The Corporatization of American Health Care : The Rise of Corporate Hegemony and the Loss of Professional Autonomy

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 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.