’s largest rental landlord. More than 240,000 US homes are now in the hands of investors, mostly private equity firms. Because they own so many properties, these companies can jack up rents and fees while slow-walking upkeep and repairs. For Chisholm, that meant appliances that didn’t work, no running water in the sink, and a building infested with rats and roaches. When she contacted the management company, she had to wait months for repairs before getting a Zillow alert for her own house: The management company had listed it for rent even though she had just paid up.

While the stories Dayen offers take place all across the country, from rural areas to Los Angeles’s urban sprawl, and involve people in very different communities and careers, they have the same nugget of truth at their heart: When companies are allowed to keep consolidating, people lose. Without robust regulation that keeps consolidation in check, corporations will keep laying waste to our economy and our lives.

Dayen wrote his book before the current health crisis but in many ways anticipated it. Concentrated supply chains are brittle and unable to cope with major disruptions, such as a pandemic that spikes demand for toilet paper and nose swabs alike. Meat-processing giants that squeeze out smaller players through aggressive line speeds and cost cutting are now major Covid-19 hot spots, thanks to a focus on the bottom line instead of higher safety standards and humane worker treatment. “Amazingly,” Dayen writes, “news deserts correlate with the spread of infectious diseases, as epidemiologists rely on local articles to track outbreaks.”

As Dayen convincingly shows, monopolies are so interwoven in our economy and our lives that there is no escape from them. But his book also highlights some of the challenges faced by a politics that is primarily focused on monopoly. If you see it everywhere without pausing to clarify what is anticompetitive behavior and what is just plain old greed, you risk having the concept lose its specific meaning.

Dayen points a finger at the tech monopolies Google and Facebook, for example, for ravaging the media industry by bleeding advertising dollars dry through their dominance of the market. But there are also other forces pummeling the industry: Wall Street ownership, fickle billionaire backers, and smaller publications’ struggle to find new sources of revenue. Meanwhile, the media industry itself is dotted with monopolies, such as News Corp, which owns The Wall Street Journal and the New York Post and dozens of other properties; TV conglomerates that control local news; and dominant talk radio brands. Later, in a chapter on private equity, we begin to see how the problem with its quest for acquisitions is not only that it shrinks competition but also that it shifts companies’ focus from the production and distribution of goods to the maximization of money for investors. Private equity has, for example, fed upon the retail sector and spit out discarded brands like Sears and Toys “R” Us. This parasitic relationship seems to be less about monopoly power than avarice and a lack of regulation. Certainly, private equity funds have bought up companies in a number of sectors, leading to consolidation. But that’s not what happened to these retailers: The hedge funds came in, loaded the companies with debt, got fat off the fees, and then let the companies fail.

Dayen says that his book’s ambition is not to rehash economic arguments made elsewhere but to turn those arguments into a movement. But a call to action has to be clearly defined. Likewise, as liberal and left politics in the past demonstrated, alongside anti-monopolist politics must be a program of strong social policies. Breaking up health insurance cartels, for example, will help lower costs, but it won’t ensure health care for all. Anti-monopolism must define its potential and its limits and be married to other policy interventions.

There is a compelling reason to focus on anti-monopolist politics, which has garnered bipartisan support over the years. In Tennessee, Republican and Democratic lawmakers alike have tried to get rid of state limitations on municipal broadband service that were imposed at the behest of telecom giants. “We’re aligned on this issue, because it’s not theoretical, it’s practical,” says Chattanooga Mayor Andy Berke, a Democrat. “I’m a small-c conservative,” Christopher Mitchell, a researcher at the Institute for Local Self Reliance, tells Dayen. “The idea of a family moving because they lack broadband is devastating.” Representatives Alexandria Ocasio-Cortez and Rashida Tlaib stood with Freedom Caucus leaders Jim Jordan and Mark Meadows in demanding that a military contract monopolist return over $16 million in excess funds that it was able to squeeze out of the government. But it is where bipartisan support ends—on matters of redistribution and universal programs—that the lines are drawn between those seeking economic justice for all and those seeking merely a less tilted field.

One reason anti-monopolism is so popular among a certain set is that the solutions to monopoly power are easy to find. In fact, we often don’t need anything new. “We know how to handle monopolies,” Dayen points out, citing existing laws that can protect us against antitrust abuses but that have been misinterpreted or watered down. To him, this should be at the center of any anti-monopolist movement: restoring these laws with their original power and using them to break up monopolies, block mergers that create future ones, and regulate any that remain as public utilities. That’s all “entirely possible under existing law,” he adds.

The institutions are also in place, and not just in the Department of Justice and the Federal Trade Commission (which are supposed to police monopolies and bust trusts). The Federal Communications Commission is supposed to ensure universal, high-speed Internet access under the Telecommunications Act of 1996. The Civil Aeronautics Board, created in 1938, used to keep airlines from getting concentrated while ensuring widespread access to travel.

But if this is all a matter of laws and regulatory bodies doing the jobs they were given, then why aren’t they? Here Dayen looks to the underlying politics of monopolization. “The mechanisms are clear,” he writes, but “getting the political class to enforce them is the stumbling block.”

Some have tried to take on this fight. Over 750 cities and towns now have some form of community broadband, and advocates are trying to undo state restrictions on expanding it. Some cities, such as Tulsa, Okla., and Mesquite, Texas, have placed limits on the growth of monopoly dollar store chains. Other communities have fought back against prison monopolists that have pushed for the elimination of in-person visitation, forcing family members to pony up for video and phone calls. But as Dayen notes, without national organization, no national anti-monopoly program stands a chance. So far, the so-called New Brandeisians and other anti-monopolist legal scholars have mostly remained cloistered in academia and think tanks; only occasionally do they find themselves speaking at congressional hearings or informing presidential candidates’ platforms. Revitalizing America’s anti-monopoly tradition requires sparking a broader mobilization. “We are living in an antimonopoly moment,” Dayen writes hopefully. Now it must “become an antimonopoly movement.”