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In this book, the authors, as policy analysts, examine the overall context and dynamics of modern medicine, focusing on the changing conditions of medical practice through the lens of corporatization of medicine, physician unionization, physician strikes, and current health policy directions. Conditions affecting the American medical profession have been dramatically altered by the continuing crises of cost increases, quality concerns, and lack of access facing our population, along with the ongoing corporatization toward bottom-line dictates. Pressures on practitioners have been intensifying with much greater scrutiny over their clinical decision-making. Topics explored among the chapters include: History of the Corporatization of American Medicine: The Market Paradigm Reigns Pharmaceuticals, Hospitals, Nursing Homes, Drug Store Chains, and Pharmacy Benefit Manager/Insurer Integration Medical Practice: From Cottage Industry to Corporate Practice Medical Malpractice Crisis: Oversight of the Practice of Medicine Big Data: Information Technology as Control over the Profession of Medicine Physician Employment Status: Collective Bargaining and Strikes The Corporatization of American Health Care offers different perspectives with the hopes that physicians will unite in a new awareness and common cause to curtail excessive profit-making, renew professional altruism, restore the charitable impulse to health provider institutions, and unite with other professionals to truly raise levels of population health and the quality of health care. It is also a necessary resource for health policy analysts, healthcare administrators, health law attorneys, and other associated health professions.
In this book, the authors, as policy analysts, examine the overall context and dynamics of modern medicine, focusing on the changing conditions of medical practice through the lens of corporatization of medicine, physician unionization, physician strikes, and current health policy directions. Conditions affecting the American medical profession have been dramatically altered by the continuing crises of cost increases, quality concerns, and lack of access facing our population, along with the ongoing corporatization toward bottom-line dictates. Pressures on practitioners have been intensifying with much greater scrutiny over their clinical decision-making. Topics explored among the chapters include: History of the Corporatization of American Medicine: The Market Paradigm Reigns Pharmaceuticals, Hospitals, Nursing Homes, Drug Store Chains, and Pharmacy Benefit Manager/Insurer Integration Medical Practice: From Cottage Industry to Corporate Practice Medical Malpractice Crisis: Oversight of the Practice of Medicine Big Data: Information Technology as Control over the Profession of Medicine Physician Employment Status: Collective Bargaining and Strikes The Corporatization of American Health Care offers different perspectives with the hopes that physicians will unite in a new awareness and common cause to curtail excessive profit-making, renew professional altruism, restore the charitable impulse to health provider institutions, and unite with other professionals to truly raise levels of population health and the quality of health care. It is also a necessary resource for health policy analysts, healthcare administrators, health law attorneys, and other associated health professions.
Tracking the evolution of medical care from an individualized small cottage profession to a giant impersonal corporate industry costing Americans over $3 trillion each year. Over the past three decades, the once-efficient American health care system has evolved into a complex maze of monopolies and a racket of bureaucratic checks, approvals, denials, roadblocks, and detours. This shift has created a massive and at times redundant workforce that frustrates patients, as well as physicians, nurses, and administrative staff. Health care costs the United States over $3 trillion each year and consumes over 18% of the country's gross domestic product. That's more than $11,000 for each person in the country each year—more than double what it costs in most Western European countries to deliver equal or even better care. In Corporatizing American Health Care, Robert W. Derlet, MD, traces the progression of health care policy in the United States. How, he asks, has US health care transformed from bedside medicine—a model of small practices and patient-focused care—into corporate medicine, which prioritizes profit and deals with both patient care and outcomes as billing codes? Arguing that the US Congress is the root of the problem, he describes how Congress has failed to enact legislation to prevent corporate monopolies in the health care industry. Instead, corrupted by large campaign donations and corporate lobbyists, Congress has crafted loopholes benefiting corporations and harming people. Drawing on his decades as a practicing physician caring for thousands of patients, as well as his university and medical school teaching experience, Derlet follows changes to both policy and practice across many sectors of health care. Scrutinizing how hospitals work, he also takes a hard look at high prescription drug prices, unresponsive insurance companies, problems with the Affordable Care Act, the growing medical implant device industry, and even nursing homes. Finally, he explains why the dominance of corporations and their lobbyists over health policy means that we now pay more for our care and our medications but have less choice both in what doctors we see and in what drugs we take. Breaking down the complex ABCs of health care to reveal the unscrupulous practices of the health care industry, Corporatizing American Health Care is perfect for both students and general readers who want to understand the changes in our system from the perspective of an actual doctor.
The inspiring true story of how a small group of dedicated leaders achieved radical and relentless change to save McLean, Harvard’s historic psychiatric hospital Lloyd I. Sederer, MD, recounts the unfettered story of how McLean survived impending closure or sale to once again prosper and regain its international stature as the hospital where you would want a loved one to be treated for a psychiatric or substance use disorder. Only growth and innovation can reverse an institutional fiscal crisis. Dr. Sederer describes how, over six years of hemorrhaging money, McLean eluded the now pervasive corporatization of American healthcare and was clinically and financially rebuilt despite the odds, all while serving with integrity and soul more patients than ever before. Caught in the Crosshairs of American Healthcare offers leaders and aspiring leaders in healthcare and other complex organizations a candid look behind the curtain of McLean’s transformation into a hospital open to all, no longer only the rich and famous. Dr. Sederer also finely details • the corporatization of medicine putting profits before patients, • endless insurance hurdles, • how to prove clinical improvements, and • our broken and inequitable health and mental health systems of care. Caught in the Crosshairs of American Healthcareshows that with grit, brains, and support, we can still change our world.
Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
We are surrounded by medical miracles: polio has been eradicated; childhood leukemia is now treatable; death by cardiovascular disease has declined by two-thirds in the last fifty years. Yet while American medicine has never been better, angst ove...
The problems of U.S. health care are of intense public interest today. The debate over where to go next to rein in costs and improve access to quality health care has become bitterly partisan, with distorted rhetoric largely uninformed by history, evidence, or health policy science. Based on present trends, our expensive dysfunctional system threatens patients, families, the government, and taxpayers with future bankruptcy. This book takes a 60-year view of our health care system, from 1956 to 2016, from the perspective of a family physician who has lived through these years as a practitioner in two rural communities, a professor and administrator of family medicine in medical schools, a journal editor for 30 years, and a researcher and writer on health care for more than four decades. There has been a complete transformation of health care and medical practice over that time from physicians in solo or small group practice and community hospitals to an enormous, largely corporatized industry that has left behind many of the traditions of personalized health care. This is an objective, non-partisan look at the major trends changing U.S. health care over these years, and points out some of the highs--and lows--of these changes, which may surprise some readers. It also compares the three basic alternatives for health care reform currently being debated.
A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.