There is a specific, sulfurous scent that permeates the air when the United States Congress decides to engage in the theatrics of “accountability.” It smells of dry-cleaned wool, stale coffee, and the distinct, metallic tang of hypocrisy. This Thursday, the Capitol will play host to the latest production of this weary, repetitive play: five CEOs from the nation’s largest health insurance conglomerates—UnitedHealth, CVS Health (Aetna), Cigna, Elevance, and Humana—are being hauled in front of House committees to answer for the crime of doing exactly what American capitalism was designed to do.

The stated purpose of this gathering, according to the press releases hastily typed by junior staffers with degrees in Creative Fiction, is for House Republicans to “place blame” for rising healthcare costs. One has to marvel at the sheer, unadulterated audacity of the premise. Asking a health insurance executive why premiums are soaring is like asking a shark why it ate the surfer. It is in their nature. It is their biological imperative. They are not charitable organizations designed to bandage your wounds; they are algorithmic extraction machines designed to calculate the precise maximum amount of money they can siphon from your dying wallet before your heart stops beating.

House Republicans, sudden converts to the plight of the common man now that election cycles are perpetual, are reportedly eager to grill these executives. This is the political equivalent of a dog barking at a vacuum cleaner it has no intention of biting. The Grand Old Party, traditionally the cheerleaders of the invisible hand, now finds itself in the awkward position of complaining that the invisible hand is strangling their constituents. They will posture, they will preen, and they will shout about “rising costs” while carefully stepping around the reality that the entire industry exists to serve shareholders, not patients. The cognitive dissonance required to champion unregulated markets in the morning and scream about price gouging in the afternoon would shatter a lesser species, but the American politician is built of sterner, stupider stuff.

On the other side of the aisle, the Democrats will undoubtedly engage in their own brand of impotent flailing, likely reciting tragic anecdotes about grandmothers in Ohio who had to sell their insulin to pay for their heating oil. It is all very touching, and entirely useless. Both parties treat these CEOs not as the architects of a predatory system, but as unruly teenagers who just need a stern talking-to. The reality, which neither side will admit because it would interrupt the flow of campaign donations, is that the insurance industry is the fourth branch of government. These companies do not fear the gavel; they bought the wood it was carved from.

The executives themselves will sit there, polished to a dull sheen, reciting focus-grouped platitudes about “market volatility,” “innovation,” and the “complex landscape of care.” They will use words like “synergy” and “value-based outcomes” to describe a business model that relies on denying coverage for MRIs. They know the game. They know that for all the bluster and the camera-ready soundbites, Congress has no actual desire to dismantle the profit engine of American medicine. To do so would require actual work, and worse, it would require admitting that the commodification of human survival might have been a bad idea.

So, the premiums soar. That is the headline, the reality, and the punchline. Premiums soar because they can. Because in a system where the customer has no choice but to pay or perish, the price elasticity is infinite. The insurance giants see the American populace not as citizens, but as livestock to be shorn. And why shouldn’t they? We have allowed a system where a middleman sits between a doctor and a patient, charging a toll for the privilege of access, and then we act surprised when the toll collector buys a fourth yacht.

The hearing will conclude. The cameras will turn off. The Congresspeople will rush to cable news green rooms to declare victory over the forces of greed. The CEOs will board private jets back to their corporate fortresses, perhaps chuckling over a scotch about which Representative asked the dumbest question. And you, the viewer, the voter, the insured, will open your mail next month to find a letter informing you that your deductible has increased again, to cover the cost of the paper the letter is printed on.

This is not a bug in the system; it is the operating system. We are trapped in a loop of performative governance where the appearance of solving a problem is more profitable than actually solving it. The grilling is fake. The outrage is manufactured. The only thing real in that committee room is the contempt for the intelligence of the American public.