Friday, May 15, 2009

A brief history of American medicine and its excesses

Chronolocially:
  • WW II showed the value of science in medicine.
  • NIH funding started slow but then accelerated to astronomical sums
  • Human biological and medical science grew
  • Medical school faculties expanded to huge sizes with NIH funding
  • Many sciences were completed (anatomy, the vascular bed, renal function, heart function, joint functions and others)
  • A completed science becomes engineering and technology (Kuhn, Structure of a Scientific Revolution)
  • New technologies emerge in rapid pace
  • Medicare is cost plus funded with capital pass through for construction
  • Wall Street discovers hospitals and investments for the first time
  • For profit hospitals appear
  • Wall Street funding funds technology developments
  • Medicine becomes a business of doing more and more
  • Businesses demand growth
  • More and more procedures must be done to feed mega business
  • Medical practice and patient care suffer from the excesses and inappropriate use of technologies
  • This is the curent state of high cost, error prone medical care

1 comment:

  1. Let's face it. We are a society in which more is better and the instant fix is in. No matter that we ignore personal responsibility. There is always someone to take advantage of that weakness. Insurance companies, pharmaceutical companies, "healthcare organizations" whatever the hell that means, and even some unscrupulous doctors. Oh,I forgot the manipulative politicians most who have never had a real job and enjoy health/retirement benefits the average American can only dream of.

    But then again, where is the family physician who can help folks become more personally responsible? Well they are decreasing dramatically in numbers, under paid, and relegated to the back of the policy making bus which in reality they should be driving.

    One does not always get what they pay for. What cost benefit does a 64 slice CT offer versus that of a 32 or even a 16? What benefit do most $1500 a pop chemo therapy really provide other than weakening what might otherwise be a productive 6 months or two years?

    Come on folks. So you labored yourselves through medical school by memorization and big student loans. Does that give you a license to prey on your sworn constituents? Oh, that hippocratic oath. Sorry, I must have been in France too long.

    Steve

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