Part 1: The Backlog Economy (You Are Here) | Part 2: The PE Market Map (Next) | Part 3: The Testimony | Part 4: The AI Mirage | Part 5: The Policy Toolkit
The Backlog Economy: When Scarcity Becomes the Product
A Manifesto on the Financialization of Essential Services
The Minute That Changed Everything
At 2 a.m. on June 26, 2025, Chicago firefighter Lt. Mark McDermott watched his aerial ladder truck fail. Not in the firehouse. Not during a drill. But with flames erupting from apartment windows and families trapped inside a burning building on the city's west side.
An arsonist had poured gasoline on both stairwells. The only way out was through the windows or not at all.
McDermott's crew deployed their ladder to reach the trapped residents. The ladder wouldn't go up.
"While we were throwing the ground ladders, I heard the rig shut down behind me, which was really strange," McDermott recalled. "We had to shut the rig off totally and reset it and started the rig again."
The delay: one minute. An eternity when people are burning alive.
Four people died that night, including pregnant mother Gina Henry, her five-year-old son Jayceon, and her sister Destiny, who had thrown her own five-year-old son KJ out a third-floor window to save him before she perished.
Six people survived, pulled from the building after the crew got the ancient ladder truck working again. But the families of the dead can't stop asking: What if the truck had worked immediately?
"That minute could have made a difference," said KJ's aunt. "We don't know, but that does give us that what if."
The ladder truck was a reserve rig—30 years old, controls wired backward (push left, it goes right), barely functional. It was in service because Chicago's fire department had been waiting years for replacement trucks that were already on order.
This isn't a story about budget cuts or government incompetence. This is a story about what happens when the backlog becomes the business model.
The Reveal: Scarcity Is Now the Product
In September 2025, the CEO of REV Group—the company that controls most of America's fire truck manufacturing through brands like E-ONE, Ferrara, and KME—stood before investors and said something extraordinary:
— Mark Skonieczny, REV Group CEO
Read that again. A $4.5 billion backlog—orders that won't be filled for years—is described as "attractive." As an "opportunity."
Not a problem to solve. A feature to celebrate.
Senator Josh Hawley, who led the investigation into fire truck manufacturers, was blunt: "This didn't just happen to you accidentally. This is a business decision, isn't it? You keep these backlogs like this."
The numbers confirm it:
BEFORE PE CONSOLIDATION (2000-2010):
• Profit margins: 4-5%
• Fire truck cost: ~$500,000
• Delivery time: 6-12 months
• Market: 25+ independent manufacturers
AFTER PE CONSOLIDATION (2020-2025):
• Profit margins: 13%+ (tripled)
• Fire truck cost: $1.2M+ (more than doubled)
• Delivery time: 2-4 years
• Market concentration: 3 companies = 80% control
• REV Group CEO compensation: $6 million/year
THE ROLL-UP:
American Industrial Partners (AIP) used REV Group to absorb 26+ independent manufacturers (E-ONE, Ferrara, KME, Spartan, Ladder Tower) while closing production facilities and paying out $530 million in stock buybacks and dividends—including a $180 million special dividend to PE owners right before going public.
Senator Hawley called it what it is: "Another word for this would be a heist."
Three companies now control 80% of the U.S. fire truck market: REV Group, Pierce Manufacturing (owned by Oshkosh Corporation), and Rosenbauer. The "Mom and Pop" manufacturers are gone. Competition is dead.
And the backlog? It's not a bug. It's guaranteed future revenue. Contracted. Locked in. Backed by municipal tax receipts that can't default.
In the old economy, a company was valued by how many products it delivered. In the backlog economy, a company is valued by how many products it owes. Profit has decoupled from performance.
The Pattern: It's Not Just Fire Trucks
This same logic is running through every essential service you depend on:
Veterinary Care
Mars Inc. and JAB Holding have quietly consolidated over 800 local veterinary clinics under corporate umbrellas like VCA and National Veterinary Associates. Your "Main Street Animal Clinic" is now owned by the company that makes M&Ms. Emergency vet visits that cost $300 in 2015 now routinely hit $2,000+. Staff-to-patient ratios have declined. The clinics report record profits.
Housing Debt
Blackstone and other private equity firms have moved beyond owning single-family homes—they now own the debt on those homes through private credit funds. They're not landlords anymore; they're lenders extracting interest from homeowners who can't access traditional mortgages. And in 2026, they're pushing these high-risk, low-liquidity investments into 401(k) plans for ordinary workers.
Dental Care
Heartland Dental (backed by KKR) has rolled up thousands of independent dental practices into Dental Service Organizations (DSOs). You still see "Dr. Smith DDS" on the sign, but Dr. Smith is now an employee, not an owner. The DSO sets quotas, controls pricing, and optimizes for "revenue per patient visit."
Ambulance Services
In many cities, private equity-backed ambulance companies have multi-year backlogs for new vehicles while charging municipalities premium rates for "fleet management." Response times have increased. Equipment failures are common.
1. CONSOLIDATE independent providers below antitrust radar
1. STRIP CAPACITY (close plants, reduce staff, defer maintenance)
1. CREATE SCARCITY (backlogs, waitlists, “limited availability”)
1. EXTRACT VALUE (price increases, stock buybacks, dividends)
1. REPEAT
The “shortage” isn’t a market failure.
It’s the market working exactly as designed.
