The Future of U.S. Health Care? Corporate Power vs. the Common Good

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John Geyman, M.D. – Professor Emeritus of Family Medicine, University of Washington, School of Medicine, Seattle, WA, USA

Series: Health Care in Transition
BISAC: MED035000; MED036000
DOI: 10.52305/SGHB6950

“This superb book offers a sweeping overview of how corporate power has infiltrated and distorted U.S. medical care, and the grave consequences for patients and health care personnel.” – David Himmelstein, M.D. and Steffie Woolhandler, M.D., General Internists, Health Policy Experts, and Distinguished Professors of Public Health at City University of New York

“This book is excellent. It’s a nice, readable length, and its message is clear and strong. I think most readers will understand how health care should no longer be driven by the business ethic when the service ethic is in dire need of relief from intrusion by the business culture, so that we can place the patient first.” – Don McCanne, MD, Family Physician, Senior Health Policy Fellow and Past President of Physicians for a National Health Program (PNHP)


Despite spending more for health care than any other country in the world, the U. S. has a health care system that compares poorly with other advanced countries in terms of access, cost, and quality of care. With so many Americans being unable to afford essential care, this problem has reached crisis proportions for much of our population. As a result, health care will continue to be a front burner issue in the forthcoming 2022 and 2024 election cycles. Today we have a corporatized medical-industrial complex that has resisted recurrent reform attempts over the years. It has become too big and complex for responsible government to rein in its excesses. The COVID-19 pandemic has further exposed its fragmentation and barriers to care. The traditional service ethic of health care has been replaced by profiteering of Wall Street corporate interests and investors seeking maximal profits vs the common good. Still controversial in this country is whether health care is a human right or a privilege based on ability to pay. Other advanced countries around the world have long since built their health care systems on the basis of universal coverage ensured by government. The future of health care depends on fundamental reform. It will require winning the battle between Wall Street/corporate America and Main Street that we cannot afford to lose. This book has three goals: (1) to bring historical perspective to how the medical-industrial complex has evolved to its present strangle-hold over health care comprising one-sixth of the nation’s economy; (2) to describe the shortfalls of our supposed system in terms of access, cost, inequities, and unacceptable quality, and how past reform attempts have failed; and (3) to consider two major scenarios for reform, together with political forces for and against each and their projected outcomes. Since present trends are unsustainable, we can only hope for positive moves toward reform, as will be described.

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Table of Contents

List of Tables

List of Figures

Preface

Part 1: THE EVOLUTION OF U.S. HEALTH CARE SINCE THE 1960s

Chapter 1. Corporatization of Health Care Driving a Medical-Industrial Complex

Chapter 2. Evolution of the Private Health Insurance Industry

Chapter 3. New Medical Technologies: Impacts on the Costs of Health Care

Chapter 4. Increasing Privatization, Profiteering and Corruption

Chapter 5. Change of Values from a Service Ethic to a Business “Ethic”

Part 2: TODAY’S HEALTH CARE IN THE U.S.

Chapter 6. How Does the U.S. Health Care Rank Internationally?

Chapter 7. Disparities, Inequities and Systemic Racism

Chapter 8. Poor System Performance During the COVID Pandemic

Chapter 9. Failed Multi-Payer Financing Systems for U.S. Health Care

Chapter 10. How Wall Street and Corporate Interests Extract Profits and Professionalism
from Health Care

Chapter 11. Barriers to System Reform

Part 3: MAJOR OPPOSING FUTURE SCENARIOS FOR REFORMING HEALTH CARE

Chapter 12. “Free Market” Alternatives without Fundamental Reform

Chapter 13. Universal Coverage through National Health Insurance

Chapter 14. “Free Market” Profiteering vs. Not-for-Profit Patient Care: Which Will Prevail in 2040?

About the Author

Index