07.30.10

Guest Post by Dora Calott Wang, M.D.

Posted in Uncategorized at 10:15 am by Amber

I’m reading Dr. Calott Wang’s book right now and this guest post is a good introduction to what her book is about.
~Amber

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 
companies.

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 
direction.

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

Author Bio
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.

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1 Comment »

  1. Jessica said,

    August 1, 2010 at 12:30 am

    Thanks for this guest post. I particularly enjoyed the insights into the recent health care legislation. It’s scary that so few people have so much control over our lives. Here’s hoping we keep better tabs on that in the future.
    Jessica´s last blog post ..July 2010 Summation

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