Patients vs. Profits
An excellent article in the New York Times, Drumbeat on Profit Takers, that profiles the crusade of Arnold Relman and Marcia Angell, two former editors of the New England Journal of Medicine, against for-profit medicine.
“We should not allow the medical-industrial complex to distort our health care system to its own entrepreneurial ends,” Relman writes; medicine must “serve patients first and stockholders second.” This is the crux of the issue. The health care system has lost its way because it has forgotten that medicine is about patient care first and foremost, and everything else must be subordinated to, and designed for, that purpose.
Relman decries a “market-oriented health care system spinning out of control” with commercial forces influencing doctors’ judgments and manipulating a credulous public. He is particularly critical of commercial insurance and drug manufacturers. I would add to that list private equity firms which have taken over many hospitals and negatively influenced non-profit hospitals as well with their emphasis on the bottom line. Many of the biggest and most storied nonprofit hospitals–the ones you don’t want to hear anything bad about–are run like modern corporations with CEO’s who are compensated for ever-growing revenue margins rather than patient outcomes. Even the most dedicated and best-intentioned physicians, and they are legion, cannot help but be affected by such a for-profit culture.
I believe Damon was denied the appropriate standard of care by negligent practitioners operating in a medical-industrial complex that places profits ahead of patients. We need to restore health care to its true nonprofit origins and to its focus on the individual patient. I would not have had to write Immortal Bird–or to start this blog–if the system worked.
In Relman’s ideal health care system, the New York Times reports, “doctors would be salaried and organized into large multispecialty group practices similar to the Mayo Clinic and other private clinics; care would be delivered by a single-payer nonprofit system, financed by the taxpayers. “You’d save an enormous amount of money,” he said, much of it by eliminating the private insurance industry, “a parasite on the health care system.”
Do you agree with his solution? Do you have a better one? Or do you, like some critics cited in the Times article, disagree with this assessment of the problem?