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 HealingÂ
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 ofÂ
health care — in fact, for most of the 20th century. During thisÂ
time, the nation’s medical system was built largely by non-profit andÂ
charitable organizations, which is why so many hospitals are named forÂ
saints. Courts across the country ruled that for corporations toÂ
profit from medical care was simply “against sound public policy.” InÂ
the early 1980’s, however, when the financial and airline industriesÂ
were deregulated, a similar process occurred for American medicine.Â
For-profit corporations became newly encouraged to take leadership ofÂ
health care. Deregulating health care into the free market wasÂ
intended to drive down costs and to improve care. After all, medicalÂ
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 costsÂ
have doubled to consume 18 percent of the GDP (with a third of theseÂ
precious dollars wasted on bureaucracy). Never mind that health careÂ
has gotten increasingly inaccessible to the uninsured and even theÂ
insured, or that American health care has become an internationalÂ
poster child for reform.
The real issue is that modern medical care has simply, finally, gottenÂ
so effective. Today, even cancer and AIDs are no longer deathÂ
sentences, and if organs fail, you try to get a new one. But prior toÂ
the discovery of antibiotics and vaccines in the 1930’s, leeches wereÂ
routinely applied, and medicine was steeped in superstition. BetweenÂ
1918 and 1920, three percent of the world’s population was wiped outÂ
— by the flu.
The fair and effective distribution of life-sustaining resources likeÂ
food, water and shelter, is the very story of civilization. Yet now,Â
thanks to centuries upon centuries of civilization and scientificÂ
inquiry, we have at last, a new life-sustaining resource — modernÂ
medical care, which is less than 80 years old.
How should this powerful new resource be distributed? I believe thatÂ
medical care shouldn’t be considered an ordinary product, likeÂ
athletic shoes or flat screen TV’s. Rather, it is quickly becomingÂ
essential, like water. Yet there will be no easy answers when it comesÂ
medical care, in this brave new world in which DNA is already beingÂ
tweaked to grow completely new organs. We are embarking on a new,Â
complex and long chapter of history.
I can’t help but think that health care reform isn’t over, and wasn’tÂ
concluded with the signing of the Patient Protection and AffordableÂ
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 newÂ
Prometheus’ fire, being distributed and decided in the United States?
Physicians and patients sit face to face and discuss medical decisionsÂ
— about whether a life-sustaining cardiac bypass surgery isÂ
warranted, or whether a new liver should be gotten. But ultimately,Â
the purse strings on medical care are held by health insuranceÂ
The new health reform laws will obligate insurance companies toÂ
provide “coverage” even when patients become sick or if they have aÂ
“pre-existing condition” or what I will call “illness”. The PPACA hasÂ
a provision on “administrative simplification” scheduled to takeÂ
effect in 2014, which aims to streamline the process of doctors andÂ
health care providers asking for approvals from health insuranceÂ
companies before treatments are rendered.
But even after the new laws are implemented, health insuranceÂ
companies, many of them for-profit corporations traded on Wall Street,Â
will continue to hold the purse strings on medical care.
Our recent health reform efforts are landmark progress in the rightÂ
However, in the last thirty years, the values of Wall Street have soÂ
infiltrated the values of American society that seemingly all aspectsÂ
of life are impacted, even medical care of the human body and mind,Â
even the everyday life or death decisions that happen in doctorÂ
offices and hospital rooms.
Â© 2010 Dora Calott Wang, M.D., author of The Kitchen Shrink: AÂ
Psychiatrist’s Reflections on Healing in a Changing World
Dora Calott Wang, M.D., is Assistant Professor of Psychiatry at theÂ
University of New Mexico School of Medicine. A graduate of the YaleÂ
School of Medicine and the UCLA Neuropsychiatric Institute, sheÂ
received her M.A. in English literature from the University ofÂ
California, Berkeley, and has been the recipient of a writer’sÂ
residency from the Lannan Foundation. Her memoir, The Kitchen Shrink:Â Â
A Psychiatrist’s Reflections on Healing in a Changing World wasÂ
published by Riverhead Books, The Penguin Group.
For more information please visit www.doracalottwang.com and followÂ
the author on Facebook and Twitter.