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.
Author(s): J. Warren Salmon, Stephen L. Thompson
Publisher: Springer
Year: 2021
Language: English
Pages: 307
City: Cham
Preface
References
Acknowledgments
Contents
About the Authors
Chapter 1: History of the Corporatization of American Medicine: The Market Paradigm Reigns
Introduction
Chapter Purpose
Historical Background
Making a Business off of Sick Folks
Background to Corporate Involvement
The Committee on the Costs of Medical Care
Blue Cross Blue Shield Plans Take Off Nationwide
The Health Maintenance Organization Strategy
Rise of For-Profit Hospital Chains
The Broader Transformation
The Reagan Era of the 1980s
Further Implications
From Obamacare to Trump’s No Care
Accountable Care Organizations
Trump’s Divide
COVID-19 Pandemic
Conclusion
References
Chapter 2: Pharmaceuticals, Hospitals, Nursing Homes, Drug Store Chains, and Pharmacy Benefit Manager/Insurer Integration
Introduction
Merger Mania Amidst Policy Uncertainties
Chapter Purpose
Ongoing Corporate Federal Subsidizations
The Pharmaceutical Industry
Hospitals and Healthcare Systems
Corporatization Spreads: Nursing Homes, Prisons, and Education
Prisons and Immigrant Detention Camps
Universities
Drug Store Retail Clinics
Pharmacy Benefit Managers
Summary Thoughts
Conclusion
References
Chapter 3: Medical Practice: From Cottage Industry to Corporate Practice
General Practitioners and the Push to Specialize
The Profession Advances
What Is a Professional?
Physician Supply
Threats to Physician Professionalism and Autonomy: Rise of the Healthcare Super-Administrator and Other Dissatisfactions
Movement of Physicians from Independent and/or Small Group Practices to Employees: The Separation of Conception from Execution
Physician Burnout
The Affordable Care Act and the Influx of New Patients
The Internet Generation and the Activated Patient
MACRA: Medicare Access and CHIP Reauthorization Act of 2015
Physician Supply/Demand Issues for the Future and the Use of Physician Substitutes
Physicians in Training: Harbinger of Things to Come?
The Changing Landscape
References
Chapter 4: Medical Malpractice Crisis: Oversight of the Practice of Medicine
Introduction
Chapter Purpose
What Is Malpractice Insurance and Why Is It So Different from Other Insurance Markets?
Malpractice, Not Malpractice Jury Awards, Are the Real Issue
Malpractice Crises and Market Cycles
Too Many Lawsuits or Too Much Malpractice?
Tort Reforms Commonly Adapted by States
The Policy Discussion
Possible Solutions
Limiting Hours of Work Especially for Resident Physicians
Specialty Health Courts
Other Nations Offer a Path Forward
Looking to the Future
References
Chapter 5: Big Data: Information Technology as Control over the Profession of Medicine
Introduction
Chapter Purpose
Artificial Intelligence Concerns
Artificial Intelligence (AI) to the Rescue?
AI in Health Care
Era of Big Data
Regulation of the IT Industry
Threats to Health Sector
International Business Machines (IBM)
Microsoft
Apple
Whither Apple in All of This Diversification?
Health Care
Wearable Technology
Amazon
Health Care
Google
Facebook
Privacy and Trust
Summary
References
Chapter 6: Physician Employment Status: Collective Bargaining and Strikes
The Origins of Unionization and Collective Bargaining
What Exactly Do Unions Do?
Physician Strikes
Ethical Issues Across the Future
Conclusion
References
Chapter 7: Conclusion: Progressive Directions
Observations Elsewhere
Marketplace Medicine Dominates
What Direction Now?
Unpreparedness on Several Counts
The Current Crisis
The CARES Act of 2020
Future Role of Labor Unions
An Expanded Corporatization?
References
Index
