The future of U.S. health care? : corporate power vs. the common good / John Geyman, MD.

Includes bibliographies and index.

"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 The traditional service ethic of health care has been replaced by profiteering of Wall Street corporate interests and investors seeking maximal profits vs the common good.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"--

Intro -- Contents -- List of Tables -- List of Figures -- Preface -- Part 1: Evolution of U.S. Health Care Since the 1960s -- Chapter 1 -- Corporatization of Health Care Driving a Medical-Industrial Complex -- 1. Rise of the Medical-Industrial Complex -- 2. Today's Culture of Medical Practice and Health Care -- 3. Adverse Impacts of the Medical-Industrial Complex on Patient Care -- Conclusion -- References -- Chapter 2 -- Evolution of the Private Health Insurance Industry -- 1. Historical Perspective -- 2. Growth of Private Health Insurance: Leaving Its Roots for Maximal Profits -- 2.1. Shift from Not-for-Profit to for-Profit -- 2.1.1. Growth of a Denial Industry -- 2.1.2. Managed Care -- 2.1.3. Privatization of Public Programs -- 2.1.4. Consolidation with Growing Market Power -- 2.1.5. Growing Reach of Health Insurers into Other Parts of the Medical-Industrial Complex -- 3. Potential Approaches to Stabilize Health Care Financing -- Conclusion -- References -- Chapter 3 -- New Medical Technologies: Impacts on the Costs of Health Care -- 1. Pressures to Bring New Technologies to U.S. Health Care -- 2. How New Technologies Inflate Health Care Costs -- 3. Evaluation and Approval Process for New Technologies -- 4. Are These New Technologies Worth It? -- 5. What Lessons Can We Learn from Our Experience and Abroad? -- Conclusion -- References -- Chapter 4 -- Increasing Privatization, Profiteering and Corruption -- 1. Increasing Privatization -- 1.1. Hospitals -- 1.2. Ambulance Services -- 1.3. Nursing Homes -- 1.4. Pharmaceutical Industry -- 1.5. Private Health Insurers -- 1.6. Jails -- 2. Profiteering across the Medical-Industrial Complex -- 2.1. Hospitals -- 2.2. Physician Owned Facilities -- 2.3. Purchase of Physicians' Practices -- 2.4. Private Health Insurance -- 2.5. PhRMA -- 3. Corruption, Even Fraud -- Conclusion -- References -- Chapter 5 -- Change of Values from a Service Ethic to a Business "Ethic" -- 1. Traditional Service Ethic of Health Care -- 2. The Dominant Business "Ethic" of Today's Health Care Marketplace -- 3. Adverse Impacts on the Medical Profession and Health Professionals -- Conclusion -- References -- Part 2: Today's Health Care in the U.S. -- Chapter 6 -- How Does U.S. Health Care Rank Internationally? -- 1. Evidence-Based Comparisons of Health Care in Eleven Countries -- 2. Why U.S. Rankings Are so Low -- Conclusion -- References -- Chapter 7 -- Disparities, Inequities and Systemic Racism -- 1. Some Historical Perspective -- 1.1. Income and Wealth Disparities -- 1.2. Inequities Related to Race -- 2. Disparities, Inequities and Racism in Today's Health Care -- 3. What Can Be Done? -- Conclusion -- References -- Chapter 8 -- Poor System Performance during the COVID Pandemic -- 1. How the U.S. Was Ill Prepared for the Pandemic -- 2. Performance of U.S. during COVID Pandemic -- 2.1. In the First Four Months -- 2.2. One Year into the Pandemic

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