The Corporatization of American Health Care: The Rise of Corporate Hegemony and the Loss of Professional Autonomy, Salmon J. Warren, Thompson Stephen L.
Описание: IntroductionThis intro chapter will elaborate on the purpose of the book, followed by overviews of each chapter.
Chapter 1 - The Corporatization of Medicine: The Market ParadigmSince the 1970s, the corporatization of medicine has completely transformed the American health care delivery system; it also dramatically altered the practice of medicine and is eroding professional altruism and the dedication to science in prevention, diagnosis, and treatment. The late New England Journal of Medicine Editor Arnold Relman decried the new medical-industrial complex -- the for-profit intrusion into hospitals, nursing homes, home care, dialysis centers, and ambulatory care. Also, the pharmacy benefit management industry, which is completely for profit, arose in the late 1990s, and, along with provider institutions, is nurtured by phenomenal federal subsidization through Medicare, Medicaid, and the Part D Medicare program. Another unique phenomenon to our nation is the rapid rise of retail clinics now eclipsing ambulatory care under the aegis of corporate pharmacy chains. Quentin Young has pointed out the "vampire effect" the so-called "not-for-profit" providers being bitten by the for-profit investor providers, making their performance behaviors convergent with a complete focus on bottom-line results at the expense of access and quality health care. Beyond just the for-profit provision of services is a hugely profitable set of supply firms that have long benefited from the "medical-industrial complex," often at the expense of patient protections. These include pharmaceutical firms, medical device makers, health information technology, construction and management consulting, and accounting, legal, and other services that providers depend upon and are paid for through the public financing of the system. Chapter 2 - ObamaCare: What Went Wrong?The Obama Administration recognized the necessity of moving toward care for the uninsured, which had risen to over 47 million Americans denied care. In addition to this group, perhaps a larger number of people had private insurance or other means of paying for medical care, but it was woefully inadequate, due to the large number of underinsured. ObamaCare provides for some cost-control mechanisms, but not sufficient enough to quell the incentives to price increases for accelerating the profits of insurance companies, pharmaceutical companies, and a host of other upstarts that began to cash in on their new federal subsidization. Needless to say, enough studies in health services research continue to identify major quality issues, even while metrics are being developed by the Centers for Medicare and Medicaid Services and the private insurance industry to address quality issues. Yet, Obamacare continues to represent centrist politics and incremental reform, which accepts the belief that marketplace medicine is the clear U.S. reality. Policies to support it are in tune with what corporate payers and the ever increasing number of private providers feel makes the American health system the "best in the world," when, in fact, it is not for a part of the population. Despite Obama criticizing the private insurance industry for many of its prior horrendous practices against patients, ObamaCare is turning over billions of taxpayer dollars to support insurance firms whose profits have increased dramatically; more so, the pharmaceutical industry, in return for its support, was handed very little regulation, which has them obviously supporting this direction of care and setting the agenda for future drug development. Pharmacy benefits managers (PBMs) are flourishing even more after Bush's Medicare Part D turnover of senior drug benefits, with now the newly insured
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