The 2026 Inflection Point: Why This Matters Now
For the first time in decades, both parties agree this is a threat. Senator Elizabeth Warren (D-MA), Senator Josh Hawley (R-MO), and Senator Richard Blumenthal (D-CT) led a joint investigation. The International Association of Fire Fighters has asked the Federal Trade Commission to investigate for antitrust violations. Four cities are suing the manufacturers for price-fixing.
What's changed?
The failure points are becoming visible. When your fire department can't get a truck for four years, when your dog's emergency surgery costs $8,000, when your dentist suddenly has "productivity targets," people notice. The abstraction becomes visceral.
And private equity made a critical mistake: In 2026, they started pushing their investments into retail investor portfolios—your 401(k), your pension fund. They needed new pools of capital because institutional investors were getting skeptical. But retail investors don't have the same exit options. When things go bad, they're stuck.
The backlash is building. Not because people suddenly care about antitrust law, but because they've experienced the consequences personally.
The Human Cost: What It Looks Like on the Ground
Six-year-old KJ Lee still asks about his mother every day.
"My mommy was pretty and smart," he says.
His father, Kyle, doesn't know how to explain that she's not coming home. KJ spent 31 days in the hospital with skull fractures, burns, and broken bones after his mother threw him from a third-floor window to save his life.
The family learned about the ladder truck malfunction only when contacted by investigative journalists. No one had told them.
"When I heard it from you, I was enraged," said KJ's aunt, "because I feel like that was something they should have told us."
KANSAS CITY, MISSOURI:
5 of 15 front-line fire trucks out of service for 3 months (2023), waiting for parts manufacturers wouldn’t provide. Chief Dennis Rubin to U.S. Senate: “If there would have been a person on the second floor in need of rescue, they would have had to wait for the real fire truck to show up.”
CHICAGO:
Lt. McDermott described the fleet: trucks with holes in floors, rusty ladders, tires falling off during emergency response. The reserve ladder truck from the fatal fire has controls wired backward—basket sometimes bumps into buildings. “That’s how bad this basket is. It’s the only one there, though. So we have to live with it.”
ATLANTA:
Nearly 1/3 of fire apparatus beyond recommended lifespan. Multi-year wait for replacements already on order.
This is what the backlog economy looks like when you're not a shareholder.
The Next Frontier: The AI Efficiency Mirage
Here's the twist: The same private equity firms that created these capacity shortages are now investing heavily in "AI automation" companies that promise to "solve" them.
The pitch: "We don't need more fire trucks—we need smarter dispatch algorithms." "We don't need more nurses—we need AI diagnostics." "We don't need more production capacity—we need optimized supply chains."
The reality: They're not automating to solve the shortage. They're automating to justify the shortage.
Because if you can convince municipalities that AI-powered dispatch will reduce response times, you don't have to build more trucks. If you can convince hospitals that AI triage will improve outcomes, you don't have to hire more nurses. The scarcity remains. The extraction continues. And now there's a tech narrative to explain why it's actually innovation.
This is the 2026 playbook: Financialize the essential service, create the shortage, then sell the AI "solution" that makes the shortage permanent.
What This Means for You
Look around your life:
- Who owns your veterinary clinic?
- Who owns the ambulance service in your town?
- Who owns the dental practice where you get your teeth cleaned?
- Who manufactured the fire truck that protects your home?
Chances are, you don't know. And that's the point.
The "stealth roll-up" strategy works because each individual acquisition is small enough to evade Federal Trade Commission review. But when you add them up, you get a monopoly. And monopolies in essential services don't just raise prices—they create structural vulnerabilities.
When a fire truck company can profit more from a backlog than from deliveries, the incentive to deliver disappears. When a veterinary chain can extract more value from existing clients than from serving new ones, quality declines. When a private equity firm can make more money from financial engineering than from operational improvements, the operation deteriorates.
This isn't about "greed." It's about incentive structures. The system now rewards non-delivery. And until we change the rules, the backlogs will keep growing.
The Path Forward: What Actually Works
1. Ban private equity ownership in life-safety sectors: If failure to deliver can result in loss of life (fire, ambulance, hospitals, nursing homes), private equity should be prohibited. Model: How the U.S. restricts foreign ownership of airlines and telecom.
2. Close the "stealth roll-up" loophole: Require cumulative disclosure when a firm acquires 5+ companies in a sector, regardless of individual deal size. Make total market share visible.
3. Treat backlogs as antitrust evidence: For PE-backed essential services, backlogs beyond 12 months should trigger automatic FTC investigation for anti-competitive capacity withholding.
4. Firewall pensions and 401(k)s: Ban private equity investments in public pension funds and 401(k) default options. These are captive pools of capital that can't easily exit when things deteriorate.
5. Mandate transparency in ownership: Every essential service provider—vet clinic, dental office, ambulance company—must disclose their ultimate corporate owner in plain language at point of service.
Why This Matters Beyond Policy
This is about what kind of society we're building.
Do we want a system where scarcity is manufactured for profit? Where the backlog is more valuable than the delivery? Where essential services are financialized assets instead of public goods?
Or do we want a system where delivering the fire truck is more profitable than delaying it?
Right now, we're living in the first system. And people are dying because of it.
KJ Lee is six years old. He'll grow up without his mother because a 30-year-old ladder truck failed during the one minute it needed to work.
The backlog economy killed her. And unless we change the rules, it won't be the last time.

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