I’m reading Dr. Calott Wang’s book right now and this guest post is a good introduction to what her book is about.
Is Wall Street Making Life or Death Decisions?
By Dora Calott Wang, M.D.,
Author of The Kitchen Shrink: A Psychiatrist’s Reflections on Healing
in a Changing World
Is your health insurance company traded on Wall Street?
If so, is Wall Street deciding your medical care?
It’s hard to recall that for-profit corporations were once kept out of
health care — in fact, for most of the 20th century. During this
time, the nation’s medical system was built largely by non-profit and
charitable organizations, which is why so many hospitals are named for
saints. Courts across the country ruled that for corporations to
profit from medical care was simply “against sound public policy.” In
the early 1980’s, however, when the financial and airline industries
were deregulated, a similar process occurred for American medicine.
For-profit corporations became newly encouraged to take leadership of
health care. Deregulating health care into the free market was
intended to drive down costs and to improve care. After all, medical
care in 1980 consumed a whopping 9.1 percent of the nation’s GDP.
Never mind that after 30 years in the free market, health care costs
have doubled to consume 18 percent of the GDP (with a third of these
precious dollars wasted on bureaucracy). Never mind that health care
has gotten increasingly inaccessible to the uninsured and even the
insured, or that American health care has become an international
poster child for reform.
The real issue is that modern medical care has simply, finally, gotten
so effective. Today, even cancer and AIDs are no longer death
sentences, and if organs fail, you try to get a new one. But prior to
the discovery of antibiotics and vaccines in the 1930’s, leeches were
routinely applied, and medicine was steeped in superstition. Between
1918 and 1920, three percent of the world’s population was wiped out
— by the flu.
The fair and effective distribution of life-sustaining resources like
food, water and shelter, is the very story of civilization. Yet now,
thanks to centuries upon centuries of civilization and scientific
inquiry, we have at last, a new life-sustaining resource — modern
medical care, which is less than 80 years old.
How should this powerful new resource be distributed? I believe that
medical care shouldn’t be considered an ordinary product, like
athletic shoes or flat screen TV’s. Rather, it is quickly becoming
essential, like water. Yet there will be no easy answers when it comes
medical care, in this brave new world in which DNA is already being
tweaked to grow completely new organs. We are embarking on a new,
complex and long chapter of history.
I can’t help but think that health care reform isn’t over, and wasn’t
concluded with the signing of the Patient Protection and Affordable
Care Act in March.
I believe that health care reform will be our entire future.
In the meantime, for now, how is modern medical care, a new
Prometheus’ fire, being distributed and decided in the United States?
Physicians and patients sit face to face and discuss medical decisions
— about whether a life-sustaining cardiac bypass surgery is
warranted, or whether a new liver should be gotten. But ultimately,
the purse strings on medical care are held by health insurance
The new health reform laws will obligate insurance companies to
provide “coverage” even when patients become sick or if they have a
“pre-existing condition” or what I will call “illness”. The PPACA has
a provision on “administrative simplification” scheduled to take
effect in 2014, which aims to streamline the process of doctors and
health care providers asking for approvals from health insurance
companies before treatments are rendered.
But even after the new laws are implemented, health insurance
companies, many of them for-profit corporations traded on Wall Street,
will continue to hold the purse strings on medical care.
Our recent health reform efforts are landmark progress in the right
However, in the last thirty years, the values of Wall Street have so
infiltrated the values of American society that seemingly all aspects
of life are impacted, even medical care of the human body and mind,
even the everyday life or death decisions that happen in doctor
offices and hospital rooms.
© 2010 Dora Calott Wang, M.D., author of The Kitchen Shrink: A
Psychiatrist’s Reflections on Healing in a Changing World
Dora Calott Wang, M.D., is Assistant Professor of Psychiatry at the
University of New Mexico School of Medicine. A graduate of the Yale
School of Medicine and the UCLA Neuropsychiatric Institute, she
received her M.A. in English literature from the University of
California, Berkeley, and has been the recipient of a writer’s
residency from the Lannan Foundation. Her memoir, The Kitchen Shrink:
A Psychiatrist’s Reflections on Healing in a Changing World was
published by Riverhead Books, The Penguin Group.
For more information please visit www.doracalottwang.com and follow
the author on Facebook and Twitter.